| [Background]At present,the health status of medical staffs in China is not optimistic,which can not be ignored.At the same time,the tense physician-patient relationship sets higher demands on the emotional labor of medical staffs.How to guide medical staff to carry out appropriate emotional labor and improve their physical and mental health level has become an important issue that medical institutions and the whole society urgently need to address.Although the research on the emotional labor has made a considerable process,previous studies on the relationships between emotional labor and physical and mental health have not reached a consistent conclusion.Additionally,there is still a lack of mechanism research on the influence of emotional labor on physical & mental health of medical staffs in the past two decades,and the influence of job response behavior related to emotional requirements and the interaction among members of the organization is less considered.Therefore,there is an urgent need to explore the impact mechanism of emotional labor on physical and mental health of medical staff.[Purpose]The main purpose is to construct a model of the impact of the emotional labor of medical staff on physical and mental health,to empirically test the model of the impact mechanism,and to clarify the impact mechanism of the emotional labor of medical staff on physical and mental health.The secondary purpose is to grasp the research progress of emotional labor at home and abroad,to understand the current situation of emotional labor of medical staff in general hospitals in Hubei Province,and to provide relevant suggestions for medical institutions and medical staff.[Methods]Based on the work requirement-resource model,combining induction and deduction,qualitative and quantitative,this study comprehensively applied the following three methods to carry out research.(1)Bibliometric Method.Taking the literature on emotional labor published during 2000-2019 in the core collections of CNKI and Web of Science as the research object,this study selected the publication year,citation indicators,disciplines,document sources,authors,institutions,and keywords as measurement indicators,and using Note Express 3.2 Software for document management and bibliographic information capture,using Excel 2016 software for descriptive statistical analysis,using SATI 3.2 software to obtain keyword frequency and high-frequency keyword similarity matrix,and grasp the research progress of emotional labor at home and abroad.(2)Grounded Theory.Taking medical staff as the research object and taking the general hospitals in Hubei Province as the sample source,the interviews explained the antecedents,intervention factors,and the results of physical and mental health of medical staff.Using theoretical sampling methods,more than 40 medical staff were selected from the Hubei Provincial General Hospital in three stages.A semi-structured interview outline on the emotional labor of medical staff was designed,two experts mastered in the field of health management and informed managers were successively invited,and two medical nurses were pre-interviewed to modify and improve the interview outline.After obtaining informed consent,a combination of one-hour online and offline in-depth interviews of the samples were conducted,and the data transcription was completed within 24 hours after the interview.Three types of data analysis program techniques,open coding,main axis coding and selective coding,were adopted to conduct coding analysis,model construction and theoretical saturation testing of interview data.Use NVivo 11.0(Chinese version)software to complete the construction of the model of emotional labor of medical staff and the impact on physical and mental health.(3)Empirical Research Method.1 Subjects & Contents: Medical staff are the research objects,and the general hospitals in Hubei Province are the sample sources.Based on the impact mechanism model constructed by grounded theory,research hypotheses were put;investigate the emotional labor scores of medical staff in Hubei Province;The direct influence of personal-job fit(divided into demand-supply fit and requirement-ability fit)on emotional labor(divided into surface acting and deep acting)as well as the direct influence of the surface acting and deep acting on physical and mental health were demonstrated;the moderating effects of emotional labor in the influence of demand-supply fit and requirement-ability fit on physical and mental health were tested;the moderating role of perceived supervisor and coworker support in the above direct influence relationship were tested.2Questionnaires: The mature scales at home and abroad were used to design demographic characteristics variables(the primary characteristics includes gender,age,education,and occupation and the secondary characteristics includes professional titles,work departments,years of employment,and employment methods.)and compile questionnaires.Among them,the emotional labor scale compiled by Groth et al.(2009)consists of 6 questions;the personal-job fit scale developed by Cable and De Rue(2002)consists of 6 questions;SF-12 scale of the physical & mental health based on SF-36 compiled by Ware et al.(1996)is reduced to12 questions;the Perceived Supervisor Support Scale developed by Rhoades et al.(2001)consists of 4 questions;the Perceived Coworker Support Scale designed by Ganster et al.(1986)consists of 4 questions.The above scales use Likert's five-point scale scoring method.After converting the scores(only the SF-12 scale is negatively scored),the average scores are calculated.The value range is 1-5.The higher the score,the more positive the corresponding variable is.3Online questionnaire surveys were conducted through convenient sampling method at four Hubei Provincial General Hospitals.The reliability of the scale was evaluated by calculating the Corrected Item-Total Correlation and Cronbach's Alpha coefficient;the validity of the scale was evaluated through confirmatory factor analysis,calculation of standardized factor load coefficients and Average Variance Extracted.Descriptive analysis,independent sample T-test,one-way analysis of variance were used to analyze emotional labor and related variable scores and demographic characteristics.A structural equation model adopted,SPSS 16.0 software was used to test the direct influences and mediating effects.Using the multivariate regression analysis and Amos17.0 software to test the moderating role of perceived supervisor and coworker support.[Results](1)Results of Bibliometric Method.A total of 935 emotional labor literatures at home and abroad were included,with an average annual publication of 46.8;the average number of domestic references was 63.0,the average number of citations was13.8,the average number of downloads was 850.4,and the download citation ratio was 61.9;the average number of citations of foreign documents was 30.3 times;the research fields are concentrated in the fields of economics and management,social sciences,medicine and health,occupational health,public management,etc.;representative research scholars with high influence came along;emotional labor and job burnout,job satisfaction,emotional exhaustion,emotional intelligence,job performance,psychological capital,organizational support,turnover intention,nurses,work pressure,service quality,etc.are hot topics.(2)Results of Grounded Theory.A total of 41 medical staffs of Hubei Provincial General Hospital were included in the depth interviews.Emotional labor of medical staff can be divided into two strategies: Surface acting and deep acting.Emotional restraint and emotional disguise form the main categories of surface acting while cognitive changes and shifting situations become the main categories of deep acting;physical health,sleep quality,physical fatigue form the main category of physical health.Frustration,psychological pressure,and exhaustion form the main category of mental health;professional ethics,work load,professional knowledge,work experience,and work ability forming requirements-ability meets the main category,reasonable needs,work remuneration,working conditions,and work support form the main category of demand-supply fit;leadership coordination,leadership comfort,leadership care,and leadership trust form the main category of supervisor support,colleague comfort,colleague coordination,colleague listening,colleague experience sharing,and colleague teamwork Formed the main category of colleague support.Medical staff's requirement-ability fit and demand-supply fit influence the choice of emotional labor strategy and then affect physical health and mental health.Supervisors and colleagues support intervention to adjust the above effects.(3)Results of Empirical Research.A total of 911 medical staffs of Hubei Provincial General Hospital were included in this study,including 325 physicians and586 nurses;263 males and 648 females.The reliability of the measurement tool meets the requirements.The Cronbach's Alpha coefficient of each variable is greater than the minimum standard 0.7.The construct validity and discriminant validity of the measurement tool are good,and the data can meet the analysis requirements.The emotional labor score of the surveyed medical staffs was 2.83(SD = 0.74)and the score rate was 56.6%.Structural equation model results show that the empirical data fits well with the theoretical model(?2/df = 4.803,GFI= 0.915,NFI = 0.948,TLI = 0.949,CFI = 0.958,RMSEA = 0.065).And: 1)The demand-supply fit and the requirement-ability fit of medical staffs have significant negative impact on surface acting,and the standardized path coefficients are-0.376(P<0.001)and-0.078(p <0.05)respectively,but both have no significant effect on deep acting(P>0.05).2)Surface acting of medical staff has a significant negative impact on physical & mental health.The standardized path coefficients are-0.423(p<0.001)and-0.411(p<0.001)respectively,but deep acting has no significant effect on both physical & mental health(p> 0.05).3)The total effects of the requirement-ability fit of medical staffs on physical & mental health are0.501 and 0.608,and the mediating effects of surface acting are 0.159 and 0.155respectively;the total effects of requirement-ability fit on physical health and mental health are-0.067 and-0.043,and the mediating effects of surface acting are 0.033 and0.032.The results of moderated multiple regression analysis showed that: 1)The perceived supervisor support of the medical staff imposes a strength negative relationship on requirement-ability fit and surface acting,the standardized regression coefficient of the interaction term(requirement-ability fit ×perceived supervisor support)was-0.094(p<0.01);the moderation effects of perceived supervisor support on other relationships were not significant(p>0.05).2)The perceived coworker support of the medical staff imposes a strength negative relationship on requirement-ability fit and surface acting,the standardized regression coefficient of the interaction term(requirement-ability fit × perception coworker support)is-0.069(p<0.05);the moderation effects of perceived coworker support on other relationships were not significant(p> 0.05).[Conclusions]Emotional labor of medical staff can be divided into two strategies: Surface acting and deep acting.The emotional labor of medical staff and the impact mechanism model on physical and mental health can be described as the demand-supply fit and demand-ability fit affect emotional labor and then affect physical and mental health.Supervisors and coworkers support intervention to adjust the above effects.Both demand-supply fit and requirement-ability fit have a significant negative impact on surface acting,but have not significant impact on deep acting.Surface acting has a significant negative impact on physical & mental health,but deep acting has not significant impact on physical & mental health.Surface acting but not deep acting has a mediating effect on the impact of demand-supply fit and requirement-ability fit on physical & mental health.Perceived supervisor and coworker support have moderation effects between requirement-ability fit and surface acting.It is recommended that medical institutions improve the level of medical staff's demand-supply fit,encourage appropriate moderate emotional labor,especially avoid surface acting,and give greater supervisor and coworker support. |
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