The Effects Of Occupational Stress,resilience And Perceived Organizational Support On Fatigue Among Medical Staff:A Study Of Moderated Mediation Model

Objective: In China,the fatigue prevalence of medical staff is becoming more and more serious because of the heavy workload,high-quality medical care requirements and irregular working time etc.This study aims to describe the prevalence of fatigue among medical staff,and further explore the influencing factors and their associations of fatigue among doctors and nurses.Based on the results,I aim to draw some implications to reduce the fatigue level of medical staff,and to improve the health management at both individual and organizational levels.Methods: In this study,a multi-stage stratified random sampling method was used.A city from five regions(east,west,north,south and central)in Liaoning Province were randomly selected.Two tertiary hospitals were randomly selected from each city.112 doctors and 112 nurses were randomly selected from each chosen hospital,totaling 2240 participants.Self-reported questionnaires were distributed to them.The questionnaire included the general questionnaire,the fatigue scale(FS-14),effort-reward imbalance questionnaire(ERI),the Connor-Davidson resilience scale(CD-RISC)and the survey of perceived organizational support scale(SPOS)to assess the demographic and working characteristics,fatigue,occupational stress,resilience and perceived organizational support level of medical staff.1862 questionnaires were effectively collected,with an effective rate of 83.1%.One-way ANOVA and t-test were used to compare the differences in demographic and working characteristics of fatigue among medical staff;Pearson correlation analysis was used to test the relationships between fatigue and its influencing factors;hierarchical regression analyses were used to exam the influencing factors and their effects of fatigue,and to explore the mediating effect of resilience in the relationship between occupational stress and fatigue,and the moderating effect of perceived organizational support in the relationship between resilience and fatigue;bootstrap method was used to testify the mediating effect of resilience;simple slope was used to visualize the moderating effect of perceived organizational support;finally,path analysis was used to verify the moderated mediating effect of resilience and perceived organizational support in the association between occupational stress and fatigue.Results: 1.The average scores of physical fatigue and mental fatigue of doctors were 4.18 � 2.38 and 4.33 � 2.70 respectively;the average scores of physical fatigue and mental fatigue of nurses were 2.73 � 1.68 and 2.65 � 2.00 respectively.2.Age,monthly income,night shift,weekly working hours and doctor-patient relationship were the influencing factors of physical fatigue among doctors;marital status,weekly working hours and doctor-patient relationship were the influencing factors of mental fatigue among doctors.Night shift,weekly working hours and nurse-patient relationship were the influencing factors of physical fatigue among nurses;monthly income,weekly working hours and nurse-patient relationship were the influencing factors of mental fatigue among nurses.3.Effort-reward ratio,overcommitment,resilience and perceived organizational support were important factors affecting physical fatigue of doctors.Effort-reward ratio,resilience and perceived organizational support were important factors affecting doctors' mental fatigue.Resilience played partly mediating roles between effort-reward ratio and physical fatigue and mental fatigue.However,resilience did not have a mediating role between overcommitment and physical fatigue.The perceived organizational support did not moderate the association between resilience and physical fatigue,while the perceived organizational support played a positive moderating role between resilience and mental fatigue.The mediating effect of resilience on effort-reward ratio and mental fatigue was moderated by perceived organizational support.4.Effort-reward ratio,overcommitment,and resilience were important influencing factors of physical fatigue of nurses.Effort-reward ratio,overcommitment,resilience and perceived organizational support were important factors affecting nurses' mental fatigue.Resilience played partly mediating roles in the relationships between effort-reward ratio and physical fatigue and mental fatigue.Resilience also played partly mediating roles in the relationships between overcommitment and physical fatigue and mental fatigue.The perceived organizational support did not moderate the association between resilience and physical fatigue,while the perceived organizational support played a positive moderating role between resilience and mental fatigue.The mediating effects of resilience in the relationships between effort-reward ratio and overcommitment and mental fatigue both were moderated by perceived organizational support.Conclusion: The physical fatigue among medical staff may have been improved,but the mental fatigue is more serious now.At the individual level,occupational stress might be a very important predictor of fatigue of medical staff;resilience might be also an important positive psychological resource to prevent fatigue of medical staff,and resilience played a significant mediating role between occupational stress and fatigue.At the organizational level,perceived organizational support was also one of the key factors of fatigue among medical staff,and it played a significant role in moderating the relationship between resilience and fatigue.Hospital managers should take targeted measures to improve their salary and welfare,to increase the public image of medical staff and so on in order to reduce the occupational stress level,and to improve the resilience level of them by effective approaches,as well as to improve the perceived organizational support of medical staff,ultimately achieving the goal of improving the fatigue status of them.