Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effort

BackgroundEmergency nurses experience high stress, but the mechanisms linking effort-reward imbalance to health outcomes are unclear. Work–family conflict might mediate this relationship, and intrinsic effort could moderate it. This study aimed to explore these interactions and their impact on nurse...

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Main Authors: Le Tong, Ling Zhu, Hao Zhang, Luying Zhong, Dongmei Diao, Xiaoli Chen, Jianna Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1515593/full
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author Le Tong
Le Tong
Ling Zhu
Ling Zhu
Hao Zhang
Hao Zhang
Luying Zhong
Luying Zhong
Dongmei Diao
Dongmei Diao
Xiaoli Chen
Xiaoli Chen
Jianna Zhang
Jianna Zhang
author_facet Le Tong
Le Tong
Ling Zhu
Ling Zhu
Hao Zhang
Hao Zhang
Luying Zhong
Luying Zhong
Dongmei Diao
Dongmei Diao
Xiaoli Chen
Xiaoli Chen
Jianna Zhang
Jianna Zhang
author_sort Le Tong
collection DOAJ
description BackgroundEmergency nurses experience high stress, but the mechanisms linking effort-reward imbalance to health outcomes are unclear. Work–family conflict might mediate this relationship, and intrinsic effort could moderate it. This study aimed to explore these interactions and their impact on nurse health.MethodsA prospective cross-sectional survey was conducted from 30 tertiary hospitals across 19 provinces in mainland China. Participants completed validated scales to measure effort-reward imbalance, work–family conflict, somatic symptoms, and mental health symptoms. Statistical analyses, including mediation and moderation, were performed using the PROCESS macro to evaluate the relationships between the variables.ResultsIn this study, 1,540 emergency nurses were finally included. The analysis revealed that 80.5% of participants reported experiencing effort-reward imbalance, which was significantly associated with increased somatic symptoms and mental symptoms. Work–family conflict was identified as a significant mediator in the relationship between effort-reward imbalance and health outcomes, with a direct effect of effort-reward imbalance on overall symptoms (β = 0.554, p < 0.001). Additionally, intrinsic effort moderated the impact of effort-reward imbalance on work–family conflict; moderate levels of emotional investment provided protection against burnout, while excessive intrinsic effort heightened the risk of mental health deterioration (β = −0.104, p < 0.001).ConclusionThese findings underscored the urgent need for targeted interventions that address both effort-reward imbalance and work–family conflict in healthcare settings. Enhancing workplace conditions and supporting emotional engagement among emergency nurses are essential strategies for improving their well-being and reducing burnout risk. Future research should focus on longitudinal studies to assess the effectiveness of these interventions over time.
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spelling doaj-art-13e1159ae00b448fa6ebcb760a4a8bfb2025-08-20T02:36:49ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.15155931515593Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effortLe Tong0Le Tong1Ling Zhu2Ling Zhu3Hao Zhang4Hao Zhang5Luying Zhong6Luying Zhong7Dongmei Diao8Dongmei Diao9Xiaoli Chen10Xiaoli Chen11Jianna Zhang12Jianna Zhang13Department of Emergency Medicine and West China School of Nursing, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medical Center, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medical Center, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medical Center, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medical Center, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medical Center, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medical Center, Sichuan University, Chengdu, ChinaDepartment of Emergency Medicine and West China School of Nursing, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medical Center, Sichuan University, Chengdu, ChinaBackgroundEmergency nurses experience high stress, but the mechanisms linking effort-reward imbalance to health outcomes are unclear. Work–family conflict might mediate this relationship, and intrinsic effort could moderate it. This study aimed to explore these interactions and their impact on nurse health.MethodsA prospective cross-sectional survey was conducted from 30 tertiary hospitals across 19 provinces in mainland China. Participants completed validated scales to measure effort-reward imbalance, work–family conflict, somatic symptoms, and mental health symptoms. Statistical analyses, including mediation and moderation, were performed using the PROCESS macro to evaluate the relationships between the variables.ResultsIn this study, 1,540 emergency nurses were finally included. The analysis revealed that 80.5% of participants reported experiencing effort-reward imbalance, which was significantly associated with increased somatic symptoms and mental symptoms. Work–family conflict was identified as a significant mediator in the relationship between effort-reward imbalance and health outcomes, with a direct effect of effort-reward imbalance on overall symptoms (β = 0.554, p < 0.001). Additionally, intrinsic effort moderated the impact of effort-reward imbalance on work–family conflict; moderate levels of emotional investment provided protection against burnout, while excessive intrinsic effort heightened the risk of mental health deterioration (β = −0.104, p < 0.001).ConclusionThese findings underscored the urgent need for targeted interventions that address both effort-reward imbalance and work–family conflict in healthcare settings. Enhancing workplace conditions and supporting emotional engagement among emergency nurses are essential strategies for improving their well-being and reducing burnout risk. Future research should focus on longitudinal studies to assess the effectiveness of these interventions over time.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1515593/fullwork-life balanceemergency nursingmental healtheffort-reward imbalanceintrinsic effort
spellingShingle Le Tong
Le Tong
Ling Zhu
Ling Zhu
Hao Zhang
Hao Zhang
Luying Zhong
Luying Zhong
Dongmei Diao
Dongmei Diao
Xiaoli Chen
Xiaoli Chen
Jianna Zhang
Jianna Zhang
Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effort
Frontiers in Public Health
work-life balance
emergency nursing
mental health
effort-reward imbalance
intrinsic effort
title Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effort
title_full Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effort
title_fullStr Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effort
title_full_unstemmed Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effort
title_short Effort-reward imbalance and health outcomes in emergency nurses: the mediating role of work–family conflict and intrinsic effort
title_sort effort reward imbalance and health outcomes in emergency nurses the mediating role of work family conflict and intrinsic effort
topic work-life balance
emergency nursing
mental health
effort-reward imbalance
intrinsic effort
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1515593/full
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