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Effort-Reward Imbalance, Resilience and Perceived Organizational Support: A Moderated Mediation Model of Fatigue in Chinese Nurses

Authors Liu L, Wu D, Wang L, Qu Y, Wu H

Received 28 April 2020

Accepted for publication 4 July 2020

Published 27 July 2020 Volume 2020:13 Pages 893—901

DOI https://doi.org/10.2147/RMHP.S259339

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Marco Carotenuto


Li Liu,1 Di Wu,2 Lulu Wang,1 Yunting Qu,1 Hui Wu1

1Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China; 2School of Fundamental Sciences, China Medical University, Shenyang, Liaoning, People’s Republic of China

Correspondence: Hui Wu
Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang 110122, People’s Republic of China
Tel +86 189 0091 0568
Email hwu@cmu.edu.cn

Purpose: Fatigue undermines nurses’ well-being and work performance worldwide. Work stress is a critical factor that causes nurses’ fatigue, but the solutions are not well known. This study aimed to identify the moderated mediation model of fatigue involving effort-reward imbalance (ERI), resilience and perceived organizational support (POS) in Chinese nurses.
Methods: In a cross-sectional investigation conducted in Liaoning Province of China, 996 nurses completed the self-administered measurements of fatigue, ERI, resilience and POS. Moderated mediation was tested using the PROCESS procedure. The “pick-a-point” method was adopted to assess conditional effect on fatigue.
Results: The indirect effect of ERI on fatigue through resilience was significant (a×b = 0.119, BCa 95% CI: 0.094 to 0.146), indicating a partial mediation of resilience. POS moderated the association of resilience with fatigue (β = − 0.056, p = 0.006). The higher the level of POS was, the stronger the resilience-fatigue association became. Thus, the mediating role of resilience in the ERI-fatigue association was gradually increased with the increase of POS level (low POS: 0.073; moderate POS: 0.095; high POS: 0.116).
Conclusion: Resilience could partially mediate the ERI-fatigue association. POS could act as a moderator that enhanced the association of resilience with fatigue. A moderated mediation model of fatigue was demonstrated in Chinese nurses. Managers should establish a balanced social reciprocity, and improve nurses’ resilience and POS in order to decrease nurses’ fatigue.

Keywords: fatigue, effort-reward imbalance, resilience, perceived organizational support, nurses

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