The Influence of Effort-reward Imbalance and Perceived Organizational Support on Perceived Stress in Chinese Nurses: a Cross-sectional Study

Background: The nursing profession is characterized by high intensity and significant stress. Nurses must not only manage heavy workloads but also address diverse patient needs, engage in emotional labor, and cope with occupational exposure risks. These factors collectively contribute to substantial work-related stress for nurses. Currently, there is limited research on identifying distinct categories of nurse stress profiles and their influencing factors.

Objectives: This study aimed to explore the potential categories of perceived stress among nurses using Latent profile analysis (LPA) and to analyze the influence of sociodemographic factors, effort-reward imbalance, and perceived organizational support on perceived stress categories.

Design: Cross-sectional study METHODS: Data were collected via electronic surveys from 696 nurses in Shanxi Province, China, from February 18 to 28, 2023. The survey parameters included sociodemographic characteristics, nurse job stressors scale, effort-reward imbalance scale, and perceived organizational support scale. Latent profile analysis (LPA) was used to classify the perceived stress levels of nurses, and disordered multi-classification logistic regression was used to identify the influencing factors.

Results: The most suitable model was a three-profile model, comprising the "low perceived stress" group (10.5%), "moderate perceived stress" group (66.7%), and "high perceived stress" group (22.8%). Multi-classification logistic regression analysis showed that average working hours per day (OR = 3.022, p = 0.026), extrinsic effort (C2 vs. C1, OR = 1.589, p < 0.001; C3 vs. C1, OR = 2.515, p < 0.001), and perceived organizational support (C2 vs. C1, OR = 0.853, p < 0.001; C3 vs. C1, OR = 0.753, p < 0.001) were the factors influencing the classification of nurses' perceived stress.

Conclusions: Latent profile analysis revealed that nurses' perceived stress exhibits distinct characteristics. It is recommended that clinical administrators should identify these characteristics and the influencing factors of different nurse categories, and adopt targeted intervention strategies to reduce the levels of perceived stress.