ArticleHuman resources for health2023
How surface acting affects turnover intention among family doctors in rural China: the mediating role of emotional exhaustion and the moderating role of occupational commitment.
Article in Human resources for health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Stress and retention challenges among rural and regional physicians: a mixed-methods systematic review and framework for action.Journal of public health (Oxford, England) · 2026Pooled it
- The impact of family health resources on the economic risk of diseases in rural China: based on a path analysis.BMC public health · 2026Article
- Latent profiles of compassion fatigue among clinical nurse preceptors and their associations with work alienation.Scientific reports · 2026Article
- Factors associated with turnover intention among institutional long-term care workers in China: a multi-center cross-sectional study in China.Frontiers in public health · 2026Article
- Emotional labor and its influencing factors of clinical nurses: a cross-sectional study based on latent profile analysis.Frontiers in public health · 2025Article
- The effect of incentive factors on turnover intention of PHC workforce in rural China-from the perspective of two-factor theory.BMC health services research · 2024Article
- Exploring the Relationship between Surface Acting, Job Stress, and Emotional Exhaustion in Health Professionals: The Moderating Role of LMX.Behavioral sciences (Basel, Switzerland) · 2024Article
- The association between family doctor contract services and the health of middle-aged and older people in China: an instrumental variables analysis.Scientific reports · 2024Article
- The impact of meaning in life and professional happiness on the turnover intention of health care workers: a cross-sectional study from China.Human resources for health · 2023Observational
- Effects of person-job fit on occupational commitment among kindergarten teachers: occupational well-being as mediator and perceived organizational support as moderator.BMC psychology · 2023Article
- Perceived organizational support and occupational commitment: A study among male kindergarten teachers.Heliyon · 2023Article
- The relationship between role ambiguity, emotional exhaustion and work alienation among chinese nurses two years after COVID-19 pandemic: a cross-sectional study.BMC psychiatry · 2023Article
- Emotional labor and job satisfaction among nurses: The mediating effect of nurse-patient relationship.Frontiers in psychology · 2023Article
- The Performance of Primary Healthcare in China: The Need for a Systematic Design for Improvement Comment on "Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China".International journal of health policy and management · 2023Article
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7 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFamily doctors in rural China are the main force for primary health care, but the workforce has not been well stabilized in recent years. Surface acting is an emotional labor strategy with a disparity between inner feelings and emotional displays, provoking negative effects such as emotional exhaustion, occupational commitment reduction, and, consequently, increasing turnover rate. With the Conservation of Resources theory, this study explores how the surface acting of rural family doctors affects turnover intention through emotional exhaustion and investigates what role occupational commitment plays in this relationship.
methodsWith a valid response rate of 93.89%, 953 valid data were collected by an anonymous self-administered questionnaire survey in December 2021 in Shandong Province, China. Cronbach's Alpha and confirmatory factor analysis (CFA) were used to estimate reliability and construct validity, respectively. The PROCESS macro in SPSS was performed to analyze the mediating and moderated mediation effects of surface acting, emotional exhaustion, occupational commitment, and turnover intention.
resultsReliability and validity indicated that the measurement instruments were acceptable. Surface acting had a direct positive effect on turnover intention (β = 0.481, 95% CI [0.420, 0.543]). Emotional exhaustion partially mediated the effect of surface acting on turnover intention (indirect effect: 0.214, 95% CI [0.175, 0.256]). Occupational commitment moderated the effect of emotional exhaustion on turnover intention (β = - 0.065, 95% CI [- 0.111, - 0.019]), and moderated the indirect effect of surface acting on turnover intention via emotional exhaustion (index of moderated mediation: - 0.035).
conclusionsEmotional exhaustion partially mediates the relationship between surface acting and turnover intention among family doctors in rural China, and occupational commitment moderates the direct effect of emotional exhaustion on turnover intention and further moderates the mediating effect. Policymakers should pay more attention to the effects of emotional labor and emotional resource depletion on the stability of rural health human resources.
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