ArticleBMC nursing2026
Examining the moderated mediation effects of deep acting, personal accomplishment, and transformational leadership.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe rapid aging of the population has intensified demand for long-term care services, while persistent turnover among home care workers (HCWs) undermines service quality and sustainability. Emotional labor theory suggests that deep acting may improve retention, yet the mechanisms involving personal accomplishment and transformational leadership remain unclear.
methodsA cross-sectional survey of 386 certified HCWs in Chiayi, Taiwan measured deep acting, personal accomplishment, transformational leadership, and retention intention. Analyses included descriptive statistics, ANOVA, and PROCESS Model 8.
resultsDirect effect analysis revealed that deep acting (B = 0.165, p = .009), transformational leadership (B = 0.160, p = .005), and personal accomplishment (B = 0.136, p = .017) significantly and positively predicted retention intention. Mediation and moderation effects were not supported. Demographic analyses indicated that older, married, and more experienced HCWs reported significantly higher retention intention. Female and long-tenured staff perceived stronger transformational leadership support.
conclusionsDeep acting and transformational leadership independently promote retention. Personal accomplishment also strengthens retention but does not mediate the effect of deep acting. The absence of moderation indicates that emotional regulation and leadership act as separate predictors. Workforce stability strategies should therefore cultivate genuine emotional engagement and supportive leadership as distinct organizational pillars.
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