Perceived organizational support profiles and their moderating role in the association between emotional labor and work engagement among Chinese healthcare workers: a latent profile analysis.

Hongbin Cong, Afei Qin, Xinru Bian, Hongwei Nie, Ligang Xu

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Article in BMC health services research, 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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Hongbin Cong *State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China.

Afei Qin *Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.

Xinru BianPersonnel Department, Shandong University, Jinan, Shandong, 250100, China.

Hongwei NieState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China.

Ligang XuDepartment of Organization and Personnel (Talent Work Office), Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Huaiyin District, Jinan, Shandong, 250021, China. Slyyzzrsb@126.com.

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Abstract

backgroundEmotional labor is a common job demand in healthcare and may reduce healthcare workers' work engagement, potentially affecting workforce sustainability and service quality. Perceived organizational support (POS) may buffer this adverse effect, yet its potential latent heterogeneity is often overlooked. This study aimed to identify latent POS profiles and examine whether these profiles moderate the association between emotional labor and work engagement among Chinese healthcare workers.

methodsA cross-sectional survey was conducted between August and November 2023 among 1503 healthcare workers from 16 tertiary public hospitals in Shandong Province, China. POS was measured using the 24-item Chinese Employee Perceived Organizational Support Scale, WE was assessed with the Utrecht Work Engagement Scale, and emotional labor was measured using the Emotional Labor Scale. Latent profile analysis (LPA) was used to identify POS profiles. Multivariable ordinary least squares regression models examined associations and moderating effects. Supplementary analyses examined moderation using continuous POS measures and restricted cubic spline models.

resultsThree distinct POS profiles were identified: low (18.1%), medium (52.0%), and high (29.9%). Emotional labor was significantly negatively associated with work engagement (β = -0.35, p < 0.001). Compared with the low POS profile, healthcare workers in the medium (β = 10.65, 95% CI: 8.61-12.70, p < 0.001) and high (β = 21.74, 95% CI: 19.34-24.14, p < 0.001) profiles reported higher work engagement. Moderation analyses showed that the negative association between emotional labor and WE was significantly attenuated in the high POS profile (interaction β = 0.43, p < 0.001), whereas the medium POS profile did not show a significant buffering effect (interaction β = 0.11, p = 0.226). Findings were consistent when POS was modeled as a continuous variable, and restricted cubic spline analyses suggested that the buffering effect of POS may become more pronounced at higher levels of support.

conclusionPOS showed clear latent heterogeneity and may function as an important buffering resource in the association between emotional labor and work engagement. Strengthening organizational support systems, particularly for employees with low perceived support, may help sustain work engagement in high-demand healthcare settings. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

EmotionsHealth PersonnelOrganizational CultureWork EngagementAdultChinaCross-Sectional StudiesFemaleFrontline WorkersHumansJob SatisfactionLatent Class AnalysisMaleMiddle AgedSocial SupportSurveys and QuestionnairesEmotional laborHealthcare workforceLatent profile analysisPerceived organizational supportWork engagement

Identifiers

PMID42106692

DOI10.1186/s12913-026-14626-8

PMCPMC13326138

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