ArticleJournal of nursing management2026
The Effect of Decision Fatigue on Job Stress in Midwives: The Mediating Role of Psychological Capital and the Moderating Effect of Perceived Organizational Support.
Article in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- The Effect of Decision Fatigue on Job Stress in Midwives: The Mediating Role of Psychological Capital and the Moderating Effect of Perceived Organizational Support.Journal of nursing management · 2026Article
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7 authors.
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Abstract
backgroundMidwives face escalating decision fatigue (DF) and job stress. If left unaddressed, these issues may impair their mental health and clinical performance, compromise maternal and neonatal safety, and exacerbate workforce shortages, making it urgent to explore the underlying influencing mechanisms. This study explored the status of job stress among midwives, analyzed the correlations between DF, psychological capital (PsyCap), perceived organizational support (POS), and job stress and further examined the mediating role of PsyCap as well as the moderating role of POS on the relationship between DF and job stress.
methodsA multicenter cross-sectional survey was conducted among midwives from 146 Baby-Friendly Hospitals in Sichuan, China, between October 2024 and September 2025. Using multistage stratified cluster sampling, 1263 midwives completed questionnaires on DF, PsyCap, POS, and job stress. SPSS 26.0 was applied for descriptive statistics, one-way ANOVA, and Pearson correlation analysis, while Mplus 8.3 was used to conduct mediation and moderation analyses.
resultsThe total scores (mean ± SD) of job stress, DF, PsyCap, and POS among midwives were 90.45 ± 19.57, 20.58 ± 5.92, 88.83 ± 14.08, and 43.71 ± 9.98, respectively. One-way ANOVA showed significant differences in job stress scores across age, ethnicity, hospital ownership, hospital level, employment type, work experience, and monthly night shifts (all p < 0.05). Pearson correlation analysis revealed that job stress was positively correlated with DF (r = 0.648, p < 0.01) and negatively correlated with PsyCap (r = -0.673, p < 0.01) as well as POS (r = -0.342, p < 0.01). PsyCap partially mediated the relationship between DF and job stress (indirect effect = 0.258, 95% CI [0.223, 0.300]). Moreover, POS negatively moderated the path between PsyCap and job stress (γ = -0.165, p < 0.001), indicating a significant moderated mediation effect.
conclusionDF directly increases job stress among midwives and also exerts an indirect effect through PsyCap, with this mediation being moderated by POS. Targeted interventions to reduce DF, enhance PsyCap, and strengthen POS may alleviate job stress and improve midwives' well-being. IMPLICATION FOR NURSING MANAGEMENT: Nursing managers should formulate targeted measures to reduce midwives' DF, improve their PsyCap, and strengthen organizational support. Such comprehensive strategies may effectively relieve job stress, promote occupational well-being, and stabilize the midwifery workforce in Baby-Friendly Hospitals.
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