The dual pathways of emotional labor in psychiatric nursing: the adaptive and maladaptive emotional strategies

精神科护理中情绪劳动的双重路径:适应性和非适应性情绪策略

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Abstract

BACKGROUND: Psychiatric nurses engage in high levels of emotional labor, which can significantly influence their burnout and job performance. While prior research has linked emotional labor to burnout, the nuanced interplay between different emotional regulation strategies remains underexplored. This study examines the distinct roles of surface acting (modifying outward expressions without changing internal feelings) and deep acting (adjusting internal emotions to align with external expectations) in psychiatric nursing, identifying their differential associations on burnout through network bridge analysis and latent profile analysis. METHODS: A cross-sectional survey was conducted among 199 psychiatric nurses in a mental hospital in Wenzhou, China. Emotional labor was assessed using the Emotional Labor Scale, and burnout was measured with the Maslach Burnout Inventory-GS. Network bridge analysis was applied to identify key connections between emotional labor strategies and burnout dimensions. LPA was applied to reveal distinct emotional labor patterns. RESULTS: Surface acting emerged as the primary bridge linking emotional labor to burnout, displaying strong associations with emotional exhaustion and depersonalization. LPA identified four emotional labor profiles: moderate emotional labor (63.32%), low emotional labor (5.03%), high emotional labor (23.62%), and deep acting dominant (8.04%). Nurses in the deep acting dominant profile exhibited significantly lower burnout levels compared to other groups (p < 0.001, Cohen's d = 0.90-1.28), suggesting that deep acting mitigates burnout risks. CONCLUSION: These findings highlight the maladaptive effects of surface acting and the protective role of deep acting. Targeted interventions fostering deep acting may enhance psychiatric nurses' well-being and resilience. Future research should explore longitudinal shifts in emotional labor strategies.

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