Abstract
BACKGROUND: Studies have shown a strong correlation between occupational stress and burnout. It is still unclear whether over-commitment moderates the association of effort-reward imbalance on job burnout and the extent of its influence. AIM: To explore the moderating effect of over-commitment on the relationship between external factors of occupational stress and job burnout among emergency nurses, providing theoretical evidence for clarifying the health effects of over-commitment. STUDY DESIGN: A cross-sectional survey was conducted using a stratified cluster sampling method to select 1,540 emergency nurses from 30 hospitals in China as the study population. The Effort-Reward Imbalance (ERI) Scale and the Job Burnout Scale were used to assess the current status of effort-reward imbalance and job burnout among emergency nurses. SPSS 26.0 was used for correlation analysis, and the Bootstrap method was employed to verify the moderating effect of over-commitment. RESULTS: A total of 1,551 questionnaires were distributed, and 1,540 valid questionnaires were recovered. The effort-reward imbalance (ERI) of emergency nurses was 0.93 ± 0.57, and the job burnout score was 4.77 ± 6.16. Correlation analysis showed that effort, over-commitment, and job burnout were positively correlated (correlation coefficients: 0.65 and 0.62, respectively; p < 0.01), reward and job burnout were negatively correlated (correlation coefficients: -0.53, p < 0.01). ERI was positively correlated with job burnout (r = 0.62, p < 0.01), and the differences were statistically significant. Moderating effect analysis showed that after controlling for work characteristics such as weekly working hours, frequency of night shifts, and monthly income, adding over-commitment into the model revealed that the interaction term between ERI and over-commitment had a significant negative predictive effect on burnout (β = -0.31, t = -8.48, p < 0.001). At different levels of over-commitment, as the level of over-commitment of emergency nurses decreased, ERI was more likely to lead to job burnout. CONCLUSION: Higher levels of over-commitment appear to buffer the adverse effect of ERI on burnout, suggesting a protective moderating role.