A structural equation model analysis of the effects of emotional labor and job stress on depression among nurses with long working hours: Focusing on the mediating effects of resilience and social support

BACKGROUND: Recently, hospital services have undergone massive changes. As global competition intensifies and informed patients require improved medical services, nurses' depression has increased. OBJECTIVE: We investigated the effect of emotional labor and job stress on depression in nurses with long working hours via structural equation modeling. METHODS: The data were collected in three general hospitals with 300 beds or more from August 31 to September 12, 2016, and 400 nurse practitioners agreed to participate. We retrieved 350 self-reported questionnaires in total, of which 291 were analyzed (excluding 33 containing unidentifiable values and 26 outliers). RESULTS: The emotional labor of nurses with long working hours influenced depression, whereas job stress did not. Resilience had a negative mediating effect on the relationship between emotional labor and depressive symptoms. Social support had negative mediating effects on the relationship between job stress and depression. CONCLUSIONS: To promote the mental health of nurses in Korea, policies must decrease nurses' working hours and maintain work environments that enable them to demonstrate their full competency. Thus, it is necessary to limit long hours and implement structures and systems that promote compliance with these limitations.