Emotion regulation strategy moderates the impact of emotional labor on burnout in psychiatric nurses: a cross-sectional study

Abstract

Background: Psychiatric nurses experience unique emotional challenges, requiring management of both their own emotions and those of patients with mental health disorders. Emotional labor, particularly surface acting, has been identified as a significant stressor contributing to burnout. This study examines how emotion regulation strategies might moderate the relationship between emotional labor and burnout. Methods: This cross-sectional study recruited 244 psychiatric nurses. Participants completed questionnaires assessing emotional labor, emotion regulation strategies, and burnout. Multiple regression and moderation analyses were performed. Results: Surface acting was positively associated with burnout (β = 0.44, p < 0.001), while natural expression (β = -0.19, p = 0.02) was negatively associated with burnout. Cognitive reappraisal was negatively associated with burnout (β = -0.44, p < 0.001), while expressive inhibition was positively associated with burnout (β = 0.15, p = 0.04). Furthermore, cognitive reappraisal significantly moderated the relationship between surface acting and burnout (β = -0.57, p = 0.01). Simple slope analysis revealed that the association between surface acting and burnout was strongest at low levels of cognitive reappraisal (β = 0.50, p < 0.001) and weakest at high levels (β = 0.22, p = 0.004), becoming non-significant when cognitive reappraisal exceeded a standardized value of 1.38. Conclusion: Cognitive reappraisal serves as a protective factor against the detrimental effects of surface acting on burnout among psychiatric nurses. Interventions should focus on minimizing reliance on surface acting while enhancing cognitive reappraisal skills through mindfulness-based techniques, potentially improving resilience in emotionally demanding environments.