{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:55:28Z","timestamp":1781502928491,"version":"3.54.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Occupational well-being among healthcare professionals is a key indicator of healthcare quality and workforce sustainability. However, the mechanisms linking emotional labor to occupational well-being among endoscopy healthcare workers remain insufficiently understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to examine the relationship between emotional labor and occupational well-being and to explore the underlying mechanisms using a moderated serial mediation model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter cross-sectional survey was conducted between January and February 2026 among 364 endoscopy healthcare workers in China. Validated instruments were used to assess emotional labor, job control, work engagement, organizational support, and occupational well-being. Pearson correlation, regression analysis, and bootstrap methods were employed to test mediation and moderation effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Emotional labor was significantly negatively associated with occupational well-being (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.325,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Job control and work engagement played significant mediating roles in this relationship. Specifically, the indirect effect through job control was significant (effect\u202f=\u202f\u22120.119, 95% CI: \u22120.182 to \u22120.056), as was the indirect effect through work engagement (effect\u202f=\u202f\u22120.046, 95% CI: \u22120.091 to \u22120.001). In addition, a significant serial mediation effect was observed through job control and work engagement (effect\u202f=\u202f\u22120.107, 95% CI: \u22120.163 to \u22120.051), with a significant total indirect effect (effect\u202f=\u202f\u22120.272, 95% CI: \u22120.380 to \u22120.164). Organizational support significantly moderated the relationship between emotional labor and job control (\u03b2\u202f=\u202f0.018,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), such that higher levels of organizational support attenuated the negative effect of emotional labor on job control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Emotional labor is associated with occupational well-being among endoscopy healthcare workers through correlational pathways. Job control and work engagement serve as key mediating mechanisms, while organizational support functions as an important buffering resource. Interventions aimed at reducing excessive emotional labor demands and strengthening job resources may contribute to improved occupational well-being among healthcare professionals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1847595","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:37:31Z","timestamp":1781501851000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Emotional labor and occupational well-being among endoscopy healthcare workers: a moderated serial mediation model"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhi","family":"Zeng","sequence":"first","affiliation":[{"name":"Endoscopy Center, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazhi","family":"He","sequence":"additional","affiliation":[{"name":"Endoscopy Center, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Liao","sequence":"additional","affiliation":[{"name":"Endoscopy Center, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Deyang People\u2019s Hospital","place":["Deyang, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1678358","DOI":"10.3389\/fpubh.2025.1678358","article-title":"Nurses' well-being and its relationship with quality of nursing work life at Alsalam and Al Haram Hospitals, Saudi Arabia","volume":"13","author":"Alharbi","year":"2025","journal-title":"Front Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e0159015","DOI":"10.1371\/journal.pone.0159015","article-title":"Healthcare staff wellbeing, burnout, and patient safety: a systematic review","volume":"11","author":"Hall","year":"2016","journal-title":"PLoS One"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e2443059","DOI":"10.1001\/jamanetworkopen.2024.43059","article-title":"Nurse burnout and patient safety, satisfaction, and quality of care: a systematic review and Meta-analysis","volume":"7","author":"Li","year":"2024","journal-title":"JAMA Netw Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"100148","DOI":"10.1016\/j.ijnsa.2023.100148","article-title":"Perceptions of healthcare professionals' psychological wellbeing at work and the link to patients' experiences of care: a scoping review","volume":"5","author":"Bamforth","year":"2023","journal-title":"Int J Nurs Stud Adv"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"100140","DOI":"10.1016\/j.ijnsa.2023.100140","article-title":"Mental well-being, work engagement, and work-related and personal resources among nurse managers: a structural equation model","volume":"5","author":"Hult","year":"2023","journal-title":"Int J Nurs Stud Adv"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"15598276251356482","DOI":"10.1177\/15598276251356482","article-title":"The impact of organizational commitment and leadership behavior on the quality of nursing care as perceived by registered nurses","volume":"6","author":"Al-Hussami","year":"2025","journal-title":"Am J Lifestyle Med"},{"key":"ref7","volume-title":"The Managed Heart: Commercialization of Human Feeling","author":"Hochschild","year":"1983"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"5317359","DOI":"10.1155\/2024\/5317359","article-title":"The level and outcomes of emotional labor in nurses: a scoping review","volume":"2024","author":"Feng","year":"2024","journal-title":"J Nurs Manag"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"187","DOI":"10.3349\/ymj.2018.59.2.187","article-title":"Emotional labor and burnout: a review of the literature","volume":"59","author":"Jeung","year":"2018","journal-title":"Yonsei Med J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1007\/s11845-015-1270-0","article-title":"Effective communication enhances the patients' endoscopy experience","volume":"185","author":"Toomey","year":"2016","journal-title":"Ir J Med Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.2147\/PPA.S524039","article-title":"Knowledge, attitudes, and practices among patients undergoing gastrointestinal endoscopy in the endoscopy unit of a tertiary-care hospital","volume":"19","author":"Wei","year":"2025","journal-title":"Patient Prefer Adherence"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"50","DOI":"10.19660\/j.issn.1671-0592.2022.9.14","article-title":"Mediating effect of job stressors on the relationship between job control and burnout amongadministrative staff in tertiary hospitals in Guangzhou","volume":"26","author":"Yan","year":"2022","journal-title":"Chinese Hospitals"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1037\/0021-9010.86.3.499","article-title":"The job demands-resources model of burnout","volume":"86","author":"Demerouti","year":"2001","journal-title":"J Appl Psychol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1037\/\/0003-066x.44.3.513","article-title":"Conservation of resources. A new attempt at conceptualizing stress","volume":"44","author":"Hobfoll","year":"1989","journal-title":"Am Psychol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"151557","DOI":"10.1016\/j.apnr.2021.151557","article-title":"Developing a structural equation model from Grandey's emotional regulation model to measure nurses' emotional labor, job satisfaction, and job performance","volume":"64","author":"Hwang","year":"2022","journal-title":"Appl Nurs Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1111\/jan.14305","article-title":"Nurses' intention to stay: the impact of perceived organizational support, job control and job satisfaction","volume":"76","author":"Li","year":"2020","journal-title":"J Adv Nurs"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1303170","DOI":"10.3389\/fpsyg.2023.1303170","article-title":"Relationships among supervisor support, autonomy, job satisfaction and emotional labor on nurses within the Turkey 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Psychol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1037\/0021-9010.86.5.825","article-title":"Affective commitment to the organization: the contribution of perceived organizational support","volume":"86","author":"Rhoades","year":"2001","journal-title":"J Appl Psychol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1186\/s12912-024-02114-5","article-title":"The relationship between organizational support, professional quality of life, decent work, and professional well-being among nurses: a cross-sectional study","volume":"23","author":"Zheng","year":"2024","journal-title":"BMC Nurs"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1186\/s12912-024-02473-z","article-title":"The effect of perceived organizational support and ego-resilience on the relationship between occupational stressors and compassion fatigue in COVID-19 frontline nurses: a cross-sectional study in Sichuan, 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on job burnout","volume":"43","author":"Luo","year":"2008","journal-title":"Chin J Nurs"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1037\/a0022876","article-title":"On the costs and benefits of emotional labor: a meta-analysis of three decades of research","volume":"16","author":"H\u00fclsheger","year":"2011","journal-title":"J Occup Health Psychol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1037\/ocp0000056","article-title":"Job demands-resources theory: taking stock and looking forward","volume":"22","author":"Bakker","year":"2017","journal-title":"J Occup Health Psychol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1037\/\/1076-8998.5.1.95","article-title":"Emotion regulation in the workplace: a new way to conceptualize emotional labor","volume":"5","author":"Grandey","year":"2000","journal-title":"J Occup Health Psychol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"444","DOI":"10.23749\/mdl.v110i6.7264","article-title":"Development and validation of emotional labour in nursing scale in Italy","volume":"109","author":"Badolamenti","year":"2018","journal-title":"Med Lav"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1037\/ocp0000067","article-title":"The state of the heart: emotional labor as emotion regulation reviewed and revised","volume":"22","author":"Grandey","year":"2017","journal-title":"J Occup Health Psychol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/j.1365-2850.2004.00807.x","article-title":"Emotional labour and stress within mental health nursing","volume":"12","author":"Mann","year":"2005","journal-title":"J Psychiatr Ment Health Nurs"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12960-020-00469-9","article-title":"Burnout in nursing: a theoretical review","volume":"18","author":"Dall'Ora","year":"2020","journal-title":"Hum Resour Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1177\/21650799211002471","article-title":"Work engagement and the validity of job demands-resources model among nurses in Japan: a literature review","volume":"69","author":"Kato","year":"2021","journal-title":"Workplace Health Saf"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"637","DOI":"10.3390\/bs14080637","article-title":"Exploring the relationship between surface acting, job stress, and emotional exhaustion in health professionals: the moderating role of LMX","volume":"14","author":"Yikilmaz","year":"2024","journal-title":"Behav Sci (Basel)"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1186\/s12889-024-18289-0","article-title":"Behind the times? Associations of working-time autonomy with health-related and occupational outcomes in health care personnel- a latent profile analysis","volume":"24","author":"Jung","year":"2024","journal-title":"BMC Public Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1194018","DOI":"10.3389\/fpsyg.2023.1194018","article-title":"The job demands-resource model and performance: the mediating role of employee engagement","volume":"14","author":"Lee","year":"2023","journal-title":"Front Psychol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e345","DOI":"10.1097\/jnr.0000000000000632","article-title":"Nursing work engagement, professional quality of life, and intent to leave: a structural equation modeling pathway analysis","volume":"32","author":"Wei","year":"2024","journal-title":"J Nurs Res"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1186\/s12912-023-01573-6","article-title":"Nurses' job crafting, work engagement, and well-being: a path analysis","volume":"22","author":"Han","year":"2023","journal-title":"BMC Nurs"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"153","DOI":"10.3390\/bs14030153","article-title":"The relationship between perceived organizational support, work engagement, organizational citizenship behavior, and customer orientation in the public sports organizations context","volume":"14","author":"Park","year":"2024","journal-title":"Behav Sci (Basel)."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1037\/1076-8998.10.2.170","article-title":"Job resources buffer the impact of job demands on burnout","volume":"10","author":"Bakker","year":"2005","journal-title":"J Occup Health Psychol"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1037\/a0022676","article-title":"Antecedents and consequences of psychological and team empowerment in organizations: a meta-analytic review","volume":"96","author":"Seibert","year":"2011","journal-title":"J Appl Psychol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1146\/annurev-orgpsych-031413-091305","article-title":"Psychological safety: the history, renaissance, and future of an interpersonal construct","volume":"1","author":"Edmondson","year":"2014","journal-title":"Soc Sci Electr Publ"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1847595\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:37:36Z","timestamp":1781501856000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1847595\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":50,"alternative-id":["10.3389\/fpubh.2026.1847595"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1847595","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"article-number":"1847595"}}