Psychological Capital and Work–Family Conflict as Predictors of Work Engagement Among Senior Nurses: A Multicenter Cross-Sectional Study in Southwest China

Psychological Capital and Work–Family Conflict as Predictors of Work Engagement Among Senior Nurses: A Multicenter Cross-Sectional Study in Southwest China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Psychological Capital and Work–Family Conflict as Predictors of Work Engagement Among Senior Nurses: A Multicenter Cross-Sectional Study in Southwest China jun zhou, Le-Mei Liu, Wen-Xuan Mou, Yan Xie, Hui Li, Chun-Hui Gu, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8423153/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Work engagement is a critical indicator of nurses’ motivation, well-being, and care quality. Senior nurses constitute the backbone of the nursing workforce, yet they face increasing occupational demands, role overload, and work–family conflict, which may undermine sustained engagement. Psychological capital has been identified as an important personal resource that enhances work engagement, while work–family conflict represents a major job demand. However, evidence focusing on senior nurses, particularly in less-developed regions of China, remains limited. This study aimed to investigate the level of work engagement among senior nurses in southwestern China and to examine the associations of psychological capital and work–family conflict with work engagement. Design A cross-sectional descriptive study. Methods A multicenter cross-sectional study was conducted between May and July 2025 in 15 hospitals in southwestern China. A total of 814 senior nurses were recruited using convenience sampling. Data were collected using standardized questionnaires, including the Utrecht Work Engagement Scale, the Nurses’ Psychological Capital Scale, and the Work–Family Conflict Scale. Descriptive statistics, Pearson correlation analysis, and stepwise multiple linear regression were performed to identify factors associated with work engagement. Results The mean work engagement score among senior nurses was 72.51 ± 21.06, indicating a high level of engagement. Psychological capital was positively correlated with work engagement ( r = 0.780, P < 0.01), whereas work–family conflict showed a significant negative correlation ( r = − 0.366, P < 0.01). Regression analysis revealed that psychological capital, job satisfaction, self-rated health status, position (head nurse), and marital status were positive predictors of work engagement, while frequent night shifts and working in emergency or outpatient departments were negatively associated with work engagement (R² = 0.656, P < 0.001). Conclusion Senior nurses in southwestern China demonstrated a generally high level of work engagement. Psychological capital emerged as the strongest positive predictor, whereas work–family conflict and excessive night shifts adversely affected engagement. These findings highlight the importance of strengthening psychological resources, optimizing work schedules, and providing targeted organizational support to sustain work engagement among senior nurses and promote workforce stability. Senior nurses Work engagement Psychological capital Work-family conflict Nursing management Introduction Work engagement is defined as a positive, energetic psychological state in the workplace,characterized by high vigor and strong professional identity.Its core dimensions include vitality, dedication, and focus[ 1 ].In nursing practice, work engagement refers to a proactive and well-integrated psychological state.Higher engagement levels are strongly associated with lower turnover intentions, greater job satisfaction, and improved nursing service quality[ 2 ].Nurses with high engagement are more likely to show proactive behavior, maintain resilience under pressure, and align with organizational goals[ 3 ].Amid increasing clinical complexity and staff shortages, enhancing work engagement has become a key strategy for healthcare institutions to sustain high performance and improve nurse retention[ 4 ].Nurse work engagement is closely linked to fewer adverse events, better patient safety, and more supportive nursing environments[ 5 ].Furthermore, work engagement improves nurses’ well-being, reduces occupational stress, and promotes mental health, especially in high-intensity clinical settings[ 6 ].These findings highlight the central role of work engagement in nursing and emphasize the need for managers to create supportive environments and provide resources that sustain and enhance engagement. Nurses are the largest professional group in the healthcare system, accounting for about 59% of the workforce.They also play a key role in hospital resource management[ 7 ].Senior nurses are usually defined as those with at least 10 years of clinical experience or aged 35 years and older, occupying key positions in the healthcare system[ 8 ].With extensive clinical expertise, advanced skills, and deep institutional knowledge, they guide patient care and promote team collaboration.They often serve as mentors or informal leaders, contributing significantly to professional development, continuity of care, and organizational resilience.In high-pressure or emergency settings, their clinical judgment and leadership are especially valuable.However, senior nurses face many challenges in fulfilling their duties.They must continuously adapt to the demands of new technologies.They also balance nursing research with mentoring junior nurses, which increases their workload.Prolonged high-intensity and shift work often lead to chronic fatigue.Limited promotion opportunities and lack of recognition further increase nurses’ turnover intentions[ 9 , 10 ].Over time, these factors may gradually erode senior nurses’ motivation and commitment.Conflicts between long-term work and family responsibilities may intensify emotional exhaustion and reduce job satisfaction[ 11 ].The entry of new talent into nursing is declining due to three factors.First, China’s delayed retirement age has an impact.Second, declining birth rates contribute.Third, employment rates for nursing graduates remain low.As a result, senior nurses will remain the backbone of the workforce[ 12 ].However, research indicates that the loss of senior nurses contributes significantly to the youth-dominated nursing workforce in China[ 13 ].In addition, China’s nursing workforce faces unique challenges.For example, nurses in southwestern China face specific difficulties.Senior nurses manage clinical leadership while coping with age-related pressures.Married nurses working away from home struggle to balance family and professional commitments[ 14 , 15 ].Nursing management in China often prioritizes skills over motivation, with excessive focus on procedural compliance at the expense of intrinsic motivation.This approach increases inefficiency and worsens staff turnover.Therefore, nursing administrators and healthcare leaders should prioritize strategies that support senior nurses’ engagement, well-being, and retention. Psychological capital refers to positive psychological states developed during individual growth, comprising four components: hope, optimism, resilience, and self-efficacy[ 16 ].Extensive research shows that psychological capital is a key personal factor influencing nurses’ work engagement, with all four components positively correlated with engagement[ 17 , 18 ].Further studies suggest that psychological capital significantly enhances clinical nurses’ work engagement, with job crafting serving as a mediator in this relationship[ 17 ].Work–family conflict is a specific type of role conflict arising from incompatible demands between work and family responsibilities.Excessive workload and time demands conflicting with family duties significantly contribute to interpersonal discord.Such conflicts reduce nurses’ work engagement and overall well-being[ 19 ].Healthcare professionals experience conflict pressures not only from patient care but also from societal expectations, child-rearing concerns, and career advancement demands[ 20 ].Zhang[ 21 ] et al. reported that higher levels of work–family conflict are strongly associated with greater burnout, lower work engagement, and reduced well-being.Work–family conflict is a significant predictor of occupational fatigue and reduced well-being, while social support and positive coping buffer these effects[ 22 ].Yan[ 23 ] et al. emphasized that when social and organizational support is lacking, frequent patient mistreatment exacerbates emotional exhaustion, which negatively affects family life.This intensifies work–family conflict and decreases work engagement.In summary, psychological capital and work–family conflict are key determinants of work engagement, with the former exerting a positive influence and the latter a negative effect.Strong psychological capital mitigates the negative effects of work–family conflict, supporting higher levels of work engagement among nurses. Although research on nurses' work engagement has increased in recent years, most studies are concentrated in economically developed eastern and coastal regions and mainly focus on general or junior nurses.As a result, relatively little attention has been given to senior nurses and those working in resource-limited settings[ 24 , 25 ].Senior nurses may differ from younger nurses in career trajectories, perceived stress, and mechanisms of work engagement.However, current research has not adequately examined these differences.Furthermore, southwestern China has distinct sociocultural contexts and faces urgent challenges, including unequal healthcare resource distribution and an ageing nursing workforce.Yet, relevant studies in this region remain scarce[ 12 , 26 ].Few studies have systematically examined how psychological capital (individual resources) and work–family conflict (environmental demands) interact to influence nursing work engagement.This research gap limits the development of regionally adaptive strategies and hampers efforts to enhance nurse retention and achieve sustainable workforce development.Therefore, research focusing on senior nurses in southwestern China is urgently needed and critically important, providing a scientific basis for evidence-based management and policy development. Integrated Theoretical Framework: Benner’s Novice to Expert Theory and the JD-R Model Patricia Benner’s 1984 “novice to expert” theory provides a seminal foundation for studying nursing career development.The theory proposes that clinical competence develops through five distinct stages: novice, advanced beginner, competent, proficient, and expert[ 27 ].According to Benner’s framework, nurses progress sequentially through these five distinct phases of clinical development.Each stage reflects differences in nurses’ accumulated experience, critical thinking, and situational understanding.Benner emphasised that professional competence is built mainly through accumulated practice in real clinical settings and intuitive decision-making, rather than solely on theoretical knowledge.Senior nurses are typically distinguished by proficiency or expertise, demonstrated through advanced clinical judgment, leadership skills, and a comprehensive nursing perspective.However, senior nurses’ work engagement does not rely solely on clinical expertise.External and psychosocial factors—such as organisational support, psychological capital, and work–family conflict—also significantly affect nurses’ work motivation and overall well-being. To clarify these dynamic relationships, the Job Demands-Resources (JD-R) model provides a complementary perspective.The model suggests that employee engagement arises from a balance between job demands (e.g., workload, night shifts, work–family conflict) and job resources (e.g., autonomy, social support, psychological capital).When resources adequately counter job demands, engagement and performance improve; in contrast, inadequate resources can result in reduced engagement and occupational burnout[ 28 ]. This study integrates Benner’s theory with the JD-R model to establish a comprehensive framework.Benner’s theory contextualises the professional development stages of senior nurses, highlighting their competence and clinical authority.The JD-R model explains how job demands and resources interact at advanced stages, potentially sustaining or undermining work engagement.Integrating both models enhances understanding of senior nurses’ work engagement and highlights the need for targeted interventions tailored to their career stage and psychosocial context.The study reinforces the importance of conceptualising senior nurses as a distinct research group and stresses the need for personalised strategies to enhance their motivation, job satisfaction, and retention. This study investigated two hypotheses: (1) the current level of work enthusiasm among senior nursing staff and its influencing factors, and (2) the relationship between work enthusiasm, psychological capital, and work–family conflict. Methods Design and Setting This multicentre cross-sectional study was conducted in southwestern China from May to July 2025. Convenience sampling was used to recruit 814 senior nurses from 15 hospitals. The study was reported in accordance with the STROBE guidelines. Participants The study population consisted of senior nurses. The sample size was calculated using G*Power version 3.1.9.7. Logistic regression analysis was performed with a test power (1-β) of 0.80, significance level α = 0.05, odds ratio of 1.3, and a 15% estimated dropout rate. The minimum required sample size was 731. Data were collected using electronic questionnaires designed and distributed through the Wenjuanxing platform ( www.wjx.cn ). The questionnaire cover page included explanatory text outlining the study invitation, objectives, significance, and confidentiality principles. A pilot survey was conducted before data collection to assess the questionnaire’s clarity, comprehensibility, and potential technical or editorial issues. After obtaining the necessary approvals and coordinating with relevant departments, the research team contacted nursing human resource managers at 15 hospitals to distribute the electronic questionnaire. Hospital administrators distributed the questionnaire to eligible nurses via social media platforms such as WeChat and QQ. Participation was voluntary, with no consequences for non-participation. Each IP address could submit only one questionnaire, and incomplete questionnaires were blocked, ensuring no missing data across study variables. Inclusion and Exclusion Criteria Inclusion criteria: (1) registered nurses; (2) at least 10 years of clinical experience or age ≥ 35 years[ 8 ]; and (3) provision of informed consent with voluntary participation.. Exclusion criteria:(1) trainee nurses; (2) nurses who had been absent from work within the previous six months owing to sick leave, maternity leave, or comparable reasons. Instruments The study employed four research instruments: a general information questionnaire, the Work Engagement Scale, the Nursing Psychological Capital Scale, and the Work–Family Conflict Scale.The Psychological Capital Scale was used solely for non-commercial academic research purposes. The validated Chinese version was adopted without any modification, and appropriate citations to the original and Chinese validation studies were provided. Demographic Questionnaire The questionnaire was designed by the research team and covered the following variables: gender, age, years of service, religious affiliation, marital status, number of children, highest education level, professional title, position, average monthly income, employment status, department of assignment, frequency of night shifts, hospital grade, hospital type, self-rated health status, and job satisfaction. Utrecht Work Engagement Scale,UWES This study employed the Utrecht Work Engagement Scale (UWES), originally developed by Schaufeli[ 1 ] et al., using the Chinese version adapted by Zhang Yiwen[ 29 ] et al.The scale includes three dimensions: vigour (six items), dedication (five items), and absorption (six items), for a total of 17 items.The scale uses a 7-point Likert format (1 = never, 7 = always), producing a total score range of 17–119, with higher scores reflecting greater work engagement.The mean total score was used to classify engagement levels: ≤2 indicates low engagement, 2–4 indicates moderate engagement, and ≥ 4 indicates high engagement.In this study, the scale demonstrated high reliability, with a Cronbach's α coefficient of 0.960. Nurses' Psychological Capital Scale This study employed the Nurse Psychological Capital Scale, developed by Yuan Zhongqing et al. based on the theory of positive organizational behavior[ 30 ].The scale consists of six dimensions: Hope (7 items), Collaborative Communication (6 items), Emotional Intelligence (5 items), Sense of Responsibility (4 items), Resilience (4 items), and Self-Confidence (4 items), totaling 30 items.The scale uses a 6-point Likert format, ranging from 1 (strongly disagree) to 6 (strongly agree).This yields a total score range of 30–180, with higher scores indicating greater psychological capital.The mean total score was used to classify psychological capital levels: low, moderate, or high, represented by color intensity, with red indicating the highest level.The scale demonstrated excellent reliability in this study, with a Cronbach's α coefficient of 0.974. Work-Family Conflict Scale, WAFCS This study employed the Work-Family Conflict Scale, developed by Netemeyer[ 19 ] et al. and adapted for Chinese use by Wang Xingwen[ 31 ] et al.The scale includes two dimensions: Work-Family Conflict (WFC, 5 items) and Family-Work Conflict (FWC, 5 items), totaling 10 items.The scale uses a 7-point Likert format (1 = strongly disagree, 7 = strongly agree), producing a total score range of 10–70, with higher scores indicating greater work-family conflict.The scale demonstrated good reliability in this study, with a Cronbach's α of 0.895. Data Analysis Data were entered using Epidata 3.0 and subsequently analyzed with IBM SPSS Statistics 26.0.Quantitative data were expressed as mean ± standard deviation after normality testing, while qualitative data were reported as frequencies and percentages.T-tests and one-way ANOVA were used to compare work engagement across different demographic characteristics among senior nurses.Pearson correlation analysis was conducted to examine the associations among work engagement, psychological capital, and work-family conflict.Stepwise multiple linear regression was performed to identify the main factors affecting work engagement.Unless otherwise specified, the significance level was set at α = 0.05 for all analyses. Ethical Considerations This study was conducted in accordance with the Declaration of Helsinki.The study was approved by the Ethics Committee of Leshan People's Hospital (Approval No. LYLL [2025] KY 125).All participants provided informed consent and voluntarily enrolled, having been fully informed of the study objectives and relevant details before participation. Results GeneralCharacteristics of Participants A total of 914 questionnaires were collected. After excluding 100 invalid responses (e.g., age discrepancies such as 4 or 12 years), 814 valid questionnaires were included, resulting in a valid response rate of 89.1%.Of the 814 senior nurses included in the final analysis, 789 (96.9%) were female. The largest age group was 35–45 years, comprising 509 participants (62.5%), and most had 10–19 years of service (562, 69.0%).Most participants reported no religious affiliation (778, 95.6%), were married (730, 89.7%), and had one child (493, 60.6%).Approximately half of the participants served as charge nurses (382, 46.9%), and contract employment was the most common arrangement (545, 67.0%).Most participants worked in tertiary hospitals (579, 71.1%), and more than half reported basic satisfaction with their current profession (445, 54.7%) (Table 1). Table 1 Comparison of Work Engagement Scores by Socio-Demographic Characteristics (n=814) Characteristics Categories N （ % ） UWES score t/F P Sex Male 25（3.1） 69.08±19.65 -0.828 0.408 Female 789（96.9） 72.62±21.11 Age(years) ＜35years 184（22.6） 69.18±21.52 10.238 0.000 35-45years 509（62.5） 71.95±21.04 ＞45years 121（14.9） 79.94±18.74 Working years ＜10years 16（2.0） 67.44±20.99 7.76 0.000 10-19years 562（69.0） 70.53±21.05 20-29years 184（22.6） 76.29±19.84 ≥30years 52（6.4） 82.15±21.47 Religious afliation Yes 36（4.4） 71.92±20.86 -0.174 0.862 None 778（95.6） 72.54±21.09 Marital status Married 730（89.7） 73.26±21.11 5.159 0.006 Single 30（3.7） 69.40±18.23 Divorced or widowed 54（6.6） 64.09±20.25 Number of children（Number） 0 48（5.9） 68.69±17.61 2.007 0.135 1 493（60.6） 71.89±21.91 ≥2 273（33.5） 74.31±19.95 Highest qualification College diploma or below 178（21.9） 72.29±22.26 -0.163 0.871 Bachelor's degree or above 636（78.1） 72.58±20.73 Professional title Nurse 162（19.9） 73.13±23.34 8.658 0.000 Senior Registered Nurse 555（68.2） 70.95±20.75 Deputy Chief Nurse and above 97（11.9） 80.45±16.76 Position Responsible Nurse 382（46.9） 68.56±21.23 9.106 0.000 Responsible Team Leader 174（21.4） 72.66±21.00 General Affairs or Office Nurse 110（13.5） 76.06±20.90 Head Nurse 127（15.6） 79.58±18.63 Head of Nursing Department / Deputy Head of Nursing Department 21（2.6） 81.86±16.88 Average monthly income（CNY） ＜5000 299（36.7） 69.16±22.18 7.664 0.001 5001-8000 444（54.5） 73.80±20.06 ＞8000 71（8.7） 78.56±20.37 Employment Arrangements Contract 545（67.0） 71.06±21.52 4.701 0.009 Compilation 262（32.2） 75.21±19.93 Others 7（0.8） 84.86±12.80 Department Internal Medicine 263（32.3） 71.67±22.50 2.772 0.005 Surgery 158（19.4） 73.13±18.90 Obstetrics and Gynaecology 61（7.5） 72.18±22.91 Paediatrics 39（4.8） 75.51±20.48 Outpatient Department 30（3.7） 67.90±21.66 Emergency Department 42（5.2） 67.17±18.74 Intensive Care Unit 52（6.4） 66.54±22.88 Operating theatre 46（5.7） 82.89±15.48 Others 123（15.1） 74.34±20.12 Number of night shifts (times per month) 0time 371（45.6） 76.12±20.57 12.967 0.000 1-2times 104（12.8） 76.74±20.72 3-4times 97（11.9） 69.29±21.55 ＞4times 242（29.7） 66.47±20.25 Hospital Grade Tertiary Class 579（71.1） 72.37±20.49 -0.309 0.757 Secondary/Primary Care Hospitals 235（28.9） 72.87±22.45 Hospital Type General Hospital 738（90.7） 72.89±20.92 1.597 0.111 Specialist hospital 76（9.3） 68.84±22.23 Self-Assessment of Health Status Very good 215（26.4） 84.80±21.28 36.025 0.000 Fairly good 289（35.5） 72.11±18.50 Generally 265（32.5） 65.24±19.02 Poor 42（5.2） 59.79±18.46 Very poor 3（0.4） 52.33±24.58 Job satisfaction Extremely dissatisfied 20（2.5） 72.00±31.76 94.935 0.000 Not satisfied 47（5.8） 50.38±18.85 Indescribable 140（17.2） 58.52±14.96 Generally satisfied 445（54.7） 72.00±17.30 Very satisfied 162（19.9） 92.49±16.89 Abbreviations : UWES, Utrecht Work Engagement Scale; CNY, Chinese Yuan. Differences in work engagement based on research variables Results from t-tests and one-way analysis of variance revealed significant differences in work engagement among senior nurses across multiple factors, including age, years of service, marital status, professional title, position, average monthly income, employment status, department, frequency of night shifts, self-rated health, and job satisfaction ( P < 0.05) (Table 1). Analysis of Work Engagement, Psychological Capital and Work-Family Conflict The results showed that the overall work engagement score was 72.51 ± 21.06 (mean = 4.27 ± 1.24), indicating a high level. Dimension scores were: vigour 23.94 ± 7.89, dedication 22.41 ± 6.54, and absorption 26.16 ± 7.63. The total psychological capital score was 143.16 ± 20.91 (mean = 4.77 ± 0.70), reflecting a high level overall. Dimension scores were: Hope 31.34 ± 6.05, Collaborative Communication 29.23 ± 4.33, Emotional Intelligence 24.63 ± 3.53, Sense of Responsibility 19.50 ± 2.92, Resilience 19.34 ± 3.18, and Self-Confidence 19.12 ± 3.30. The total work-family conflict score was 24.65 ± 10.52, indicating a moderate level, with family-to-work conflict 10.30 ± 5.61 and work-to-family conflict 14.35 ± 6.80 (Table 2). Table 2 Descriptive Statistics for the Utrecht Work Engagement Scale, Nurses' Psychological Capital Scale, and Work-Family Conflict Scale (n=814) Variables Min Max M SD Vitality Dimension 6 42 23.94 7.89 Dimension of Devotion 5 35 22.41 6.54 Focus Dimension 6 42 26.16 7.63 Total Score for UWES 17 119 72.51 21.06 Overall Average Score for UWES 1 7 4.27 1.24 Dimension of Hope 7 42 31.34 6.05 Collaborative Communication Dimension 6 36 29.23 4.33 Emotional Intelligence Dimension 5 30 24.63 3.53 Sense of Responsibility Dimension 4 24 19.50 2.92 Resilience Dimension 4 24 19.34 3.18 Confidence Dimension 4 24 19.12 3.30 Total Score for Psychological Capital 30 180 143.16 20.91 Average score for Psychological Capital 1 6 4.77 0.70 FWC Dimension 5 32 10.30 5.61 WFC Dimension 5 30 14.35 6.80 Total Score for WAFCS 10 62 24.65 10.52 Abbreviations : UWES, Utrecht Work Engagement Scale; WAFCS, Work-Family Conflict Scale; WFC, Work-Family Conflicts; FWC, Family–Work Conflicts. Analysis of the Relationship between Work Engagement, Psychological Capital, and Work-Family Conflict Pearson correlation analysis indicated a strong positive correlation between work engagement and overall psychological capital among senior nursing staff ( r = 0.780, P < 0.01). All individual dimensions of psychological capital were also positively correlated with work engagement ( P < 0.01). Conversely, work engagement was negatively correlated with total work–family conflict ( r = −0.366, P < 0.01), and each dimension of work–family conflict showed significant negative correlations with work engagement ( P < 0.01) (Table 3). Table 3: Correlation between Work Engagement and Psychological Capital and Work-Family Conflict (n=814) Total Score for Psychological Capital Dimension of Hope Collaborative Communication Dimension Emotional Intelligence Dimensions Sense of Responsibility Dimension Resilience Dimension Confidence Dimension Total Score for WAFCS FWC Dimension WFC Dimension Total Score for UWES .780** .804** .682** .634** .650** .655** .690** -.366** -.251** -.359** Vitality Dimension .749** .787** .648** .605** .613** .632** .656** -.397** -.253** -.406** Dimension of Devotion .763** .788** .668** .620** .632** .631** .680** -.365** -.236** -.370** Focus Dimension .724** .729** .640** .594** .618** .613** .642** -.286** -.228** -.254** Abbreviations : UWES, Utrecht Work Engagement Scale; WAFCS, Work-Family Conflict Scale; WFC, Work-Family Conflicts; FWC, Family–Work Conflicts. Primary factors influencing work engagement Stepwise multiple linear regression analysis identified several significant predictors of work engagement among senior nurses: total psychological capital score ( P < 0.001), job satisfaction ( P < 0.001), self-rated health status ( P = 0.001), frequency of night shifts per month ( P = 0.005), department affiliation [Emergency Department ( P = 0.005), Outpatient Department ( P = 0.028)], marital status [divorced or widowed ( P = 0.006)], and position [head nurse ( P = 0.014)] (Table 4). Table 4: Stepwise Linear Regression Analysis of Work Engagement Among Senior Nurses (n=814) Variables B SE Beta t P Constants -30.706 4.078 -7.529 0.000 Total Score for Psychological Capital 0.686 0.024 0.681 28.883 ＜0.001 Job satisfaction 3.076 0.569 0.13 5.406 ＜0.001 Self-Assessment of Health Status -1.883 0.546 -0.08 -3.451 0.001 Number of night shifts (times per month) -1.03 0.367 -0.064 -2.807 0.005 Emergency Department -5.544 1.989 -0.058 -2.788 0.005 Divorced or widowed -4.865 1.755 -0.058 -2.773 0.006 Head Nurse 3.13 1.269 0.054 2.466 0.014 Outpatient Department -5.2 2.363 -0.047 -2.201 0.028 R 2 =0.656, Adjusted R 2 =0.653, F =191.951, P ＜0.001; Abbreviations : B, Non-standardised coefficient; SE, Standard errors; Beta, Standardised coefficient. Discussion The final analysis included data from 814 senior nursing professionals. The overall work engagement score averaged 4.27 ± 1.24, indicating a high level. This value was slightly higher than that reported in a previous Chinese study (3.54 ± 1.49)[32], likely because all participants in the present study were senior nurses whose advanced professional status, intrinsic motivation, and organizational support contributed to higher engagement. These results align with Xu[33] et al.'s survey of 724 specialist nurses in Xiamen, where scores ranged from 4.09 to 4.65 across dimensions, with job recognition scoring lowest (4.09) and work attitude highest (4.65). This suggests that experienced nurses, regardless of seniority or specialization, demonstrate elevated work engagement. Similarly, Holly Wei[34] et al. reported American nurses' work engagement scores ranging from 3.98 to 4.11, highlighting the influence of educational attainment and work environment. Such differences may reflect cultural contexts, healthcare system structures, and the distinct professional identity of senior Chinese nurses. In conclusion, senior and specialist nurses, particularly those with a strong professional identity, tend to show higher work engagement. The high engagement observed in this study underscores both the positive professional orientation of senior nurses in Southwest China and the critical role of psychological capital and supportive work environments in maintaining engagement. This study found a significant positive correlation between senior nurses' work engagement and psychological capital, with psychological capital identified as a key influencing factor. This finding aligns with research from South Korea, which showed that positive psychological capital not only directly predicts work engagement but also exerts an indirect effect via "job crafting" [17].Psychological capital thus functions as a vital personal resource, promoting work motivation and enhancing engagement. Additional research indicates that psychological capital enhances problem-solving skills, boosts work engagement, and improves job performance[35]. Studies in China suggest that perceived organizational support can further elevate nurses' work engagement by increasing psychological capital[36]. A review by Aungsuroch[37] et al. emphasizes that personal resources—such as self-efficacy, hope, optimism, and resilience—are important antecedents of nurses' work engagement, providing comprehensive support for the link between psychological capital and engagement. Notably, most previous studies have focused on general or mixed-seniority nurses, with limited research specifically targeting senior nurses. From the Job Demands-Resources (JD-R) perspective, senior nurses generally demonstrate higher professional self-efficacy, resilience, and a strong sense of purpose, enabling them to effectively convert psychological capital into sustained vigour, dedication, and absorption—the three dimensions of work engagement. This may explain the pronounced influence of psychological capital on work engagement observed among senior nursing staff in this study. The present study found a significant negative correlation between work engagement and work-family conflict among senior nurses, consistent with prior research. Evidence from Japan suggests that work-family conflict can reduce service attitudes, lower nursing engagement, and increase turnover risk[38] Additionally, work-family conflict may impair the quality of nursing care, reduce staff dedication, and affect workforce sustainability and patient safety[39]. Research indicates that strong leadership resources can buffer the adverse effects of work-family conflict on engagement[37]. Domestic studies report that married female nurses experience higher work-family conflict when workplace and family support—such as colleague or supervisor support and childcare resources—are insufficient. This conflict is associated with reduced motivation and increased intentions to leave[40]. High work-family conflict correlates with lower work engagement and higher occupational burnout. This study proposes that work engagement may mediate the relationship between work-family conflict and nurses’ self-rated health, a mechanism particularly relevant for senior nurses managing multiple roles[41]. Senior nurses face cumulative stress from advanced clinical responsibilities, supervisory duties, and non-standard shifts, increasing their vulnerability to the motivational costs of work-family conflict. According to the Job Demands-Resources (JD-R) theory, work-family conflict, as a job demand, can impede recovery and reduce motivation and engagement, whereas job resources—such as family support, scheduling autonomy, and social support—can mitigate these negative effects. The present study found that job satisfaction is a significant predictor of work engagement among senior nurses, with higher satisfaction associated with greater engagement. This aligns with prior research showing that nurses with higher job satisfaction exhibit increased professional dedication, improved nursing quality, and reduced turnover intentions[34, 37]. Cao[42] et al. similarly reported a positive relationship between job satisfaction and work engagement, with highly satisfied nurses demonstrating stronger motivation and commitment compared to those with lower satisfaction. However, Aiken[43] et al. noted that in some high-income countries, high job satisfaction does not always translate into elevated work engagement, due to staff shortages and heavy workloads. This discrepancy may reflect variations in nursing work environments influenced by geographic and cultural factors. Furthermore, in China, nurses who receive career development opportunities and organisational support tend to be more satisfied and engaged at work. The present study found that senior nurses with higher self-rated health exhibited greater work engagement. This aligns with the established view that personal health is a key determinant of nurses' work motivation and professional performance. Zhong[25] et al. indicate that nurses reporting better health demonstrate increased engagement, motivation, and professional dedication, as well as improved sleep quality, mental well-being, and overall life satisfaction. Conversely, nurses with poorer health are more prone to fatigue and professional disengagement. Garrosa[44] et al. reported a positive correlation between physical and mental health and work motivation and engagement. Interestingly, Letvak[45] et al. observed that some senior nurses sustain high work engagement despite poor self-reported health, likely due to strong professional commitment and extensive clinical experience. Cultural and organizational factors also contribute: in China, senior nurses often bear heavy frontline and managerial responsibilities, increasing fatigue and reducing engagement. In contrast, senior nurses in some Western countries primarily occupy managerial and educational roles, which involve less physical demand. Collectively, these findings underscore that good health supports sustained work motivation. In this study, self-rated health was identified as a significant predictor of work engagement among senior nurses, a group particularly susceptible to age-related physical strain, chronic fatigue, and prolonged occupational stress. The present study found that senior nurses working a higher number of night shifts per month exhibited lower work engagement. Frequent night shifts are associated with reduced engagement and increased emotional exhaustion. Our analysis revealed that excessive night shifts correlate with both decreased work engagement and elevated turnover intentions. These findings suggest that irregular work hours disrupt circadian rhythms, impair recovery, and negatively affect work motivation and staff retention[46]. Night shifts can compromise cognitive function, physical and mental health, and overall job satisfaction[47]. However, Van[48] et al. reported that, in certain nursing populations, increased night shift frequency did not significantly reduce work engagement, potentially due to differences in participant characteristics and healthcare settings. In China, senior nurses frequently undertake additional night shifts due to staffing shortages, which intensifies work strain. By contrast, nursing staff in several EU countries benefit from structured rostering systems and guaranteed rest periods, which mitigate the negative impact of night shifts on engagement. The study identified a significant difference in work engagement between divorced or widowed nurses and their married or single counterparts, with the former exhibiting lower engagement levels. This aligns with Xu[33] et al., who reported marital status as a significant predictor of work engagement. Among specialist nurses, married individuals generally show higher engagement than unmarried, divorced, or widowed colleagues. Sun[49] et al. also found that nurses with low perceived occupational benefits or engagement were more likely to be single, divorced, or widowed in China. Contrarily, international studies suggest marital status has minimal impact on engagement[37, 50]. Potential explanations include the high proportion of married nurses in study samples and the additional responsibilities senior nurses hold, such as mentorship, management, and care for complex patients. Divorce or widowhood may amplify stress from familial and professional obligations, reducing engagement. Cultural and social factors are also relevant; in China, spouses traditionally provide primary emotional and practical support, and their absence increases life stress, lowering energy and engagement. In contrast, in countries with strong social welfare and professional support systems, divorced or widowed nurses can access social services, peer support, and career counselling, which may mitigate the negative effects on work engagement. This study found that serving as a Head Nurse is a key determinant of work engagement. Head Nurses exhibited significantly higher engagement levels than Charge Nurses, Team Leaders, and Administrative Nurses, but showed no significant difference compared to Deputy Directors or Directors of Nursing. Xu[33] et al. reported that Head Nurses often have higher engagement than frontline clinical nurses, likely due to their managerial responsibilities and strong professional identity. Sun[49] et al. classified nurses in leadership roles as ‘high commitment/high reward,’ suggesting that managerial positions enhance work engagement. However, Van[51] and Schaufeli[52] et al. noted that managerial roles do not always correspond to higher engagement; some nurses experience burnout from administrative demands and cross-departmental coordination. Cultural and regional differences, as well as role definitions, may explain these discrepancies. In China, Head Nurses serve as departmental cores, balancing administrative, clinical, and teaching duties, which maintains close ties with frontline staff and supports high engagement[53]. In contrast, in some Western countries, Head Nurses focus mainly on administrative tasks with limited clinical involvement, potentially reducing engagement[54]. Organisational support and resource allocation also influence engagement: Chinese ward managers often benefit from promotion, training, and resources, whereas Charge and Administrative Nurses face resource constraints due to clinical and administrative burdens, leading to a mismatch between workload and engagement. In Western systems, limited resources and heavy administrative duties may similarly reduce managerial engagement[20]. Departmental affiliation, specifically whether nurses work in the Emergency or Outpatient Department, is a key determinant of work engagement. In this study, mean engagement scores in the Emergency and Outpatient Departments were slightly higher than those in the ICU (66.54 ± 22.88) but lower than in other departments. Consistent with Hu[55] et al., emergency nurses are exposed to workplace psychological violence, prolonged working hours, and role strain, which negatively affect work engagement. Zhang[20] et al. also reported that emergency and outpatient nurses face high work pressure, rapid patient turnover, and staffing shortages, increasing the risk of burnout and reducing engagement. However, some international studies suggest contrasting outcomes: during crises, emergency nurses must maintain intense focus due to high patient volume and turnover[56], and outpatient nurses, with frequent patient interactions, may sustain higher engagement levels[37]. Possible explanations include: (1) the relatively low proportion of emergency and outpatient nurses in the sample; (2) high-intensity workloads with unpredictable patient conditions, high family expectations, and frequent emergencies, which elevate emotional labor and psychological stress; and (3) limited human resources and managerial support, with frequent overtime and irregular shifts reducing recovery time. Additionally, these departments manage large patient populations and experience frequent medical disputes and complaints. Domestic hospitals often lack robust protective systems, imposing significant unseen pressures on nurses, whereas international hospitals typically implement comprehensive protective measures, mitigating such risks and supporting work engagement. Strengths and Limitations of the Work This study has several notable strengths. First, it focuses on senior nurses, a cohort that plays a critical role in clinical practice, management, and mentorship but is often overlooked in research on work engagement. Studying this group provides novel insights into the factors affecting experienced nurses’ engagement. Second, the study examines multiple determinants, including psychological capital, job satisfaction, self-rated health, marital status, frequency of night shifts, position level, and department type, offering a multidimensional perspective on work engagement. Third, the large sample size enhances statistical power and reliability, improving the generalisability of the findings to similar healthcare settings. However, several limitations should be acknowledged. The cross-sectional design prevents causal inference, highlighting the need for longitudinal or interventional studies to verify causal relationships. The use of self-administered questionnaires may introduce social desirability and common method biases. Although the sample was drawn from southwestern China, participant distribution was uneven, with most participants from Leshan and Chengdu, which may limit generalisability to other cultural or institutional contexts. Finally, other potential determinants of work engagement—such as organisational climate, leadership style, and patient outcomes—remain unexplored, underscoring the need for further research. Implications for Nursing Management This study offers comprehensive insights into nursing management practices. First, hospital administrators should cultivate senior nurses’ psychological capital through resilience training, positive psychology interventions, and mentoring programs to enhance work engagement and motivation. Second, given the negative effects of frequent night shifts and work-family conflict, staffing levels and rostering systems should be optimised to reduce night-shift burdens and promote work-life balance. Third, managers should improve career progression pathways and recognition mechanisms to strengthen job satisfaction and professional identity, particularly for senior nurses balancing clinical and managerial responsibilities. Special attention should also be given to nurses experiencing divorce or bereavement, as they may require additional organisational support and psychological counselling to sustain engagement. Nursing managers, especially ward managers, should be provided with adequate resources and organisational trust to effectively fulfil leadership roles and foster team commitment. Finally, departments with lower engagement levels, such as emergency and outpatient units, require targeted strategies, including enhanced organisational support, balanced workload distribution, and expanded professional development opportunities. A multi-tiered management approach—encompassing individual resource support, organisational policy refinement, and tailored departmental strategies—can effectively sustain and enhance senior nurses’ work engagement. Conclusion This study investigates the current state of work engagement among senior nursing staff and its influencing factors. Findings indicate that although overall work engagement is high, it is affected by multiple individual and occupational factors. Psychological capital, job satisfaction, and self-rated health are positively correlated with work engagement, serving as key protective factors. In contrast, work-family conflict and frequent night shifts negatively impact engagement. Differences were also observed based on marital status, position, and department. Specifically, married or unmarried nurses, ward managers, and those working in non-emergency or outpatient departments exhibited higher engagement levels. Comprehensive analysis suggests that individual psychological resources, professional identity, and a supportive work-life balance are crucial for sustaining engagement. Conversely, excessive night shifts, insufficient family support, and unclear role expectations may hinder engagement. Therefore, senior nursing management should focus on enhancing psychological capital and career development, optimising night-shift scheduling, improving the work environment, and addressing the specific needs of staff according to marital status and departmental affiliation. Institutional frameworks should also strengthen the motivational role of managerial positions, such as ward managers, leveraging their exemplary and guiding functions. Future research should employ longitudinal designs to evaluate the effects of interventions on work engagement, providing evidence-based guidance to enhance nursing workforce stability and healthcare service quality. Declarations Acknowledgments We would like to extend our gratitude to all those who participated in the research. Author Contributions J.Z and L.M.L contributed to research design and fieldwork. J.Z drafted the manuscript and revised it critically. L.M.L conducted data analysis and assisted in drafting. W.X.M and Y.X were responsible for questionnaire administration and contributed to data collation and analysis. H.L and C.H.G conducted questionnaire surveys and data collection. Q.L.C and X.Y provided resource support, manuscript review, editing, and overall supervision. Funding No funding was received for this manuscript. Data Availability Statement The data that support the fndings of this study are available from the corresponding author upon reasonable request. Clinical trial number Not applicable. Ethics Approval and Consent to Participate The study was subject to a rigorous review process and was approved by the Ethics Committee of Leshan People's Hospital (Approval No.: LYLL [2025] KY 125). Informed consent was obtained from all participants. Consent for publication Not applicable. Competing interests The authors declare no conficts of interest. References Schaufeli WB, Salanova M, González-romá V, Bakker AB. 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Supplementary Files SupplementaryFileS1PsychologicalCapitalScaleStatement.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 21 Jan, 2026 Editor assigned by journal 19 Jan, 2026 Editor invited by journal 30 Dec, 2025 Submission checks completed at journal 29 Dec, 2025 First submitted to journal 29 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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12:58:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":69622,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFileS1PsychologicalCapitalScaleStatement.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8423153/v1/a528017ca9dc8cd0a9ebfd26.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Psychological Capital and Work–Family Conflict as Predictors of Work Engagement Among Senior Nurses: A Multicenter Cross-Sectional Study in Southwest China","fulltext":[{"header":"Introduction","content":"\u003cp\u003eWork engagement is defined as a positive, energetic psychological state in the workplace,characterized by high vigor and strong professional identity.Its core dimensions include vitality, dedication, and focus[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].In nursing practice, work engagement refers to a proactive and well-integrated psychological state.Higher engagement levels are strongly associated with lower turnover intentions, greater job satisfaction, and improved nursing service quality[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].Nurses with high engagement are more likely to show proactive behavior, maintain resilience under pressure, and align with organizational goals[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].Amid increasing clinical complexity and staff shortages, enhancing work engagement has become a key strategy for healthcare institutions to sustain high performance and improve nurse retention[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].Nurse work engagement is closely linked to fewer adverse events, better patient safety, and more supportive nursing environments[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].Furthermore, work engagement improves nurses\u0026rsquo; well-being, reduces occupational stress, and promotes mental health, especially in high-intensity clinical settings[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].These findings highlight the central role of work engagement in nursing and emphasize the need for managers to create supportive environments and provide resources that sustain and enhance engagement.\u003c/p\u003e \u003cp\u003eNurses are the largest professional group in the healthcare system, accounting for about 59% of the workforce.They also play a key role in hospital resource management[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].Senior nurses are usually defined as those with at least 10 years of clinical experience or aged 35 years and older, occupying key positions in the healthcare system[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].With extensive clinical expertise, advanced skills, and deep institutional knowledge, they guide patient care and promote team collaboration.They often serve as mentors or informal leaders, contributing significantly to professional development, continuity of care, and organizational resilience.In high-pressure or emergency settings, their clinical judgment and leadership are especially valuable.However, senior nurses face many challenges in fulfilling their duties.They must continuously adapt to the demands of new technologies.They also balance nursing research with mentoring junior nurses, which increases their workload.Prolonged high-intensity and shift work often lead to chronic fatigue.Limited promotion opportunities and lack of recognition further increase nurses\u0026rsquo; turnover intentions[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].Over time, these factors may gradually erode senior nurses\u0026rsquo; motivation and commitment.Conflicts between long-term work and family responsibilities may intensify emotional exhaustion and reduce job satisfaction[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].The entry of new talent into nursing is declining due to three factors.First, China\u0026rsquo;s delayed retirement age has an impact.Second, declining birth rates contribute.Third, employment rates for nursing graduates remain low.As a result, senior nurses will remain the backbone of the workforce[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].However, research indicates that the loss of senior nurses contributes significantly to the youth-dominated nursing workforce in China[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].In addition, China\u0026rsquo;s nursing workforce faces unique challenges.For example, nurses in southwestern China face specific difficulties.Senior nurses manage clinical leadership while coping with age-related pressures.Married nurses working away from home struggle to balance family and professional commitments[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].Nursing management in China often prioritizes skills over motivation, with excessive focus on procedural compliance at the expense of intrinsic motivation.This approach increases inefficiency and worsens staff turnover.Therefore, nursing administrators and healthcare leaders should prioritize strategies that support senior nurses\u0026rsquo; engagement, well-being, and retention.\u003c/p\u003e \u003cp\u003ePsychological capital refers to positive psychological states developed during individual growth, comprising four components: hope, optimism, resilience, and self-efficacy[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].Extensive research shows that psychological capital is a key personal factor influencing nurses\u0026rsquo; work engagement, with all four components positively correlated with engagement[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].Further studies suggest that psychological capital significantly enhances clinical nurses\u0026rsquo; work engagement, with job crafting serving as a mediator in this relationship[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].Work\u0026ndash;family conflict is a specific type of role conflict arising from incompatible demands between work and family responsibilities.Excessive workload and time demands conflicting with family duties significantly contribute to interpersonal discord.Such conflicts reduce nurses\u0026rsquo; work engagement and overall well-being[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].Healthcare professionals experience conflict pressures not only from patient care but also from societal expectations, child-rearing concerns, and career advancement demands[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].Zhang[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] et al. reported that higher levels of work\u0026ndash;family conflict are strongly associated with greater burnout, lower work engagement, and reduced well-being.Work\u0026ndash;family conflict is a significant predictor of occupational fatigue and reduced well-being, while social support and positive coping buffer these effects[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].Yan[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] et al. emphasized that when social and organizational support is lacking, frequent patient mistreatment exacerbates emotional exhaustion, which negatively affects family life.This intensifies work\u0026ndash;family conflict and decreases work engagement.In summary, psychological capital and work\u0026ndash;family conflict are key determinants of work engagement, with the former exerting a positive influence and the latter a negative effect.Strong psychological capital mitigates the negative effects of work\u0026ndash;family conflict, supporting higher levels of work engagement among nurses.\u003c/p\u003e \u003cp\u003eAlthough research on nurses' work engagement has increased in recent years, most studies are concentrated in economically developed eastern and coastal regions and mainly focus on general or junior nurses.As a result, relatively little attention has been given to senior nurses and those working in resource-limited settings[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].Senior nurses may differ from younger nurses in career trajectories, perceived stress, and mechanisms of work engagement.However, current research has not adequately examined these differences.Furthermore, southwestern China has distinct sociocultural contexts and faces urgent challenges, including unequal healthcare resource distribution and an ageing nursing workforce.Yet, relevant studies in this region remain scarce[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].Few studies have systematically examined how psychological capital (individual resources) and work\u0026ndash;family conflict (environmental demands) interact to influence nursing work engagement.This research gap limits the development of regionally adaptive strategies and hampers efforts to enhance nurse retention and achieve sustainable workforce development.Therefore, research focusing on senior nurses in southwestern China is urgently needed and critically important, providing a scientific basis for evidence-based management and policy development.\u003c/p\u003e\n\u003ch3\u003eIntegrated Theoretical Framework: Benner’s Novice to Expert Theory and the JD-R Model\u003c/h3\u003e\n\u003cp\u003ePatricia Benner’s 1984 “novice to expert” theory provides a seminal foundation for studying nursing career development.The theory proposes that clinical competence develops through five distinct stages: novice, advanced beginner, competent, proficient, and expert[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].According to Benner’s framework, nurses progress sequentially through these five distinct phases of clinical development.Each stage reflects differences in nurses’ accumulated experience, critical thinking, and situational understanding.Benner emphasised that professional competence is built mainly through accumulated practice in real clinical settings and intuitive decision-making, rather than solely on theoretical knowledge.Senior nurses are typically distinguished by proficiency or expertise, demonstrated through advanced clinical judgment, leadership skills, and a comprehensive nursing perspective.However, senior nurses’ work engagement does not rely solely on clinical expertise.External and psychosocial factors—such as organisational support, psychological capital, and work–family conflict—also significantly affect nurses’ work motivation and overall well-being.\u003c/p\u003e \u003cp\u003eTo clarify these dynamic relationships, the Job Demands-Resources (JD-R) model provides a complementary perspective.The model suggests that employee engagement arises from a balance between job demands (e.g., workload, night shifts, work–family conflict) and job resources (e.g., autonomy, social support, psychological capital).When resources adequately counter job demands, engagement and performance improve; in contrast, inadequate resources can result in reduced engagement and occupational burnout[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study integrates Benner’s theory with the JD-R model to establish a comprehensive framework.Benner’s theory contextualises the professional development stages of senior nurses, highlighting their competence and clinical authority.The JD-R model explains how job demands and resources interact at advanced stages, potentially sustaining or undermining work engagement.Integrating both models enhances understanding of senior nurses’ work engagement and highlights the need for targeted interventions tailored to their career stage and psychosocial context.The study reinforces the importance of conceptualising senior nurses as a distinct research group and stresses the need for personalised strategies to enhance their motivation, job satisfaction, and retention.\u003c/p\u003e \u003cp\u003eThis study investigated two hypotheses: (1) the current level of work enthusiasm among senior nursing staff and its influencing factors, and (2) the relationship between work enthusiasm, psychological capital, and work–family conflict.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003ch2\u003eDesign and Setting\u003c/h2\u003e\u003cp\u003eThis multicentre cross-sectional study was conducted in southwestern China from May to July 2025. Convenience sampling was used to recruit 814 senior nurses from 15 hospitals. The study was reported in accordance with the STROBE guidelines.\u003c/p\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eThe study population consisted of senior nurses. The sample size was calculated using G*Power version 3.1.9.7. Logistic regression analysis was performed with a test power (1-β) of 0.80, significance level α\u0026thinsp;=\u0026thinsp;0.05, odds ratio of 1.3, and a 15% estimated dropout rate. The minimum required sample size was 731. Data were collected using electronic questionnaires designed and distributed through the Wenjuanxing platform (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"http://www.wjx.cn\" target=\"_blank\"\u003ewww.wjx.cn\u003c/a\u003e\u003c/span\u003e\u003cspan address=\"http://www.wjx.cn\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). The questionnaire cover page included explanatory text outlining the study invitation, objectives, significance, and confidentiality principles. A pilot survey was conducted before data collection to assess the questionnaire\u0026rsquo;s clarity, comprehensibility, and potential technical or editorial issues. After obtaining the necessary approvals and coordinating with relevant departments, the research team contacted nursing human resource managers at 15 hospitals to distribute the electronic questionnaire. Hospital administrators distributed the questionnaire to eligible nurses via social media platforms such as WeChat and QQ. Participation was voluntary, with no consequences for non-participation. Each IP address could submit only one questionnaire, and incomplete questionnaires were blocked, ensuring no missing data across study variables.\u003c/p\u003e\n\u003ch3\u003eInclusion and Exclusion Criteria\u003c/h3\u003e\n\u003cp\u003eInclusion criteria: (1) registered nurses; (2) at least 10 years of clinical experience or age\u0026thinsp;\u0026ge;\u0026thinsp;35 years[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]; and (3) provision of informed consent with voluntary participation.. Exclusion criteria:(1) trainee nurses; (2) nurses who had been absent from work within the previous six months owing to sick leave, maternity leave, or comparable reasons.\u003c/p\u003e\n\u003ch3\u003eInstruments\u003c/h3\u003e\n\u003cp\u003eThe study employed four research instruments: a general information questionnaire, the Work Engagement Scale, the Nursing Psychological Capital Scale, and the Work\u0026ndash;Family Conflict Scale.The Psychological Capital Scale was used solely for non-commercial academic research purposes. The validated Chinese version was adopted without any modification, and appropriate citations to the original and Chinese validation studies were provided.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDemographic Questionnaire\u003c/h2\u003e \u003cp\u003eThe questionnaire was designed by the research team and covered the following variables: gender, age, years of service, religious affiliation, marital status, number of children, highest education level, professional title, position, average monthly income, employment status, department of assignment, frequency of night shifts, hospital grade, hospital type, self-rated health status, and job satisfaction.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eUtrecht Work Engagement Scale,UWES\u003c/h3\u003e\n\u003cp\u003eThis study employed the Utrecht Work Engagement Scale (UWES), originally developed by Schaufeli[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] et al., using the Chinese version adapted by Zhang Yiwen[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] et al.The scale includes three dimensions: vigour (six items), dedication (five items), and absorption (six items), for a total of 17 items.The scale uses a 7-point Likert format (1\u0026thinsp;=\u0026thinsp;never, 7\u0026thinsp;=\u0026thinsp;always), producing a total score range of 17\u0026ndash;119, with higher scores reflecting greater work engagement.The mean total score was used to classify engagement levels: \u0026le;2 indicates low engagement, 2\u0026ndash;4 indicates moderate engagement, and \u0026ge;\u0026thinsp;4 indicates high engagement.In this study, the scale demonstrated high reliability, with a Cronbach's α coefficient of 0.960.\u003c/p\u003e\n\u003ch3\u003eNurses' Psychological Capital Scale\u003c/h3\u003e\n\u003cp\u003eThis study employed the Nurse Psychological Capital Scale, developed by Yuan Zhongqing et al. based on the theory of positive organizational behavior[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].The scale consists of six dimensions: Hope (7 items), Collaborative Communication (6 items), Emotional Intelligence (5 items), Sense of Responsibility (4 items), Resilience (4 items), and Self-Confidence (4 items), totaling 30 items.The scale uses a 6-point Likert format, ranging from 1 (strongly disagree) to 6 (strongly agree).This yields a total score range of 30\u0026ndash;180, with higher scores indicating greater psychological capital.The mean total score was used to classify psychological capital levels: low, moderate, or high, represented by color intensity, with red indicating the highest level.The scale demonstrated excellent reliability in this study, with a Cronbach's α coefficient of 0.974.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eWork-Family Conflict Scale, WAFCS\u003c/h2\u003e \u003cp\u003eThis study employed the Work-Family Conflict Scale, developed by Netemeyer[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] et al. and adapted for Chinese use by Wang Xingwen[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] et al.The scale includes two dimensions: Work-Family Conflict (WFC, 5 items) and Family-Work Conflict (FWC, 5 items), totaling 10 items.The scale uses a 7-point Likert format (1\u0026thinsp;=\u0026thinsp;strongly disagree, 7\u0026thinsp;=\u0026thinsp;strongly agree), producing a total score range of 10\u0026ndash;70, with higher scores indicating greater work-family conflict.The scale demonstrated good reliability in this study, with a Cronbach's α of 0.895.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eData were entered using Epidata 3.0 and subsequently analyzed with IBM SPSS Statistics 26.0.Quantitative data were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation after normality testing, while qualitative data were reported as frequencies and percentages.T-tests and one-way ANOVA were used to compare work engagement across different demographic characteristics among senior nurses.Pearson correlation analysis was conducted to examine the associations among work engagement, psychological capital, and work-family conflict.Stepwise multiple linear regression was performed to identify the main factors affecting work engagement.Unless otherwise specified, the significance level was set at α\u0026thinsp;=\u0026thinsp;0.05 for all analyses.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003e This study was conducted in accordance with the Declaration of Helsinki.The study was approved by the Ethics Committee of Leshan People's Hospital (Approval No. LYLL [2025] KY 125).All participants provided informed consent and voluntarily enrolled, having been fully informed of the study objectives and relevant details before participation.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eGeneralCharacteristics of Participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 914 questionnaires were collected. After excluding 100 invalid responses (e.g., age discrepancies such as 4 or 12 years), 814 valid questionnaires were included, resulting in a valid response rate of 89.1%.Of the 814 senior nurses included in the final analysis, 789 (96.9%) were female. The largest age group was 35–45 years, comprising 509 participants (62.5%), and most had 10–19 years of service (562, 69.0%).Most participants reported no religious affiliation (778, 95.6%), were married (730, 89.7%), and had one child (493, 60.6%).Approximately half of the participants served as charge nurses (382, 46.9%), and contract employment was the most common arrangement (545, 67.0%).Most participants worked in tertiary hospitals (579, 71.1%), and more than half reported basic satisfaction with their current profession (445, 54.7%) (Table 1).\u003c/p\u003e\n\u003cp\u003eTable 1 Comparison of Work Engagement Scores by Socio-Demographic Characteristics (n=814)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"572\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCategories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003cem\u003e（\u003c/em\u003e\u003cem\u003e%\u003c/em\u003e\u003cem\u003e）\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUWES score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e25（3.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e69.08±19.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.828\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.408\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e789（96.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.62±21.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＜35years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e184（22.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e69.18±21.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e35-45years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e509（62.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e71.95±21.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＞45years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e121（14.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e79.94±18.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWorking years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＜10years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e16（2.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e67.44±20.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10-19years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e562（69.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e70.53±21.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20-29years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e184（22.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e76.29±19.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e≥30years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e52（6.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e82.15±21.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eReligious afliation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36（4.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e71.92±20.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.862\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e778（95.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.54±21.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e730（89.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e73.26±21.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30（3.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e69.40±18.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eDivorced or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e54（6.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e64.09±20.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNumber of children（Number）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e48（5.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e68.69±17.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e493（60.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e71.89±21.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e≥2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e273（33.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e74.31±19.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHighest qualification\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCollege diploma or below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e178（21.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.29±22.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.871\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBachelor's degree or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e636（78.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.58±20.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eProfessional title\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e162（19.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e73.13±23.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.658\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSenior Registered Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e555（68.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e70.95±20.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eDeputy Chief Nurse and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e97（11.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e80.45±16.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePosition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eResponsible Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e382（46.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e68.56±21.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eResponsible Team Leader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e174（21.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.66±21.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eGeneral Affairs or Office Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e110（13.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e76.06±20.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eHead Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e127（15.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e79.58±18.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eHead of Nursing Department / Deputy Head of Nursing Department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21（2.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e81.86±16.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAverage monthly income（CNY）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＜5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e299（36.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e69.16±22.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.664\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5001-8000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e444（54.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e73.80±20.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＞8000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e71（8.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e78.56±20.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEmployment Arrangements\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eContract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e545（67.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e71.06±21.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.701\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCompilation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e262（32.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e75.21±19.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7（0.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e84.86±12.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDepartment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eInternal Medicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e263（32.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e71.67±22.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.772\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSurgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e158（19.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e73.13±18.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eObstetrics and Gynaecology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e61（7.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.18±22.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePaediatrics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39（4.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e75.51±20.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eOutpatient Department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30（3.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e67.90±21.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eEmergency Department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e42（5.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e67.17±18.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eIntensive Care Unit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e52（6.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e66.54±22.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eOperating theatre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46（5.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e82.89±15.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e123（15.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e74.34±20.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNumber of night shifts (times per month)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e371（45.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e76.12±20.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.967\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1-2times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e104（12.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e76.74±20.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3-4times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e97（11.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e69.29±21.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＞4times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e242（29.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e66.47±20.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHospital Grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eTertiary Class\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e579（71.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.37±20.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.757\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSecondary/Primary Care Hospitals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e235（28.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.87±22.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHospital Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eGeneral Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e738（90.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.89±20.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.597\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSpecialist hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e76（9.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e68.84±22.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSelf-Assessment of Health Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eVery good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e215（26.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e84.80±21.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFairly good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e289（35.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.11±18.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eGenerally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e265（32.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e65.24±19.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e42（5.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e59.79±18.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eVery poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3（0.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e52.33±24.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eJob satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eExtremely dissatisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20（2.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.00±31.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e94.935\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNot satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e47（5.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e50.38±18.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eIndescribable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e140（17.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e58.52±14.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eGenerally satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e445（54.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.00±17.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eVery satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e162（19.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e92.49±16.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations\u003c/strong\u003e: UWES, Utrecht Work Engagement Scale; CNY, Chinese Yuan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDifferences in work engagement based on research variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResults from t-tests and one-way analysis of variance revealed significant differences in work engagement among senior nurses across multiple factors, including age, years of service, marital status, professional title, position, average monthly income, employment status, department, frequency of night shifts, self-rated health, and job satisfaction (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05) (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnalysis of Work Engagement, Psychological Capital and Work-Family Conflict\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results showed that the overall work engagement score was 72.51 ± 21.06 (mean = 4.27 ± 1.24), indicating a high level. Dimension scores were: vigour 23.94 ± 7.89, dedication 22.41 ± 6.54, and absorption 26.16 ± 7.63. The total psychological capital score was 143.16 ± 20.91 (mean = 4.77 ± 0.70), reflecting a high level overall. Dimension scores were: Hope 31.34 ± 6.05, Collaborative Communication 29.23 ± 4.33, Emotional Intelligence 24.63 ± 3.53, Sense of Responsibility 19.50 ± 2.92, Resilience 19.34 ± 3.18, and Self-Confidence 19.12 ± 3.30. The total work-family conflict score was 24.65 ± 10.52, indicating a moderate level, with family-to-work conflict 10.30 ± 5.61 and work-to-family conflict 14.35 ± 6.80 (Table 2).\u003c/p\u003e\n\u003cp\u003eTable 2 Descriptive Statistics for the\u0026nbsp;Utrecht Work Engagement Scale, Nurses' Psychological Capital Scale, and Work-Family Conflict Scale (n=814)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"533\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eMin\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eMax\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eVitality Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e23.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDimension of Devotion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e22.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFocus Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e26.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal Score for UWES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e72.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOverall Average Score for UWES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDimension of Hope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCollaborative Communication Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e29.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEmotional Intelligence Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSense of Responsibility Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eResilience Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eConfidence Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal Score for Psychological Capital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e143.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAverage score for Psychological Capital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFWC\u0026nbsp;Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWFC Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal Score for WAFCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations\u003c/strong\u003e: UWES, Utrecht Work Engagement Scale; WAFCS,\u0026nbsp;Work-Family Conflict Scale;\u0026nbsp;WFC,\u0026nbsp;Work-Family Conflicts;\u0026nbsp;FWC,\u0026nbsp;Family–Work Conflicts.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnalysis of the Relationship between Work Engagement, Psychological Capital, and Work-Family Conflict\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePearson correlation analysis indicated a strong positive correlation between work engagement and overall psychological capital among senior nursing staff (\u003cem\u003er\u003c/em\u003e = 0.780, \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.01). All individual dimensions of psychological capital were also positively correlated with work engagement (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.01). Conversely, work engagement was negatively correlated with total work–family conflict (\u003cem\u003er\u003c/em\u003e = −0.366, \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.01), and each dimension of work–family conflict showed significant negative correlations with work engagement (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.01) (Table 3).\u003c/p\u003e\n\u003cp\u003eTable 3: Correlation between Work Engagement and Psychological Capital and Work-Family Conflict (n=814)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\" width=\"722\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal Score for Psychological Capital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eDimension of Hope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCollaborative Communication Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eEmotional Intelligence Dimensions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSense of Responsibility Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eResilience Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eConfidence Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal Score for WAFCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFWC Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eWFC Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal Score for UWES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.780**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.804**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.682**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.634**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.650**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.655**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.690**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.366**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.251**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.359**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eVitality Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.749**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.787**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.648**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.605**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.613**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.632**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.656**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.397**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.253**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.406**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDimension of Devotion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.763**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.788**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.668**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.620**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.632**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.631**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.680**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.365**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.236**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.370**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFocus Dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.724**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.729**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.640**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.594**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.618**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.613**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e.642**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.286**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.228**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-.254**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations\u003c/strong\u003e: UWES, Utrecht Work Engagement Scale; WAFCS,\u0026nbsp;Work-Family Conflict Scale;\u0026nbsp;WFC,\u0026nbsp;Work-Family Conflicts;\u0026nbsp;FWC,\u0026nbsp;Family–Work Conflicts.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrimary factors influencing work engagement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStepwise multiple linear regression analysis identified several significant predictors of work engagement among senior nurses: total psychological capital score (\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt; 0.001), job satisfaction (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.001), self-rated health status (\u003cem\u003eP\u003c/em\u003e = 0.001), frequency of night shifts per month (\u003cem\u003eP\u003c/em\u003e = 0.005), department affiliation [Emergency Department (\u003cem\u003eP\u003c/em\u003e = 0.005), Outpatient Department (\u003cem\u003eP\u003c/em\u003e = 0.028)], marital status [divorced or widowed (\u003cem\u003eP\u003c/em\u003e = 0.006)], and position [head nurse (\u003cem\u003eP\u003c/em\u003e = 0.014)] (Table 4).\u003c/p\u003e\n\u003cp\u003eTable 4: Stepwise Linear Regression Analysis of Work Engagement Among Senior Nurses (n=814)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eConstants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-30.706\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-7.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal Score for Psychological Capital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.686\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.681\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e28.883\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eJob satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.569\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.406\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSelf-Assessment of Health Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.883\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-3.451\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNumber of night shifts (times per month)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.807\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEmergency Department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-5.544\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.989\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.788\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDivorced or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-4.865\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.755\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.773\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHead Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.269\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOutpatient Department\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-5.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e=0.656, Adjusted\u0026nbsp;\u003cem\u003eR\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e=0.653,\u0026nbsp;\u003cem\u003eF\u003c/em\u003e=191.951,\u0026nbsp;\u003cem\u003eP\u003c/em\u003e ＜0.001;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations\u003c/strong\u003e: B, Non-standardised coefficient; SE, Standard errors; Beta, Standardised coefficient.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe final analysis included data from 814 senior nursing professionals. The overall work engagement score averaged 4.27 ± 1.24, indicating a high level. This value was slightly higher than that reported in a previous Chinese study (3.54 ± 1.49)[32], likely because all participants in the present study were senior nurses whose advanced professional status, intrinsic motivation, and organizational support contributed to higher engagement. These results align with Xu[33] et al.'s survey of 724 specialist nurses in Xiamen, where scores ranged from 4.09 to 4.65 across dimensions, with job recognition scoring lowest (4.09) and work attitude highest (4.65). This suggests that experienced nurses, regardless of seniority or specialization, demonstrate elevated work engagement. Similarly, Holly Wei[34] et al. reported American nurses' work engagement scores ranging from 3.98 to 4.11, highlighting the influence of educational attainment and work environment. Such differences may reflect cultural contexts, healthcare system structures, and the distinct professional identity of senior Chinese nurses. In conclusion, senior and specialist nurses, particularly those with a strong professional identity, tend to show higher work engagement. The high engagement observed in this study underscores both the positive professional orientation of senior nurses in Southwest China and the critical role of psychological capital and supportive work environments in maintaining engagement.\u003c/p\u003e\n\u003cp\u003eThis study found a significant positive correlation between senior nurses' work engagement and psychological capital, with psychological capital identified as a key influencing factor. This finding aligns with research from South Korea, which showed that positive psychological capital not only directly predicts work engagement but also exerts an indirect effect via \"job crafting\" [17].Psychological capital thus functions as a vital personal resource, promoting work motivation and enhancing engagement. Additional research indicates that psychological capital enhances problem-solving skills, boosts work engagement, and improves job performance[35]. Studies in China suggest that perceived organizational support can further elevate nurses' work engagement by increasing psychological capital[36]. A review by Aungsuroch[37] et al. emphasizes that personal resources—such as self-efficacy, hope, optimism, and resilience—are important antecedents of nurses' work engagement, providing comprehensive support for the link between psychological capital and engagement. Notably, most previous studies have focused on general or mixed-seniority nurses, with limited research specifically targeting senior nurses. From the Job Demands-Resources (JD-R) perspective, senior nurses generally demonstrate higher professional self-efficacy, resilience, and a strong sense of purpose, enabling them to effectively convert psychological capital into sustained vigour, dedication, and absorption—the three dimensions of work engagement. This may explain the pronounced influence of psychological capital on work engagement observed among senior nursing staff in this study.\u003c/p\u003e\n\u003cp\u003eThe present study found a significant negative correlation between work engagement and work-family conflict among senior nurses, consistent with prior research. Evidence from Japan suggests that work-family conflict can reduce service attitudes, lower nursing engagement, and increase turnover risk[38] Additionally, work-family conflict may impair the quality of nursing care, reduce staff dedication, and affect workforce sustainability and patient safety[39]. Research indicates that strong leadership resources can buffer the adverse effects of work-family conflict on engagement[37]. Domestic studies report that married female nurses experience higher work-family conflict when workplace and family support—such as colleague or supervisor support and childcare resources—are insufficient. This conflict is associated with reduced motivation and increased intentions to leave[40]. High work-family conflict correlates with lower work engagement and higher occupational burnout. This study proposes that work engagement may mediate the relationship between work-family conflict and nurses’ self-rated health, a mechanism particularly relevant for senior nurses managing multiple roles[41]. Senior nurses face cumulative stress from advanced clinical responsibilities, supervisory duties, and non-standard shifts, increasing their vulnerability to the motivational costs of work-family conflict. According to the Job Demands-Resources (JD-R) theory, work-family conflict, as a job demand, can impede recovery and reduce motivation and engagement, whereas job resources—such as family support, scheduling autonomy, and social support—can mitigate these negative effects.\u003c/p\u003e\n\u003cp\u003eThe present study found that job satisfaction is a significant predictor of work engagement among senior nurses, with higher satisfaction associated with greater engagement. This aligns with prior research showing that nurses with higher job satisfaction exhibit increased professional dedication, improved nursing quality, and reduced turnover intentions[34, 37]. Cao[42] et al. similarly reported a positive relationship between job satisfaction and work engagement, with highly satisfied nurses demonstrating stronger motivation and commitment compared to those with lower satisfaction. However, Aiken[43] et al. noted that in some high-income countries, high job satisfaction does not always translate into elevated work engagement, due to staff shortages and heavy workloads. This discrepancy may reflect variations in nursing work environments influenced by geographic and cultural factors. Furthermore, in China, nurses who receive career development opportunities and organisational support tend to be more satisfied and engaged at work.\u003c/p\u003e\n\u003cp\u003eThe present study found that senior nurses with higher self-rated health exhibited greater work engagement. This aligns with the established view that personal health is a key determinant of nurses' work motivation and professional performance. Zhong[25] et al. indicate that nurses reporting better health demonstrate increased engagement, motivation, and professional dedication, as well as improved sleep quality, mental well-being, and overall life satisfaction. Conversely, nurses with poorer health are more prone to fatigue and professional disengagement. Garrosa[44] et al. reported a positive correlation between physical and mental health and work motivation and engagement. Interestingly, Letvak[45] et al. observed that some senior nurses sustain high work engagement despite poor self-reported health, likely due to strong professional commitment and extensive clinical experience. Cultural and organizational factors also contribute: in China, senior nurses often bear heavy frontline and managerial responsibilities, increasing fatigue and reducing engagement. In contrast, senior nurses in some Western countries primarily occupy managerial and educational roles, which involve less physical demand. Collectively, these findings underscore that good health supports sustained work motivation. In this study, self-rated health was identified as a significant predictor of work engagement among senior nurses, a group particularly susceptible to age-related physical strain, chronic fatigue, and prolonged occupational stress.\u003c/p\u003e\n\u003cp\u003eThe present study found that senior nurses working a higher number of night shifts per month exhibited lower work engagement. Frequent night shifts are associated with reduced engagement and increased emotional exhaustion. Our analysis revealed that excessive night shifts correlate with both decreased work engagement and elevated turnover intentions. These findings suggest that irregular work hours disrupt circadian rhythms, impair recovery, and negatively affect work motivation and staff retention[46]. Night shifts can compromise cognitive function, physical and mental health, and overall job satisfaction[47]. However, Van[48] et al. reported that, in certain nursing populations, increased night shift frequency did not significantly reduce work engagement, potentially due to differences in participant characteristics and healthcare settings. In China, senior nurses frequently undertake additional night shifts due to staffing shortages, which intensifies work strain. By contrast, nursing staff in several EU countries benefit from structured rostering systems and guaranteed rest periods, which mitigate the negative impact of night shifts on engagement.\u003c/p\u003e\n\u003cp\u003eThe study identified a significant difference in work engagement between divorced or widowed nurses and their married or single counterparts, with the former exhibiting lower engagement levels. This aligns with Xu[33] et al., who reported marital status as a significant predictor of work engagement. Among specialist nurses, married individuals generally show higher engagement than unmarried, divorced, or widowed colleagues. Sun[49] et al. also found that nurses with low perceived occupational benefits or engagement were more likely to be single, divorced, or widowed in China. Contrarily, international studies suggest marital status has minimal impact on engagement[37, 50]. Potential explanations include the high proportion of married nurses in study samples and the additional responsibilities senior nurses hold, such as mentorship, management, and care for complex patients. Divorce or widowhood may amplify stress from familial and professional obligations, reducing engagement. Cultural and social factors are also relevant; in China, spouses traditionally provide primary emotional and practical support, and their absence increases life stress, lowering energy and engagement. In contrast, in countries with strong social welfare and professional support systems, divorced or widowed nurses can access social services, peer support, and career counselling, which may mitigate the negative effects on work engagement.\u003c/p\u003e\n\u003cp\u003eThis study found that serving as a Head Nurse is a key determinant of work engagement. Head Nurses exhibited significantly higher engagement levels than Charge Nurses, Team Leaders, and Administrative Nurses, but showed no significant difference compared to Deputy Directors or Directors of Nursing. Xu[33] et al. reported that Head Nurses often have higher engagement than frontline clinical nurses, likely due to their managerial responsibilities and strong professional identity. Sun[49] et al. classified nurses in leadership roles as ‘high commitment/high reward,’ suggesting that managerial positions enhance work engagement. However, Van[51] and Schaufeli[52] et al. noted that managerial roles do not always correspond to higher engagement; some nurses experience burnout from administrative demands and cross-departmental coordination. Cultural and regional differences, as well as role definitions, may explain these discrepancies. In China, Head Nurses serve as departmental cores, balancing administrative, clinical, and teaching duties, which maintains close ties with frontline staff and supports high engagement[53]. In contrast, in some Western countries, Head Nurses focus mainly on administrative tasks with limited clinical involvement, potentially reducing engagement[54]. Organisational support and resource allocation also influence engagement: Chinese ward managers often benefit from promotion, training, and resources, whereas Charge and Administrative Nurses face resource constraints due to clinical and administrative burdens, leading to a mismatch between workload and engagement. In Western systems, limited resources and heavy administrative duties may similarly reduce managerial engagement[20].\u003c/p\u003e\n\u003cp\u003eDepartmental affiliation, specifically whether nurses work in the Emergency or Outpatient Department, is a key determinant of work engagement. In this study, mean engagement scores in the Emergency and Outpatient Departments were slightly higher than those in the ICU (66.54 ± 22.88) but lower than in other departments. Consistent with Hu[55] et al., emergency nurses are exposed to workplace psychological violence, prolonged working hours, and role strain, which negatively affect work engagement. Zhang[20] et al. also reported that emergency and outpatient nurses face high work pressure, rapid patient turnover, and staffing shortages, increasing the risk of burnout and reducing engagement. However, some international studies suggest contrasting outcomes: during crises, emergency nurses must maintain intense focus due to high patient volume and turnover[56], and outpatient nurses, with frequent patient interactions, may sustain higher engagement levels[37]. Possible explanations include: (1) the relatively low proportion of emergency and outpatient nurses in the sample; (2) high-intensity workloads with unpredictable patient conditions, high family expectations, and frequent emergencies, which elevate emotional labor and psychological stress; and (3) limited human resources and managerial support, with frequent overtime and irregular shifts reducing recovery time. Additionally, these departments manage large patient populations and experience frequent medical disputes and complaints. Domestic hospitals often lack robust protective systems, imposing significant unseen pressures on nurses, whereas international hospitals typically implement comprehensive protective measures, mitigating such risks and supporting work engagement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and Limitations of the Work\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has several notable strengths. First, it focuses on senior nurses, a cohort that plays a critical role in clinical practice, management, and mentorship but is often overlooked in research on work engagement. Studying this group provides novel insights into the factors affecting experienced nurses’ engagement. Second, the study examines multiple determinants, including psychological capital, job satisfaction, self-rated health, marital status, frequency of night shifts, position level, and department type, offering a multidimensional perspective on work engagement. Third, the large sample size enhances statistical power and reliability, improving the generalisability of the findings to similar healthcare settings. However, several limitations should be acknowledged. The cross-sectional design prevents causal inference, highlighting the need for longitudinal or interventional studies to verify causal relationships. The use of self-administered questionnaires may introduce social desirability and common method biases. Although the sample was drawn from southwestern China, participant distribution was uneven, with most participants from Leshan and Chengdu, which may limit generalisability to other cultural or institutional contexts. Finally, other potential determinants of work engagement—such as organisational climate, leadership style, and patient outcomes—remain unexplored, underscoring the need for further research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplications for Nursing Management\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study offers comprehensive insights into nursing management practices. First, hospital administrators should cultivate senior nurses’ psychological capital through resilience training, positive psychology interventions, and mentoring programs to enhance work engagement and motivation. Second, given the negative effects of frequent night shifts and work-family conflict, staffing levels and rostering systems should be optimised to reduce night-shift burdens and promote work-life balance. Third, managers should improve career progression pathways and recognition mechanisms to strengthen job satisfaction and professional identity, particularly for senior nurses balancing clinical and managerial responsibilities. Special attention should also be given to nurses experiencing divorce or bereavement, as they may require additional organisational support and psychological counselling to sustain engagement. Nursing managers, especially ward managers, should be provided with adequate resources and organisational trust to effectively fulfil leadership roles and foster team commitment. Finally, departments with lower engagement levels, such as emergency and outpatient units, require targeted strategies, including enhanced organisational support, balanced workload distribution, and expanded professional development opportunities. A multi-tiered management approach—encompassing individual resource support, organisational policy refinement, and tailored departmental strategies—can effectively sustain and enhance senior nurses’ work engagement.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study investigates the current state of work engagement among senior nursing staff and its influencing factors. Findings indicate that although overall work engagement is high, it is affected by multiple individual and occupational factors. Psychological capital, job satisfaction, and self-rated health are positively correlated with work engagement, serving as key protective factors. In contrast, work-family conflict and frequent night shifts negatively impact engagement. Differences were also observed based on marital status, position, and department. Specifically, married or unmarried nurses, ward managers, and those working in non-emergency or outpatient departments exhibited higher engagement levels. Comprehensive analysis suggests that individual psychological resources, professional identity, and a supportive work-life balance are crucial for sustaining engagement. Conversely, excessive night shifts, insufficient family support, and unclear role expectations may hinder engagement. Therefore, senior nursing management should focus on enhancing psychological capital and career development, optimising night-shift scheduling, improving the work environment, and addressing the specific needs of staff according to marital status and departmental affiliation. Institutional frameworks should also strengthen the motivational role of managerial positions, such as ward managers, leveraging their exemplary and guiding functions. Future research should employ longitudinal designs to evaluate the effects of interventions on work engagement, providing evidence-based guidance to enhance nursing workforce stability and healthcare service quality.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to extend our gratitude to all those who participated in the research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJ.Z and L.M.L contributed to research design and fieldwork. J.Z drafted the manuscript and revised it critically. L.M.L conducted data analysis and assisted in drafting. W.X.M and Y.X were responsible for questionnaire administration and contributed to data collation and analysis. H.L and C.H.G conducted questionnaire surveys and data collection. Q.L.C and X.Y provided resource support, manuscript review, editing, and overall supervision.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the fndings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was subject to a rigorous review process and was approved by the Ethics Committee of Leshan People's Hospital (Approval No.: LYLL [2025] KY 125). Informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conficts of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSchaufeli WB, Salanova M, Gonz\u0026aacute;lez-rom\u0026aacute; V, Bakker AB. The Measurement of Engagement and Burnout: A Two Sample Confirmatory Factor Analytic Approach. J Happiness Stud. 2002;3(1):71\u0026ndash;92.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang L, Chen H, Wan Q, Cao T, Dong X, Huang X, Lu H, Shang S. Effects of self-rated workload and nurse staffing on work engagement among nurses: A cross-sectional survey. 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J Emerg Nurs. 2016;42(4):325\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Senior nurses, Work engagement, Psychological capital, Work-family conflict, Nursing management","lastPublishedDoi":"10.21203/rs.3.rs-8423153/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8423153/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWork engagement is a critical indicator of nurses\u0026rsquo; motivation, well-being, and care quality. Senior nurses constitute the backbone of the nursing workforce, yet they face increasing occupational demands, role overload, and work\u0026ndash;family conflict, which may undermine sustained engagement. Psychological capital has been identified as an important personal resource that enhances work engagement, while work\u0026ndash;family conflict represents a major job demand. However, evidence focusing on senior nurses, particularly in less-developed regions of China, remains limited. This study aimed to investigate the level of work engagement among senior nurses in southwestern China and to examine the associations of psychological capital and work\u0026ndash;family conflict with work engagement.\u003c/p\u003e\u003ch2\u003eDesign\u003c/h2\u003e \u003cp\u003eA cross-sectional descriptive study.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA multicenter cross-sectional study was conducted between May and July 2025 in 15 hospitals in southwestern China. A total of 814 senior nurses were recruited using convenience sampling. Data were collected using standardized questionnaires, including the Utrecht Work Engagement Scale, the Nurses\u0026rsquo; Psychological Capital Scale, and the Work\u0026ndash;Family Conflict Scale. Descriptive statistics, Pearson correlation analysis, and stepwise multiple linear regression were performed to identify factors associated with work engagement.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean work engagement score among senior nurses was 72.51\u0026thinsp;\u0026plusmn;\u0026thinsp;21.06, indicating a high level of engagement. Psychological capital was positively correlated with work engagement (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.780, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), whereas work\u0026ndash;family conflict showed a significant negative correlation (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;0.366, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Regression analysis revealed that psychological capital, job satisfaction, self-rated health status, position (head nurse), and marital status were positive predictors of work engagement, while frequent night shifts and working in emergency or outpatient departments were negatively associated with work engagement \u003cem\u003e(R\u0026sup2;\u003c/em\u003e= 0.656, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eSenior nurses in southwestern China demonstrated a generally high level of work engagement. Psychological capital emerged as the strongest positive predictor, whereas work\u0026ndash;family conflict and excessive night shifts adversely affected engagement. These findings highlight the importance of strengthening psychological resources, optimizing work schedules, and providing targeted organizational support to sustain work engagement among senior nurses and promote workforce stability.\u003c/p\u003e","manuscriptTitle":"Psychological Capital and Work–Family Conflict as Predictors of Work Engagement Among Senior Nurses: A Multicenter Cross-Sectional Study in Southwest China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-23 12:57:55","doi":"10.21203/rs.3.rs-8423153/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-01-21T11:52:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-19T09:31:09+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-30T10:05:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-30T04:12:10+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-12-30T04:04:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a97862c2-e472-4a3c-ad18-3d92a7ca5347","owner":[],"postedDate":"January 23rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-23T12:57:55+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-23 12:57:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8423153","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-8423153","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}