Relationship between ICU nurses' healthy work environment and work engagement in Zhuhai:the mediating role of occupational coping self-efficacy

Zhang Hongtao; Tang Zhiwei; Zhang Jinmei; Tang Lili; Liu Ning

doi:10.11986/j.issn.1673-873X.2025.09.17

Abstract：Objective To investigate whether ICU nurses' occupational coping self-efficacy mediates the relationship between a healthy work environment and work engagement among ICU nurses in Zhuhai,and thereby provide evidence for policy-makers and nursing managers.Methods From 1 May to 30 June 2024,369 ICU nurses from Grade A secondary or above general hospitals in Zhuhai were surveyed using a questionnaire comprising a self-designed general information questionnaire,the American Association of Critical-Care Nurses-Healthy Work Environment Assessment Tool(AACN-HWEAT),the Occupational Coping Self-Efficacy Scale for Nurses(OCSEN),and the Utrecht Work Engagement Scale(UWES).Pearson correlation analysis and structural equation modeling with mediation analysis were used to examine relationships among healthy work environment,occupational coping self-efficacy,and work engagement,and to analyze the pathways and mecha-nisms linking the three variables.Results The total healthy work environment score among Zhuhai ICU nurses was 64.28±12.14,the total occupational coping self-efficacy score was 31.96±5.84,and the total work engagement score was 54.80±18.81.Work engagement was positively correlated with both healthy work environment and occupational coping self-efficacy(r=0.505 and r=0.609,respectively;P＜0.05).Structural equation modeling path analysis showed that healthy work environment(β=0.236,P＜0.05)and occupational coping self-efficacy(β=0.564,P＜0.05)each had direct positive effects on work engagement,and healthy work environment also indirectly affected work engagement through occupational coping self-efficacy,with an indirect effect of 0.303;the mediating effect of occupational coping self-efficacy accounted for 56.21％of the total effect.Conclusion ICU nurses in Zhuhai report healthy work environment and occupational coping self-efficacy at a slightly above-moderate level;both factors positively predict work engagement,and occupational coping self-efficacy partially mediates the relationship be-tween healthy work environment and work engagement.Hospital leaders and nursing managers can enhance nurses' work engagement-and thus support nursing quality and patient safety by improving ICU work environments and strengthening nurses' occupational coping self-efficacy.