Introduction
Emotional labor was first proposed by Hochschild [1] in her book “The Managed Heart: Commercialization of Human Feeling”. It was defined as the management of feelings to create a publicly observable facial and bodily display for reward. Teaching is a profession with high emotional labor demands. Teachers’ emotions play a crucial role in education; how teachers experience and express emotions directly affects their teaching methods, which in turn influences not only learners’ behavior but also teachers’ curriculum design, instructional strategies, and teaching efficacy [2, 3]. A study has revealed that teachers suppress or feign emotions in approximately one-third of their classes [4].
Teachers’ emotional labor refers to the efforts made to generate, inhibit, and manage their emotions through various strategies during the teaching process, following normative beliefs and expectations of the teaching profession [5, 6]. Currently, there is no unified structure for teachers’ emotional labor [6]. Researchers have mostly explored the structure based on the three-dimensional model of emotional labor proposed by Diefendorff [7], namely surface acting, deep acting and expression of genuine emotions.
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Teachers’ emotional labor is a double-edged sword, and different types of emotional labor can have different consequences. Numerous studies have confirmed that emotional labor is closely associated with job burnout, job satisfaction, psychological health, and individual well-being [8‐10]. Surface acting hinders teachers’ teaching strategies and pedagogical efficacy in learning assessment, and is positively associated with burnout and negatively associated with psychological well-being, job satisfaction and organizational attachment [8, 11, 12]. Deep acting and expression of genuine emotions enhance teachers’ efficacy in curriculum design, instructional strategies, and assessment of learning [3], and are significantly and positively correlated with teachers’ psychological well-being and teaching satisfaction [13].
In nursing education, nursing teachers report higher levels of negative emotions and burnout. A staggering 85.2% of academic nursing faculties and 80% of clinical nursing teachers experience moderate to high levels of burnout [14, 15]. The incidence of anxiety and depression among nursing teachers is 12.1% and 13.4%, respectively [16]. A national cross-sectional study even revealed that one-quarter of doctoral nursing teachers plan to leave their positions within 2 years, with two-thirds of participants intending to depart within 6 years [17]. Emotional labor is a significant determinant of burnout and occupational health among educational professionals. Therefore, focusing on the emotional labor of nursing teachers and helping them to adopt appropriate emotional labor strategies are essential for reducing their burnout and turnover rates.
Given the impact of emotional labor on individuals and organizations, researchers have developed assessment tools for emotional labor among various teachers, including elementary school teachers, secondary school teachers, and novice English as a Foreign Language teachers [18‐20]. However, the structure of these scales is not consistent. For instance, the Teacher Emotional Labor Scale developed by Cukur [21] includes surface acting, deep acting, autonomous emotion regulation, and emotion dissonance. While Li’s study encompassed surface acting, deep acting, positive resonance, and negative resonance [22]. Moreover, these evaluation items focus on the characteristics of different teachers, and many items include the process of teacher-student parents interactions, which does not align with the context of nursing education.
Emotional labor is an important part of nursing [23], and is also reflected in nursing education processes. Nursing teachers are not only responsible for imparting professional knowledge to students but also play a significant role in cultivating students’ professional emotions and attitudes [24]. Research findings indicate that teachers need to demonstrate teaching enthusiasm to foster students’ professional commitment [25]. As nursing is a profession with high emotional labor demands, nursing students’ emotional work during clinical practice also requires support from nursing teachers. The Future of Nursing 2020–2030 report advocates for nursing teachers to help nursing students enhance their emotional resilience and foster a psychologically safe culture [26]. They are often described as the primary providers of emotional labor and support for students [27]. Furthermore, in nursing education, incidents of student incivility are becoming increasingly common, including using mobile phones in class, arriving late, displaying boredom or indifference, lack of focus, mocking or disrespecting teachers, general ridicule or insolence towards teachers, challenging teachers’ credibility, and leaving the classroom early [28, 29]. However, nursing teachers often need to lead by example and approach uncivil students with politeness, which inadvertently increases the emotional labor of nursing teachers. Their self-esteem and confidence may be compromised, and they may even lose the motivation to teach, adversely affecting both their personal and professional lives [30].
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Therefore, it is crucial to adopt appropriate emotional labor to improve job satisfaction, reduce job burnout, and decrease turnover intentions among nursing teachers. However, no reliable and valid tool has been available to assess the emotional labor of nursing teachers. Consequently, as part of a larger research project and based on preliminary research findings, this study aims to develop a self-assessment tool for nursing teachers’ emotional labor and evaluate its psychometric properties. The development of the scale could contribute to identifying the level and factors of nursing teachers’ emotional labor and provide a basis for targeted interventions to improve their emotional health and well-being.
Methods
Participants
Eligible nursing teachers were recruited using convenience sampling from two nursing colleges and two clinical teaching hospitals in Liaoning Province, Mainland China in July 2024. The inclusion criteria for participants were: academic and clinical nursing teachers engaged in teaching activities that include theory classes, practical classes, clinical internships, and clinical practice; teaching undergraduate and postgraduate nursing students; informed consent and voluntary participation in this study. The sample size was determined based on the requirements for factor analysis, with a minimum of five participants per variable [31]. This study was approved by the Ethics Committee of China Medical University (Approval No. of [2024] 141). All procedures adhered to the ethical standards of the Declaration of Helsinki. Finally, a total of 366 nursing teachers were included in the study. This sample (n = 366) was used for the second phase (scale development) and the third phase (scale validation). The sample was randomly divided into two groups, one for scale development (n = 166) and the other for scale validation (n = 200).
Design
This study employed a three-phase methodology involving item generation and revision, scale development, and scale validation. In the initial phase, preliminary items were created based on concept analysis, qualitative research and literature review. Content validity of these items was assessed and modifications were made through expert review. Additionally, a pilot survey was conducted with a sample of nursing teachers to further refine the items. In the second phase, we collected data from nursing teachers in Liaoning, China, using an online questionnaire. Data analysis was performed using SPSS 25.0 and AMOS 24.0. Item analysis and exploratory factor analysis (EFA) were used to evaluate the items. In the third phase, the reliability and validity of the scale were examined. The development procedure of the Nursing Teacher Emotional Labor Scale is shown in Fig. 1.
Fig. 1
The development procedure of the NTELS
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Phase 1: item generation and revision
Item generation
The clarification of the concept is a prerequisite for item formation. The measurement content of this study focuses on the emotional labor of nursing teachers. As part of a larger study, the conceptualization of the emotional labor of nursing teachers was developed in a two-step process. First, we used Rodgers’ evolutionary concept analysis approach [32] to clarify the attributes of teachers’ emotional labor. Through the analysis of 39 papers from six databases, the attributes of teachers’ emotional labor were categorized as individual-centered emotional efforts in educational contexts. Consistent with Diefendorff’s [7] model of emotional labor, surface acting, deep acting, and expression of genuine emotions were included. Second, a descriptive qualitative research method was used to conduct semi-structured interviews with 18 nursing teachers to clarify the definition, attributes and dimensions of nursing teachers’ emotional labor by gaining an understanding of their emotional labor experiences. Based on the results of the qualitative study, nursing teachers’ emotional labor was defined as individual-centered emotional efforts of nursing teachers using a variety of strategies to express emotions that conform to organizational requirements and social expectations and promote the development of nursing students in educational contexts. It is measured through the Nursing Teacher Emotional Labor Scale (NTELS). Qualitative research results identified four dimensions: surface acting, deep acting, expression of genuine emotions, and emotional termination. Surface acting is characterized by a discrepancy between external emotional expressions and internal feelings, where educators alter their outward expressions without changing their internal feelings. Deep acting involves efforts to change internal feelings to align them with observable expressions. Expression of genuine emotions refers to situations where internal emotional experiences and external expressions are consistent, reflecting genuine natural emotional expressions. Emotional termination is related to the deliberate strategy of altering one’s emotional state to be devoid of emotional expression and internal feelings. The items in the four dimensions of the scale were developed based on the content of the nursing teachers’ interviews by the research team, which included a professor of nursing education, a faculty in the field of nursing education, and two PhDs in nursing education. In addition, through an extensive literature review, the team supplemented the items from the existing teacher emotional labor scale. Ultimately, 29 items across four dimensions were formed as the initial items for the NTELS.
Item revision
Seven experts in the fields of nursing education, emotional labor, nursing psychology, and scale development were invited to evaluate the relationship between the scale items and the latent variables being measured, as well as the clarity and brevity of the items. All experts held master’s degrees or above, had senior technical titles, and possessed over 20 years of work experience. The content validity of the scale was evaluated by the seven experts using a 4-point Likert scale, where 4 indicates “relevant”, 3 as “moderately relevant”, 2 as “weakly relevant”, and 1 as “not relevant”. The scale-level content validity index (S-CVI) and item-level content validity index (I-CVI) were calculated. The I-CVI is the number of experts scoring 3 or 4 divided by the total number of experts, and the S-CVI is the average of the I-CVI scores. Generally, an S-CVI ≥ 0.8 and I-CVI ≥ 0.78 are required [33].
Pilot survey
A pilot survey was conducted with 30 nursing teachers, who were asked to evaluate the scale’s relevance, comprehensibility, comprehensiveness, clarity, and time requirements. This step was used to form the preliminary version of the NTELS.
Phase 2: scale development
Item analysis
The critical ratio and item-total correlation coefficients were used to evaluate the discriminant ability and applicability of the items. The sample was divided into a high group (top 27% scorers) and a low group (bottom 27% scorers) for analysis. An acceptable critical ratio for each item was 3.0 or above, and significant (P < 0.05). The minimum item-total correlation coefficient was required to be 0.4. Additionally, the Cronbach’s α coefficient for the scale did not increase after removing each item. A preliminary exploratory factor analysis was conducted to explore factor loadings, requiring factor loadings greater than 0.4 and no cross-loadings [34].
Exploratory factor analysis
The suitability of the scale for exploratory factor analysis was determined by calculating the KMO value and Bartlett’s test of sphericity. A significant result from Bartlett’s test and a KMO value closer to 1 indicate a better fit for factor analysis. Principal component analysis with varimax orthogonal rotation was used for extraction. Factor retention criteria included an eigenvalue > 1, factor loadings > 0.4, and a single factor containing three or more items [35].
Phase 3: scale validation
Confirmatory factor analysis
Based on the exploratory factor analysis, confirmatory factor analysis (CFA) was conducted using AMOS software with the maximum likelihood method. The model fit was evaluated using the following indices: Chi-square degree of freedom ratio (X2/df) < 3.00, Comparative Fit Index (CFI), Incremental Fit Index (IFI), and Tucker-Lewis Index (TLI) above 0.9, Root Mean Square Error of Approximation (RMSEA) < 0.09, and Root Mean Square Residual (RMR) < 0.08 [36]. Additionally, these model fit statistics serve as guidelines and should not be interpreted as golden rules [37].
Convergent and discriminant validity
Convergent validity refers to the degree of association between theoretically similar constructs. In contrast, discriminant validity emphasizes the distinctiveness and specificity of different constructs [31]. Generally, an average variance extracted (AVE) value above 0.5 and a composite reliability (CR) value above 0.7 for each dimension, with the square root of the AVE being higher than the inter-factor correlations, indicate good convergent and discriminant validity [38, 39].
Criterion-related validity
Criterion-related validity refers to the evidence of the relationship between the attributes in a measurement tool and their performance on other variables. According to Grandy’s model of emotional labor [40]and the conceptual model of teachers’ emotional labor developed previously by the research team, teachers’ emotional labor is closely related to their emotional exhaustion. We used the emotional exhaustion dimension of the Maslach Burnout Inventory-Educators Survey (MBI-ES) to measure emotional exhaustion among nursing teachers [41]. The emotional exhaustion dimension includes 9 items, with a Cronbach’s α coefficient of 0.892, indicating good reliability. The scale uses a 7-point Likert scale scored from 0 to 6, representing “never” to “every day”.
Reliability test
The reliability of the NTELS was tested using internal consistency reliability and test-retest reliability. Generally, a scale’s Cronbach’s α coefficient should be > 0.8, and the dimension’s Cronbach’s α coefficient should be > 0.7 [31, 42]. After a 2-week interval, 30 marked nursing teachers were retested, and the test-retest reliability was evaluated using correlation coefficients, with a requirement of > 0.7 [43].
Results
Participants characteristics
This study collected 366 valid questionnaires, with an effective recovery rate of 92.19%. The majority of participants were female (n = 346, 94.5%). The age of nursing teachers was predominantly between 31 and 40 years (n = 251, 68.6%), and their teaching experience was mainly between 5 and 20 years (n = 259, 70.8%). Nearly all nursing teachers held a bachelor’s degree or higher. Table 1 presents detailed information on the participants.
Table 1
Characteristics of the participants (N = 366)
Factor | Categories | n | % |
|---|---|---|---|
Gender | Male | 20 | 5.5 |
Female | 346 | 94.5 | |
Age(years) | ≤ 30 | 27 | 7.4 |
31–40 | 251 | 68.6 | |
41–50 | 79 | 21.6 | |
51–60 | 9 | 2.4 | |
Marital statue | Unmarried | 36 | 9.8 |
Married | 318 | 86.9 | |
Divorce or seperation | 12 | 3.3 | |
Administrative duties | Yes | 37 | 10.1 |
No | 329 | 89.9 | |
Higest education | Higher diploma | 5 | 1.4 |
Bachelor degree | 309 | 84.4 | |
Master degree | 42 | 11.5 | |
Doctor degree | 10 | 2.7 | |
Type of teachers | Academic faculties | 33 | 9.0 |
Clinical nurse teachers | 333 | 91.0 | |
Graduate advisor | Yes | 14 | 3.8 |
No | 352 | 96.2 | |
Teaching years | <5 | 87 | 23.8 |
5–10 | 153 | 41.8 | |
11–20 | 106 | 28.9 | |
>20 | 20 | 5.5 | |
Professional title | Primary | 149 | 40.7 |
Intermediate | 193 | 52.7 | |
Vice professor or professor | 24 | 6.6 | |
Teaching load per year (academic hour) | <100 | 142 | 38.8 |
100–500 | 146 | 39.9 | |
>500 | 78 | 21.3 |
Item revision
Based on the recommendations of experts and discussions within the research group, revisions were made to the scale items. These revisions primarily included two aspects. First, some similar items on the scale were merged and deleted. For example, five items including “I naturally express my true emotions to students” and “Seeing the progress and success of nursing students in their studies, I sincerely feel pleasure and show it” were deleted. Second, some items on the scale were revised. For instance, the phrase “deliberately show” in item 5 was changed to “intentionally display”. Through this process, a preliminary version of the NTELS with 24 items across four dimensions was formed. The I-CVI for all items ranged from 0.857 to 1.000, and the S-CVI was 0.993, indicating good content validity of the scale. In the pilot survey, respondents suggested that it is necessary to clarify the teaching context of nursing in the scale. Therefore, the nursing education context was introduced in detail in the scale’s instructions, which also increased the clarity and conciseness of the scale.
Item analysis
The skewness and kurtosis absolute values of all items were less than 1.5, indicating that the normality test was satisfied. The correlations between the scores of the 24 items and the total score ranged from 0.049 to 0.718. Items 6, 17, 18, and 21 had correlation coefficients with a total scale score below 0.4 and no statistically significant difference. In addition, the CR values for these four items in the high-low-27% group were less than 3.0. The total Cronbach’s α coefficient for the scale was 0.863, and the Cronbach’s α coefficient for the scale would increase after removing the four items. In light of these results, the four items were deleted, forming a 20-item NTELS. The coefficients of the retained 20 items with the total scale score ranged from 0.405 to 0.718 (P < 0.01), and the CR values ranged from 5.025 to 11.729 (P < 0.001), meeting the selection criteria (See Supplementary Material 1).
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Exploratory factor analysis
In this study, the results showed a KMO value of 0.856, and Bartlett’s test of sphericity chi-square value was 2276.725 (P < 0.001), indicating that the scale was suitable for exploratory factor analysis. Principal component analysis and varimax orthogonal rotation were used to extract common factors. The results showed that 20 items extracted a total of 4 common factors, with a cumulative variance contribution rate of 70.962%. Each item had a loading of more than 0.4 on its corresponding common factor, and there was no cross-loading phenomenon. The 4 common factors extracted from the scale were consistent with the initial dimensions of the scale, namely surface acting (6 items), deep acting (6 items), expression of genuine emotions (3 items), and emotional termination (5 items). The scree plot and rotated loading matrix results of the scale’s exploratory factor analysis are shown in Fig. 2; Table 2, respectively.
Fig. 2
Scree plot of the NTELS
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Table 2
Exploratory factor analysis of the scale
Items | F1 | F2 | F3 | F4 |
|---|---|---|---|---|
Q2 | 0.835 | |||
Q7 | 0.818 | |||
Q1 | 0.808 | |||
Q4 | 0.807 | |||
Q3 | 0.791 | |||
Q5 | 0.626 | |||
Q9 | 0.882 | |||
Q11 | 0.868 | |||
Q13 | 0.863 | |||
Q10 | 0.784 | |||
Q8 | 0.733 | |||
Q12 | 0.679 | |||
Q15 | 0.861 | |||
Q16 | 0.852 | |||
Q14 | 0.837 | |||
Q20 | 0.804 | |||
Q23 | 0.792 | |||
Q22 | 0.769 | |||
Q19 | 0.766 | |||
Q24 | 0.736 |
Confirmatory factor analysis
AMOS 28.0 software was used to analyze the data from 200 participants for confirmatory factor analysis. The initial model fit indices were X2/df = 3.136, CFI = 0.879, IFI = 0.880, TLI = 0.859, RMSEA = 0.104, RMR = 0.081, indicating that the initial model fit was not ideal and required further modification. Based on the model modification indices, 4 covariances were gradually added. Each covariance correlation is between the residuals of different items on the same dimension and all can be explained. This fits the preset model and the modified model fit indices were X2/df = 2.309, CFI = 0.927, IFI = 0.928, TLI = 0.914, RMSEA = 0.081, RMR = 0.073, all within the acceptable range. The results indicate that the scale and the modified model have a good overall fit (Fig. 3).
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Fig. 3
The schematic diagram of final standardized model fitting of the NTELS
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Convergent and discriminant validity
In the analysis of convergent validity, the AVE values of each dimension ranged from 0.53 to 0.77 (> 0.5), and the CR values ranged from 0.86 to 0.92 (> 0.7), indicating that the scale has good convergent validity. In the analysis of discriminant validity, the square root values of the AVE for each dimension ranged from 0.728 to 0.877, all of which were higher than the correlation coefficients of other factors, indicating that the NTELS has good discriminant validity (See Table 3).
Table 3
Convergent validity and discriminant validity of the scale
Factors | Correlation between factors | AVE | CR | |||
|---|---|---|---|---|---|---|
F1 | F2 | F3 | F4 | |||
F1 | 0.728 | 0.53 | 0.87 | |||
F2 | 0.345 | 0.806 | 0.65 | 0.92 | ||
F3 | 0.076 | 0.603 | 0.877 | 0.77 | 0.91 | |
F4 | 0.528 | 0.377 | 0.384 | 0.748 | 0.56 | 0.86 |
Criterion-related validity
In this study, the Emotional Exhaustion Sub-scale was selected to test the criterion-related validity of the NTELS. The results showed that surface acting and emotional termination were significantly positively correlated with emotional exhaustion, while deep acting was significantly negatively correlated with emotional exhaustion. Expression of genuine emotions was negatively, but not statistically, correlated with emotional exhaustion.
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Reliability test
The Cronbach’s α coefficient for the NTELS was 0.907, and the Cronbach’s α coefficients for the four dimensions were 0.886, 0.926, 0.905, and 0.863, respectively. The total scale’s test-retest reliability was 0.865, indicating that the scale has good stability. The final version of the NTELS is shown in Supplementary Material 2.
Discussion
The stressors experienced by teachers and the impact of their emotions are increasingly significant, with their emotional experiences and expressions having important implications for individual health and students’ learning. To our knowledge, this is the first study to explore the structure of emotional labor among nursing teachers and develop a self-report assessment tool. Consistent with the conceptual framework of nursing teachers’ emotional labor, we validated the four-dimensional structure of the scale, including surface acting, deep acting, expression of genuine emotions, and emotional termination.
The scale is tailored to the context of nursing education, and the psychometric results indicate that it can measure the level of emotional labor among nursing teachers scientifically and effectively. Researchers and educational administrators can use it to investigate and analyze the influencing factors of nursing teachers’ emotional labor, as well as the relationship between different emotional labor strategies and their occupational health and job performance. This, in turn, can provide a basis for helping nursing teachers select appropriate emotional labor strategies to enhance their emotional well-being.
In terms of the scale’s validity, content validity, structural validity, and criterion-related validity were successfully verified. The results show that the I-CVI and S-CVI are well above the recommended standards, indicating that the scale can accurately measure the intended constructs [44]. In the EFA, all items extracted 20 items and 4 dimensions, explaining 70.962% of the total variance. In the CFA, the modified model fits the data well, with all indices within an acceptable range, indicating that the constructed NTELS has good structural validity.
The first dimension of the scale is surface acting, which refers to nursing teachers altering their external expressions and behavioral states, adopting disguise or suppression of emotional feelings to display emotions required by their work. This factor focuses on the external emotional expressions of teachers and comprises six items. For example, “Despite sometimes feeling exhausted, I deliberately project an enthusiastic demeanor in my teaching role” and “I pretend the emotions required for teaching duties”. On one hand, the teacher enthusiasm perceived by nursing students in the classroom can promote students’ classroom commitment and suppress classroom-related boredom [25, 45]. Therefore, nursing teachers need to hide their true emotions and display a passionate demeanor in teaching. On the other hand, the teaching process of nursing teachers can occur in clinical situations that involve not only both teachers and students, but may also include patients and their families. Nursing teachers are busy with the needs of nursing students and patients, and they lack time to express their feelings and emotions, making emotional suppression a key strategy for nursing teachers [46]. Additionally, nursing teachers also need to appropriately maintain professional authority and appropriate teacher-student relationships by feigning certain external emotions. Therefore, surface acting is an important aspect of emotional labor for nursing teachers.
The second dimension of the scale is deep acting, which includes six items. Unlike surface acting, deep acting focuses on the inner feelings, instructing them to make adjustments and changes from the depths of their thoughts and values through cognitive changes and attention adjustments. For example, nursing teachers may attribute various aspects and rationalize teaching events in the educational context. Research shows that a lack of motivation and interest among students in the classroom is a significant challenge faced by nursing educators in the nursing education environment [47]. Deep acting, through internal emotional regulation, is an important coping strategy for nursing teachers. They can change their perceptions, focus on positive perspectives, and stimulate positive professional emotions [48]. The results of the study showed that most of the nursing teachers had more than 5 years of teaching and an intermediate professional title. Their long-term teaching experience and good communication skills can also help them use deep acting to regulate emotions.
The expression of genuine emotions is confirmed as the third dimension of the scale, where nursing teachers spontaneously and sincerely experience and express their inner emotions. Similar to previous research, the expression of true emotions is considered a way of emotional labor for teachers [5, 21]. Unlike deep acting, nursing educators can naturally feel and express emotions that align with organizational requirements, such as “The emotions I display to students are consistent with my true internal feelings” and “The emotions I express to my students flow naturally”. Student academic progress, including clinical reasoning and successful patient interactions, is an important source of joyful teaching moments for nursing educators, which also promotes their genuine experience and expression of emotions [49]. Furthermore, it reflects the nursing teachers’ ethics of caring. Caring for students is an important part of the teacher’s ethics. Nursing teachers proactively utilize their existing abilities to assist nursing students in their growth, which is consistent with Isenbarger [50], who states that emotional labor is carried out by the teacher within a caring relationship. They not only display positive emotions toward students but also exhibit strict behavior toward them. Thus, the expression of genuine emotions is another dimension of the emotional labor of nursing teachers.
Additionally, this study confirmed the strategy of emotional termination, where nursing teachers strive to cease internal emotional feelings and external emotional expressions. For example, “Faced with students demonstrating a poor attitude towards learning, my emotions remain unaffected” and “Even if my efforts are not recognized by the students, I don’t feel frustrated”. On one hand, nursing educators use emotional termination strategies to maintain objectivity and rationality and continue their teaching work. On the other hand, it is also a self-control defense strategy for nursing educators to maintain mental health. This strategy also reflects the characteristics that distinguish nursing teachers from other types of teachers. Emotional distancing is an important coping strategy in nursing that refers to the emotional detachment and neutrality of the nurse from the patient; this approach is a protective coping mechanism for the individual [51, 52]. It can help nurses maintain professionalism by distancing themselves from the patient’s pain and negative emotions, thereby reducing emotional exhaustion and compassion fatigue [52]. In this study, clinical nursing faculty members comprised more than 90% of the participants, and the emotional labor styles they adopt in clinical nursing work may influence their emotional regulation and emotional expression styles when in their roles as teachers. The professional demands of nursing work may be an important factor in motivating nursing teachers to use emotional termination. In addition, this dimension also reflects the uniqueness of emotional labor among nursing educators in the Chinese cultural context. The eastern collectivistic culture emphasizes caring for others, and individuals are expected to control their emotions to promote harmony [2]. Emotional termination becomes a new strategy for nursing educators to avoid conflict and maintain distance.
In addition to good validity, we verified the internal consistency and test-retest reliability of the NTELS. The scale’s Cronbach’s α coefficient and test-retest coefficients are above the recommended values, indicating its good reliability and repeatability.
In summary, the NTELS is an instrument designed to measure the emotional labor of nursing teachers, characterized by its scientific validity and broad applicability. Initially, during the item development phase, qualitative research conducted before the scale construction provided an in-depth analysis of emotional labor experiences within the context of nursing education. This analysis offered a scientific foundation for the construction of the scale and ensured the representativeness of the items. Furthermore, existing teacher emotional labor scales were utilized to supplement the items. Secondly, expert review and pilot testing ensured the applicability and clarity of the initial scale content. Thirdly, during the item analysis phase, four items were eliminated, leaving a total of 20 items that met the criteria for item-total score correlation and critical ratio, indicating the scale’s appropriate discrimination. Additionally, the removal of any item did not increase the scale’s Cronbach’s α coefficient, supporting the scale’s good homogeneity. Finally, psychometric testing results demonstrated that the newly developed scale has good reliability and validity, making it suitable for measuring the emotional labor of nursing educators.
It must be acknowledged that this study has certain limitations. First, the nursing educators recruited in this study are from Liaoning Province, China, which may limit the representativeness of the study population. It is recommended that future studies conduct large sample multi-center investigations to further validate the effectiveness of NTELS among nursing teachers. Second, although participants covered both academic and clinical nursing educators, clinical nursing teachers were predominant. Therefore, it is recommended that future studies adopt a random stratified method to verify the generalizability of this scale. Finally, the cultural context may influence the results since this study was conducted in China. Further research is recommended to test the psychometric properties of the NTELS in different countries.
Conclusion
The Nursing Teacher Emotional Labor Scale is the first tool to assess the emotional labor of nursing teachers in the context of nursing education. The newly developed scale, which includes 4 dimensions and 20 items, has good reliability and validity and serves as a tool for nursing teachers to self-assess their emotional labor in nursing education. At the same time, it also provides an effective basis for nursing education administrators to improve teachers’ emotional labor styles and enhance their emotional well-being.
Acknowledgements
We would like to express our grateful thanks to all participants for participanting this study.
Declarations
Ethics approval and consent to participate
This study was approved by the Ethics Committee of China Medical University (Number: [2024] 141). All participants confirmed informed consent prior to participation and were allowed to withdraw from the study at any point. Data were collected anonymously. After collection, the data were kept strictly confidential and were all managed by numbering to ensure data security. All methods had been implemented in accordance with the ethical guidelines of the latest Helsinki Declaration.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
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