The mediating role of decent work perception in role clarity and job embeddedness among Chinese nurses: a cross-sectional study

Decent work perception refers to an individual’s psychological perception that their work or job is dignified from a psychological perspective [1], which is reflected in the recognition degree of job rewards, job position, career development, career recognition and work atmosphere, and can reflect the individual’s level of immersion in work. Moreover, the previous research of the research team confirmed that psychological empowerment plays a mediating effect between the decent work perception and work immersion [2]. Role clarity refers to the degree to which an individual understands work standards and organizational expectations. It is also a prerequisite to ensure that an individual can complete work tasks with high quality and efficiency [3‐4]and is closely related to job satisfaction [5]. Research [3] shows that individuals with low role clarity have low job satisfaction and a high turnover rate.

Job embeddedness refers to the attachment of individuals to continue to work in an organization due to the influence of comprehensive external factors. It reflects the matching, connection and sacrifice between individuals, organizations and communities [6] and is an important variable to predict individual turnover and explain the reasons for turnover [7‐10]. For highly embedded employees, they actively encode empathic leadership behaviors as leadership characteristics conducive to their own development, more actively build and maintain closer relationships during the implementation of empathic leadership behaviors, pay more attention to the goals and values of the empathic leader, and strive to align their work goals and values with those of the leader through the cognitive-emotional system [11],this makes rational cognition dominant in the cognitive-emotional interaction process, and thus employees with high job embeddedness have a higher perception of the loss of leaving the empathic leader and the organization, thus greatly reducing the likelihood of leaving the empathic leader, and expecting more to maintain high-quality interpersonal relationships with the empathic leader in order to maximize their own interests. Conversely, under conditions of low job embeddedness, employees have unstable relationship quality with their organizations and leaders, inhibit cognitive units such as coding, goals and values, expectations and beliefs, regard the situational characteristics of the leader’s empathic behaviors as activities that do not concern them, and have differences between their own expectations and beliefs, and work goals and values and those of the empathic leader, and have a lower perception of loss for leaving the empathic leader, and are unable to take the initiative in establishing positive interpersonal interactions with the empathic. The leader will not be able to establish positive interpersonal interactions with the empathic leader, thus weakening the degree of employees’ identification with the empathic leader [12].

Therefore, the level of job embedding of nurses is of concern. At present, there have been studies on the correlation between role clarity and the perception of decent work [3], and the correlation between decent work perception and job embeddedness [13]. It can be seen that there may be a correlation between role clarity and job embeddedness, but there is no research that directly proves whether there is a correlation or not, therefore, Hypothesis 1: There is a correlation between role clarity and job embeddedness. In addition, since role clarity is correlated with perceived decent work and perceived decent work is correlated with job embeddedness, therefore, Hypothesis 2: Perceived decent work mediates the relationship between role clarity and job embeddedness.

A total of 320 questionnaires were collected, and 309 valid questionnaires were obtained after the non-compliant questionnaires were proposed, with a valid recovery rate of 96.6%, and the socio-demographic data of the respondents are shown in Table 1.

In this study, decent work perception consists of job reward, job position, work atmosphere, career development, career recognition, the total scores of decent work perception, role clarity and job embeddedness were 52.55 ± 6.38, 32.67 ± 5.65 and 69.47 ± 12.05 respectively, and the mean scores of the dimensions were 10.51 ± 1.28, 6.53 ± 1.13, and 13.89 ± 2.41 respectively, which were all moderate. Table 2.

Pearson correlation analysis showed that the total score of job embeddedness was positively correlated with the total score of decent work perception and role clarity. Table 3.

With role clarity as the independent variable, job embeddedness as the dependent variable, and decent work perception as the mediating variable, structural equations were constructed using Amos 24.0 software, and the data were fitted and corrected using the maximum likelihood ratio method. The results showed that the chi-squared freedom ratio (χ²/df) = 3.051 < 5; goodness-of-fit index (GFI) = 0.896, adjusted goodness-of-fit index (AGFI) = 0.857, Tucker–Lewis index (TLI) = 0.918, normed fit index (NFI) = 0.903, and comparative fitness index (CFI) = 0.932, all of which are > 0.8; root mean square error of approximation (RMSEA) = 0.082 ≈ 0.08, indicating that all parameters are within the acceptable range [20], the model fit is good and the model is acceptable. The model showed that role clarity and perception of decent work can directly and positively predict job embeddedness with path coefficients of 0.095 and 0.914 (both P < 0.001); Role clarity can also indirectly act on job embeddedness through perception of decent work with an indirect effect of 0.702 and a mediating effect of 88.1% of the total effect. Bootstrap (repeated 5000 times) results showed that both the direct and indirect effects of role clarity on job embeddedness were statistically significant, and none of the 95% CIs included 0, indicating that the model was partially mediated (Fig. 1 and Table 4).

In this study, the score of clinical nurses’ decent work perception was 52.55 ± 6.38, which was at a moderate level, similar to the results of Liu’s [21]study (52.26 ± 9.64), she studied the multiple mediating roles of humanized nursing ability and professional respect in the influencing mechanism of decent work on nurses’ perception of responsibility, and concluded: A strong perception of decent work not only helps nurses to better perceive the humanistic care atmosphere in the working environment, but also encourages them to integrate the concept of humanistic care into nursing practice, so as to further develop professional characteristics such as the quality, awareness and ability of humanistic care, and improve their humanistic nursing ability. In addition, nurses with high humanized nursing ability will have a higher level of professional comprehensive quality and self-efficacy, thus improving their fit with their affiliated organizations, prompting them to make practical efforts to achieve the common goals of the organization, guiding them to hold a positive attitude towards their own work results, and thus stimulating nurses’ perception of responsibility [21], which is consistent with the conclusion of this study; slightly lower than the results of Ma’s [22] study (55.67 ± 12.87), the theme of her research is to explore the mediating role of decent work perception in psychological capital and coping ability of nurses in border areas of Yunnan Province and higher than the results of Min’s [23] (51.48 ± 7.33) and Cai’s [24] studies (48.77 ± 9.84), she studied the influencing factors of nurses’ perception of decent work in the emergency department, which is different from the research object in this study. The reasons are as follows: (1) It may be related to the different research subjects included. The nurses in this study were mainly from the surgical department. Compared with the emergency department, the patients in the surgery department have relatively stable conditions [25], less stress, more security, so their decent work perception is higher. (2) In this study, 89% of the nurses had a bachelor’s degree, and nurses who had received higher levels of education had higher expectations for their development, and they generally believed that their education did not match their job responsibilities, making it difficult to realize their values, consistent with Suliman’s [25] study that nurses with lower education may be more satisfied with their jobs, and thus, decent work perception was at a moderate level.

The cognition of role clarity includes role conflict and role ambiguity, with the former referring to conflict between different roles assumed by the individual or caused by different expectations from the environment, and the latter referring to uncertainty in the role environment experienced by the individual, that is, a lack of clarity about the role [26]. In this study, the role clarity score is 32.67 ± 5.65, which is at a moderate level, and the lowest scoring entry was “I am not sure if my work is accepted by my superiors”, and the highest scoring entry was “I know my job responsibilities “. It can be seen that nurses are very clear about their job responsibilities, but they are not very clear about whether their leaders recognize their work. Therefore, nursing managers should adopt encouraging management measures to recognize nurses’ work, such as specific and tangible individual rewards (performance, small gifts, etc.) to improve nurses’ motivation [26]. Job embeddedness refers to the sum of various positive factors that prevent individuals from leaving work [6]. In this study, the job embeddedness score of nurses was 69.47 ± 12.05, which was at a moderate level, higher than the results of Zhao [13](67.86 ± 12.53), he is studying the correlation between male nurses’ sense of decent work and job embedding. It may be because the nursing industry is still dominated by women, and male nurses lack career achievement and psychological pressure, which leads to a lower job embeddedness level than the results of this study.

The results of this study show that the total score of job embeddedness positively correlated with the total score of decent work perception, total score of role clarity, job reward score, career development score, and career recognition score(r = 0.640、0.658、0.529, all P < 0.05), indicating that the higher the nurses’ perception level of decent work and the higher their perception of role clarity, the higher their level of job embeddedness, which is consistent with the research results of Song and Zhao [27‐28]. The “job requirements-resources” theory can also provide support for the promotion of decent work perception on job embeddedness, which reveals that job requirements will consume nurses’ physical, psychological or emotional resources, lead to job burnout or health problems, and then tend to avoid positive work behaviors [29]. However, nurses can mobilize relevant resources to offset the negative emotions brought about by job requirements. In short, job resources help promote job embeddedness. The dual effect of this theory shows that decent work perception of can not only enhance work motivation by providing work resources, but also alleviate job burnout and promote health by alleviating work requirements [29].

In this study, the mediation effect analysis found that decent work perception played a partially mediating role between role clarity and job embeddedness, accounting for 88.1%, that is, role clarity could not only directly affect the job embeddedness level but also indirectly affect the job embeddedness level of nurses through decent work perception, which was consistent with the research hypothesis. The possible reason is that while enjoying decent work, clinical nurses will improve their clear cognition of their role, so that they are more willing to devote themselves to clinical work, and thus actively complete their work [24]. Nurses with a high sense of decent work are more able to perceive their own value at work, have more confidence and hope to cope with the complex and changing working environment, and show higher motivation at work, thus the degree of job embeddedness is higher. It is suggested that nursing managers should pay attention to the impact of nurses’ role clarity and sense of decent work on job embeddedness, strengthen the hardware and software construction of the practice environment, inspire nursing staff to work actively; establish a standardized and reasonable title promotion system, strengthen career expectations and development, provide skills training according to the characteristics of nurses, enhance their own ability and work autonomy; pay attention to the cultivation of nursing staff’s organizational value concepts, and strengthen the humanistic care and psychological support for their career development. The system focuses on cultivating the concept of organizational value of nursing staff, strengthening humanistic care and psychological support, and providing inexhaustible motivation for their career development and commitment.

This study shows that the decent work perception, role clarity and job embeddedness are all at a moderate level, and the decent work perception plays a partial mediating effect between role clarity and job embeddedness.