Multidimensional mechanisms of occupational stress among healthcare workers: a structural equation modeling analysis from the seventh Guangxi health service survey

Objective The issue of work-related stress among medical personnel has become a key factor affecting the quality of healthcare services and the sustainable development of the medical industry. Taking healthcare workers in Guangxi as the research object, this study aims to systematically explore the multidimensional influencing factors and intrinsic action mechanisms of their occupational stress based on the structural equation model (SEM), clarify the direct and indirect effects among variables, and thus provide theoretical support and empirical evidence for formulating scientific and effective stress intervention strategies for Guangxi and other regions with similar characteristics. Method Based on the dataset of medical staff in the Guangxi Zhuang Autonomous Region from the Seventh National Health Service Survey of China, 916 healthcare professionals from various medical institutions in Guangxi were selected as the research sample. A structured questionnaire was used to collect measurement data on latent variables including work environment, professional environment, job characteristics and personal characteristics, work experience, and work pressure. SPSS 26.0 was adopted for reliability analysis (Cronbach’s α coefficient) and exploratory factor analysis, while AMOS 26.0 was used to conduct confirmatory factor analysis for testing the structural validity of the scales, and construct a structural equation model to carry out path verification and effect analysis of the research hypotheses. Results The model fitting results showed that all adaptation indices reached the ideal level (χ 2 /df = 4.001, GFI = 0.942, AGFI = 0.921, NFI = 0.943, CFI = 0.986, SRMR = 0.059, RMSEA = 0.057). Specific path analysis indicated that: (1) Work environment had a significant negative direct effect on work pressure ( β = −0.272, p 0.001), and also exerted a significant positive influence on job characteristics and personal characteristics ( β = 0.454, p 0.001) as well as work experience ( β = 0.206, p 0.001); (2) Professional environment had a direct negative impact on work pressure ( β = −0.200, p 0.001), and had significant positive effects on work environment ( β = 0.561, p 0.001) and work experience ( β = 0.224, p 0.001); (3) Work experience had a significant negative effect on work pressure ( β = −0.115, p = 0.015), meaning poorer work experience led to higher occupational stress; (4) Job characteristics and personal traits had a significant positive direct effect on work pressure ( β = 0.551, p 0.001), which was contrary to the initial hypothesis, and they could indirectly affect work pressure through the mediating role of work experience (path effect value = 0.407, p 0.001). In addition, the study verified a significant negative chain mediating effect of the path work environment→job characteristics and personal characteristics→work experience→work pressure (estimate = −0.021, 95% CI −0.040,-0.006, p 0.01). Work environment, professional environment, and work experience were the core factors for alleviating healthcare workers’ stress, acting on stress levels through both direct and mediating effects. All research hypotheses were supported except for the non-statistically significant path from professional environment to job and personal characteristics. Conclusion In view of the characteristics of concentrated ethnic minorities and unbalanced urban–rural distribution of medical resources in Guangxi, efforts should be made to optimize the physical and social aspects of the work environment of medical staff, build a harmonious doctor-patient relationship to improve the professional environment, and enhance professional identity and career growth experience to strengthen work satisfaction. It is necessary to build a multi-stakeholder collaborative intervention system involving the government, medical institutions and society, implement resource inclination and differentiated policies for grassroots and ethnic minority medical and health institutions in Guangxi, and formulate targeted pressure reduction measures combined with regional and ethnic characteristics. This can provide practical guidance for alleviating the work pressure of healthcare workers in Guangxi, stabilizing the local medical talent team, and promoting the sustainable development of the medical and health industry in ethnic minority areas.