The impact of emotional labor on sleep-related worry among pediatric nurses in Chinese public hospitals: the mediating role of self-regulatory fatigue

Background Pediatric nurses frequently engage in emotional labor in their interactions with children who have difficulty expressing themselves and with anxious families. This practice is associated with emotional numbness and burnout, and may negatively affect the quality of care. While pediatric nurses are a high-risk group for emotional labor, the intrinsic associations among emotional labor, self-regulatory fatigue, and sleep-related worry in this population remain unclear. Aims This study aims to examine the mediating role of self-regulatory fatigue in the relationship between emotional labor and sleep-related worry. Method This multicenter cross-sectional study recruited 604 pediatric nurses from various medical institutions across China. Data were collected using self-reported questionnaires, including a demographic questionnaire, the Emotional Labor Scale (ELS), the Self-regulatory Fatigue Scale (SRF-S), and the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), which was used to assess sleep-related worry. Descriptive statistics, correlation analysis, univariate analysis, and multivariate analysis were performed using SPSS 27.0. Mediation analysis was conducted using the PROCESS macro (Model 4) for SPSS 27.0. Results Emotional labor showed significant positive correlations with self-regulatory fatigue ( r = 0.469, p < 0.01) and sleep-related worry ( r = 0.460, p < 0.01). Self-regulatory fatigue was positively correlated with sleep-related worry ( r = 0.394, p < 0.01). Mediation analysis indicated that self-regulatory fatigue statistically partially mediated the relationship between emotional labor and sleep-related worry, accounting for 26.9% of the total effect (based on 5,000 bootstrap samples; 95% CI for the indirect effect: [0.0493, 0.1243]). Conclusion The findings indicate that, among pediatric nurses, emotional labor and sleep-related worry are positively associated, and this relationship is statistically mediated by self-regulatory fatigue.