What sustains the healthcare workers? A qualitative study of occupational wellbeing in health and medical services

Background Occupational wellbeing among healthcare professionals is an essential determinant of organizational effectiveness and public health. Yet, in many healthcare systems, it remains overlooked, while chronic stress, policy instability, and limited resources undermine workforce sustainability. Objective This study aimed to explore the multidimensional factors that sustain or challenge occupational wellbeing among healthcare professionals in Iran. Methods A qualitative design was employed using purposive sampling to select 19 participants, including physicians, nurses, and mental health experts. Semi-structured interviews were conducted, and data were analyzed through thematic analysis guided by King and Horrocks’ framework, integrating inductive and deductive coding. Results Five interrelated domains were identified: psychological and emotional wellbeing, individual resilience and coping, organizational design and leadership, healthcare-specific stressors, and socio-cultural influences. These dimensions interacted dynamically, shaping professionals’ sense of autonomy, mastery, solidarity, and purpose. While workload, systemic instability, and policy ambiguity eroded wellbeing, resilience was strengthened through spirituality, collegial support, and family networks. Conclusion Occupational wellbeing is best understood as a dynamic, holistic process shaped by structural, psychological, and cultural factors. Sustainable improvement requires human-centered management that emphasizes supportive leadership, organizational culture, and systemic redesign to foster resilient, creative, and purposeful healthcare professionals.