Associations Between Leadership Self-Efficacy, Self-Leadership, and Work-Related Quality of Life Among Healthcare Professionals in Albania: A Structural Equation Mediation Analysis

Background: Work-related quality of life (WRQoL) has become a critical indicator of healthcare professionals’ (HCPs) well-being in increasingly demanding healthcare systems. Recent research highlights the role of individual psychological resources in shaping work outcomes. However, limited evidence exists on how these resources interact within a mediation framework, particularly in South-Eastern European contexts characterized by workforce shortages, migration, and unequal distribution of healthcare staff. Objective: To examine the associations between leadership self-efficacy, self-leadership, work-related quality of life (Pos-WRQoL), and stress at work (SAW) among Albanian HCPs, and to test whether self-leadership statistically mediates the associations between leadership self-efficacy and these work-related outcomes within the proposed model. Methods: A cross-sectional observational study was conducted between November 2025 and March 2026 among 394 healthcare professionals. Data were collected via an online survey using instruments assessing leadership self-efficacy, self-leadership, and WRQoL. Structural equation modelling was used to examine the cross-sectional mediation model, with indirect effects estimated via bootstrapping and model fit assessed using standard indices. Results: Leadership self-efficacy was positively associated with self-leadership (β = 0.549, p < 0.001), Pos-WRQoL (β = 0.265, p < 0.001), and SAW (β = 0.154, p < 0.05). Self-leadership was positively associated with Pos-WRQoL (β = 0.494, p < 0.001) and SAW (β = 0.295, p < 0.001). Mediation analysis indicated statistically significant indirect associations through self-leadership between leadership self-efficacy and both Pos-WRQoL (indirect β = 0.271, p < 0.001) and SAW (indirect β = 0.162, p < 0.001). Model fit indices indicated an acceptable fit (CFI = 0.991; TLI = 0.991; RMSEA = 0.074; SRMR = 0.043). Conclusions: Leadership self-efficacy and self-leadership were positively associated with Pos-WRQoL among HCPs; however, their positive association with SAW suggests that higher levels of individual psychological resources do not necessarily coincide with lower perceived stress. These findings highlight the potential relevance of considering individual psychological resources alongside organisational conditions when examining workforce well-being and sustainability in resource-constrained healthcare systems such as Albania.