Emotional labor and burnout among healthcare workers in Korea: occupation-specific moderated mediation through job satisfaction (a cross-sectional secondary analysis)

Abstract Background Evidence links emotional labor to burnout among hospital workers, yet most studies focus on nurses or aggregate diverse allied health occupations into a single group. This cross-sectional secondary analysis examined whether job satisfaction mediates the association between emotional labor and burnout, and whether the mediation pathway differs by occupation among hospital-based healthcare workers. Methods We analyzed data from a standardized self-administered survey conducted in July 2022 across six hospitals under the Korea Veterans Health Service. Of 570 eligible healthcare workers, 290 responded (response rate 50.9%), including clinical laboratory scientists, radiologic technologists, physical therapists, and dental hygienists. Emotional labor, job satisfaction, and burnout were assessed using validated questionnaires. We applied generalized structural equation modeling to test an occupation-specific moderated mediation model (emotional labor → job satisfaction → burnout), adjusting for age, sex, employment status, weekly working hours, self-rated health status, and hospital. Results Dental hygienists showed the highest mean emotional labor and burnout levels. In the overall mediation model, higher emotional labor was associated with lower job satisfaction (a = − 0.765; 95% CI − 0.857 to − 0.674) and higher burnout both directly (c′ = 0.340; 95% CI 0.261 to 0.420) and indirectly via job satisfaction (indirect effect = 0.096; 95% CI 0.050 to 0.143), corresponding to 22.1% mediation of the total effect (total effect = 0.436; 95% CI 0.357 to 0.516). In occupation-specific models, the indirect effect through job satisfaction was significant for clinical laboratory scientists and radiologic technologists, whereas the direct effect of emotional labor on burnout remained significant across all four occupations. Conclusion Emotional labor was positively associated with burnout among healthcare workers, and job satisfaction accounted for a meaningful portion of this association. The mediation pathway differed by occupation, suggesting that burnout mitigation strategies may benefit from occupation-tailored approaches, with particular attention to strengthening job satisfaction where mediation is evident.