Do challenge stress and hindrance stress affect quality of health care? Empirical evidence from China

Severe job stress has adverse effects on the health of Chinese healthcare workers. We investigated associations between job stress, health, and quality of health care among Chinese healthcare workers. To analyze associations between stress, health, and quality of health care among healthcare workers in 74 Chinese hospitals, we surveyed 2426 healthcare workers of primary, secondary, and tertiary hospitals in Western, Central, and Eastern China in 2017. Structural equation modelling was used to examine relationships between job stress, health, and quality of health care. The mediating effect of health on the association between job stress and quality of health care was examined with the Sobel test. In the final model, health had a moderate direct positive effect on the quality of health care (β = 0.24; p < 0.001). Challenge stress had a direct inverse effect on health (β = −0.05; p < 0.05) and a significant direct positive effect on the quality of health care (β = 0.26; p < 0.001). Hindrance stress had a significant inverse effect on health (β = −0.37; p < 0.001) and a moderate inverse effect on the quality of health care (β = −0.19; p < 0.001). The correlation between challenge stress and hindrance stress was significant and positive (β = 0.59; p < 0.001). A partial mediation effect was in the final model. The health status of healthcare workers is an important concern at all levels of Chinese hospitals. To improve quality of healthcare, appropriate challenge stress is recommended among young staff, and interventions targeting hindrance stress should be developed and implemented in all hospital departments.