Mediating role of emotional labor in the association between emotional intelligence and fatigue among Chinese doctors: a cross-sectional study

Background: Fatigue is highly prevalent among doctors worldwide. However, no research has been done to examine the associations of emotional intelligence (EI) and emotional labor strategy with fatigue among Chinese doctors. This study aimed to examine whether or not emotional labor strategy mediates the association between EI and fatigue in this occupational group. Methods: A cross-sectional study was conducted in Shenyang from March to April 2014. A set of self-administered questionnaires was distributed to 950 doctors, including Chalder Fatigue Scale (CFS), Wong and Law Emotional Intelligence Scale (WLESS) and a 14-item emotional labor scale. Complete responses were obtained from 740 (77. 9%) participants. Hierarchical linear regression was performed to examine the associations of EI and emotional labor strategies (surface acting, SA; deep acting, DA; natural acting, NA) with fatigue. Asymptotic and resampling strategies were used to examine the mediating roles of emotional labor strategies. Results: The mean score of fatigue was 8.02 (SD = 3.39). After adjusting for age, gender, marital status, job rank, monthly income, weekly working time, shift and department, EI was negatively associated with fatigue (beta = - 0.270, P < 0.001). SA was positively associated with fatigue (beta = 0.168, P < 0.001), whereas NA was negatively associated with fatigue (beta = -0.105, P = 0.004); however, DA was not significantly associated with fatigue (beta = 0.034, P = 0.381). Thus, SA (a X b = - 0.026, BCa 95% CI: - 0.050, - 0.011) and NA (a X b = - 0.024, BCa 95% CI: - 0.046, - 0.006) significantly mediated the association between EI and fatigue, respectively. Conclusions: There was a high level of fatigue among Chinese doctors. EI could indirectly reduce fatigue partially through modifying SA and NA strategies, respectively. EI intervention, education and training in emotional labor should be carried out to cope with fatigue.