Occupational Stress and Burnout Among Nurse Managers: Coping Pathways and Leadership Adaptation in Postpandemic Healthcare.

BACKGROUND

Nurse managers (NMs) play a pivotal role in sustaining care quality, workforce stability, and organizational resilience, yet chronic managerial stress and emotional demands have led to increasing burnout in this group. Understanding the association of coping strategies with this phenomenon is essential to supporting leadership sustainability.

AIM: To examine how problem-focused coping (PFC) and emotion-focused coping (EFC) strategies mediate the relationship between occupational stress and burnout among NMs and to identify demographic factors associated with burnout.

METHODS

The study adopted a cross-sectional correlational design and collected data from 116 NMs in two hospitals in southern Taiwan using validated self-report instruments. Mediation analyses were conducted using bootstrapped regression models (PROCESS Model 4) with 5000 resamples.

RESULTS

Occupational stress correlated positively with burnout (r = 0.58, p < 0.001). EFC significantly mediated this relationship (B = 5.01, 95% CI [2.39, 8.07]), amplifying stress effects and was associated with higher burnout levels, whereas PFC showed no significant mediation. Burnout was significantly associated with younger age, fewer children, and poorer perceived physical condition.

CONCLUSIONS

EFC was associated with higher burnout levels under conditions of elevated occupational stress, whereas PFC offered limited protection without organizational reinforcement. These findings refine the stress-coping framework by demonstrating that coping's effectiveness depends on contextual and institutional conditions and provide actionable insights for leadership development and workforce sustainability in healthcare organizations.

IMPLICATIONS FOR NURSING MANAGEMENT: Leadership development programs should incorporate emotional regulation, mentoring, and organizational support systems to strengthen adaptive capacity among NMs. Institutional policies that balance workload and promote psychological well-being are crucial to sustaining effective nursing leadership.