Effects of Nursing Workforce and Work Environment on Health System Resilience in Public Health Emergencies: A
Yun Hu1, Aozhou Weng1, Xiyi Wang1
1School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
Journal of Advanced Nursing
|January 11, 2026
Summary
Enhancing health system resilience requires investing in nursing competence and supportive work environments. This study identified four resilience patterns, guiding targeted strategies for public health emergencies.
Area of Science:
- Healthcare Management
- Nursing Science
- Public Health Policy
Background:
- Health system resilience is crucial for navigating public health emergencies.
- Nursing competence and the work environment are key factors influencing a health system's ability to withstand and recover from crises.
- Understanding the interplay between these factors and different resilience patterns is essential for effective preparedness.
Purpose of the Study:
- To examine the associations between nursing competence, work environment, and health system resilience.
- To analyze how nursing competence and work environment relate to distinct patterns of health system resilience.
- To provide evidence-based insights for enhancing healthcare systems' adaptability during disasters.
Main Methods:
- A multi-center, cross-sectional study involving 2435 nurses across 33 hospitals in eastern China.
- Utilized questionnaires for nursing competence, work environment resources, nurse disaster resilience, and organizational commitment.
- Employed structural equation modeling, cluster analysis, and multivariable regression to analyze relationships and identify resilience patterns.
Main Results:
- Nursing competence and work environment support significantly influenced health system resilience.
- Four resilience patterns were identified: strong, marginal, low, and critical vulnerability.
- Strong resilience was associated with balanced individual-organizational resources, while vulnerable systems depended heavily on environmental support.
Conclusions:
- Policymakers and managers should develop targeted strategies focusing on nurse workforce investment and optimized work environments.
- These strategies are vital for enhancing health system resilience across various levels of public health emergencies.
- The findings offer evidence for improving nurse training and resource allocation to bolster healthcare system adaptability.
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