The Impact of Stigma on Autonomous Motivation Among Psychiatric Hospital Staff in China: The Mediating Role of...

Stigma is a persistent psychosocial stressor in psychiatric care settings, yet its impact on the motivation of nursing staff and other healthcare professionals remains underexplored. This study examined how four dimensions of stigma-perceived stigma, self-stigma, social concealment, and positive response-relate to autonomous motivation and whether turnover intention mediates these relationships.

A cross-sectional survey was conducted with 2813 employees from 36 psychiatric hospitals across six provinces in China. Validated scales measured stigma dimensions, turnover intention, and autonomous motivation. Structural equation modeling with bootstrapped confidence intervals tested direct and indirect pathways.

Perceived stigma directly predicted lower autonomous motivation, whereas self-stigma and social concealment reduced motivation only indirectly via turnover intention. Notably, since the positive response dimension was reverse-scored, higher stigma scores (representing lower positive response) were associated with reduced autonomous motivation through both direct and indirect pathways. Perceived stigma showed no significant indirect effect through turnover intention.

Different stigma dimensions influence motivation through distinct psychological mechanisms. Strategies that reduce internalized stigma, foster value-affirming behaviors, and address turnover-related strain may help sustain autonomous motivation in high-pressure psychiatric settings. These findings offer actionable insights for nursing managers seeking to strengthen workforce engagement and retention.