Self-worth, emotional labor, work engagement, and anxiety among nurses: a latent profile and mediation analysis

Nurse anxiety threatens care quality and workforce stability. The objective of this study was to examine the relationship between self-worth and anxiety among nurses, and to investigate the chain mediating roles of work engagement and emotional labor across heterogeneous subgroups.

Using a cross-sectional design and random sampling, a questionnaire survey was conducted among 1,280 nurses from a Grade A tertiary hospital in Wuhan from March to August 2025. The measurement tools included a General Information Questionnaire, the Adult Self-Worth Questionnaire, the Generalized Anxiety Disorder Scale, the Work Engagement Scale, and the Emotional Labor Scale. Latent Profile Analysis (LPA) was applied to identify heterogeneous subgroups. PLS-SEM was used to examine the relationships between nurses' self-worth and anxiety (with work engagement and emotional labor as mediating variables).

Three nurse subgroups were identified: the "Resource-Depleted Group" (19.38%), the "Balanced Group" (69.92%), and the "Resource-Abundant Group" (10.70%). The anxiety scores of the three subgroups were (7.51 ± 4.61), (7.16 ± 5.16), and (6.46 ± 4.43) (mean ± SD), respectively, showing statistically significant differences (F = 7.85, p < 0.050). Hierarchical mediation analysis revealed that the chain mediation effect was non-significant in the Resource-Depleted Group, where only professional self-worth exerted a direct negative predictive effect on anxiety (β = -1.1047, p < 0.050). In contrast, significant chain mediation effects were observed in both the Balanced Group and Resource-Abundant Group (both p < 0.050).

: Three subgroups with significantly distinct resource states were identified among nurses: the Resource-Depleted Group, the Balanced Group, and the Resource-Abundant Group. Moreover, the effect of self-worth on nurses' anxiety through work engagement and emotional labor was found to be subgroup-dependent.