The decent work level of nurses in China: A systematic review and meta-analysis

Decent work, as defined by the International Labour Organization, refers to employment that provides workers with fair income, safety, dignity, and an equal environment-core standards ensuring labor value is realized in a safe, fair, and dignified setting. At present, there is no meta-analysis on the level of decent work of nurses in China, making it impossible to quantify the level. Therefore, we aimed to assess the current level of decent work of nurses and provide some reference for further improving the development of nursing careers.

Five Chinese and English databases (CNKI, PubMed, EMBASE, Web of science and CINAHL) were systematically searched for the research on the decent work level of nurses in China from the establishment of the database to March 2026. We used a random-effects model to analyse. Our primary outcome was the decent work level of nurses in China. The Agency for Healthcare Research and Quality was used to evaluate the quality of the cross-sectional studies.

A total of 38 cross-sectional studies involving 22,561 nurses in China were included. From the meta-analysis, we found that the level of decent work of nurses was 50.46 out of 80 (95% confidence interval [CI]: 47.77,53.15), the total score ranged from 16 to 80, the five sub-dimensions (Work reward, Work position, Career development, Professional recognition, and Work atmosphere) were 11.65 (95% CI: 10.66,12.65), 8.43 (95% CI: 7.65,9.20), 9.68 (95% CI: 8.93,10.43), 8.13 (95% CI: 7.48,8.78), and 10.33 (95% CI: 9.53,11.12), respectively. Subgroup analysis showed that male, high school diploma, registered nurses, nurses who were employed in non-supervisory clinical positions, those who had experienced workplace violence had a low level of decent work. We have indicated that the level of decent work for nurses in China is at a moderate level. Policymakers and managers should consider paying attention to nurses with lower levels of decent work and the career development plans of clinical nurses and whether a good working atmosphere has been formed, potentially laying a solid foundation for further improving the development of nurses.