Psychological Health Risk Factors Among Healthcare Workers: A Structural Equation Modeling Approach

Background: The psychological health of healthcare workers is a critical global public health concern. Identifying associated risk factors and their interrelationships is key to informing the development of effective interventions. This study aimed to construct a risk factor model for psychological health among healthcare workers and to examine the strength and patterns of associations between various factors and psychological health outcomes using structural equation modeling. Methods: A cross-sectional survey was conducted among 930 healthcare professionals. Structural equation modelling (SEM) was used to test the theoretical hypotheses, with bootstrapping used for path significance and multiple indicators multiple causes (MIMIC) models used for robustness validation. Results: The social environment and job demand risks were greater than the negative events and psychological adjustment risks. The final model explained 62.2% of the variance in psychological health. The social environment and organizational management functioned as distal risk factors, exerting indirect effects. Job demands, negative events, and job resource risks were associated with psychological health through psychological adjustment. Most of the hypothesized direct associations with the outcomes-burnout, anxiety, depression, suicidal ideation, and turnover intentions-were significant, except for the direct effects of job resource risk on anxiety and job demand/resource risk on suicidal ideation. MIMIC analysis confirmed the stability of the model. Conclusions: The proposed model clarifies how multilevel risk factors interact to affect healthcare workers' psychological health. The findings support the development of comprehensive, prioritized interventions, including strengthened legal protections, dynamic staffing schemes in high-pressure departments, and routine psychological resilience training for staff.