Mediating effect of psychological capital between perceived organizational support and work engagement in Chinese nurses: a systematic review and meta-analytic structural equation modeling

Global nursing shortages require the implementation of evidence-based strategies to improve work engagement. Although perceived organizational support (POS) and psychological capital (PsyCap) are recognized as important factors, their interaction exhibits variability across different cultural settings, particularly in high-pressure settings like the healthcare system in China. This study aimed to identify the mediating effect of PsyCap in the relationship between POS and work engagement in Chinese nurses, and to identify possible moderating variables. Relevant articles were searched in the CNKI, Wanfang, Weipu, PubMed, Web of Science, Embase, and Cochrane databases until 4 August 2024. To investigate the relationships between POS, PsyCap, and work engagement in cross-sectional studies, a two-stage meta-analytic structural equation modeling (MASEM) was utilized. The potential moderating roles of age, gender, region, hospital type, survey time, and study quality were tested using meta-regression analysis. A total of 54 studies involving 33 026 Chinese nurses were included. The study found that POS and work engagement were positively related in Chinese nurses (β = 0.308, 95% CI = [0.297, 0.319]). PsyCap (β = 0.257, 95% CI = [0.250, 0.264]) mediated this relationship. The proportion of female nurses in the sample was found to be a moderator (SE = 0.005, <i>p</i> = 0.045). POS and PsyCap had a positive impact on the work engagement of Chinese nurses. With the high turnover rates of Chinese nurses, female nurses who exhibit low PsyCap and work engagement need more organizational support. Conclusion: Based on these findings, it should be recommended that interventions focusing on providing organizational support and fostering PsyCap be implemented to increase the work engagement of Chinese nurses. Such interventions may include targeted support programs, professional development opportunities, and psychological well-being training.