Examining the moderated mediation effects of deep acting, personal accomplishment, and transformational leadership

The rapid aging of the population has intensified demand for long-term care services, while persistent turnover among home care workers (HCWs) undermines service quality and sustainability. Emotional labor theory suggests that deep acting may improve retention, yet the mechanisms involving personal accomplishment and transformational leadership remain unclear. A cross-sectional survey of 386 certified HCWs in Chiayi, Taiwan measured deep acting, personal accomplishment, transformational leadership, and retention intention. Analyses included descriptive statistics, ANOVA, and PROCESS Model 8. Direct effect analysis revealed that deep acting (B = 0.165, p = .009), transformational leadership (B = 0.160, p = .005), and personal accomplishment (B = 0.136, p = .017) significantly and positively predicted retention intention. Mediation and moderation effects were not supported. Demographic analyses indicated that older, married, and more experienced HCWs reported significantly higher retention intention. Female and long-tenured staff perceived stronger transformational leadership support. Deep acting and transformational leadership independently promote retention. Personal accomplishment also strengthens retention but does not mediate the effect of deep acting. The absence of moderation indicates that emotional regulation and leadership act as separate predictors. Workforce stability strategies should therefore cultivate genuine emotional engagement and supportive leadership as distinct organizational pillars.

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Publication Details

Journal
BMC Nursing
Published
2026-03-21
DOI
https://doi.org/10.1186/s12912-026-04568-1
Primary Topic
Conflict Management and Negotiation
Type
article
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article

Examining the moderated mediation effects of deep acting, personal accomplishment, and transformational leadership

Tung-sheng Kuo
BMC Nursing
Conflict Management and Negotiation
article

Examining the moderated mediation effects of deep acting, personal accomplishment, and transformational leadership

Tung-sheng Kuo
article en

Abstract

The rapid aging of the population has intensified demand for long-term care services, while persistent turnover among home care workers (HCWs) undermines service quality and sustainability. Emotional labor theory suggests that deep acting may improve retention, yet the mechanisms involving personal accomplishment and transformational leadership remain unclear. A cross-sectional survey of 386 certified HCWs in Chiayi, Taiwan measured deep acting, personal accomplishment, transformational leadership, and retention intention. Analyses included descriptive statistics, ANOVA, and PROCESS Model 8. Direct effect analysis revealed that deep acting (B = 0.165, p = .009), transformational leadership (B = 0.160, p = .005), and personal accomplishment (B = 0.136, p = .017) significantly and positively predicted retention intention. Mediation and moderation effects were not supported. Demographic analyses indicated that older, married, and more experienced HCWs reported significantly higher retention intention. Female and long-tenured staff perceived stronger transformational leadership support. Deep acting and transformational leadership independently promote retention. Personal accomplishment also strengthens retention but does not mediate the effect of deep acting. The absence of moderation indicates that emotional regulation and leadership act as separate predictors. Workforce stability strategies should therefore cultivate genuine emotional engagement and supportive leadership as distinct organizational pillars.

BMC Nursing
Nanhua University (TW)
Openalex Percentile: Top 18%
Conflict Management and Negotiation
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