Sustaining employee wellbeing: a mediation analysis of resilience as a pathway from sustainable HRM to happiness in healthcare and wellness settings

Introduction: Employee wellbeing has emerged as a critical concern for contemporary organizations, particularly in healthcare and wellness sectors where human capital is essential for service delivery. Although these professionals frequently encounter high demands, long working hours, and emotionally demanding tasks, sustaining their wellbeing represents both an ethical priority and strategic necessity for organizational sustainability. While research suggests that sustainable human resource management (HRM) practices foster employee wellbeing and long-term organizational performance, critical questions remain about the mechanisms through these practices operate. Specifically, it remains unclear whether sustainable HRM influences wellbeing solely through indirect pathways (such as building employee capacities) or also through direct effects, and whether these mechanisms operate similarly across different institutional and workforce contexts. Methods: We used a quantitative research strategy to collect data from 631 employees working in healthcare and wellness institutions in Lithuania during 2025. The questionnaire was distributed via organizational channels and professional networks. We analyzed the data using partial least squares structural equation modeling (PLS-SEM) with SmartPLS 4.0 software, employing bootstrapping procedures. Results: The measurement model demonstrated strong reliability and validity. Hypothesis testing revealed that sustainable HRM practices significantly and positively related to employee resilience, and employee resilience significantly related to happiness at work. Sustainable HRM also demonstrated a strong direct effect on happiness at work. The indirect effect through employee resilience was statistically significant, confirming partial mediation. Together, sustainable HRM and employee resilience explained 39.1% of variance in happiness at work, while sustainable HRM accounted for 8.0% of variance in employee resilience. Discussion: Research findings contribute to theoretical understanding by demonstrating that sustainable HRM influences happiness at work through dual pathways: directly through immediate perceptions of organizational support, fairness, and care, and indirectly through development of employee resilience as an adaptive capacity. This partial mediation pattern aligns with Conservation of Resources Theory and Broaden-and-Build Theory, revealing that sustainable HRM creates value through both immediate attitudinal enhancement and long-term resource development. Practically, results indicate that sustainable HRM including decent work, work place democracy and sustainable career climate could be presented as strategic investments that have directly impact to happiness at work and employee resilience.