Emotional labor regulation profiles and predictors among institutional elderly care workers: a cross-sectional study in western China

Emotional labor, the management of feelings and expressions to meet emotional demands, is crucial in the elderly care industry. However, this workforce faces challenges such as high turnover, burnout, and a lack of effective emotional management systems. Meanwhile, research on emotional labor in China has primarily focused on traditional service sectors, with insufficient attention to elderly care workers. This study aims to systematically examine the current state of emotional labor and its influencing factors among elderly care workers in Sichuan Province. Thus, it seeks to provide theoretical support and practical guidance for building a sustainable elderly care service system and addresses a gap in the literature on this occupational group. From June to December 2025, an online survey was administered to 900 elderly care workers from 67 long-term care facilities across Sichuan Province, using convenience sampling. A total of 592 valid responses were received (response rate: 65.8%). Data were collected using a general information questionnaire and the Emotional Labor Scale. Statistical analysis was performed using SPSS 26.0, including descriptive statistics, independent-sample t-tests, one-way ANOVA, and multiple linear regression. Regression analyses were guided by the Job Demands-Resources (JD-R) framework. The overall emotional labor score of participants was 48.97 ± 12.865, with deep acting showing the highest mean item score (4.72 ± 1.139), followed by emotional display (3.55 ± 1.220) and surface acting (2.94 ± 1.129). Multiple linear regression identified daily working hours and social support as core predictors of total emotional labor burden: social support negatively correlated with overall emotional labor intensity, while extended daily working hours predicted heavier emotional regulation demands. Specifically, job satisfaction and social support were negatively associated with surface acting. Gender, daily working hours, job satisfaction, on-the-job training, and residents’ agitated behaviors were positively associated with deep acting. Daily working hours were also positively associated with the emotional display dimension. Elderly care workers in western China exhibited clearly distinct dimensional patterns in emotional labor strategies, with deep acting as the dominant mode of regulation. Regression models identified daily working hours and social support as core correlates of overall emotional labor, with distinct predictors for each subdimension. These findings enrich the empirical evidence for emotional labor theory in aged care within the JD-R and Conservation of Resources frameworks and offer practical guidance for interventions to reduce the emotional regulation burden and support workforce stability.