Understanding the resilience paradox among healthcare workers experiencing work family conflict

Work-family conflict (WFC) is a recognised occupational stressor for clinicians. However, integrated contextual evidence on how it harms quality of life (QoL) and whether internal and professional resources can offset that harm remains scarce in South-Asian health systems. This study aimed to quantify the direct impact of WFC on QoL, test psychological capital (PsyCap) as a mediator, examine occupational commitment (OC) as a conditional moderator of the WFC → PsyCap pathway, and evaluate the proposed moderated and mediated relationships among Pakistani healthcare professionals. An in-person cross-sectional survey was administered to 271 healthcare professionals from five tertiary institutions in Rawalpindi and Islamabad (response rate = 77%; 57% doctors, 43% nurses). Validated five-point Likert scales measured WFC (α = 0.83), PsyCap (α = 0.85), OC (α = 0.88), and QoL (α = 0.73). Hierarchical regression was used to assess direct effects; PROCESS Model 1 tested moderation, and Model 4 tested mediation, each with 5000 bias-corrected bootstrap samples. Respondents reported moderate work-family conflict (WFC) (M = 3.30 ± 0.81) and favourable quality of life (QoL) (3.71 ± 0.67). WFC demonstrated a small negative correlation with QoL ( r = -.196, p < .001). Psychological capital (PsyCap) positively predicted QoL (β = 0.31, p < .001). Hierarchical regression indicated that WFC significantly predicted lower QoL (β = − 0.35, p < .001; ΔR² = 0.10, f² = 0.13). Adding PsyCap increased the explained variance to 32% (additional ΔR² = 0.10, f² = 0.11). The WFC × occupational commitment (OC) interaction on PsyCap was significant (β = − 0.15, SE = 0.07, p = .008; ΔR² = 0.03, f² = 0.03), indicating that the association between WFC and PsyCap varied across levels of occupational commitment. Johnson–Neyman analysis demonstrated that WFC was significantly associated with lower PsyCap when OC scores exceeded 3.1. The indirect WFC → PsyCap → QoL pathway was non-significant (B = 0.013, 95% CI − 0.015, 0.040). WFC exerts a substantial direct burden on clinicians’ QoL, whereas PsyCap independently contributes to well-being. Occupational commitment significantly altered the relationship between WFC and PsyCap; however, higher occupational commitment did not consistently buffer the adverse effect of WFC on psychological resources across all levels. Because PsyCap did not mediate the conflict–well-being relationship, longitudinal studies are required to evaluate delayed resource-loss and recovery processes proposed by Conservation-of-Resources theory. Organisational interventions should prioritise reducing work-family conflict while simultaneously strengthening professional support systems and psychological resources among clinicians.