Associations of multidimensional occupational stress and social support with anxiety and depressive tendencies among hospital workers in China: cross sectional survey study

Healthcare workers experience high levels of occupational stress and are at increased risk of anxiety and depression. Although prior research has documented multiple workplace stressors and the potential role of social support, less is known about how different dimensions of occupational stress relate to anxiety and depressive tendencies and whether support from different sources modifies these associations. This study aimed to identify specific dimensions of occupational stress associated with anxiety and depressive tendencies among healthcare workers in China and to examine whether perceived social support from family members, friends, and significant others moderated these relationships. We conducted a cross-sectional online survey using convenience and quota sampling among N = 414 physicians, nurses, and administrative staff at a tertiary hospital in Guangzhou, China. In hierarchical regression models, adding occupational stressors significantly improved model fit for both anxiety tendency ( ΔR² = 0.178, p < .001) and depressive tendency ( ΔR² = 0.151, p < .001). In the fully adjusted models, role ambiguity was positively associated with anxiety ( B = 1.54, p = .002) and depressive tendency ( B = 1.50, p = .008), as were strenuous working conditions (anxiety: B = 1.30, p < .001; depressive tendency: B = 0.87, p = .032). No individual source of perceived social support showed an independent association with either outcome. Exploratory moderation analyses suggested that the relevance of social support varied across occupational stressors and sources of support. In particular, support from significant others moderated the association between role overload and anxiety (Holm-adjusted p = .005), with this association becoming weaker as perceived support increased. By examining occupational stress and social support from a multidimensional perspective, this study highlights the importance of distinguishing among specific stressors and sources of support when addressing healthcare workers’ mental health. The findings suggest that workforce mental health strategies may benefit from addressing specific work-related stressors while recognizing that the relevance of supportive resources may vary across occupational and interpersonal contexts.