Occupational stress, psychological resources, coping responses, and job satisfaction among healthcare workers in Ho Chi Minh City: a three-wave prospective cohort study.

Abstract

Background: Healthcare workers (HCWs) in Vietnam face compounding occupational stressors placing them at elevated risk for diminished job satisfaction, depression, and anxiety. Longitudinal within-person evidence linking occupational stress to job satisfaction remains sparse in Southeast Asian low- and middle-income countries such as Vietnam.

Methods: A three-wave prospective cohort study enrolled 1,500 healthcare workers (HCWs; physicians, nurses, pharmacists, technicians) from 15 healthcare facilities in Ho Chi Minh City (T1: January-March 2023; T2: July-September 2023; T3: January-March 2024). Occupational stress (Effort-Reward Imbalance, ERI), psychological resources (resilience, perceived social and organizational support), coping responses (adaptive and maladaptive coping), and mental health outcomes were assessed at each wave using established self-report instruments adapted for Vietnamese use. Latent growth curve (LGC) modeling characterized job satisfaction trajectories across three waves; Random Intercept Cross-Lagged Panel Modeling (RI-CLPM) estimated within-person indirect associations between psychological resources and job satisfaction as the primary outcome. Multiple imputation and cluster-robust standard errors were applied.

Results: Twelve-month retention was 92.6%. Mean job satisfaction (JSS) scores declined from T1 to T2 (mixed-effects contrast: b = -5.10, p < .001) and, to a significantly smaller degree, from T2 to T3 (b = -1.25, p < .001; contrast-of-contrasts b = 3.85, p < .001). Exploratory comparisons suggested heterogeneity in decline magnitude across professional groups; partial scalar invariance provided incomplete support for these comparisons, which remain exploratory because they were unadjusted for group-level occupational and demographic differences. Deviations in observed ERI composite scores at T1 were associated with subsequent deviations in resilience, adaptive coping, maladaptive coping, total perceived social support, and organizational support at T2. These variables were, in turn, associated with job satisfaction at T3, including a primary resilience (Brief Resilience Scale, BRS) pathway indirect association (ERI→BRS→JSS = -1.28, 95% Monte Carlo CI [-1.71, -0.85]). All five primary indirect associations were statistically significant (Benjamini-Hochberg q < 0.001).

Conclusions: Job satisfaction declined across the study period, with exploratory evidence of heterogeneity across professional groups. Within-person patterns were consistent with Conservation of Resources theory. These preliminary findings identify candidate targets for future intervention research; pre-registered replication is needed.