Volume 14, Issue 1 (Winter 2026)
Iran J Health Sci 2026, 14(1): 25-34 |
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Ethics code: IR.MAZUMS.REC.1400.615
Clinical trials code: IR.MAZUMS.REC.1400.615
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Kalteh H, Etemadinezhad S, kalteh A, Mousavinasab S, Heidari H, ramzani S. Structural Equation Modeling of Work Ability in Iranian Healthcare Workers: Direct and Indirect Effects of Job Demands and Leadership Through Job Satisfaction and General Health. Iran J Health Sci 2026; 14 (1) :25-34
URL: http://jhs.mazums.ac.ir/article-1-1013-en.html
URL: http://jhs.mazums.ac.ir/article-1-1013-en.html
Hajiomid Kalteh 
, Siavash Etemadinezhad * , Azimeh Kalteh , Seyed-Nouraddin Mousavinasab , Hamidreza Heidari , Solale Ramzani
, Siavash Etemadinezhad * , Azimeh Kalteh , Seyed-Nouraddin Mousavinasab , Hamidreza Heidari , Solale Ramzani
Department of Occupational Health Engineering, Health Science Research Center, Faculty of Health, Mazandaran University of Medical Science, Sari, Iran. , dr.setemadi@yahoo.com
Abstract: (81 Views)
Background and Purpose: Healthcare workers face substantial physical and psychological job demands that can affect their work ability. Although previous studies have examined the relationships between psychosocial factors and work ability individually, few have addressed their combined effects within a comprehensive, theory-driven framework. Grounded in the job demands–resources (JD-R) model, this study explored the pathways between psychosocial factors and work ability among Iranian healthcare workers. Data were analyzed using structural equation modeling (SEM) to examine the direct and indirect effects of psychosocial factors, including job demands, leadership, job satisfaction, and general health.
Materials and Methods: This cross-sectional study included 579 healthcare workers in Iran. Data were collected using self-administered questionnaires, including the work ability index (WAI) and selected dimensions of the Copenhagen psychosocial questionnaire II (COPSOQ II). Descriptive statistics, the Pearson correlation, and SEM were used. Model fit was evaluated using comparative fit index (CFI), Tucker-Lewis index (TLI), goodness of fit index (GFI), and root mean square error of approximation (RMSEA) (P<0.05).
Results: Work ability was negatively correlated with job satisfaction (r=-0.378), leadership (r=-0.249), and job demands (r=-0.259) (all P<0.01), and showed a weak positive correlation with general health (r=0.094, P<0.05). The SEM showed excellent fit (χ²=0.756, df=2, P=0.685; CFI=1; TLI=1.02; GFI=0.99; RMSEA=0). Leadership had a significant indirect effect on work ability through job satisfaction (β=-0.142), while job demands had a direct negative effect (β=-0.19). General health was not a significant predictor in the final model.
Conclusion: Job demands directly reduce work ability, while leadership has a negative indirect effect through job satisfaction. These unexpected patterns suggest that contextual factors may influence the JD-R model’s predicted relationships, underscoring the need for caution and further research.
Materials and Methods: This cross-sectional study included 579 healthcare workers in Iran. Data were collected using self-administered questionnaires, including the work ability index (WAI) and selected dimensions of the Copenhagen psychosocial questionnaire II (COPSOQ II). Descriptive statistics, the Pearson correlation, and SEM were used. Model fit was evaluated using comparative fit index (CFI), Tucker-Lewis index (TLI), goodness of fit index (GFI), and root mean square error of approximation (RMSEA) (P<0.05).
Results: Work ability was negatively correlated with job satisfaction (r=-0.378), leadership (r=-0.249), and job demands (r=-0.259) (all P<0.01), and showed a weak positive correlation with general health (r=0.094, P<0.05). The SEM showed excellent fit (χ²=0.756, df=2, P=0.685; CFI=1; TLI=1.02; GFI=0.99; RMSEA=0). Leadership had a significant indirect effect on work ability through job satisfaction (β=-0.142), while job demands had a direct negative effect (β=-0.19). General health was not a significant predictor in the final model.
Conclusion: Job demands directly reduce work ability, while leadership has a negative indirect effect through job satisfaction. These unexpected patterns suggest that contextual factors may influence the JD-R model’s predicted relationships, underscoring the need for caution and further research.
Keywords: Job demands, Leadership, Job satisfaction, General health, Work ability index (WAI), Healthcare workers
Type of Study: Original Article |
Subject:
Occupational Health
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