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

Background and Purpose: Healthcare workers face substantial physical and psychological job demands that can affect their work ability. Although previous studies have examined isolated relationships between psychosocial factors and work ability, few have addressed their combined effects within a comprehensive, theory-driven framework. Grounded in the Job Demands–Resources (JD-R) model, this study aimed to explore and test 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 ۵۷۹ 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, Pearson correlation, and SEM were used. Model fit was evaluated using CFI, TLI, GFI, and RMSEA (p < ۰.۰۵). Results: Work ability was negatively correlated with job satisfaction (r = −۰.۳۷۸), leadership (r = −۰.۲۴۹), and job demands (r = −۰.۲۵۹) (all p < ۰.۰۱), and showed a weak positive correlation with general health (r = ۰.۰۹۴, p < ۰.۰۵). The SEM showed excellent fit (χ² = ۰.۷۵۶, df = ۲, p = ۰.۶۸۵; CFI = ۱.۰۰; TLI = ۱.۰۲; GFI = ۰.۹۹; RMSEA = ۰.۰۰). Leadership had a significant indirect effect on work ability through job satisfaction (β = −۰.۱۴۲), while job demands had a direct negative effect (β = −۰.۱۹). 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 relationships predicted by the JD-R model, highlighting the need for caution and further research.

کلیدواژه ها:

Job Demands ، Leadership ، Job Satisfaction ، General Health ، Work Ability Index ، Healthcare Workers ​​​​​​​