Predictors of Nurses Work Engagement at General Hospitals in Kedah: The Roles of Workload, Autonomy, Supervisor Support, and Resilience

Abstract

Nurses’ work engagement is fundamental to safe and consistent care in Malaysia’s public hospitals, particularly where heavy workloads and resource constraints are routine. Drawing on the Job Demands–Resources (JD–R) model and Conservation of Resources (COR) theory, this study examines how one key demand (workload), two job resources (autonomy, supervisor support), and one personal resource (resilience) shape nurses’ work engagement in Kedah. A cross-sectional design was employed using validated instruments for all constructs. Analyses included psychometric checks, correlations, multiple regression, and single mediation modelling of the pathway from workload to resilience to nurses work engagement. Overall, nurses reported high engagement despite challenging demands. Supervisor support emerged as a consistent positive driver, whereas autonomy alone did not significantly enhance engagement in this context. Workload showed a nuanced pattern: when combined with resilience, it demonstrated a moderate “challenge” effect, yet simultaneously undermined engagement indirectly by eroding resilience. Mediation testing confirmed resilience as the mechanism explaining how workload lowers engagement, producing a “competitive” pattern where a small positive direct link coexists with a negative indirect pathway. Theoretically, these findings refine JD–R by showing that resilience mediates the effects of demands more strongly than resources, while from a COR perspective, they demonstrate a resource-loss pathway from workload to reduced engagement. Practically, hospital management should regulate workload surges, strengthen supervisory support, and mainstream shift-sensitive resilience training; autonomy initiatives will yield greater impact when supported by enabling leadership and adequate structural scaffolding.