Revealing Indonesian healthcare workers’ burnout, work engagement, and job satisfaction during the covid-19 pandemic: the lens of the job demands-resources model

Herachwati, Nuri; Haqq, Zulkifli Nurul; Choirunnisa, Zuyyinna; Pramesti, Gebrina Ayu; Rahmandika, Harris Prasetya Article Revealing Indonesian healthcare workers’ burnout, work engagement, and job satisfaction during the covid-19 pandemic: the lens of the job demands-resources model Cogent Business & Management Provided in Cooperation with: Taylor & Francis Group Suggested Citation: Herachwati, Nuri; Haqq, Zulkifli Nurul; Choirunnisa, Zuyyinna; Pramesti, Gebrina Ayu; Rahmandika, Harris Prasetya (2024) : Revealing Indonesian healthcare workers’ burnout, work engagement, and job satisfaction during the covid-19 pandemic: the lens of the job demandsresources model, Cogent Business & Management, ISSN 2331-1975, Taylor & Francis, Abingdon, Vol. 11, Iss. 1, pp. 1-20, https://doi.org/10.1080/23311975.2024.2371328 This Version is available at: https://hdl.handle.net/10419/326383 Standard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. 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If the documents have been made available under an Open Content Licence (especially Creative Commons Licences), you may exercise further usage rights as specified in the indicated licence. https://creativecommons.org/licenses/by/4.0/ Cogent Business & Management ISSN: 2331-1975 (Online) Journal homepage: www.tandfonline.com/journals/oabm20 Revealing Indonesian healthcare workers’ burnout, work engagement, and job satisfaction during the covid-19 pandemic: the lens of the job demands-resources model Nuri Herachwati, Zulkifli Nurul Haqq, Zuyyinna Choirunnisa, Gebrina Ayu Pramesti & Harris Prasetya Rahmandika To cite this article: Nuri Herachwati, Zulkifli Nurul Haqq, Zuyyinna Choirunnisa, Gebrina Ayu Pramesti & Harris Prasetya Rahmandika (2024) Revealing Indonesian healthcare workers’ burnout, work engagement, and job satisfaction during the covid-19 pandemic: the lens of the job demands-resources model, Cogent Business & Management, 11:1, 2371328, DOI: 10.1080/23311975.2024.2371328 To link to this article: https://doi.org/10.1080/23311975.2024.2371328 © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group Published online: 02 Jul 2024. Submit your article to this journal Article views: 1821 View related articles View Crossmark data Citing articles: 1 View citing articles Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=oabm20 ManageMent | ReseaRch aRticle Cogent Business & ManageMent 2024, VoL. 11, no. 1, 2371328 Revealing Indonesian healthcare workers’ burnout, work engagement, and job satisfaction during the covid-19 pandemic: the lens of the job demands-resources model nuri herachwatia,b , Zulkifli nurul haqqc,d , Zuyyinna choirunnisab,c , gebrina ayu Pramestie and harris Prasetya Rahmandikaa aDepartment of Management, Faculty of economics and Business, universitas airlangga, surabaya, indonesia; bDepartment of Human Resource Development, Postgraduate school, universitas airlangga, surabaya, indonesia; cCenter for Dynamic Capability, universitas airlangga, surabaya, indonesia; dDepartment of Management, Faculty of economics and Business, universitas Muhammadiyah semarang, semarang, indonesia; eDepartment of technology Management, Faculty of Creative Design and Digital Business, institut teknologi sepuluh nopember, surabaya, indonesia ABSTRACT this study aims to shed light on the working conditions of healthcare institutions (hcis) during the covid-19 pandemic by adopting and extending the job demands-resources (JD-R) model to the psychological conditions (i.e., burnout, work engagement, and job satisfaction) of healthcare workers (hcWs). a quantitative design was employed. a cross-sectional survey was conducted, in which questionnaires were distributed to hcWs (n = 400). Partial least squares structural equation modeling (Pls-seM) was employed to test the proposed hypotheses. additionally, this study employed two-stage least squares (2sls) regression analysis to address endogeneity concerns. the findings confirm the JD-R model (i.e., the health impairment process, the motivational process, and the cross-link relationships) and its impact on hcWs’ job satisfaction. this study contributes to existing literature on the JD-R model by highlighting the crisis context in revealing the JD-R model and its impact on work-related well-being and hci practitioners in ensuring business processes in crisis circumstances such as the covid-19 pandemic, particularly decreasing burnout and increasing work engagement and job satisfaction of hcWs. 1. Introduction During the covid-19 pandemic, healthcare institutions (hcis) were a stressful workplace. the imbalance of job demands-resources (JD-R) appeared as a major challenge for hcWs during the covid-19 pandemic (gómez-salgado et al., 2021). specifically, the increasing number of patients led hcWs to work constantly. since covid-19’s emergence in indonesia in March 2020, it only took three months to go from two cases to more than 30,000 cases in June 2020, representing more than 300 cases per day on average. similarly, a shortage of medical equipment such as ventilators hindered hcWs from carrying out their healthcare responsibilities. in June 2020, more than 15,000 ventilator shortages were reported in indonesia: 0.03 ventilators per 1000 patients (Olivia et al., 2020). Furthermore, according to the JD-R model (schaufeli, 2017), the imbalance impaired hcWs’ psychological conditions, increasing burnout and © 2024 the author(s). Published by informa uK Limited, trading as taylor & Francis group CONTACT nuri Herachwati [email protected] Department of Management, Faculty of economics and Business, and Department of Human Resource Development, Postgraduate school, universitas airlangga, airlangga Rd. 4-6, surabaya, indonesia 60286. https://doi.org/10.1080/23311975.2024.2371328 this is an open access article distributed under the terms of the Creative Commons attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. the terms on which this article has been published allow the posting of the accepted Manuscript in a repository by the author(s) or with their consent. ARTICLE HISTORY Received 30 november 2022 Revised 15 april 2024 accepted 4 June 2024 KEYWORDS Job demands; job resources; burnout; work engagement; job satisfaction; decent work; healthcare workers (hcWs) REVIEWING EDITOR hung-che Wu, nanfang college guangzhou, china SUBJECTS Work & Organizational Psychology; healthcare Management; human Resource Management; Management & Organization 2 n. heRachWati etal. decreasing work engagement, interfering with healthcare services for society in a crisis since hcWs play a significant role in the quality and effectiveness of healthcare services offered by hcis (saraiva etal., 2023). in addition, numerous studies have found that hcWs experienced high levels of burnout and low levels of work engagement during the covid-19 pandemic (Barello etal., 2021; Britt etal., 2021). Despite their contributions, however, the prevailing studies have confined the investigation of burnout and work engagement in separate inquiries. this focus reflects a fragmented investigation, as well as knowledge, of hcWs’ psychological conditions during covid-19. Furthermore, job satisfaction is another individual work-related well-being issue during covid-19 pandemic, in which hcWs become dissatisfied with their jobs during stressful situations such as the covid-19 pandemic (nia etal., 2021). in this vein, since hcWs play crucial role in providing high-quality health services, managing and maintaining them to ensure job satisfaction is a necessity (said & el-shafei, 2021). Unfortunately, the studies on the JD-R model and its impact on job satisfaction during covid-19 have remained constrained (Blanco-Donoso et al., 2022; Ran et al., 2020), suggesting opportunities for further investigation in this domain. therefore, a comprehensive investigation to further explore the ramifications of working conditions on the consolidation of burnout and work engagement. Furthermore, extending the focus to job satisfaction is required, providing more extensive knowledge in this domain. the major motivation for this study lies in recognizing the immense challenges faced by hcWs at the frontlines of healthcare service delivery during the covid-19 pandemic in indonesia. Professional demands and unprepared resources for dealing with the unprecedented covid-19 pandemic affected levels of burnout, work engagement, and job satisfaction among hcWs. since hcWs are the backbone of the healthcare system, their working conditions impact not only their psychological conditions and well-being at work, but also the quality of healthcare services provided to society. By exploring this issue, this study not only contributes to the existing body of knowledge in this domain, but also offers a valuable contribution to hcis to comprehend and address challenges. therefore, this study has three purposes. Firstly, by applying the JD-R model, this study investigates the impact of job demands and resources on burnout and work engagement in the context of hcWs. secondly, this study strives to reveal the cross-links setting of the JD-R model: (a) job demands and work engagement; and (b) job resources and burnout. Finally, considering workers’ well-being in the workplace, this study examines the effect of burnout and work engagement on job satisfaction. this study finds that the high level of job demands increases burnout but decreases work engagement. Furthermore, the high level of job resources enhances work engagement but reduces burnout. in addition, job satisfaction is determined by a low level of burnout and a high level of work engagement. in line with these findings, this study offers several noteworthy theoretical and practical contributions. Firstly, this study supports the J-DR model in understanding how the working conditions of hcis played a significant role in shaping the psychological conditions of hcWs during the covid-19 pandemic. secondly, this study suggests that hci practitioners develop appropriate working conditions for hcWs’ to promote favorable hcWs’ psychological conditions during pandemics or other emergencies. Finally, this study is structured as follows. section 1 is the introduction, describing the research background. section 2 presents literature review and hypothesis development. section 3 presents the methods. section 4 presents the results. section 5 presents the discussion. section 6 describes the research contributions, both theoretical and practical. section 7 provides the conclusions. section 8 provides limitations and avenues for further research. 2. Literature review and hypothesis development 2.1. Job demands-resources (JD-R) model the JD-R model has become a leading model for research into job characteristics and workers’ psychological conditions, including in the healthcare sector (Bakker & Demerouti, 2017). the JD-R model describes the working conditions in two parts. Firstly, job demands refer to the physical, psychological, social, or organizational aspects of work well-being that require sustained physical and/or psychological efforts by workers. Job demands are further divided into two categories: challenges, referring to job demands perceived as potential factors for cOgent BUsiness & ManageMent 3 personal growth, development, and goal accomplishment; and hindrances, referring to job demands perceived as preventive factors for personal growth, development, and goal accomplishment. however, both characteristics are associated with strain (Bakker & Demerouti, 2017; Webster & adams, 2020). examples of job demands include work overload, role ambiguity, and time pressure. Poorly designed and excessive job demands cause workers to suffer from strain, stress, and burnout (Bakker et al., 2014), resulting in poor performance. secondly, job resources refer to the physical, psychological, social, or organizational aspects of work that serve to achieve work goals, reduce job demands and associated physiological and psychological costs, or stimulate growth, learning, and personal development. Job resources are motivational factors that activate workers’ positive attitudes in the workplace. examples of job resources include autonomy, feedback, and personal growth. availability of adequate job resources has been identified as a determining factor for workers’ well-being in the workplace, such as greater work engagement (schaufeli & Bakker, 2004), which results in high-quality performance in accomplishing desired work goals. the JD-R model also depicts the psychological consequences of working conditions. Firstly, the health impairment process describes the negative impact of job demands on the psychological and physical conditions of workers, such as burnout. secondly, the motivational process describes the positive effect of job resources on psychological and physical conditions for workers, such as work engagement (schaufeli, 2017). 2.2. Burnout Burnout refers to excessive stress experienced by workers in a professional environment and is caused by constant and chronic occupational stress (Bakker etal., 2014). specifically, burnout is characterized by three dimensions (Maslach etal., 2001). Firstly, exhaustion refers to the level of a person’s fatigue caused by the work that they are doing. secondly, cynicism refers to a person’s negative attitude toward their work, which is characterized by indifference and establishing personal distance from their work. thirdly, inadequacy refers to the perception of incompetence in carrying out work and a lack of achievement and productivity in the workplace. consequently, burnout generates negative outcomes on an individual level. 2.3. Work engagement Work engagement refers to a psychological condition wherein a person performing a work activity is fully immersed, energized, and enthusiastic about said activity. this construct reflects a positive, work-related state of mind (Bakker et al., 2014). Work engagement occurs when a person identifies a cohesive alignment between distinct work-related interests and the conducted work. specifically, work engagement is characterized by three dimensions (schaufeli & Bakker, 2004). Firstly, vigor refers to high levels of energy and mental resilience at work, the willingness of hcWs to demonstrate their efforts to get the job done, and persistence in the face of adversity. secondly, dedication refers to being strongly involved in a job and experiencing a sense of significance, enthusiasm, inspiration, pride, and challenge. thirdly, absorption refers to being fully concentrated and happily engrossed in work, with time appearing to pass quickly. 2.4. Job satisfaction Job satisfaction refers to a worker’s positive emotions towards their work, which reflects the work-related well-being of the worker. Job satisfaction and dissatisfaction are determined by the perceived alignment between individual job expectations and attributes provided by the job (locke, 1969). scholars have highlighted that the interaction of a person with their environment specifies individual job satisfaction, or interactional effect (heimerl etal., 2020). specifically, job satisfaction is related to two aspects, namely intrinsic and extrinsic satisfaction (chi et al., 2023). intrinsic satisfaction refers to an individual’s feelings about the nature of the job itself, including pride in doing a certain job and the opportunity to perform 4 n. heRachWati etal. particular tasks and assist co-workers. extrinsic satisfaction refers to an individual’s feelings about external conditions related to their job, including career path, higher compensation, and rewards. scholars have stressed that job satisfaction determines individual outcomes, including productivity and performance (Qureshi et al., 2019). 2.5. Implications of job demands on HCWs’ burnout and work engagement excessive job demands are considered predictors of the strain and stress experienced by workers. in the healthcare sector, previous studies have found that excessive job demands experienced by hcWs cause burnout (Britt et al., 2021; Vrontis et al., 2022). specifically, various excessive job demands have been identified by scholars, including work overload, lack of formal rewards, work conflict, and work-life conflict (Broetje et al., 2020; Kaiser et al., 2020). Moreover, the emergence of covid-19 exacerbated hcWs’ job demands and made them vulnerable to burnout. specifically, the increasing patient demands, long work hours, heavy workloads, time pressure, long-term of personal protective equipment (PPe), and quarantine provisions were the prominent excessive job demands during the covid-19 pandemic (Britt et al., 2021; Mojtahedzadeh etal., 2021). Drawing from the health impairment process of the JD-R model, this phenomenon adversely impacted hcWs during the pandemic, both physically (e.g., headaches, skin damage, respiratory problems, and inefficient communication due to the use of PPe) and psychologically (e.g., extreme fatigue, fear of being infected and infecting family members, and depression for bad stigma as a virus spreader). Based on this explanation, the following hypothesis is proposed: h1a: Job demands positively influence burnout. excessive job demands received by hcWs during the covid-19 led to the perception of inability to fulfill the work optimally. excessive job demands hinder hcWs from performing well (Bakker etal., 2014). if this phenomenon occurs constantly, hcWs tend to have low work engagement. Previous studies have found that hcWs’ excessive job demands negatively influence their work engagement (giménez-espert et al., 2020; Zhang et al., 2021). Workers with high levels of job demands are more likely to have low levels of work engagement (cheng et al., 2020; han et al., 2019). therefore, the following hypothesis is proposed: h1b: Job demands negatively influence work engagement. 2.6. Impact of job resources on HCWs’ burnout and work engagements Previous studies have found that job resources have a negative relationship with worker burnout (cheng et al., 2020; han et al., 2019). Job resources help buffer burnout in the workplace. this finding implies that burnout can be reduced if workers receive specifically resources in the workplace (Bakker & de Vries, 2021), specifically having access to sufficient job resources and being well-equipped to cope with job demands. the buffer reduces the negative consequences of stressors, including burnout. in the context of the covid-19, support from co-workers, adequate equipment, good work arrangements, and more rewards were considered prominent job resources by hcWs. Relevant to the buffering effect, the provided job resources aid hcWs in fulfilling their various job demands, and in turn, hindering potential burnout in the workplace. Moreover, previous studies have found that sufficient job resources received by hcWs during the covid-19 pandemic determined the low level of burnout (Barello et al., 2021; Kaiser et al., 2020). as such, the following hypothesis is proposed: h2a: Job resources negatively influence burnout. Furthermore, job resources determine work engagement. Previous studies have found that adequate job resources determine hcWs’ work engagement (Britt et al., 2021; cheng et al., 2020). in addition, various substantial job resources for hcWs have been identified by scholars, including supervisor support, fair management and rewards, autonomy, professional skills, and collaborative work climate (Broetje et al., 2020; Kaiser et al., 2020). cOgent BUsiness & ManageMent 5 Moreover, during the covid-19 pandemic, strict provision of PPe, support from superiors and co-workers, clear and adequate communication, and feeling appreciated were crucial for hcWs (Britt et al., 2021; Mojtahedzadeh et al., 2021). Drawing from the motivational process of the JD-R model, workers who are provided with relevant and sufficient resources develop a perception of support; in turn, their level of work engagement increases (Bakker etal., 2014). in this vein, job resources play a dual role, as an intrinsic motivational role (leading to personal interest fulfillment) and as an extrinsic motivational role (leading to a willingness to devote effort to work). as such, the more resources that are available, the more that employees feel engaged. hence, the following hypothesis is proposed: h2b: Job resources positively influence work engagement. 2.7. Implications of burnout and work engagement on HCWs: Job satisfaction in the healthcare sector, hcWs’ satisfaction is essential for obtaining excellent health services (said & el-shafei, 2021). hcWs’ satisfaction is determined by their interaction not only with the work environment, but also with patients as customers or other stakeholders. if hcWs are satisfied, their well-being is ensured, and in turn, they are able to provide excellent healthcare services. however, during the covid-19 pandemic, the duties of hcWs escalated significantly, causing them to face challenges in establishing and maintaining job satisfaction among hcWs. studies have found that working conditions are associated with job satisfaction (Bashir et al., 2020; cheng et al., 2020). Burnout is inversely related to job satisfaction, thereby reducing job satisfaction. Previous studies have found that hcWs are dissatisfied with their jobs if they suffer burnout (Blanco-Donoso et al., 2022; Ran et al., 2020). For instance, hcWs may suffer from extreme fatigue because of the obligation to fulfill various and excessive healthcare demands over time. Drawing from the interactional effect of job satisfaction (heimerl etal., 2020), this constant phenomenon consequently drives hcWs to perceive that their jobs unfavorably influenced them, leading to job dissatisfaction. Based on this discussion, the following hypothesis is proposed: h3: Burnout negatively influences job satisfaction. Furthermore, work engagement determines job satisfaction. Previous studies have found that hcWs’ work engagement has a significant impact on job satisfaction (cheng etal., 2020; han etal., 2019). hcWs who feel proud and enthusiastic about providing healthcare services perform better and feel joy and happiness in their work. Based on the interactional effect of job satisfaction (heimerl et al., 2020), these positive psychological conditions consequently encourage hcWs to develop positive perceptions that the job fulfills their personal interest, in turn, leading to job satisfaction. therefore, the following hypothesis is proposed: h4: Work engagement negatively influences job satisfaction. the research framework of this study, based on the hypotheses given above, is presented in Figure 1. 3. Methods 3.1. Sample and data collection procedure this study employed survey method, involving the Regional Public hospital based in surabaya, indonesia (Rumah Sakit Umum Dr. Soetomo, RsUD Dr. soetomo) for unit analysis. RsUD Dr. soetomo is a government-owned hci classified as an “a” class hci, which is responsible for the highest referral and is a central hospital on a provincial level (Ministry of health of the Republic of indonesia, 2020). the covid-19 cases at RsUD Dr. soetomo came not only from surabaya, but also from other cities in east Java. therefore, that RsUD Dr. soetomo is an hci with a high level of work demands due to the covid-19 pandemic. this study also used the quantitative approach. a convenience sampling technique was employed, involving hcWs affiliated with RsUD Dr soetomo (i.e., doctors, nurses, and other supporting medical personnel) as respondents. the rationale for selecting these hcWs as respondents was that they play a 6 n. heRachWati etal. critical role as frontline in the hci in dealing with unprecedented emergency conditions such as the covid-19 pandemic, indicating that they encountered immense challenges not only in fulfilling their psychological well-being at work, but also in completing work demands to provide excellent healthcare services. Quantitative data were collected through an open online questionnaire, using google Forms as the survey platform. Due to social activity restriction during the covid-19 pandemic by the indonesian government, an online survey was an appropriate method to collect data. Furthermore, by activating the feature of “limit to one response,” the questionnaire ensured that one respondent could send only one response, preventing multiple responses from one source. Furthermore, the link to the questionnaire was sent to the head of the Research and Development (R&D) division of RsUD Dr. soetomo. since the questionnaire was approved, the head of the R&D division then delivered the link to the questionnaire to hcWs. the questionnaire asked respondents for their consent to participate in this study and informed them that their participation was voluntary, anonymous, and confidential. the entire process of data collection lasted two months following the sending of the questionnaire link. all items used in the questionnaire were adopted from previous english-language studies. in order to adapt to the context of the respondents, the measurement items were translated into Bahasa indonesia. 3.2. Measurements all constructs incorporated in the model were measured using multi-item measures (see appendix). all of the multi-item measures used four-point response scales, ranging from “strongly disagree” to “strongly agree.” Job demands capture the extent to which work attributes require sustained workers’ efforts. Job demands were measured using nine items adapted from a previous study (Barello et al., 2021). Job resources capture the extent to which work attributes serve workers to achieve work goals. Job resources were measured using six items adapted from a previous study (Barello et al., 2021). Burnout describes the excessive stress suffered by workers and was measured using nine items from the Bergen Burnout inventory short Version (salmela-aro et al., 2011). Work engagement depicts the feeling of immersed, energized, and enthusiastic by workers about their work and was measured using nine items of the Utrecht Work engagement scale (UWes) short Version (schaufeli et al., 2006). Job satisfaction delineates the feeling of pleasure by workers about their work and was measured using eight items adapted from a previous study (chao etal., 2015), which were adapted from the Minnesota satisfaction Questionnaire. Figure 1. Research framework. cOgent BUsiness & ManageMent 7 3.3. Data analysis initially, the data collected were assessed for potential bias, using statistical software to conduct a harman’s single-factor test. Furthermore, the collected data were used to evaluate model fit. next, measurement and structural models were assessed, including item measurement validity test, construct reliability test, hypotheses test, and model quality evaluation. in this regard, analysis of partial least squares structural equation modeling (Pls-seM) was conducted, assisted by Pls-seM software, owing to its ability to test and predict complex models with numerous constructs, item measurements, and structural paths. Pls-seM is a causal-predictive approach that emphasizes prediction when estimating statistical models to provide causal explanations (hair et al., 2019). 4. Results 4.1. Sample profile 400 hcWs participated in this study by filling out the designed questionnaires. in total, 72% of the respondents were female, while most of the respondents aged between 30 and 40 years (40%) and held vocational degrees (42%). Of the respondents, 52.5% had contract-based employment, and the majority of the respondents had tenure of more than 20 years (34.3%). table 1 presents the demographic characteristics of respondents. 4.2. Common method variance (CMV) since this study used a cross-sectional design with a single source of data for the measurement of all constructs, common method variance (cMV) may possibly emerge (Podsakoff et al., 2003). in this vein, this study conducted harman’s single-factor test to determine whether cMV was a significant problem. the results show that single-factor variance was 27.57%, which is less than the threshold criteria of 50%. this result shows that cMV does not appear to be a problem in this analysis. 4.3. Model fit Despite the debate regarding the reporting of the model fit for Pls-seM studies is perpetual (Dash & Paul, 2021; hair et al., 2019), there is a growing interest among scholars to proliferate reporting of this Table 1. the demographic of respondents. Characteristic Frequency (n = 400) Percentage (%) gender Male 112 28 Female 288 72 age <30 years 50 12.5 30–40 years 160 40 41–50 years 101 25.3 >50 years 89 22.3 education secondary school 37 9.3 Diploma 168 42 Bachelor 161 40.3 Master 31 7.8 Doctor 3 0.8 employment status Civil servants 190 47.5 Contract-based 210 52.5 tenure <5 years 48 12 5–10 years 62 15.5 11–15 years 102 25.5 16–20 years 51 12.8 >20 years 137 34.3 14 n. heRachWati etal. things will come to them in the future. guided by this value, hcWs maintain a positive psychological state in the workplace during times of crisis. if this situation occurs persistently, hcWs will perceive that they are capable and motivated to do their job and fulfill their self-interest as medical workers, and in turn, feel satisfied with their job. in terms of statistical results comparison, both Pls-seM and Ols estimates yield similar statistical results for supporting all proposed hypotheses. however, these results diverge from those obtained through 2sls estimates, which unsupported most of the proposed hypotheses. For instance, job demands show a statistically insignificant effect on work engagement. Yet, the coefficient on work engagement is non-trivial, indicating a negative correlation between job demands and work engagement. similarly, job resources exhibit a statistically insignificant effect on burnout and work engagement. nevertheless, the magnitude of the coefficient on burnout and work engagement is not negligible. this denotes a negative effect of job resources on burnout, alongside a positive effect on work engagement. Moreover, 2burnout exhibits a statistically insignificant effect on job satisfaction. nonetheless, the coefficient on job satisfaction is not ignorable, indicating a negative effect of burnout on job satisfaction. the divergence in the 2sls results is presumably attributed to the omission of variables (antonakis et al., 2010). since this study solely applied the JD-R model to examine job outcomes, likely, other significant factors are not accounted for in the proposed model, thus, influencing the statistical results.this is indicated by the magnitude of R2 values obtained from the 2sls estimates for all dependent constructs, which range from weak to moderate: burnout (1.9%); work involvement (0.2%); and job satisfaction (16.8%). in other words, this implies that a considerable proportion of the variation, ranging from 83.2 to 99.8%, remains unexplained by the proposed model. to illustrate, the insignificant effect of job resources on work engagement aligns with the evolving perspective that work engagement is influenced by factors beyond job resources alone, such as leadership and individual traits (alotaibi etal., 2020; Mubarak etal., 2021). according to self-determination theory (Deci & Ryan, 2008), workers require strong interpersonal relationships, particularly with their leaders, to fulfill their relatedness needs. establishing such relationships fosters psychological fulfillment within individuals, contributing to their engagement at work. this process illustrates the pivotal role of leaders in fostering work engagement as well as the motivational pathway mechanism by leaders (Decuypere & schaufeli, 2020). additionally, while job resources serve as a material pathway mechanism provided by organizations (Demerouti et al., 2001); however, job resources may perceived as insufficient to fulfill the needs of relational support such as the organic and qualitative leader-worker relationship, especially amid the covid-19 pandemic, which necessitates a sense of belonging during crises. Overall, the findings of Pls-seM and Ols estimates are noteworthy and contribute substantially to the exploratory analysis of the JD-R model. Meanwhile, the results of 2sls estimates enable further explorative investigation of the proposed model for conclusive insights. 6. Research contributions 6.1. Theoretical contributions the findings of this study make several theoretical contributions. Firstly, this study empirically examined how working conditions play an important role in shaping workers’ psychological conditions in the context of hcis during covid-19. By applying the JD-R model (Bakker & Demerouti, 2017), the findings reveal that job demands increased the level of burnout and decreased the level of work engagement, extending the research on working conditions during covid-19 (Barello et al., 2021; Britt et al., 2021). the findings highlight that contextual factor such as the covid-19 pandemic need to be considered as the trigger of stressful working conditions for hcWs. secondly, this study empirically examined the effect of job demands on work engagement and the effect of job resources on burnout. the findings indicate that excessive job demands diminish work engagement, whereas effective job resources alleviate burnout. the study extends the limited avenue of the investigation on cross-links in the JD-R model (cheng etal., 2020; han et al., 2019), specifically providing the context of hcis during the covid-19 pandemic. Finally, this study empirically tested how burnout and work engagement determined the level of hcWs’ cOgent BUsiness & ManageMent 15 satisfaction in the workplace during the covid-19 pandemic. the findings reveal that severe burnout led to job dissatisfaction, whereas a high level of work engagement encouraged job satisfaction, expanding the investigation of workers’ psychological well-being in the workplace (Blanco-Donoso et al., 2022; Ran et al., 2020). 6.2. Practical contributions this study has a number of practical implications when managing hcWs regarding their working and psychological conditions during the covid-19 pandemic. the findings show that hcWs play a crucial role when providing healthcare services in time of crisis. Maintaining hcWs’ psychological conditions is necessary in order to allow them to carry out their duties effectively. in this regard, hci managers need to set appropriate working conditions for hcWs in emergency situations such as the covid-19 pandemic. By doing so, hci managers need to ensure adequate work duration (e.g., shift work setting) and apply situation-based flexible employment schemes (e.g., volunteer medical personnel). Moreover, hci managers need to provide supporting tools (e.g., PPe, ventilator devices, etc.), advanced systems in healthcare work processes (e.g., telemedicine, digital media applications, etc.), and fair and attractive compensation programs. With these tools, the level of burnout will decrease, and the level of work engagement will increase, and in turn, hcWs’ job satisfaction will elevate. 7. Conclusions During the covid-19 pandemic, hcis’ working conditions affected hcWs’ psychological conditions. specifically, hcWs with excessive job demands, including heavy workloads, endless duration of work, and high risk of contagion, tended to have severe burnout and low levels of work engagement. conversely, hcWs with decent job resources, including healthcare supporting tools, additional health and well-being programs, and better rewards, were more likely to have low levels of burnout and high levels of work engagement. Furthermore, this study found that hcWs suffering from massive burnout tended to feel dissatisfied with their jobs; conversely, hcWs with a high level of engagement at work tended to be satisfied with their jobs. 8. Limitations and avenues for further research this study has several limitations, but it also offers recommendations for future research. Firstly, this study found that convenience sampling has limited external validity with regards to research on hcWs during the covid-19 pandemic. as such, future research, if using this kind of sampling, should generalize findings to a larger population with caution. in addition, the use of convenience sampling does not provide equal opportunities for respondents from the entire population to respond (Malhotra, 2015). Future studies should use different sampling techniques (e.g., probability sampling) to ensure the generalizability of the findings for hcWs. secondly, despite a sufficient sample size, this study examined the JD-R model and its implications for the well-being of hcWs in only one hci, limiting its generalizability. thus, it will be more valuable if future studies use multiple organizations as data source. Further research should be conducted in other industries, both manufacturing and services, to provide diverse insights into job characteristics. thirdly, this study used a cross-sectional design, which may not have captured the JD-R model and its implications for the well-being of hcWs, which may have changed over time due to the increase in covid-19 cases or other emergencies. therefore, future studies should use a time-lagged or longitudinal design. Fourthly, this study employed several statistical methods as robustness checks. in terms of causality testing, as well as consistent with recommendations from previous research (antonakis etal., 2010; Benitez et al., 2020), future studies are strongly encouraged to incorporate endogeneity tests (e.g., 2sls) in the cause-and-effect relationship research designs. in terms of predictive performance (shmueli etal., 2019), future Pls-seM research is suggested to assess the predictive power of the proposed model (e.g., Plspredict). hence, future research may standardize these estimation procedures in the field of business and management research. Finally, this study used job satisfaction of hcWs as an outcome. Further research should use other outcome constructs (e.g., job performance 16 n. heRachWati etal. or team performance) related to the JD-R model. Furthermore, future investigations should add other constructs (e.g., leadership, personal traits) in terms of mediation or moderation of relationships. Authors’ Contributions Nuri Herachwati: research conceptualization and design; data analysis and interpretation; paper drafting; and paper revising critically for intellectual content. Zulkifli Nurul Haqq: data analysis and interpretation; paper drafting; and paper revising critically for intellectual content. Zuyyinna Choirunnisa: data analysis and interpretation; paper drafting; and paper revising critically for intellectual content. Gebrina Ayu Pramesti: data collection and data analysis and interpretation. Harris Prasetya Rahmandika: data collection and data analysis and interpretation. all authors consent to being responsible for all facets of the work. Disclosure statement no potential conflict of interest was reported by the authors. Funding this research was funded under Research grant 2021 from Universitas airlangga, indonesia. About the authors Nuri Herachwati is an associate Professor at the Department of Management, Faculty of economics and Business, Universitas airlangga, and concurrently, the head of Master Program of human Resource Development, Postgraduate school, Universitas airlangga. she received her Doctoral degree at Universitas airlangga. her major scientific interests are in the fields of human resource management, human development, organizational behavior, and performance and productivity. she has published academic research in several scientific journals including the Scientific Reports, the Problems and Perspectives in Management, among others. Zulkifli Nurul Haqq is an assistant Professor at the Department of Management, Faculty of economics and Business, Universitas Muhammadiyah semarang and a Researcher at the center for Dynamic capability, Universitas airlangga. he holds a Master degree in management at Universitas airlangga. his research interests are in the fields of human resource management, leadership, organizational behavior, and organizational change. Zuyyinna Choirunnisa is an assistant Professor at the Department of human Resource Development, Postgraduate school, Universitas airlangga and a Researcher at the center for Dynamic capability, Universitas airlangga. she obtained her Doctoral degree at Universitas airlangga. her research interests focus on human resource development, strategic management, and organizational change. she has published papers in several scientific journals including the Journal of Asia Business Studies, the International Journal of Educational Management, among others. Gebrina Ayu Pramesti is a Master student at the Department of technology Management, Faculty of creative Design and Digital Business, institut teknologi sepuluh nopember. her research interests focus on human resource development, organizational behavior, and management technology. Harris Prasetya Rahmandika is a lecturer at the Department of Management, Faculty of economics and Business, Universitas airlangga. he received his Master degree in management at Universitas airlangga. his research interests focus on human resource management and organizational behavior. ORCID nuri herachwati http://orcid.org/0009-0009-8068-7490 Zulkifli nurul haqq http://orcid.org/0000-0001-5335-8469 Zuyyinna choirunnisa http://orcid.org/0000-0002-1829-3193 harris Prasetya Rahmandika http://orcid.org/0000-0001-5300-5727 Data availability statement the data that support the findings of this study are available from the corresponding author, upon reasonable request. cOgent BUsiness & ManageMent 17 References ahmad, s., Omar, R., & Quoquab, F. (2021). Family firms’ sustainable longevity: the role of family involvement in business and innovation capability. Journal of Family Business Management, 11(1), 1–20. https://doi.org/10.1108/ JFBM-12-2019-0081 alotaibi, s. M., amin, M., & Winterton, J. (2020). Does emotional intelligence and empowering leadership affect psychological empowerment and work engagement? Leadership & Organization Development Journal, 41(8), 971–991. https://doi.org/10.1108/lODJ-07-2020-0313 antonakis, J., Bendahan, s., Jacquart, P., & lalive, R. (2010). On making causal claims: a review and recommendations. The Leadership Quarterly, 21(6), 1086–1120. https://doi.org/10.1016/j.leaqua.2010.10.010 antonakis, J., Bendahan, s., Jacquart, P., & lalive, R. (2014). causality and endogeneity: Problems and solutions. in D. V. Day (ed.), The Oxford handbook of leadership and organizations (pp. 93–107). Oxford University Press. Bae, J., & lawler, J. J. (2000). Organizational and hRM strategies in Korea: impact on firm performance in an emerging economy. Academy of Management Journal, 43(3), 502–517. https://doi.org/10.5465/1556407 Bakker, a. B., & de Vries, J. D. (2021). Job demands–resources theory and self-regulation: new explanations and remedies for job burnout. Anxiety, Stress, and Coping, 34(1), 1–21. https://doi.org/10.1080/10615806.2020.1797695 Bakker, a. B., & Demerouti, e. (2017). Job demands–resources theory: taking stock and looking forward. Journal of Occupational Health Psychology, 22(3), 273–285. https://doi.org/10.1037/ocp0000056 Bakker, a. B., Demerouti, e., & sanz-Vergel, a. i. (2014). Burnout and work engagement: the JDR approach. Annual Review of Organizational Psychology and Organizational Behavior, 1(1), 389–411. https://doi.org/10.1146/ annurev-orgpsych-031413-091235 Barello, s., caruso, R., Palamenghi, l., nania, t., Dellafiore, F., Bonetti, l., silenzi, a., Marotta, c., & graffigna, g. (2021). Factors associated with emotional exhaustion in healthcare professionals involved in the cOViD-19 pandemic: an application of the job demands-resources model. International Archives of Occupational and Environmental Health, 94(8), 1751–1761. https://doi.org/10.1007/s00420-021-01669-z Bashir, a., amir, a., Jawaad, M., & hasan, t. (2020). Work conditions and job performance: an indirect conditional effect of motivation. Cogent Business & Management, 7(1), 1801961. https://doi.org/10.1080/23311975.2020.1801961 Benitez, J., henseler, J., castillo, a., & schuberth, F. (2020). how to perform and report an impactful analysis using partial least squares: guidelines for confirmatory and explanatory is research. Information & Management, 57(2), 103168. https://doi.org/10.1016/j.im.2019.05.003 Blanco-Donoso, l. M., Moreno-Jiménez, J., gallego-alberto, l., amutio, a., Moreno-Jiménez, B., & garrosa, e. (2022). satisfied as professionals, but also exhausted and worried!!: the role of job demands, resources and emotional experiences of spanish nursing home workers during the cOViD-19 pandemic. Health & Social Care in the Community, 30(1), e148–e160. https://doi.org/10.1111/hsc.13422 Bowlby, J. (1969). Attachment and loss, Vol. 1: Attachment. Basic Books. Britt, t. W., shuffler, M. l., Pegram, R. l., Xoxakos, P., Rosopa, P. J., hirsh, e., & Jackson, W. (2021). Job Demands and resources among healthcare professionals during virus pandemics: a review and examination of fluctuations in mental health strain during cOViD-19. Applied Psychology = Psychologie Appliquee, 70(1), 120–149. https://doi. org/10.1111/apps.12304 Broetje, s., Jenny, g. J., & Bauer, g. F. (2020). the key job demands and resources of nursing staff: an integrative review of reviews. Frontiers in Psychology, 11(January), 84. https://doi.org/10.3389/fpsyg.2020.00084 Butt, a., ahmad, h., ali, F., Muzaffar, a., & shafique, M. n. (2023). engaging the customer with augmented reality and employee services to enhance equity and loyalty. International Journal of Retail & Distribution Management, 51(5), 629–652. https://doi.org/10.1108/iJRDM-04-2021-0165 chao, M. c., Jou, R. c., liao, c. c., & Kuo, c. W. (2015). Workplace stress, job satisfaction, job performance, and turnover intention of health care workers in rural taiwan. Asia-Pacific Journal of Public Health, 27(2), nP1827–nP1836. https://doi.org/10.1177/1010539513506604 cheng, h., Yang, h., Ding, Y., & Wang, B. (2020). nurses’ mental health and patient safety: an extension of the Job Demands–Resources model. Journal of Nursing Management, 28(3), 653–663. https://doi.org/10.1111/jonm.12971 chi, h., Vu, t., nguyen, h. V., & truong, t. h. (2023). how financial and non–financial rewards moderate the relationships between transformational leadership, job satisfaction, and job performance. Cogent Business & Management, 10(1). https://doi.org/10.1080/23311975.2023.2173850 Dash, g., & Paul, J. (2021). cB-seM vs Pls-seM methods for research in social sciences and technology forecasting. Technological Forecasting and Social Change, 173(august), 121092. https://doi.org/10.1016/j.techfore.2021.121092 Datanesia. (2023). Indonesia Darurat Dokter (issue september). Deci, e. l., & Ryan, R. M. (2008). self-determination theory: a macrotheory of human motivation, development, and health. Canadian Psychology / Psychologie Canadienne, 49(3), 182–185. https://doi.org/10.1037/a0012801 Decuypere, a., & schaufeli, W. (2020). leadership and work engagement: exploring explanatory mechanisms. German Journal of Human Resource Management: Zeitschrift Für Personalforschung, 34(1), 69–95. https://doi. org/10.1177/2397002219892197 Demerouti, e., Bakker, a., nachreiner, F., & schaufeli, W. (2001). the job demands-resources model of burnout. Journal of Applied Psychology, 86(3), 499–512. https://doi.org/10.1037/0021-9010.86.3.499 18 n. heRachWati etal. efendi, F., aurizki, g. e., auwalin, i., & McKenna, l. (2022). the need for speed: a qualitative study on nurse recruitment and management amidst the cOViD-19 pandemic in indonesia. Journal of Multidisciplinary Healthcare, 15, 1809–1817. https://doi.org/10.2147/JMDh.s370758 Fornell, c., & larcker, D. F. (1981). evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.2307/3151312 giménez-espert, M. d c., Prado-gascó, V., & soto-Rubio, a. (2020). Psychosocial risks, work engagement, and job satisfaction of nurses during cOViD-19 pandemic. Frontiers in Public Health, 8(vember), 566896. https://doi. org/10.3389/fpubh.2020.566896 gómez-salgado, J., Domínguez-salas, s., Romero-Martín, M., Romero, a., coronado-Vázquez, V., & Ruiz-Frutos, c. (2021). Work engagement and psychological distress of health professionals during the cOViD-19 pandemic. Journal of Nursing Management, 29(5), 1016–1025. https://doi.org/10.1111/jonm.13239 hair, J. F., hult, g. t. M., Ringle, c. M., & sarstedt, M. (2014). A primer on partial least squares structural equation modelling (PLS-SEM). sage Publications, inc. hair, J. F., Risher, J. J., sarstedt, M., & Ringle, c. M. (2019). When to use and how to report the results of Pls-seM. European Business Review, 31(1), 2–24. https://doi.org/10.1108/eBR-11-2018-0203 han, J., Yin, h., Wang, J., & Zhang, J. (2019). Job demands and resources as antecedents of university teachers’ exhaustion, engagement and job satisfaction. Educational Psychology, 40(3), 318–335. https://doi.org/10.1080/014434 10.2019.1674249 heimerl, P., haid, M., Benedikt, l., & scholl-grissemann, U. (2020). Factors influencing job satisfaction in hospitality industry. SAGE Open, 10(4), 215824402098299. https://doi.org/10.1177/2158244020982998 henseler, J., Ringle, c. M., & sarstedt, M. (2015). a new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115–135. https://doi.org/10.1007/ s11747-014-0403-8 hu, l., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. https://doi.org/10.1037/1082-989X.3.4.424 Kaiser, s., Patras, J., adolfsen, F., Richardsen, a. M., & Martinussen, M. (2020). Using the job demands–resources model to evaluate work-related outcomes among norwegian health care Workers. SAGE Open, 10(3), 215824402094743. https://doi.org/10.1177/2158244020947436 Khairulbahri, M. (2021). lessons learned from three southeast asian countries during the cOViD-19 pandemic. Journal of Policy Modeling, 43(6), 1354–1364. https://doi.org/10.1016/j.jpolmod.2021.09.002 locke, e. a. (1969). What is job satisfaction? Organizational Behavior and Human Performance, 4(4), 309–336. https:// doi.org/10.1016/0030-5073(69)90013-0 Malhotra, n. K. (2015). Essentials of marketing research: A hands-on orientation (1st ed.). Pearson education limited. Małkowska, a., tomal, M., Uhruska, M., Pawlak, J., Maier, g., & nichiforeanu, a. (2021). the impact of job satisfaction on valuers’ attitudes towards professional ethics. International Journal of Strategic Property Management, 25(6), 497– 513. https://doi.org/10.3846/ijspm.2021.15768 Maslach, c., schaufeli, W. B., & leiter, M. P. (2001). Job brunout. Annual Review of Psychology, 52(1), 397–422. https:// doi.org/10.1146/annurev.psych.52.1.397 Ministry of health of the Republic of indonesia. (2020). http://bppsdmk.kemkes.go.id/web/filesa/peraturan/119. pdf Mojtahedzadeh, n., Wirth, t., nienhaus, a., harth, V., & Mache, s. (2021). Job demands, resources and strains of outpatient caregivers during the covid-19 pandemic in germany: a qualitative study. International Journal of Environmental Research and Public Health, 18(7), 1–26. https://doi.org/10.3390/ijerph18073684 Mubarak, n., Khan, J., Yasmin, R., & Osmadi, a. (2021). the impact of a proactive personality on innovative work behavior: the role of work engagement and transformational leadership. Leadership & Organization Development Journal, 42(7), 989–1003. https://doi.org/10.1108/lODJ-11-2020-0518 nair, P. K., ali, F., & leong, l. c. (2015). Factors affecting acceptance & use of ReWinD: Validating the extended unified theory of acceptance and use of technology. Interactive Technology and Smart Education, 12(3), 183–201. https:// doi.org/10.1108/itse-02-2015-0001 nia, h. s., arslan, g., naghavi, n., Froelicher, e. s., Kaveh, O., sharif, s. P., & Rahmatpour, P. (2021). a model of nurses’ intention to care of patients with cOViD-19: Mediating roles of job satisfaction and organisational commitment. Journal of Clinical Nursing, 30(11–12), 1684–1693. https://doi.org/10.1111/jocn.15723 ningrum, a. P., & Missel, M. (2023). Urip iku urup (life is lit) by service to others: a qualitative study of frontline healthcare workers’ lived experiences providing patient care in indonesia’s cOViD-19-designated hospital. BMC Health Services Research, 23(1), 262. https://doi.org/10.1186/s12913-023-09257-2 Olivia, s., gibson, J., & nasrudin, R. (2020). indonesia in the time of covid-19. Bulletin of Indonesian Economic Studies, 56(2), 143–174. https://doi.org/10.1080/00074918.2020.1798581 Podsakoff, P. M., MacKenzie, s. B., lee, J. Y., & Podsakoff, n. P. (2003). common method biases in behavioral research: a critical review of the literature and recommended remedies. The Journal of Applied Psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879 Qureshi, M. a., Qureshi, J. a., thebo, J. a., shaikh, g. M., Brohi, n. a., & Qaiser, s. (2019). the nexus of employee’s commitment, job satisfaction, and job performance: an analysis of FMcg industries of Pakistan. Cogent Business & Management, 6(1), 1–13. https://doi.org/10.1080/23311975.2019.1654189 cOgent BUsiness & ManageMent 19 Ran, l., chen, X., Peng, s., Zheng, F., tan, X., & Duan, R. (2020). Job burnout and turnover intention among chinese primary healthcare staff: the mediating effect of satisfaction. BMJ Open, 10(10), e036702. https://doi.org/10.1136/ bmjopen-2019-036702 said, R. M., & el-shafei, D. a. (2021). Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during cOViD-19 pandemic in Zagazig city, egypt. Environmental Science and Pollution Research International, 28(7), 8791–8801. https://doi.org/10.1007/s11356-020-11235-8 salmela-aro, K., Rantanen, J., hyvönen, K., tilleman, K., & Feldt, t. (2011). Bergen Burnout inventory: Reliability and validity among Finnish and estonian managers. International Archives of Occupational and Environmental Health, 84(6), 635–645. https://doi.org/10.1007/s00420-010-0594-3 sande, J. B., & ghosh, M. (2018). endogeneity in survey research. International Journal of Research in Marketing, 35(2), 185–204. https://doi.org/10.1016/j.ijresmar.2018.01.005 saraiva, M., alfaiate, c., gomes, l. P., correia, a. R., & Jorge, F. (2023). the Perception of quality and the performance in primary health care of central alentejo–Portugal. Cogent Business & Management, 10(1), 1–16. https://doi.org/10 .1080/23311975.2023.2208423 sarstedt, M., Ringle, c. M., cheah, J. h., ting, h., Moisescu, O. i., & Radomir, l. (2020). structural model robustness checks in Pls-seM. Tourism Economics, 26(4), 531–554. https://doi.org/10.1177/1354816618823921 schaufeli, W. B. (2017). applying the Job Demands-Resources model: a ‘how to’ guide to measuring and tackling work engagement and burnout. Organizational Dynamics, 46(2), 120–132. https://doi.org/10.1016/j.orgdyn.2017.04.008 schaufeli, W. B., & Bakker, a. B. (2004). Job demands, job resources, and their relationship with burnout and engagement: a multi-sample study. Journal of Organizational Behavior, 25(3), 293–315. https://doi.org/10.1002/job.248 schaufeli, W. B., Bakker, a. B., & salanova, M. (2006). the measurement of work engagement with a short questionnaire: a cross-national study. Educational and Psychological Measurement, 66(4), 701–716. https://doi. org/10.1177/0013164405282471 shmueli, g., sarstedt, M., hair, J. F., cheah, J. h., ting, h., Vaithilingam, s., & Ringle, c. M. (2019). Predictive model assessment in Pls-seM: guidelines for using Plspredict. European Journal of Marketing, 53(11), 2322–2347. https:// doi.org/10.1108/eJM-02-2019-0189 tenenhaus, M., Vinzi, V. e., chatelin, Y. M., & lauro, c. (2005). Pls path modeling. Computational Statistics & Data Analysis, 48(1), 159–205. https://doi.org/10.1016/j.csda.2004.03.005 Vrontis, D., el chaarani, h., el abiad, Z., el nemar, s., & haddad, a. Y. (2022). Managerial innovative capabilities, competitive advantage and performance of healthcare sector during covid-19 pandemic period. Foresight, 24(3/4), 504–526. https://doi.org/10.1108/Fs-02-2021-0045 Vuong, B. n., giao, h. n. K., & hung, D. V. (2023). how transformational leadership influences employees’ job-related outcomes through public service motivation: Does power distance orientation matter? Cogent Business & Management, 10(1), 1–24. https://doi.org/10.1080/23311975.2023.2176281 Webster, J. R., & adams, g. a. (2020). the differential role of job demands in relation to nonwork domain outcomes based on the challenge-hindrance framework. Work & Stress, 34(1), 5–33. https://doi.org/10.1080/02678373.2019.1 662855 Zhang, M., Zhang, P., liu, Y., Wang, h., hu, K., & Du, M. (2021). influence of perceived stress and workload on work engagement in front-line nurses during cOViD-19 pandemic. Journal of Clinical Nursing, 30(11-12), 1584–1595. https://doi.org/10.1111/jocn.15707 20 n. heRachWati etal. Appendix: Measurement items Construct Code item Job Demands (Barello etal., 2021) JD1 My pace of work has increased significantly JD2 i’m passing at work more time than i should JD3 the number of patients that i am assisting daily has increased JD4 i’m spending so much energies at work, that my private life has been suffering from it JD5 since the Covid-19 emergency has begun, i cannot pass enough time with my loved ones JD6 the Covid-19 emergency is forcing me to cope with emotionally difficult situations JD7 the Covid-19 emergency is putting me in touch with other people’s suffering more frequently JD8 the Covid-19 emergency is making me take difficult decisions at work JD9 i often feel like i have to hide my emotions while at work. Job resources (Barello et al., 2021) JR1 My organization has adequately trained me on what to do in case of health emergencies such as the Covid-19 JR2 My organization gave me the Personal Protective equipment for the management of the Covid-19 emergency JR3 i have received all the necessary information from my organization on how to face the Covid-19 emergency JR4 My organization is timely in informing me about every important decision regarding the management of the Covid-19 emergency JR5 My organization has started initiatives for the psychological support of healthcare workers JR6 My organization has developed technological supports to facilitate the continuity of care with patients, such as telemedicine Burnout (salmela-aro etal., 2011) BeX1 i am snowed under with work BeX2 i often sleep poorly because of the circumstances at work BeX3 i constantly have bad conscience because my work forces me to neglect my close friends and relatives BCY1 i feel dispirited at work and i think of leaving my job BCY2 i feel that i have gradually less to give BCY3 i feel that i am gradually losing interest in my patients or my other employees Bin1 i frequently question the value of my work Bin2 My expectations to my job and to my performance have reduced Bin3 Honestly i felt more appreciated at work before Work engagement (schaufeli etal., 2006) WeV1 at my work, i feel bursting with energy WeV2 at my job, i feel strong and vigorous WeV3 When i get up in the morning, i feel like going to work WeD1 i am enthusiastic about my job WeD2 My job inspires me WeD3 i am proud of the work that i do Wea1 i feel happy when i am working intensely Wea2 i am immersed in my work Wea3 i get carried away when i am working Job satisfaction (Chao etal., 2015) Js1 i’m satisfied with my pay and benefits Js2 i’m content with the fame that comes with my job title Js3 i’m glad to take advantage of my expertise in medial duties Js4 i’m glad to serve and provide patients with safety Js5 i’m satisfied with the achievement i made at work Js6 i’m satisfied with my work environment Js7 i’m content with the welfares and days-off policy offered to medical professionals Js8 i’m satisfied with the way of our working system, including scheduling and transferring