Resilience and professional identity among young healthcare workers in a Shanghai megahospital during COVID-19: a cross-sectional study

Abstract

Background: Public health crises such as the COVID-19 pandemic place immense psychological and professional pressure on healthcare workers, particularly those early in their careers. While much research has focused on burnout and stress, fewer studies have examined the role of professional identity and its organizational determinants among actively employed young healthcare professionals.

Methods: This cross-sectional study surveyed 326 young healthcare workers (≤40 years old) across clinical, research, and administrative roles in a megahospital in Shanghai, China. A validated multidimensional scale was used to assess professional identity. Independent variables included job satisfaction, workload, exposure to high-risk duties, and perceived organizational support (including satisfaction with humanistic care and working conditions). Descriptive statistics, Mann-Whitney U and Kruskal-Wallis H tests, and multivariate linear regression were employed.

Results: The majority of respondents (92.9%) reported a high level of professional identity (median score: 81, IQR: 13). Satisfaction with humanistic care (B = 3.431, p = 0.009) and working conditions (B = 3.679, p = 0.003) were strong predictors of higher professional identity scores. Significant differences in professional identity were observed based on gender, income satisfaction, and exposure to COVID-19 patients.

Conclusion: This study highlights the essential role of organizational resources-particularly perceived humanistic care and adequate working conditions-in sustaining professional identity among young healthcare professionals during public health emergencies. The findings underscore the need for system-level interventions that support resilience and workforce stability. These insights may inform global strategies for healthcare human resource management in high-pressure contexts.

Keywords: COVID-19; humanistic care; organizational resources; professional identity; public health emergency; working conditions; young healthcare workers.

Figure 1

Geographic location of Renji hospital. Renji hospital is located in Pudong New Area, Shanghai, China. The map indicates the precise location of the hospital, highlighting its position within Shanghai to contextualize the study setting.

Figure 2

Median professional identity scores across key subgroups. Bar plots showing the median professional identity scores stratified by gender, income satisfaction, weekly working hours, and occupational type. Each bar represents the group median, with scores ranging from 77 to 84.

Figure 3

Predictors of professional identity. Standardized regression coefficients (β) with 95% confidence intervals from a multivariate linear regression model predicting total professional identity scores. The strongest predictors were satisfaction with working conditions and perceived humanistic care. Contact with COVID-19 patients, gender, marital status, and monthly income showed smaller effects. Error bars indicate ±1 standard error of β.

Figure 4

Conceptual JD-R pathway explaining professional identity formation. This figure illustrates a modified Job Demands–Resources (JD-R) model tailored to the context of young healthcare workers during public health emergencies. Solid lines represent statistically significant associations confirmed in this study (e.g., perceived work condition → occupational identity), while dashed lines indicate theoretically plausible but empirically non-significant relationships (e.g., work stress → occupational identity). Although the associations for job demands such as long working hours and direct exposure were not statistically significant, they are retained in the diagram to reflect their established theoretical relevance in JD-R literature. Occupational identity is shown both as a psychological construct shaped by resources and as an eventual job outcome, reflecting its dual role in professional development and engagement. Variables such as “organizational resources” in the diagram correspond to specific measured items in the manuscript, including satisfaction with humanistic care, adequacy of working conditions, and perceived support from hospital administration (measured by the item: “I feel that the hospital provides adequate administrative support during public health emergencies”). These terms were unified under theoretical constructs for conceptual clarity, consistent with the JD-R framework. Occupational identity appears twice to reflect its dual role—as both an intermediate psychological state influenced by work context and a final job-related outcome.