Nurses' perceptions of decent work: a scoping review.

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Learn more: PMC Disclaimer | PMC Copyright Notice BMC Nurs . 2026 Apr 7;25:366. doi: 10.1186/s12912-026-04628-6 Search in PMC Search in PubMed View in NLM Catalog Add to search Nurses’ perceptions of decent work: a scoping review Jingxi Xu Jingxi Xu 1 Affiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310007 China 2 School of Public Health and Nursing, Hangzhou Normal University, Hangzhou, Zhejiang 311121 China Find articles by Jingxi Xu 1, 2 , Hong Luo Hong Luo 1 Affiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310007 China 3 Center for Humanistic Spirit in Medical Research, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310007 China Find articles by Hong Luo 1, 3, ✉ , Bowen Xue Bowen Xue 1 Affiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310007 China 4 Department of Psychology and Behavioural Sciences, Zhejiang University, Hangzhou, Zhejiang 310058 China Find articles by Bowen Xue 1, 4, ✉ Author information Article notes Copyright and License information 1 Affiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310007 China 2 School of Public Health and Nursing, Hangzhou Normal University, Hangzhou, Zhejiang 311121 China 3 Center for Humanistic Spirit in Medical Research, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310007 China 4 Department of Psychology and Behavioural Sciences, Zhejiang University, Hangzhou, Zhejiang 310058 China ✉ Corresponding author. Received 2026 Jan 26; Accepted 2026 Apr 2; Collection date 2026. © The Author(s) 2026 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ . PMC Copyright notice PMCID: PMC13085669  PMID: 41947185 Abstract Background Against the backdrop of the UN’s universal health coverage target (Sustainable Development Goal 3.8), increasing demand for healthcare services has created new challenges and requirements in the field of nursing. Perceptions of decent work among nurses are associated with improved quality of care. However, the current state of research is poorly understood as no reviews have been conducted. Methods We conducted a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Scoping Review guidelines. We searched Web of Science, Scopus, SpringerLink, ScienceDirect, and Ovid databases for relevant articles up to September 2025. Results A total of 1282 studies were initially retrieved, among which 20 met the inclusion criteria. The studies included cross-sectional studies and qualitative studies. This review found that nurses’ perceptions of decent work were at a low to moderate level. In clinical nursing, decent work has been examined as an independent, mediating, and response variable, showing varying associations with the quality of nursing services. Moreover, perceptions of decent work vary across cultures, revealing an individual’s position within the social structure. Conclusions Based on the existing articles evidence, the improvement of decent working standards has a significant positive impact on the quality of nursing services. However, as most studies have adopted cross-sectional designs, future research should explore longitudinal designs to strengthen causal interpretations. Furthermore, future research should employ diverse and systematic methodological approaches to extend investigations of the relationship between decent work and job satisfaction (and its potential mechanisms), as one included study reported no significant association between the two variables. Keywords: Decent work, Nursing, Scoping review Introduction In recent years, societies around the world have been undergoing unprecedented transformations. The rapid development of emerging technologies such as artificial intelligence, big data, and brain–computer interfaces is redefining the meaning and boundaries of work. For many workers, the significance of work has extended beyond basic survival and financial compensation and now includes respect, fairness, self-realization, and a sense of security. These ideas are summarized in the concept of decent work, which was first proposed by the International Labour Organization, emphasizing the need to ensure fundamental working conditions for all workers [ 1 ]. However, these shifts have not benefited all occupational groups equally. As an essential part of healthcare systems, nurses face multiple occupational risks including workplace violence [ 2 ], bullying [ 3 ], harassment [ 4 ], occupational exposure [ 5 ], and burnout [ 6 ]. These challenges reduce nurses’ sense of professional safety and well-being and hinder the sustainable development of nursing practice. Therefore, ensuring decent work for nurses has become a critical issue in global nursing policy and management. In recent years, decent work has become a key variable for assessing work quality in studies on organizational effectiveness and employee well-being. As understanding of the concept of decent work has expanded, it has come to be recognized as a concept extending beyond employment and work quality, encompassing workers’ perceived sense of security and social protection throughout the work process [ 4 , 7 ]. It mainly includes five dimensions: (1) a safe working environment that ensures both physical and interpersonal security (for example, the absence of physical, psychological, or emotional abuse); (2) reasonable working hours that allow sufficient rest and leisure time; (3) organizational values that align and complement those of family and society; (4) fair and adequate compensation; and (5) access to comprehensive medical and social protection [ 8 ]. Accordingly, decent work among nurses refers to their experience of engaging in nursing within a safe, fair, and supportive work environment that provides respect, adequate support, reasonable remuneration, social protection, and opportunities for professional development. Under such conditions, nurses recognize their intrinsic value and achieve both professional fulfilment and personal growth [ 9 ]. Against this background, a growing body of research has applied the concept of decent work to the nursing field to explore its impact on nurses’ professional experiences and outcomes. Several studies have examined nurses’ perceptions of decent work, finding that decent work functions as a positive factor that enhances work engagement and reduces turnover intention [ 10 ]. It also serves as a mediating mechanism, alleviating the negative effects of effort–reward imbalance and burnout while promoting nurses’ sense of well-being [ 11 ]. Research has also explored the influencing factors of perceived decent work among different nursing populations, including paediatric intensive care unit and psychiatric nurses [ 12 , 13 ]. However, current findings are scattered across different research designs and populations, making it difficult to draw consistent conclusions or establish an integrated understanding of decent work in nursing. Given these inconsistencies, there is a clear need to review and synthesize existing findings to better understand the current research landscape. To date, no comprehensive scoping review has summarized how nurses’ perceptions of decent work have been conceptualized, measured, and applied in empirical studies. Therefore, this scoping review aims to map the current state of research on nurses’ perceptions of decent work, identify key themes and methodological trends, and provide evidence to inform future research and nursing management practices. This scoping review also summarizes measurement tools and influencing factors across different cultural contexts. Methods Research design This research was conducted as a scoping review, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Scoping Review (PRISMA-ScR) guidelines (see Supplementary Material) [ 14 ]. A scoping review is a form of knowledge synthesis that follows a clearly defined approach to map existing evidence on a topic, identify key concepts, sources, and influencing factors, and describe how research in the field has been conducted. Currently, research on nurses’ perceptions of decent work remains in its infancy. Hence, as an emerging literature review methodology, the scoping review can effectively integrate existing findings, identify knowledge gaps, and summarize evidence on nurses perceived decent work in clinical settings. Therefore, we employed a scoping review approach to explore the status of nurses’ perceptions of decent work, aiming to inform the development of targeted interventions to enhance decent work among clinical nurses. The review process included the following steps: (1) identifying the research questions (2), identifying relevant studies (3), selecting eligible studies (4), charting the data, and (5) collating, summarizing, and reporting the results. The two core research questions that guided this review are as follows: What is the status of nurses’ perceptions of decent work? What strategies have been proposed that aim to enhance nurses’ perceptions of decent work? Eligibility criteria In line with JBI guidelines, we employed the Population, Concept, and Context (PCC) framework to identify eligible sources of evidence [ 15 ]. Table 1 provides a summary of the eligibility criteria mapped to the PCC framework. To ensure the methodological quality and reliability of the included evidence, this review limits the literature sources to original research articles published in peer-reviewed journals, thereby ensuring that the studies analyzed have verifiable rigor. The search was restricted to English-language articles, as the research team lacked resources for translation of non-English articles. We also systematically excluded non empirical literature, regardless of peer-review status. The exclusion scope includes various types of reviews (systematic reviews, meta-reviews, narrative reviews) and meta-analyses, as well as books, conference abstracts, master’s theses, non-peer-reviewed articles, and records that cannot be accessed in full. Additionally, considering that grey literature (such as dissertations, conference abstracts) lacks standardized indexing in the search process and is difficult to ensure comprehensiveness and reproducibility, to ensure the systematicity and transparency of the review process, this study did not include it [ 16 ]. Table 1. Eligibility criteria mapped to the PCC framework PCC element Inclusion criteria Exclusion criteria Population nurses, including registered nurses, clinical nurses, psychiatric nurses, and other nursing staff studies not involving nurses or not reporting nurse-specific findings Concept perceptions, level, correlates, influencing factors, or related roles of decent work studies not addressing decent work or not examining it as a focal concept Context nursing work settings in healthcare environments such as hospitals, psychiatric settings, intensive care units and nursing homes non-healthcare contexts or studies without a relevant work nursing Open in a new tab Data collection and screening Search strategy The research team adopted iterative searching and reference literature tracing to maximize the capture of key evidence based on the initial literature review and with guidance from relevant methodological guidelines. Although no librarians were involved in developing the search strategy, this approach mitigated to a certain extent any potential impact caused by the limitations of the search strategy’s breadth and database selection [ 17 , 18 ]. We conducted a preliminary search in the PubMed database to determine MeSH terms and free terms. The final search concepts were then divided into two major categories: nurses and decent work. The search terms included free terms (such as “nurse” and “decent work”) and MeSH terms (such as “nurses”). The search terms were combined using the Boolean operators OR and AND. We used the truncation symbol * to cover spelling variations. The specific search terms for each database can be found in the supplementary materials. Subsequently, five electronic databases were searched: Web of Science, SpringerLink, Scopus, ScienceDirect, and Ovid. The main search was performed on September 30,2025. In addition, we manually searched citations from relevant reviews to determine if they contained any studies in the inclusion scope for our review. While peer-reviewed study protocols were ineligible, we “forward searched” from these articles for any eligible research with study outcomes. Selection of sources of evidence All retrieved records were imported into EndNote 21.5 for reference management. In the title and abstract screening phase, we first conduct a pre-screening process. Coders independently applied the predefined screening criteria to a randomly selected set of 25 records, followed by a meeting to reach consensus. This screening process and inclusion criteria were iteratively refined and applied to the next randomly selected set of 25 records. Inter-coder reliability was assessed using Fleiss’ kappa, which ranges from 0 (no agreement) to 1 (perfect agreement), with values between 0.61 and 0.80 generally considered to indicate substantial agreement. Once a satisfactory inter-coder reliability was achieved and the final screening process was established, we transitioned to a single independent coder mode, where one coder independently completed title and abstract screening [ 19 , 20 ]. For the full-text screening phase, a dual independent coding method was adopted, in which two coders independently screened the full-text articles. For an article to be included, it had to meet all predefined inclusion criteria; meeting any single exclusion criterion was enough for it to be excluded. In cases of disagreement between the two coders regarding inclusion or exclusion, a third coder intervened in the screening process and made the final decision. Prior to the formal full-text screening, the coding team conducted a pilot test on 10 randomly selected articles to assess the feasibility of the screening protocol. The formal screening criteria were iteratively refined based on the pilot test results to finalize the screening process. During the full-text screening phase, the coding team maintained regular communication to discuss the content of the screened articles and issues related to the applicability of the inclusion criteria, thereby ensuring the consistency and scientific rigor of the screening process. The selection of evidence sources proceeded in three steps: (1) conducting a verification check as a second round of screening, to ensure all included articles strictly met the inclusion criteria; (2) manually searching the reference lists of relevant review articles to identify potentially eligible studies; and (3) prospectively searching for peer-reviewed research protocols associated with studies that have reported eligible findings. Any additional literature identified through steps (2) and (3) was assessed as per the abovementioned title, abstract, and full-text screening procedures. Data extraction We used Microsoft Excel for data extraction from the final included literature. Data extraction was conducted by two independent coders. The specific process is as follows: the primary coder was responsible for marking relevant text content in the included literature and entering the corresponding data into the extraction tool. The secondary coder verified the completeness and accuracy of the data entry, documented any discrepancies, and resolved them through discussion and consensus between the two parties. If consensus could not be reached after discussion, a third coder was consulted. To test the operability and stability of the data extraction method, we selected two full-text articles reporting a cross-sectional study and one reporting a qualitative study for a pilot extraction test. Based on the test results, the data extraction tool was iteratively optimized. The information extracted from the included literature had to cover (at minimum) the following variables: Basic article information: first author, publication year, research method. Study population: specific department, sample size, country. Study outcomes: measurement tools, influencing factors, perception levels. Synthesis of results Due to the considerable heterogeneity in the results of the included studies, the extracted data in this study were classified and integrated mainly into the following three dimensions: independent, mediating, and response variables. Results A total of 1282 records were identified in the initial database search. After deduplication and screening, 20 studies were included in this review. The detailed screening process is shown in Fig. 1 . Fig. 1. Open in a new tab PRISMA flow diagram of literature screening after retrieval Basic characteristics Table 2 provides detailed information on the basic characteristics of the included studies. Most studies ( n = 18) used cross-sectional designs. The studies examined decent work primarily as an independent ( n = 8), mediating ( n = 6), or response variable ( n = 6). Among the included studies, 3 involved registered nurses, 13 focused on clinical nurses, 2 on psychiatric nurses, 1 on pediatric intensive care unit nurses, and 1 on nursing home nurses. Regarding measurements of decent work, 12 studies used the revised Decent Work Scale developed by Mao et al. [ 21 ], while 6 studies employed the original Decent Work Scale developed by Duffy et al. [ 8 ]. Two studies did not specify the measurement tools used. Among the 18 quantitative studies, average scores for decent work perceptions varied by measurement instrument. Regardless of the scale used, the results consistently pointed to a low to moderate level of perceived decent work among nurses. Table 2. Basic characteristics of included studies Author Country/Region Year Participant Research methods Average score Outcome measurements Variable name Ajayi et al. Nigeria 2025 registered nurses ( n = 280) DWS; Job burnout; Affective commitment; Intention to emigrate 2.047 (SD 0.362) decent work-emigration intention decent work as an independent variable Xue et al. China/Zhejiang 2024 clinical nurses ( n = 476) DWPS; Utrecht work engagement scale; turnover intention scale 53.36 ± 10.61 decent work-turnover intention EI-Gazar et al. Egypt 2025 registered nurses ( n = 204) DWS; Perceived Insider Status Scale; Psychological Well-being Scale; Work Ability–Personal Radar Scale 3.21 (SD 1.16) decent work-work ability Xue et al. China/Zhejiang 2024 clinical nurses ( n = 480) DWPS; Chinese version of the Minnesota Satisfaction Questionnaire; MBI-GS; Chinese version of the Turnover Intention Questionnaire 53.42 ± 10.631 decent work-turnover intention EI-Gazar et al. Egypt 2025 clinical nurses ( n = 268) DWS; Felt obligation scale; Organizational identification scale; Internal whistleblowing intentions scale 3.36 (SD 0.85) decent work-internal whistleblowing intentions Yu et al. China 2024 clinical nurses ( n = 425) DWPS; WOLF; PES 52.94 ± 6.46 decent work-work immersion Zoromba et al. Egypt 2025 clinical nurses ( n = 203) DWS; Eysenck Personality Questionnaire 4.32 ± 1.47 decent work-ethical ideologies EI-Gazar et al. Egypt 2024 clinical nurses ( n = 289) DWS; Psychological Ownership Scale; Shirom–Melamed vigor measure 3.49 (SD 0.88) decent work-vigour at work Chen et al. China/Zhejiang 2025 clinical nurses ( n = 309) DWPS; Role clarity scale Chinese version; Job embeddedness scale Chinese version 52.55 ± 6.38 role clarity-decent work-job embeddedness decent work as a mediating variable Othman et al. Egypt 2025 clinical nurses ( n = 454) Leader Humility Scale; DWPS; Grit Scale 2.94 (SD 0.86) humble leadership-decent work-nurses’grit Sönmez et al. Turkey 2023 clinical nurses ( n = 311) PES-NWI; DWS; Health-Related Quality of Life-4; Job Satisfaction-Global Item 54.27 (SD 14.57) subscales of PES-NWI-decent work-physical and mental health Wang et al. China 2024 clinical nurses ( n = 1513) Nurse Innovation Behavior Scale; Conditions of Work Effectiveness Questionnaire-II; DWPS 42.97 ± 9.25 structural empowerment-decent work-innovative behavior Zhang et al. China/Zhejiang 2024 psychiatric nurses ( n = 397) ERI; DWPS; MBI-GS; General Well-Being Schedule Scale 55.68 ± 10.84 effort-reward imbalance-decent work-well-being Zheng et al. China/Shanxi 2024 clinical nurses ( n = 792) Perceived Organizational Support Scale; Professional Quality of Life Scale; DWPS; Nurse Occupational Well-being Questionnaire 52.46 ± 14.05 organizational support-decent work-occupational well-being Feng et al. China/Zhejiang 2025 clinical nurses ( n = 838) DWPS; Chinese version of the compassion fatigue short scale; Gallup workplace audit 54.98 ± 13.18 compassion fatigue-decent work decent work as a response variable Xue et al. China/Zhejiang 2024 psychiatric nurses ( n = 358) ERI; Social support rating scale; DWPS 55.69 ± 10.42 effort-reward imbalance-decent work Cao et al. China/Jiangsu 2025 PICU nurses ( n = 176) DWPS 51.46 ± 8.22 age; professional title; monthly income; educational level; workplace violence Gil Portugal 2022 care workers ( n = 40) semi-structured interviews / work stress; profession recognition; low wages; organizational conflict; lack of qualified staff Xue et al. China/Zhejiang 2025 registered nurses ( n = 20) semi-structured interviews / leadership style; the attitudes of patients and the public; individual’s traits; professional experience; income level Zheng et al. China 2025 clinical nurses ( n = 1930) DWPS; WOLF; Psychological Capital Questionnaire 49.10 ± 6.18 work-related flow; psychological capital; age; education background; workplace violence; the economic level of the city; gender; monthly income Open in a new tab DWS: Decent Work Scale DWPS: Decent Work Perception Scale MBI-GS: Maslach Burnout Inventory-General Survey Scale WOLF: Work-related Flow Inventory Chinese Version PES: Psychological Empowerment Scale PES-NWI: Practice Environment Scale of the Nursing Work Index ERI: Effort-Reward Imbalance There has been an annual increase in publications since 2022, with China having the most publications followed by Egypt (Fig. 2 ). Fig. 2. Open in a new tab Publications by country (volume and year) Most included studies adopted a variable-oriented paradigm, examining the interrelationships between decent work and related psychological or occupational variables. Four studies specifically focused on identifying factors influencing nurses’ perceptions of decent work (see Fig. 3 ). Fig. 3. Open in a new tab Conceptual framework of decent work as a variable Factors related to decent work Ten studies reported factors that were positively associated with nurses’ perceptions of decent work, including work competence [ 22 ], job embeddedness [ 23 ], grit [ 24 ], physical and mental health [ 25 ], innovative behaviour [ 26 ], work immersion [ 27 ], subjective well-being [ 11 , 28 ], ethics [ 29 ], and vigor at work [ 30 ]. Six studies showed factors that were significantly negatively associated with perceived decent work among nurses including emigration intention [ 31 ], turnover intention [ 10 , 32 ], compassion fatigue [ 33 ], effort-reward imbalance [ 13 ], and internal whistleblowing intentions [ 34 ]. Four studies found that perceptions of decent work are influenced by multiple dimensions, including demographic characteristics (such as age, professional title, monthly income, and educational level), occupational environment factors (such as workplace violence, work environment, job stress, staff shortages, and organizational conflict), social–cognitive factors (such as perceived social recognition), organizational management factors (such as managerial attitudes and leadership style), and individual-level factors (such as personality traits and psychological capital) [ 9 , 12 , 35 , 36 ]. Decent work as an independent variable Eight studies regarded decent work as an independent variable. It had a negative impact on nurses’ intentions to emigrate [ 31 ] and resign [ 10 , 32 ]. At the same time, it had a positive effect on nurses’ work ability [ 22 ], internal whistleblowing intentions [ 34 ], work immersion [ 27 ], ethical ideologies [ 29 ], and vigor at work [ 30 ]. Decent work as a mediating variable Six studies treated decent work as a mediating variable, exerting a positive mediating effect on role clarity and job embeddedness [ 23 ], humble leadership and nurses’ grit [ 24 ], Practice Environment Scale of the Nursing Work Index and physical and mental health (with no significant correlation with job satisfaction) [ 25 ], structural empowerment and innovative behavior [ 26 ], effort-reward imbalance, and organizational support and well-being [ 11 , 28 ]. Decent work as a response variable Two studies treated decent work as a response variable. The results showed that compassion fatigue [ 33 ] and effort-reward imbalance [ 13 ] both reduced nurses’ perception of decent work. Discussion This scoping review has provided a comprehensive overview of research on nurses’ perceptions of decent work, with particular attention to how decent work has been operationalized as an independent, mediating, and response variable. Across the 20 studies reviewed, nurses generally reported low to moderate levels of perceived decent work, highlighting the ongoing challenges in achieving fair, safe, and empowering work environments in the nursing profession. Decent work as an independent variable When examined as an independent variable, decent work has been shown to exert multidimensional effects on nurses’ job performance, turnover intention, and subjective well-being. Three studies indicated that nurses with greater access to decent work opportunities reported lower turnover or migration intentions [ 10 , 31 , 32 ]. Based on the conservation of resources theory, one study conducted in developing countries found that access to key resources such as financial support and standardized skills training motivates nurses to achieve decent working conditions, thereby reducing professional attrition and migration intentions [ 31 , 37 ]. Two studies conducted in China revealed that nursing work tends to be stable and align with traditional professional values. When nurses experience higher job satisfaction and recognition, they are more likely to perceive their work as decent [ 10 , 32 ]. Four studies demonstrated a positive association between perceptions of decent work and nurses’ job performance [ 22 , 27 , 29 , 30 ]. Three of these confirmed the mediating role of psychological empowerment, which serves as an intrinsic motivational mechanism. Psychological empowerment reflects the extent to which organizations provide nurses with access to knowledge and participation in decision-making, enhancing their sense of autonomy and agency in professional practice. Accordingly, when nurses work in decent conditions, organizational empowerment can strengthen their professional autonomy, stimulate motivation, and improve performance [ 27 , 30 , 38 ]. Another study reported that nurses with higher perceptions of decent work regarded themselves as integral members of the organization, which encouraged moral courage and whistleblowing behaviors; these can in turn help improve nursing management policies [ 34 ]. Another study showed that the organizational values and adequate leisure and rest time dimensions of Duffy’s Decent Work Scale significantly predicted nurses’ professional idealism, providing evidence for optimizing human resource allocation in clinical nursing practice [ 29 ]. Decent work as a mediating variable Across the included studies, decent work demonstrated a positive mediating effect in the link between various variables and nursing services, suggesting that interventions targeting decent work are often feasible for nursing managers to adopt and implement. Although six studies examined [ 11 , 23 – 26 , 28 ] the mediating role of decent work, one found no significant association between decent work and job satisfaction. This finding may be explained by the study’s context: it was conducted during the most intense outbreak of the COVID-19 pandemic in Turkey, during which nurses’ annual leave was cancelled and their right to resign or retire was temporarily restricted [ 25 ]. These unfavorable working conditions and the mismatch between effort and reward may have led to emotional exhaustion, thereby influencing the study results [ 25 , 39 ]. Future research should further explore the strength and potential mechanisms of this relationship. In terms of improving nurses’ subjective well-being and overall health, decent work enhances nurses’ welfare by fostering healthy, safe, and harmonious work environments, providing fair remuneration and career development opportunities, and ensuring the protection of their legitimate rights and recognition of professional competence [ 11 , 25 , 28 ]. This mechanism helps reduce work-related stress, promotes physical and psychological well-being, and ultimately increases overall happiness among nurses. Within the work context, based on the job demands–resources theory, job demands deplete nurses’ physical and emotional resources and are key factors of burnout [ 23 , 24 , 26 , 40 ]. Nurses with a high perception of decent work can mobilize occupational resources such as social support and job autonomy to counter negative emotions, thereby fostering positive outcomes including innovative behavior, work competence, and emotional resilience. Decent work as a response variable Multiple studies indicated that factors such as compassion fatigue, effort-reward imbalance, monthly income, psychological capital, management attitudes, and leadership styles exert a combined influence on nurses’ perception of decent work [ 9 , 12 , 13 , 33 , 35 , 36 ]. One study revealed [ 33 ] that compassion fatigue and work engagement have different impacts on nurses’ perception of decent work. Specifically, work engagement plays a positive mediating role, reflecting not only nurses’ work attitude and sense of responsibility but also serving as a key factor in maintaining a positive identification with their professional role when confronted with compassion fatigue. Higher work engagement helps nurses sustain their self-efficacy and derive a sense of accomplishment and satisfaction from their work, thereby fostering perceptions of decent work. Conversely, nurses with high levels of compassion fatigue tend to perceive a threat to their dignity at work, which weakens their positive identification with their professional role, makes nurse-patient interactions more challenging, and ultimately leads to a lower sense of decent work. Another study demonstrated [ 41 ] that nursing experience, effort-reward imbalance, and social support all significantly influence psychiatric nurses’ perception of work decency. Notably, the study pointed out that nurses with less than five years of work experience reported a significantly higher perception of decent work compared to those with over 25 years of experience. This discrepancy may stem from senior nurses’ perceived career stagnation, coupled with healthcare institutions’ greater focus on newly recruited nurses, making limited promotion opportunities a critical barrier to their professional development. When nurses perceive a significant imbalance between their high work input and low financial rewards coupled with a high-stress work environment, it can easily induce strong feelings of unfairness and disrespect, trigger job burnout and emotional detachment, and ultimately undermine their sense of decent work. In this process, social support, as an important external resource, provides both emotional and practical assistance and encouragement, alleviates work pressure, and positively moderates and reinforces nurses’ perceptions of decent work [ 13 ]. Four studies indicated that factors associated with nurses’ perceptions of decent work can be categorized into demographic, intrinsic, and extrinsic factors [ 9 , 12 , 35 , 36 ]. Among demographic characteristics, age, professional title, monthly income, and educational level are key predictors of perceived decent work. Nurses with longer work experience and higher income tend to report stronger perceptions of decent work. However, the influence of educational level remains inconsistent across studies. Zheng found that more educated nurses reported higher levels of perceived decent work, possibly because they possess stronger learning abilities, broader professional knowledge, and greater professional confidence [ 36 ]. In contrast, some researchers observed that more educated nurses reported lower perceptions of decent work, which may be due to hospitals’ insufficient recognition of highly educated nurses’ roles in departmental management, clinical decision-making, and research innovation, thereby diminishing their sense of workplace dignity and decent work [ 12 , 35 ]. According to our analysis, the dimensions of decent work perceived by nurses vary across different contexts. Among nurses in general hospitals, work engagement is the most frequently studied dimension. This may be because decent work, fostered by favorable working conditions and professional recognition, can directly enhance nurses’ level of work engagement, satisfy their basic needs and sense of professional recognition, and encourage individuals to more actively undertake work tasks and responsibilities [ 10 , 23 , 27 , 33 , 36 ]. For psychiatric nurses, effort-reward imbalance has become a particular concern. Due to long-term exposure to patient violence and aggressive behaviors, high-intensity workloads, and other special challenges in daily work, their physical and mental resources are significantly depleted, making the maintenance of effort-reward balance a critical issue in nursing management [ 11 , 13 ]. In long-term care facilities, the aging population has intensified problems such as shortages of professional nursing staff and excessive workloads, which have become major obstacles to decent work [ 35 ]. These findings suggest that nursing managers should prioritize targeted interventions based on the specific characteristics of nursing groups in particular contexts, focusing on the most vulnerable areas. In terms of intrinsic factors, personal traits, professional experience, work-related flow, and psychological capital are positively associated with perceived decent work. Nurses with strong self-efficacy and advanced professional skills tend to exhibit higher intrinsic motivation when facing occupational challenges. Their ability to remain engaged in nursing practice enhances their sense of professional value and achievement, which in turn buffers the negative effects of intense work and strengthens their perception of decent work [ 9 , 36 ]. From an extrinsic perspective, workplace violence, work stress, lack of professional recognition, staff shortages, organizational conflict, managerial attitudes, and leadership styles have been identified as negative predictors of perceived decent work [ 9 , 12 , 35 ]. Nurses who have experienced workplace violence often suffer psychological harm, which may trigger fear, anxiety, emotional exhaustion, and reduced work enthusiasm, thereby directly diminishing their perception of decent work [ 12 ]. In contrast, a positive and supportive work environment can enhance nurses’ perceptions of decent work. Support from colleagues and managers helps nurses recognize their professional value and social contribution, improves their social status and professional recognition, and strengthens their overall perception of decent work [ 13 ]. Cultural factors and perceptions of decent work Perceptions of decent work are strongly influenced by cultural factors. In Western contexts, decent work is more closely associated with individual rights, financial compensation, and social status [ 42 ]. Western societies, generally grounded in individualistic cultural values [ 43 ], emphasize personal career achievement and self-actualization. Employees confirm their sense of decency through professional performance, salary level, and social recognition, highlighting economic and social dimensions. In China, however, face culture is a crucial cultural factor [ 44 ], encompassing social status, personal dignity, external respect, and public image [ 45 , 46 ]. For example, research has indicated that the shortage of male nurses in China is influenced by gender norms in Confucian culture, where caregiving work is traditionally considered a female domain, while men are expected to pursue socially “decent” careers that support the family. Hence, gender stereotypes influence how male nurses’ social status and work dignity is perceived [ 47 , 48 ]. Evidently, perceptions of decent work in the Chinese context involve not only financial concerns and career achievements but are also deeply shaped by social relationships, cultural expectations, and collective values, giving decent work a more social and relational character. Therefore, cultural differences in decent work not only reflect variations in how societies define “decency” but also reveal differences in individual positioning within social structures and cultural contexts. This suggests that managers in different cultural settings need to carefully consider the influence of culture on employees’ perceptions of decent work. Implications for nursing management This review offers several implications for clinical nursing practice and management. First, our findings highlight the crucial role of decent work in promoting organizational sustainability and improving nursing care quality. This suggests that hospital administrators, when addressing organizational challenges, should consider nurses’ perceptions of decent work [ 32 ]. For example, hospitals can provide opportunities for nurses to participate in external training and professional development programs, helping them expand their professional horizons and career prospects, thereby enhancing their sense of decent work. At the individual level, nurses can actively seek social support from colleagues, family members, and friends to strengthen their perception of decent work [ 13 ]. Finally, perceptions of decent work have primarily been measured using scales developed by Duffy et al. [ 8 ] and Mao et al. [ 21 ] or through localized adaptations of these instruments. This review highlights that the understanding and meaning of decent work vary across cultural settings. Therefore, each country should consider local cultural values, social norms, and workplace expectations when measuring and promoting decent work, ensuring that assessment tools and management strategies are culturally relevant and contextually appropriate. Limitations and future research This study adopted a rigorous search strategy based on the research questions and summarized the most recent scientific evidence. However, it has certain limitations. First, during the formulation of the search strategy for this study, no librarians were involved. This may have affected the comprehensiveness and accuracy of the search to some extent, potentially limiting the transparency, reproducibility, and systematic nature of the study. To make up for this deficiency as much as possible, the research team adopted an iterative search and reference-literature-tracking approach—based on a preliminary literature review, combined with medical subject headings (MeSH) and free words, and referring to relevant methodological guidelines—striving to comprehensively obtain relevant key evidence. Second, only English-language publications were included, which may have led to the omission of studies published in other languages. Future reviews could expand the search scope to include multilingual databases to enhance the comprehensiveness and representativeness of the findings. In addition, most of the studies included in this review were cross-sectional surveys or qualitative studies, and we did not conduct a formal quality assessment. Future research should adopt more diverse methodologies to gain a deeper understanding of the current state of research on decent work. Conclusions This study synthesized current evidence on nurses’ perceptions of decent work and provided a theoretical basis for nursing managers to develop various strategies for improving work conditions. The findings indicate that decent work, as an independent, mediating, or response variable, influences nurses’ service quality in different ways. This finding suggests that future nursing managers should promote decent work through fair and respectful organizational environments, improved working conditions, equitable compensation, and opportunities for professional development. Such an approach is likely to contribute to nurse retention and workforce stability by reducing turnover intention and its associated economic costs, including recruitment, training, and productivity losses, thereby making a compelling case for investment in decent work initiatives from both clinical and financial perspectives. Acknowledgements The authors thank all researchers who contribute to the studies of Nurse ‘decent work. Abbreviations DWS Decent Work Scale DWPS Decent Work Perception Scale MBI-GS Maslach Burnout Inventory-General Survey Scale WOLF Work-related Flow Inventory Chinese Version PCC Population, Concept, and Context PES Psychological Empowerment Scale PES-NWI Practice Environment Scale of the Nursing Work Index ERI Effort-Reward Imbalance Author contributions HL and BWX were the primary investigators of the study. JXX and BWX conducted data collection. JXX and BWX conducted data analysis and wrote this paper. JXX, HL, and BWX revised the manuscript. All authors read and approved the final manuscript. Funding This work was funded by the National Center for Mental Health, China, as part of the project Promoting Mental Health through Excellent Traditional Chinese Culture (Grant No. GXWH2025A-001). Data availability The data that were used to support the findings of this scoping review can be found within the text of the cited references included in this study. Declarations Ethics approval and consent to participate Not applicable. Consent for publication No applicable. Competing interests The authors declare no competing interests. Footnotes Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Contributor Information Hong Luo, Email: [email protected]. Bowen Xue, Email: [email protected]. References 1. Blustein DL, Olle C, Connors-Kellgren A, Diamonti AJ. Decent work: a psychological perspective. Front Psychol. 2016;7. 10.3389/fpsyg.2016.00407. [ DOI ] [ PMC free article ] [ PubMed ] 2. Thornton J. Violence against health workers rises during COVID-19. Lancet. 2022;400(10349):348–348. 10.1016/S0140-6736(22)01420-9. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 3. 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Data Availability Statement The data that were used to support the findings of this scoping review can be found within the text of the cited references included in this study. 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