Well-being is generally defined as an individual's positive emotional state and cognitive appraisal of life. When applied to the workplace, work-related well-being refers to employees' subjective positive emotions and evaluations toward their professional role (1). For nurses, higher levels of work-related well-being can reduce burnout, promote workforce stability, and enhance patient satisfaction (2–4). Therefore, its quantitative assessment and optimization have important implications.

Hepatobiliary surgery units are characterized by high clinical acuity, heavy workloads, complex perioperative management, and a high incidence of complications. Nurses working in these settings frequently encounter critically ill patients, unpredictable disease progression, and demanding technical procedures, which can lead to sustained occupational stress and emotional exhaustion (5). In such high-risk environments, maintaining nurses' well-being is crucial not only for their physical and mental health, but also for ensuring the safety and quality of patient care.

Work-related well-being is shaped by multiple factors, including personal characteristics, workplace conditions, and social support. Previous research has often focused on external determinants while overlooking the role of internal psychological resources (6). Psychological resilience, an essential internal resource, is defined as the ability to adaptively regulate psychological and behavioral responses when facing environmental challenges (7, 8). It may therefore serve as a key factor influencing well-being. Similarly, occupational stress exerts dual effects: it can foster growth but may also impair efficiency and compromise nurses' physical and mental health (9–11). Exploring its relationship with well-being is thus crucial. Another relevant construct is professional benefit perception, which describes the positive emotional state derived from recognizing the value of one's profession (12, 13). This perception strengthens professional identity and retention intention, and may further influence nurses' well-being.

Previous studies have consistently shown that psychological resilience plays a protective role in nurses' occupational well-being, particularly in high-stress clinical environments. Research among mental health nurses and other frontline nursing groups has demonstrated that higher levels of resilience are associated with better professional quality of life, lower emotional exhaustion, and improved psychological well-being (14, 15). Resilience enables nurses to adapt to ongoing workplace stressors, regulate emotional responses, and maintain a sense of professional efficacy under pressure.

Occupational stress, by contrast, has been widely recognized as a major risk factor for impaired well-being among nurses. Systematic reviews and empirical studies indicate that excessive workload, emotional labor, and responsibility for critically ill patients are strongly associated with reduced job satisfaction, increased burnout, and poorer mental health outcomes (16, 17). In high-intensity specialties, such as mental health and surgical nursing, sustained exposure to occupational stress may erode nurses' psychological resources if adequate buffering mechanisms are not present. Emerging evidence further suggests that positive psychological and professional resources can mitigate the negative impact of occupational stress. Perceived professional benefits, reflecting nurses' recognition of professional value, personal growth, and social affirmation, have been linked to stronger professional identity and higher work-related well-being (18, 19). Together, these findings highlight the importance of examining both occupational stressors and protective psychological resources when investigating work-related well-being among nurses.

The present study was theoretically grounded in the Job Demands–Resources (JD-R) model, which posits that employee well-being is determined by the balance between job demands and available personal and job-related resources (20, 21). According to this framework, excessive job demands, such as occupational stress, may undermine well-being, whereas personal resources (e.g., psychological resilience) and job-related resources (e.g., perceived professional benefits) can buffer the negative effects of demands and promote positive work-related outcomes. In the context of nursing, particularly in high-intensity specialties, the JD-R model has been widely applied to explain variations in occupational well-being, burnout, and mental health. Based on this model, the present study conceptualized occupational stress as a job demand, psychological resilience as a key personal resource, and perceived professional benefits as a positive job-related resource, with work-related well-being as the primary outcome.

To date, few studies have simultaneously examined psychological resilience, occupational stress, perceived professional benefits, and work-related well-being among hepatobiliary surgical nurses using structural equation modeling. The mechanisms through which these variables interact, particularly the potential mediating roles of resilience and professional benefit perception, remain unclear. Therefore, this study targeted hepatobiliary surgical nurses in Jiangsu Province and aimed to: (1) describe the status of psychological resilience, occupational stress, perceived professional benefits, and work-related well-being; (2) identify the main influencing factors of work-related well-being; and (3) construct and test a structural equation model to clarify the pathways linking resilience, occupational stress, perceived professional benefits, and work-related well-being. The findings are expected to provide an empirical basis for nursing managers to develop targeted interventions to enhance nurses' well-being and promote team stability in hepatobiliary surgery units.

This study found that hepatobiliary surgical nurses exhibited relatively low levels of psychological resilience compared with the national norm, while their perceived professional benefits were at a moderately low level. These findings suggest that nurses in this high-risk, high-intensity specialty may experience greater challenges related to occupational stress. Hepatobiliary surgery units are characterized by high surgical volumes, complex disease conditions, and frequent postoperative complications, all of which require sustained vigilance and rapid decision-making. Under such circumstances, nurses may experience repeated exposure to critical events and emotional strain, potentially depleting their psychological resources and undermining resilience over time.

Occupational stress in this study mainly originated from patient care, followed by management and interpersonal factors, which is consistent with previous studies conducted among nurses in acute and critical care settings (22–24). Stressors such as fear of clinical errors, responsibility for critically ill patients, and coping with unexpected deterioration or death are particularly salient in hepatobiliary surgery. The relatively lower scores for work environment and equipment suggest that, although material resources may be relatively adequate, the psychological demands of direct patient care remain the primary source of stress (25).

Perceived professional benefits were moderate overall but slightly lower than those reported in some prior studies. Notably, the dimensions of personal growth and positive career perception scored relatively higher, indicating that hepatobiliary nurses are able to gain a sense of competence and professional development through managing diverse and complex clinical conditions. In contrast, the lowest scores were observed for team belongingness, suggesting that deficits in team cohesion and organizational connectedness may weaken nurses' overall sense of benefit from their profession.

With regard to work-related well-being, work value scored the highest among all dimensions, while management and job characteristics scored the lowest. This pattern implies that nurses derive substantial meaning and fulfillment from direct patient care and from perceiving their work as valuable, but may feel less supported by management and less satisfied with aspects of job design such as autonomy, role clarity, and task allocation. These findings highlight the relevance of both organizational and psychological factors in relation to nurses' work-related well-being.

Consistent with the hypotheses, psychological resilience and perceived professional benefits were positively associated with work-related well-being, whereas occupational stress was negatively associated. Nurses with higher resilience tended to report higher levels of work-related well-being, which aligns with previous research suggesting that resilience is linked to better emotional regulation, higher professional efficacy, and lower burnout. As resilient individuals are more capable of adapting to adversity and maintaining goal-directed behavior, they may be better able to preserve a positive outlook and satisfaction with their work despite ongoing challenges.

Perceived professional benefits also showed a significant positive relationship with work-related well-being. When nurses are able to realize self-worth, gain recognition from patients, families, and society, and experience personal and professional growth through their work, they are more likely to develop a strong sense of professional identity and fulfillment. This, in turn, enhances their subjective well-being at work. The present findings are consistent with the view that perceived professional benefits may represent a positive psychological resource associated with motivation and commitment.

By contrast, occupational stress was negatively correlated with work-related well-being, indicating that higher stress levels are associated with diminished positive work experiences. In hepatobiliary surgery, the heavy workload, high acuity, and emotional burden related to complex patient care may result in fatigue, anxiety, and reduced job satisfaction. When stress exceeds nurses' coping capacity and is not effectively buffered by resilience or positive professional experiences, it may erode their sense of well-being and increase the risk of burnout or turnover intention.

Multivariate analysis showed that psychological resilience, perceived professional benefits, occupational stress, number of children, employment type, and monthly income were jointly associated with work-related well-being. Specifically, resilience and professional benefits were positive predictors, whereas occupational stress showed a negative association. These findings suggest that both psychological and contextual factors play important roles in shaping nurses' well-being. Beyond psychological factors, the present findings also highlight the importance of socioeconomic and contractual conditions in shaping nurses' work-related well-being. Employment type and monthly income were independently associated with well-being, suggesting that job stability and adequate financial compensation may contribute to a greater sense of security and satisfaction at work. Nurses employed under more stable contractual arrangements may experience less uncertainty regarding career development and income continuity, which could be reflected in higher levels of well-being. Similarly, sufficient income may alleviate financial stress and support better work–life balance, indirectly relating to more positive work experiences. These results underscore that nurses' well-being is embedded not only in individual psychological resources but also in broader employment and socioeconomic contexts.

Nurses with one child reported higher levels of work-related well-being than those with no children or multiple children, which may reflect a more favorable work–family balance when caregiving responsibilities are moderate rather than minimal or excessive (26, 27). Employment stability and adequate income were also positively associated with well-being, underscoring the importance of job security and financial recognition in enhancing nurses' sense of satisfaction and future orientation.

The structural equation model further illustrated the pattern of associations among these variables. Psychological resilience was directly and positively associated with work-related well-being, suggesting that resilience may represent an important protective psychological resource (28–30). Occupational stress was negatively associated with work-related well-being and also exerted an additional indirect negative effect through perceived professional benefits, suggesting that high stress may weaken nurses' capacity to perceive rewards and meaning from their work (24, 31, 32). At the same time, perceived professional benefits were directly and indirectly associated with work-related well-being, partly through their association with psychological resilience.

Overall, psychological resilience and perceived professional benefits partially mediated the associations between occupational stress and work-related well-being.

These findings support a resource-based perspective, in which psychological resilience and perceived professional benefits form an internal reservoir that allows nurses to cope more effectively with occupational stress and maintain a positive evaluation of their work. For hepatobiliary surgical nurses, who are exposed to continuous clinical challenges, strengthening these psychological resources may be particularly important for sustaining long-term well-being and professional engagement. Taken together, these findings suggest that work-related well-being among hepatobiliary surgical nurses is associated with an interplay between individual psychological resources and structural socioeconomic and contractual conditions.

Although causal inferences cannot be drawn from this cross-sectional study, the observed associations may have practical implications for nursing management. The present study provides several practical implications for nursing managers in hepatobiliary surgery and similar high-intensity units. First, interventions aimed at reducing excessive occupational stress remain essential. Optimizing staffing and shift schedules may be associated with more favorable working conditions, which in turn may support nurses' work-related well-being. Timely debriefing and emotional support following critical incidents may also help nurses process stressful experiences more effectively. Second, strategies to enhance psychological resilience should be incorporated into continuing education and professional development programs. Evidence-based resilience interventions, such as mindfulness training, cognitive–behavioral techniques, and stress management workshops, may help nurses develop more adaptive coping styles and emotional regulation skills. Flexible work arrangements and supportive supervision may further reinforce resilience by providing a more secure and predictable work environment. Third, nursing managers should actively foster nurses' perceived professional benefits. This may include creating opportunities for career development, encouraging participation in clinical decision-making, recognizing outstanding performance, and enhancing team communication and cohesion. For nurses with heavier family responsibilities or less stable employment status, targeted support—such as flexible scheduling, fair promotion policies, and transparent compensation schemes—may help reduce perceived inequities and promote a stronger sense of belonging.

This study has several limitations. First, the cross-sectional design precludes causal inferences regarding the relationships among psychological resilience, occupational stress, perceived professional benefits, and work-related well-being. Longitudinal or intervention studies are needed to further clarify causal pathways. Second, convenience sampling from hospitals within a single province may limit the generalizability of the findings to other regions or healthcare settings. Future research should include multi-center samples from different geographic and institutional contexts. Third, all data were collected through self-report questionnaires, which may be subject to recall bias and social desirability effects. Incorporating objective indicators (e.g., turnover, sickness absence) and qualitative methods could provide a more comprehensive understanding of nurses' well-being. In addition, although all measurement instruments used in this study were established Chinese versions with documented reliability and validity, confirmatory factor analysis was not conducted to re-examine structural validity in the current sample. Future studies may further assess the factorial structure of these instruments using independent samples.

Despite these limitations, the present study highlights the crucial roles of psychological resilience and perceived professional benefits in buffering occupational stress and promoting work-related well-being among hepatobiliary surgical nurses. These findings suggest that perceived professional benefits may function as an important positive psychological resource associated with work-related well-being.