Journal of Nursing

Decision Difficulty, Work-Family Conflict, and Social Support for Chinese Nurses in Guangzhou after the Two-Child Policy

Xiayin Jian, Meiling Huang, Thomas KS Wong, Jing Hu, Yingchun Zeng


Background: Although mainland China implemented a two-child policy (every legally married may have two children) on January 1, 2016, women in China are becoming increasingly cautious in their decision-making about family planning, due to work-family conflicts and a lack of social support. 

Objective: The aim of this study was to investigate Chinese nurses' intents to have a second child, and to explore the relationship between decision making difficulties in terms of childbearing intents, work-family conflict, and social support for Chinese nurses.

Methods: Data were collected at three different hospital levels in four districts of Guangzhou, from 711 nurses of childbearing age (18-50 years) who had had at least one child. A structured questionnaire was used, composed of the Decisional Conflict Scale (DCS), Work-Family Conflict Scale (WFCS), and Scale of Perceived Social Support (SPSS).

Results: Participants’ mean age was 33.6 years (18-50). The mean scores of decisional conflict by DCS, work-family conflict by WFCS and perceived social support by SPSS were 40.9 (SD = 14.8), 55.83 (SD = 15.18) and 57.85 (SD = 15.77), respectively. Work-family conflict was positively correlated with decisional conflict (P < 0.01), and social support was negatively related to decisional conflict (P < 0.01). By logistic regression analysis, family interference with work (FIW), especially time-based FIW, was a significant predictor of nurses having decisional conflicts in their childbearing intents (OR=1.083, 95% CI: 1.045 to 1.123). Perceived social support was another significant predictor of decisional difficulty (OR=0.981, 95% CI: 0.970 to 0.992).

Discussion: This study found that female nurses, working night shifts and with temporary job contract had higher decisional conflicts in intents of having a second child. The results showed that for Chinese nurses, work-family conflict influences decisional conflicts about having a second child.  

More importance should be attached to fulfill nurse’s needs of bearing children.


Decisional conflict, Social support, Two-child policy, Work-family conflict

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