BACKGROUND AND OBJECTIVE: Occupational dysfunction is frequent among healthcare workers, but little is known about factors related to occupational participation and stress coping behavior among healthcare workers. This cross-sectional study aimed to analyze structural relationships among occupational dysfunction, stress coping, and occupational participation in healthcare workers. METHODS: Participants were 601 healthcare workers in 13 facilities. Data were collected with participant profile, Classification and Assessment of Occupational Dysfunction (CAOD), Coping Scale (CS), and Self-completed Occupational Performance Index (SOPI). Data were analyzed by descriptive statistics, item response theory (IRT), confirmatory factor analysis (CFA), correlation analysis, and path analysis. RESULTS: CFAs of CAOD, CS, and SOPI indicated good fit to the predicted models. In IRT, CAOD and SOPI showed conformity, but two items of CS showed nonconformity. The correlation between CAOD-SOPI was high to moderate (-0.486 to -0.246; p < 0.001), whereas that between CAOD and emotion-focused coping was weakly negative. SOPI and CS were negatively associated with occupational dysfunction (p < 0.000). CONCLUSIONS: This model demonstrated that SOPI and CS had a negative structural relationship with occupational dysfunction. Therefore, it seems important to encourage occupational participation (in the areas of self-care, productivity, and leisure) to reduce occupational dysfunction in healthcare workers.