Stress, Interpersonal and Inter-role Conflicts, and Psychological Health Conditions Among Nurses: Vicious and Virtuous Circles Within and Beyond the Wards
Overview
Authors
Affiliations
Background: The increasing costs of nurses' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions should consider that perceived stress and conflicts- but also potential resources- within the wards can crossover the healthcare settings, impacting nurses' private lives and viceversa, potentially creating vicious circles exacerbating stress, conflicts/violence or, conversely, virtuous circles of psychological/relational wellbeing. Based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model, and responding to the need to go in-depth into this complex dynamic, this study aims to explore potential vicious circles featured by the negative effects of the interplay (main/mediating effects) between perceived stressors in nursing linked to interpersonal conflicts (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families), work-family inter-role conflicts (Work-Family/Family-Work-Conflicts), and work-related stress (Effort-Reward-Imbalance) on nurses' psychological/relational health (Anxiety, Depression, Somatization, Interpersonal-Sensitivity, Hostility). The potential moderating role of work-resources (Job-Control, Social-Support, Job-Satisfaction) in breaking vicious circles/promoting virtuous circles was also explored.
Method: The STROBE Checklist was used to report this cross-sectional multi-centre study. Overall, 265 nurses completed self-report questionnaires. Main/mediating/moderating hypotheses were tested by using Correlational-Analyses and Hayes-PROCESS-tool.
Results: Data confirmed the hypothesized detrimental vicious circles (main/mediating effects), impairing nurses' psychological health conditions at individual level (Anxiety, Depression, Somatization), but also at relational level (Hostility and Interpersonal-Sensitivity). The moderating role of all work resources was fully supported.
Conclusion: Findings could be used to implement interventions/practices to effectively prevent the maintenance/exacerbation of vicious circles and promote psychological/relational wellbeing in healthcare settings and beyond.
Ruan X, Lou Y, Zhang X, Wu Z, Yuan H Biomed Eng Online. 2025; 24(1):15.
PMID: 39923066 PMC: 11806821. DOI: 10.1186/s12938-025-01344-1.
Tong L, Zhu L, Zhang H, Zhong L, Diao D, Chen X Front Public Health. 2025; 12():1515593.
PMID: 39830181 PMC: 11740724. DOI: 10.3389/fpubh.2024.1515593.
Zhang P, Li S, Li Y, Zhang B, Liang F, Li J BMC Psychiatry. 2024; 24(1):589.
PMID: 39215260 PMC: 11363659. DOI: 10.1186/s12888-024-06042-1.
Zhao T, Yan H, Wang H, Guo M BMC Nurs. 2024; 23(1):598.
PMID: 39187804 PMC: 11346038. DOI: 10.1186/s12912-024-02276-2.
Vallone F, Cattaneo Della Volta M, Zurlo M BMC Nurs. 2024; 23(1):569.
PMID: 39148064 PMC: 11328495. DOI: 10.1186/s12912-024-02250-y.