Li Yuan, Li Jie, Zhou Chunfen, Peng Hanmei, Luo Biru, Hu Yanling, Fang Jinbo
Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
BMC Psychiatry. 2025 Apr 2;25(1):319. doi: 10.1186/s12888-025-06742-2.
Nurses are particularly susceptible to the adverse psychological effects of alexithymia, a personality trait characterized by difficulties in identifying and describing emotions. However, the mechanisms linking alexithymia to psychological distress among nurses remain unclear. The present study aimed to unravel the link between alexithymia and psychological distress in nurses, and to explore the potential mediating roles of workplace conflict and emotional exhaustion.
A cross-sectional survey was conducted among 4088 nurses from 43 public hospitals in China. The participants completed a web-based questionnaire that comprised the Toronto Alexithymia Scale (TAS-20), the Interpersonal Conflict at Work Scale (ICAWS), the Emotional Exhaustion Scale (EES), and the Kessler Psychological Distress Scale (K6). The chain mediation model was evaluated using Mplus, with the bias-corrected bootstrap method. Moreover, a sensitivity analysis utilizing a structural equation modeling approach was performed to corroborate the findings.
Among the 3977 nurses who returned valid questionnaires, participants reported mean scores of 53.95 ± 10.78 for alexithymia and 7.26 ± 5.75 for psychological distress, with 22.0% meeting the threshold for alexithymia and 16.9% exhibiting clinically significant psychological distress. The study revealed that alexithymia had a direct positive effect on psychological distress (β = 0.164, 95% CI [0.148-0.181]). Furthermore, workplace conflict (β = 0.036, 95% CI [0.031-0.042]) and emotional exhaustion (β = 0.118, 95% CI [0.108-0.128]) independently mediated the pathway linking alexithymia to psychological distress, and also operated sequentially in a chain mediation pathway (β = 0.010, 95% CI [0.008-0.012]). Sensitivity analyses confirmed the robustness of these findings.
This study suggests that alexithymia not only directly affects psychological distress but also exerts chain mediation effects through workplace conflict and emotional exhaustion. The findings unravel the complex mechanisms underlying the alexithymia-psychological distress link, providing valuable insights to guide efforts in safeguarding nurses' mental health. By addressing alexithymia and cultivating a supportive organizational environment, managers can facilitate the build-up of emotional resources, ultimately enhancing the psychological well-being of nurses.
护士特别容易受到述情障碍的不良心理影响，述情障碍是一种人格特质，其特征是在识别和描述情绪方面存在困难。然而，述情障碍与护士心理困扰之间的联系机制仍不清楚。本研究旨在揭示护士述情障碍与心理困扰之间的联系，并探讨工作场所冲突和情绪耗竭的潜在中介作用。
对中国43家公立医院的4088名护士进行了横断面调查。参与者完成了一份基于网络的问卷，其中包括多伦多述情障碍量表（TAS-20）、工作场所人际冲突量表（ICAWS）、情绪耗竭量表（EES）和凯斯勒心理困扰量表（K6）。使用Mplus软件，采用偏差校正自助法评估链式中介模型。此外，利用结构方程建模方法进行了敏感性分析，以证实研究结果。
在3977名返回有效问卷的护士中，参与者的述情障碍平均得分为53.95±10.78，心理困扰平均得分为7.26±5.75，22.0%的人达到述情障碍阈值，16.9%的人表现出临床上显著的心理困扰。研究表明，述情障碍对心理困扰有直接的正向影响（β = 0.164，95% CI [0.148 - 0.181]）。此外，工作场所冲突（β = 0.036，95% CI [0.031 - 0.042]）和情绪耗竭（β = 0.118，95% CI [0.108 - 0.128]）独立介导了述情障碍与心理困扰之间的途径，并且在链式中介途径中依次起作用（β = 0.010，95% CI [0.008 - 0.012]）。敏感性分析证实了这些发现的稳健性。
本研究表明，述情障碍不仅直接影响心理困扰，还通过工作场所冲突和情绪耗竭产生链式中介效应。这些发现揭示了述情障碍与心理困扰联系背后的复杂机制，为指导保障护士心理健康的努力提供了有价值的见解。通过解决述情障碍问题并营造支持性的组织环境，管理者可以促进情感资源的积累，最终提高护士的心理健康水平。
