The structural model of anxiety symptoms and work-life areas in nurses with the mediating role of moral distress and emotion regulation

Abstract

Background: Nurses play a crucial role in the healthcare system, making it important to investigate their workplace and psychological issues due to the sensitive nature of their job.Objectives: This study aimed to explore the mediating role of moral distress and emotion regulation in the relationship between work-life areas and anxiety symptoms among nurses during the COVID-19 outbreak.Methods: In this cross-sectional study, 255 nurses from Shahid Beheshti Hospital in Kashan city (Iran) were selected using simple random sampling. Participants completed questionnaires including the Demographic Information Questionnaire, Areas of Work-life Scale (AWS), Beck Anxiety Inventory (BAI), Moral Distress Scale (MDS), and Cognitive Emotional Regulation Questionnaire (CERQ). The data were analyzed using Pearson's correlation and Structural Equation Modeling (SEM).Results: The findings indicated a significant negative correlation between certain work-life areas and anxiety symptoms (r=-0.30, P<0.05). Furthermore, the mediating role of moral distress and maladaptive emotion regulation was confirmed (GFI=0.99, IFI=0.99, NFI=0.99, CFI=0.99, RMSEA=0.075, χ2=2.134).Conclusion: The results suggest that challenging work-life situations can exacerbate nurses’ anxiety. Additionally, moral distress and maladaptive emotion regulation are shown to significantly influence the severity of anxiety symptoms. Therefore, it seems providing education on ethical decision-making and adaptive emotion regulation can be beneficial in reducing nurses’ anxiety.

Keywords

• work-life areas
• anxiety
• moral distress
• emotion regulation
• nurses