Mediating effects of positive coping styles among oncology nurses between psychological resilience and professional grief: a cross-sectional study

积极应对方式在肿瘤科护士心理韧性和职业悲伤之间的中介作用:一项横断面研究

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Abstract

Professional grief is a global challenge in oncology nursing. It refers to the constellation of grief reactions experienced by nurses after the death of patients under their care, and it seriously undermines mental health and job performance. Psychological resilience-a positive psychological attribute-enables individuals to achieve adaptive adjustment and maintain mental well-being. However, systematic evidence on the inter-relationships among psychological resilience, positive coping styles, and professional grief is lacking. This study clarifies how psychological resilience relates to professional grief among oncology nurses and elucidates the mechanisms through which positive coping styles operate. The findings furnish international nurse managers with a low-cost, high-impact target for psychological interventions and expand the global evidence map for prevention and mitigation professional grief. A questionnaire survey was conducted using purposive sampling among 540 oncology nurses in fifteen tertiary-level hospitals in Sichuan Province from November 2024 to February 2025. Instruments included psychological resilience (MeRS), positive coping styles (SCSQ), and professional grief (GSSN). A total of 518 valid questionnaires were returned, with an effective response rate of 95.9%. The results showed that psychological resilience had a significant direct effect on professional grief (β =  - 0.511, 95% CI [- 0.374, - 0.280]), a positive effect on positive coping styles (β = 0.526, 95% CI [0.177, 0.232]), and-via the mediator-remained significantly associated with professional grief (β =  - 0.346, 95% CI [- 0.275, - 0.168]). Positive coping styles, in turn, significantly predicted lower professional grief (β =  - 0.313, 95% CI [- 0.656, - 0.375]). Positive coping styles partially mediated the relationship between psychological resilience and professional grief among oncology nurses, with a mediation effect value of 0.164 and a mediation effect of 32.094% of the total effect. This is the non-Western study to delineate a mechanistic pathway from resilience to reduced grief via positive coping styles. The model is culture-independent and cost-effective, offering global oncology managers a concrete lever-strengthening positive coping-to mitigate nurses' grief and safeguard workforce well-being.

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