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Li Y, Li J, Zhou C, Peng H, Luo B, Hu Y, Fang J. Unravelling the link between alexithymia and psychological distress in nurses: a multi-hospital cross-sectional study exploring the mediating roles of workplace conflict and emotional exhaustion. BMC Psychiatry 2025; 25:319. [PMID: 40175983 PMCID: PMC11967151 DOI: 10.1186/s12888-025-06742-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 03/18/2025] [Indexed: 04/04/2025] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Yuan Li
- 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
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China
| | - Jie Li
- Mental Health Center, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Chunfen Zhou
- Mental Health Center, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Hanmei Peng
- 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
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China
| | - Biru Luo
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China
| | - Yanling Hu
- 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
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China
| | - Jinbo Fang
- West China Hospital / West China School of Nursing, Sichuan University, Chengdu, 610041, China.
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Miyamoto K, Tanaka H, Bagnou JH, Clavel C, Prigent E, Benamara A, Le Scanff C, Martin JC, Nakamura S. Impact of eye movements and facial expressions on social performance during a collaborative problem-solving task. Acta Psychol (Amst) 2025; 254:104782. [PMID: 39923549 DOI: 10.1016/j.actpsy.2025.104782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 12/19/2024] [Accepted: 02/05/2025] [Indexed: 02/11/2025] Open
Abstract
Social performance is associated with producing good relationships in social communication. In recent years, there has been a growing emphasis on the importance of collaborative problem- solving in social communication. Aiming to enhance collaborative problem-solving, we investigated the characteristics of behavioral signals that impact social performance. In this paper, we analyzed the eye movements and facial expressions of pairs of participants working on a collaborative problem-solving task online. Our eye movement analysis showed that the lower the percentage of looking at the conversation partner is and the higher the percentage of looking outside is, the lower is the social performance. Our facial expression analysis showed that the lower the intensity of expression is in inner brow raiser, the cheek raiser, and the lip corner puller, the lower is the social performance.
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Affiliation(s)
- Kana Miyamoto
- Nara Institute of Science and Technology, Ikoma, Japan.
| | | | - Jennifer Hamet Bagnou
- Université Paris-Saclay, CNRS, Laboratoire Interdisciplinaire des Sciences du Numérique, Orsay, France
| | - Céline Clavel
- Université Paris-Saclay, CNRS, Laboratoire Interdisciplinaire des Sciences du Numérique, Orsay, France
| | - Elise Prigent
- Université Paris-Saclay, CNRS, Laboratoire Interdisciplinaire des Sciences du Numérique, Orsay, France
| | - Amine Benamara
- Université Paris-Saclay, CNRS, Laboratoire Interdisciplinaire des Sciences du Numérique, Orsay, France
| | - Christine Le Scanff
- Université Paris-Saclay, Laboratoire Complexité, Innovation Activités Motrices et Sportives, Orsay, France; Université d'Orléans, Laboratoire Complexité, Innovation Activités Motrices et Sportives, CIAMS, Orléans, France
| | - Jean-Claude Martin
- Université Paris-Saclay, CNRS, Laboratoire Interdisciplinaire des Sciences du Numérique, Orsay, France
| | - Satoshi Nakamura
- Nara Institute of Science and Technology, Ikoma, Japan; School of Data Science, The Chinese University of Hong Kong, Shenzhen, China
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Bazzari AH, Bazzari FH. The correlation between alexithymia and communication skills among undergraduate pharmacy students. Heliyon 2025; 11:e41402. [PMID: 39958744 PMCID: PMC11825255 DOI: 10.1016/j.heliyon.2024.e41402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 12/08/2024] [Accepted: 12/19/2024] [Indexed: 02/18/2025] Open
Abstract
Awareness of self-emotions and the emotions of others is a key factor in ensuring that health professionals communicate effectively with patients. This is of great importance for pharmacists, who, as primary healthcare providers, depend daily on effective communication to ensure the best therapeutic outcomes. Here, we aimed to evaluate the level of alexithymia, its correlation with communication skills and associated demographics in a university sample of undergraduate pharmacy students. The study utilized a printed questionnaire consisting of three parts: demographics, the Perth Alexithymia Questionnaire (PAQ), and the Health Professionals Communication Skills Scale (HP-CSS). A total of 212 students participated with a mean age of 21.59 ± 3.38 years, including males (n = 88, 41.5 %) and females (n = 124, 58.5 %). The results revealed moderate alexithymia levels and relatively satisfactory communication skills among the participants. Males had higher alexithymia scores and lower communication skills compared to females. Self-reported GPA values negatively correlated with alexithymia level but not with communication skills. The level of alexithymia negatively correlated with total communication skills, irrespective of gender, and the four dimensions of communication. In conclusion, alexithymia is negatively correlated with communication skills among undergraduate pharmacy students, highlighting the necessity of emotional awareness in patient communication and care.
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Affiliation(s)
- Amjad H. Bazzari
- Department of Basic Scientific Sciences, Faculty of Science, Applied Science Private University, Amman, 11931, Jordan
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Ozdemir C, Kaplan A. Examining nurses' humanistic behaviour ability and empathy levels in clinical practice: A descriptive and exploratory study. J Clin Nurs 2024; 33:3115-3127. [PMID: 38234293 DOI: 10.1111/jocn.16992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/25/2023] [Accepted: 01/07/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND It is critical for nurses to provide healthcare services to healthy/sick individuals with a humanistic approach and with empathy. AIMS This research aimed to determine nurses' humanistic behaviour ability, empathy levels and related factors in clinical practice. DESIGN A descriptive cross-sectional and exploratory study. METHODS Probability sampling method was used, and 337 nurses working in two public hospitals were included in the study. Data was collected using the Humanistic Practice Ability of Nursing Scale and the Empathy Level Determination Scale. Structural equation model analysis and descriptive statistics were used to evaluate the hypothesised model. This study adhered to the STROBE checklist for reporting. RESULTS Nurses' humanistic ability and empathy level in nursing practices were found to be above average. Both the ability to act humanely in nursing practices and their empathy levels were found to be significantly higher in nurses who were married and had children. A significant relationship was found between empathy levels and humanistic behaviours. Accordingly, nurses' empathy levels positively affected their humanistic care behaviours, and the model established between the two concepts was found to be statistically appropriate. CONCLUSIONS Nurses' empathy levels positively affect their ability to act humanistically. The result of the model established between the two concepts also supports this. Care strategies should be developed that consider factors that will improve empathetic and humanistic behaviours in nurses and maximise individualised care practices. IMPLICATIONS FOR THE PROFESSION Increasing the awareness of nurses about the factors affecting humanistic behaviours and empathic attitudes while caring for individuals in clinical practice, will contribute to improving the quality of nursing care.
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Affiliation(s)
- Cevriye Ozdemir
- Department of Medical Services and Techniques, University of Kayseri, Kayseri, Turkey
| | - Ali Kaplan
- Department of Medical Services and Techniques, University of Kayseri, Kayseri, Turkey
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Tuncer GZ, Çetinkaya Duman Z. Effects of Shared Decision Making Model-Based Guided Self-Help Program on Emotional Eating and Uncontrolled Eating Behavior in Individuals with a Severe Mental Disorder: A Randomized Controlled Trial. Issues Ment Health Nurs 2024; 45:331-343. [PMID: 38412065 DOI: 10.1080/01612840.2023.2297310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE The study was aimed at determining the effectiveness of the Shared Decision Making Model-based Guided Self-Help Program (SDM-GSH) on emotional eating behavior and uncontrolled eating behavior in individuals with a severe mental disorder. METHOD This randomized controlled experimental study was conducted in the Community Mental Health Center of a university hospital between September 2020 and November 2022. The sample of the study consisted of 64 participants. Of them, 33 were in the Experimental Group and 31 were in the control group. To collect the study data, the Patient Information Form, Emotional Eater Questionnaire, and Three-Factor Eating Questionnaire were administered. The participants in the Experimental Group took part in the SDM-GSH. The study data were collected from the participants in the Experimental and Control Groups before, right after and 6 months after the intervention. RESULTS The comparison of the BMI values of the participants with a severe mental disorder who took part in the SDM-GSH demonstrated that their pre-intervention BMI values significantly decreased at the measurements preformed right after and 6 months after the intervention (p < 0.05). The mean emotional eating (λ = 0.189, η2 = 0.811) and uncontrolled eating (λ = 0.218, η2 = 0.782) scores obtained by the participants in the Experimental Group before the intervention significantly decreased at the measurements preformed right after and 6 months after the intervention (p < 0.05). CONCLUSION Based on the results of our study, it is concluded that the SDM-GSH positively affected the BMI values, emotional eating behaviors and uncontrolled eating behaviors of the participants with a severe mental disorder.
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Affiliation(s)
- Gülsüm Zekiye Tuncer
- Department of Psychiatric Nursing, Dokuz Eylül University Institute of Health Sciences, Izmir, Turkey
| | - Zekiye Çetinkaya Duman
- Department of Psychiatric Nursing, Dokuz Eylül University Faculty of Nursing, Izmir, Turkey
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Karabey T, Aras M. The effect of exposure to intimate partner violence of female nurses on communication skills and burnout levels. Arch Psychiatr Nurs 2023; 47:27-34. [PMID: 38070992 DOI: 10.1016/j.apnu.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 02/08/2023] [Accepted: 04/23/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE Although intimate partner violence is a type of violence that women are frequently exposed to, its victims are adversely affected by violence at various levels, bio-psycho-socially. This study was conducted to determine the relationship between exposure to spousal violence, communication skills and burnout levels in female nurses. MATERIAL AND METHODS The study was carried out in a descriptive and cross-sectional research design. The study was conducted in a university hospital in the Black Sea region of Turkey in September 2021. Sample selection was not made in the study, and female nurses who agreed to participate in the study were included in the study. The study's sample size is 165 female nurses. A personal Information Form, Intimate Partner Violence Scale, Communication Skills Scale, and Burnout Scale were used to collect data. FINDINGS It was concluded that the exposure of female nurses to spouse violence significantly affects their communication skills and there is a significant relationship between nurses' communication skills and burnout levels (P = 0.001). PRACTICAL IMPLICATIONS The attitudes and behaviors of nurses who are strong in the caregiving process are very important. Personal characteristics, communication styles and body language of nurses who are exposed to partner violence are reflected in nursing care practices and affect the caregiving process. In this context, prevention and intervention approaches for intimate partner violence of female nurses should be known.
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Affiliation(s)
- Tuba Karabey
- Gaziosmanpasa University Faculty of Health Science, Tokat, Turkey.
| | - Mehtap Aras
- Gaziosmanpasa University Faculty of Health Science, Tokat, Turkey.
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