Perceived stress and depression among Chinese nurses: a cross-sectional mediation analysis of psychological flexibility and its components - Report - MDSpire

Perceived stress and depression among Chinese nurses: a cross-sectional mediation analysis of psychological flexibility and its components

  • By

  • Zeyu Huang

  • Pan Diao

  • Tian Tian

  • Lei Yang

  • Xiaomei Li

  • May 28, 2026

  • 0 min

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Clinical Report: Stress Perception and Depression in Chinese Nurses

Overview

This study examines the relationship between perceived stress and depression among Chinese nurses, highlighting the mediating role of psychological flexibility. Findings indicate that psychological flexibility partially buffers the impact of perceived stress on depression.

Background

Perceived stress is a critical risk factor for depression, particularly among healthcare professionals like nurses. Understanding the mechanisms that mediate this relationship is essential for developing effective interventions. Given the high prevalence of depression in nursing, addressing these psychological factors is crucial for improving both nurse well-being and patient care.

Data Highlights

MeasureCorrelationp-value
Perceived Stress and Depressionr = 0.63< 0.01
Direct Associationb = 0.4795% CI: 0.45 to 0.49
Indirect Association via Psychological Flexibilityb = 0.1295% CI: 0.11 to 0.13
Acceptance and Cognitive Defusionb = 0.1495% CI: 0.13 to 0.15
Values and Committed Actionb = 0.0695% CI: 0.04 to 0.08
Mindfulness and Self-as-Contextb = 0.0195% CI: 0.00 to 0.02

Key Findings

  • Depression among nurses is positively correlated with perceived stress (r = 0.63, p < 0.01).
  • Perceived stress has a direct association with depression (b = 0.47).
  • Psychological flexibility mediates the relationship between perceived stress and depression (b = 0.12).
  • Acceptance and cognitive defusion are significant components of psychological flexibility that impact depression (b = 0.14).
  • The indirect association through mindfulness and self-as-context was not significant.

Clinical Implications

The findings suggest that enhancing psychological flexibility may serve as a protective factor against depression in nurses. Interventions targeting psychological flexibility, particularly through acceptance and cognitive defusion strategies, could be beneficial in mitigating the effects of perceived stress.

Conclusion

This study underscores the importance of psychological flexibility in understanding the relationship between perceived stress and depression among nurses. Future research should explore targeted interventions to enhance psychological flexibility in this population.

Related Resources & Content

  1. BMC Psychiatry (Springer) — Workplace violence predicts depression and anxiety in nurses: a multi-center longitudinal study in China
  2. BMC Psychiatry (Springer) — The Impact of Workplace Thriving on the Relationship Between Emotional Labor and Presenteeism Among Psychiatric Nurses With and Without Sleep Issues
  3. Frontiers in Pediatrics — Moral distress among pediatric nurses: a cross-sectional study from Sichuan, China
  4. BMC Psychiatry (Springer) — The mediating role of self-compassion in the relationship between big five personality traits and depression among Chinese preclinical medical students: a multicenter cross-sectional study
  5. Healing hands – hurting minds
  6. Effects of acceptance and commitment therapy on negative emotions, automatic thoughts and psychological flexibility for depression and its acceptability: a meta-analysis
  7. Perceived Stress and Psychological Distress among Chinese Nurses: The Mediating and Moderating Roles of Psychological Flexibility and Insomnia

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