The Role of Self-Control and Self-Compassion in Predicting Resilience based on Perceived Stress and Alexithymia among Nurses

پژوهش های روان شناسی بالینی و مشاوره

Articles in Press, Accepted Manuscript, Available Online from 14 July 2025   

Document Type: Original Article

DOI: 10.22067/tpccp.2025.89809.1696

Authors

Elahe Geramipour¹; Sheida Sodagar^{* 2}; Maryam Bahrami Hidaji²

¹Master of Clinical Psychology, Department of clinical Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.

²Assistant Professor, Department of Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

Abstract

Introduction
Healthcare workers, including nurses, as the largest group providing care and treatment services, bear significant responsibilities towards human health (Embriaco et al., 2007). The dissemination of the coronavirus has precipitated a psychological predicament among healthcare professionals, manifesting in persistent ramifications for their social and emotional well-being (Schwartz et al., 2020; Warchoł-Biedermann et al., 2022). Perceived stress has been linked to the indirect effects of the ongoing coronavirus pandemic on mental health. Alexithymia, a psychological condition characterized by difficulty describing emotions and experiencing them fully, has been identified as a potential mediator in this relationship, according to research by Li et al. (2022). Among the various factors affecting nurses' performance, self-control and resilience in the challenges and professional problems of nurses and the reduction of stress and alexithymia are of particular importance (Mousavi et al., 2024). The rationale for studying healthcare professionals is twofold: firstly, the high level of stress and alexithymia in this population, and secondly, the importance of this issue in improving nurses' performance in society. The present study aims to determine the mediating role of self-control and self-compassion in predicting resilience based on perceived stress and alexithymia among nurses.
 
Method
The present study is a descriptive and correlational study with structural equation modeling approach. The sample size was 246 people, selected based on the study by Luo et al. (Luo et al., 2019), which was conducted through convenience sampling of nurses working in hospitals and medical centers in Qazvin province (including Pasteur and Bu -Ali hospitals) in 2021. The data collection instruments encompassed five questionnaires: the Perceived Stress Scale (PSS-14) (Cohen et al., 1994; Cohen, 1983), the Toronto Alexithymia Scale (TAS-20) (Leising et al., 2009), the Short Form of Self-Control (SC) (Tangney et al., 2004), the Self-Compassion Scale (SCS) (Neff, 2003), and the Connor-Davidson Resilience Scale (CD-RISC) (Connor & Davidson, 2003). In the measurement model of the present study, 14 indicators were considered to reflect three latent structures. In order to evaluate the fitness of the proposed model, the path analysis model was implemented and analyzed using confirmatory factor analysis in AMOS software version 18 and structural equation modeling in SPSS software version 22.
 
Findings
The results of the study indicated that, with the exception of the spiritual influences component in resilience, the Cronbach's alpha coefficients of the other research components and variables were close to or higher than 0.7. This finding suggests that the internal consistency of the questionnaire items employed in this study is satisfactory. (β=0.336). given that the factor loadings of all indicators exceed 0.32, it can be concluded that all factors possess the necessary power to measure the latent variables of the present study. The findings revealed a negative indirect relationship between perceived stress and resilience, which was found to be statistically significant (P<0.001). This relationship was mediated by self-compassion (P<0.001, β=-0.100) and self-control (P<0.001, β=-0.144).  Consequently, the present study hypothesizes that self-compassion and self-control act as mediators, negatively and significantly moderating the relationship between perceived stress and resilience among nurses.
 
Discussion & Conclusion
The findings of the present study demonstrated that perceived stress can negatively and significantly predict resilience among nurses. Consequently, nurses who exhibited elevated perceived stress levels demonstrated diminished resilience. This finding is consistent with the studies of Thompson et al. (2018), Foroutan et al. (2018), and Afshari and Amin (2018). The extant literature suggests a negative correlation between perceived stress and resilience, with higher levels of perceived stress corresponding to lower resilience. Indeed, the adverse consequences of stress arising from academic and occupational challenges have a deleterious effect on the quality of work and the retention of employment. Resilience, defined as the ability to overcome and master difficult situations in one's life, is a critical factor in combating these challenges. Individuals who exhibit high resilience have been shown to possess a strong internal control power, a capacity for empathy, a positive self-concept, an optimistic outlook, and the ability to effectively organize their daily responsibilities (afshari & Amin, 2018; Froutan et al., 2018; Thompson et al., 2018).
In the present study, alexithymia was found to be a predictor of resilience levels among nurses, with a negative and significant relationship between the two variables. This finding aligns with the conclusions of previous studies by Morice-Ramat et al. (2018), Craparo et al. (2018), and Gui et al. (2013). In their study of nurses and residents, the researchers found that alexithymia exhibited an inverse and significant correlation with resilience, such that individuals with higher alexithymia reported lower levels of resilience. Additionally, a positive and significant correlation was identified between perceived stress in nurses and alexithymia. This phenomenon could be attributed to our cultural value attributed to high resilience in the face of adversity. The ability to regulate emotions in response to daily events and generate a positive outlook has been demonstrated to enhance individual performance and social interactions. The condition has been linked to anxiety disorders and social isolation in society (Craparo et al., 2018; Gui et al., 2013; Morice-Ramat et al., 2018). The psychological factors mentioned in the present study have the potential to influence the performance of healthcare staff, their accuracy and skill in providing effective care services, as well as their protection against disease. Given the evidence, healthcare institutions should integrate structured stress management programs into their mental health initiatives for medical staff. Research indicates that such interventions not only enhance psychological awareness among healthcare professionals—especially nurses—but also enable early detection of occupational risk factors, thereby preventing more severe psychological consequences.

Keywords

Perceived Stress; Nurses; Resilience; Self-Compassion; Alexithymia

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