The Relationships between Mindfulness, Resilience, and Clinical Self-Efficacy among Iranian Nurses

Kaeidi, Ziba; Tajvidi, Mansooreh; Beiranvand, Afsaneh; Mohamadi, Rasool; Najafi, Hamzeh; Tolabi, Tahereh

doi:10.22087/ijac.2025.510671.1056

The Relationships between Mindfulness, Resilience, and Clinical Self-Efficacy among Iranian Nurses

Document Type : Research

Authors

Ziba Kaeidi ¹

Mansooreh Tajvidi ²

Afsaneh Beiranvand ³

Rasool Mohamadi ⁴

Hamzeh Najafi ⁵

Tahereh Tolabi ⁶

¹ Student Research Committee, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran

² Department of Nursing, K.C.,Islamic Azad University, Karaj, Iran

³ Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran

⁴ Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran

⁵ Imam Khomeini Hospital, Lorestan University of Medical Sciences, Poldokhtar, Iran

⁶ Cardiovascular Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.

10.22087/ijac.2025.510671.1056

Abstract

Resilience and self-efficacy are critical attributes for nurses. While multiple factors influence these traits, understanding their determinants could enhance nurses' resilience and clinical performance, ultimately improving healthcare quality. This study explored the relationships between mindfulness, resilience, and clinical self-efficacy among Iranian nurses. A descriptive-correlational study was conducted in 2023 with 540 nurses from Lorestan Educational Hospitals in Khorramabad, Iran. Data were collected using demographic information, Connor and Davidson’s Resilience Scale, Brown and Ryan’s Mindfulness Questionnaire, and Cheraghi et al.’s Clinical Performance Self-Efficacy Scale. The results showed that nurses exhibited high clinical performance self-efficacy, moderate-to-high mindfulness, and moderate resilience. Significant positive correlations were observed between mindfulness and resilience (r=0.374, P< 0.001), mindfulness and clinical self-efficacy (r=0.331, P< 0.001), and resilience and clinical self-efficacy (r=0.452, P=0.001), with all correlations being statistically significant. Regression analysis further revealed that each one-unit increase in mindfulness was associated with a 0.374-unit rise in resilience. Similarly, every one-unit increase in mindfulness corresponded to a 0.386-unit increase in clinical self-efficacy. In contrast, a one-unit increase in resilience was linked to a 0.498-unit increase in clinical self-efficacy. Higher levels of mindfulness were found to positively influence nurses' resilience and clinical self-efficacy. To enhance these competencies training should be incorporated into continuing education programs for hospital nurses. Furthermore, nursing students should receive targeted preparation in these areas during their clinical training to better equip them for professional practice.

Keywords

Resilience

Self-efficacy

Mindfulness

Nurses

1. Taghilou H, Jafarzadeh Gharajag, Z. Investigating the relationship between burnout and job performance in the corona epidemic from the perspective of nurses. Quarterly Journal of Nursing Management. 2020; 9(4): 27-33.
2. Beiranvand S, Mohammad khan Kermanshahi S, Memarian R, Hosseinabadi R. Critical Care Nursing Instructors’ Perception of Clinical Education Competencies: A Qualitative Study. Interdisciplinary Journal of Acute Care. 2021; 2(2): 57-65. doi: https://doi.org/10.22087/ijac.2022.385234.1003
3. Hayajneh Y.A. Identification of the influence of organizational variables on hospital staff nurses' job performance.2000. The University of Iowa.
4. De Almeida Vicente A, Shadvar S, Lepage S, Rennick JE. Experienced pediatric nurses' perceptions of work-related stressors on general medical and surgical units: A qualitative study. International Journal of Nursing Studies. 2016 Aug;60:216-24. doi: https://doi.org/10.1016/j.ijnurstu.2016.05.005
5. Karami K, Hasanvand S, Sabzi A.H. The Effect of Emotional Intelligence Skills Training on Resilience of Critical Care Unit Nurses. Interdisciplinary Journal of Acute Care. 2021; 2(2): 74-79. doi: https://doi.org/10.22087/ijac.2022.465158.1014
6. Yılmaz, E. B. (2017). Resilience as a strategy for struggling against challenges related to the nursing profession. Chinese Nursing Research, 4(1), 9-13
7. Hofgaard LS, Nes RB, Røysamb E. Introducing two types of psychological resilience with partly unique genetic and environmental sources. Sci Rep. 2021 Apr 21;11(1):8624. doi: https://doi.org/10.1038/s41598-021-87581-5
8. McCrayJ, Joseph-Richard P. Towards a model of resilience protection: Factors influencing doctoral completion. Higher Education. 2020; 80:679-699.
9. Soltani Shal R, Ahmadpour Z, Abbastabar Bozrudi M. Psychometric characteristics of multidimensional measure of nurses’ personal resilience. Avicenna Journal of Nursing and Midwifery Care.2021; 29(1):1-13.
10. Hassani P, Cheraghi F, Yaghmaei F. Self-efficacy and self-regulated learning in clinical performance of nursing students: a qualitative research. Iranian Journal of Medical Education. 2008; 8(1), 33-42.
11. Sagone E, De Caroli M.E. Relationships between resilience, self-efficacy, and thinking styles in Italian middle adolescents. Procedia-Social and Behavioral Sciences.2013; 92: 838-845.
12. Sharma, N. R. (2013). Resilience and self-efficacy as correlates of well-being among the elderly persons. Journal of the Indian Academy of Applied Psychology, 39(2), 281.
13. Ghawadra SF, Abdullah KL, Choo WY, Phang CK. Mindfulness-based stress reduction for psychological distress among nurses: A systematic review. Journal of Clinical Nursing. 2019Nov;28(21-22):3747-3758. doi: https://doi.org/10.1111/jocn.14987
14. Trygg Lycke S, Airosa F, Lundh L. Emergency Department Nurses' Experiences of a Mindfulness Training Intervention: A Phenomenological Exploration. Journal of Holistic Nursing. 2023 Jun;41(2):170-184. doi: https://doi.org/10.1177/08980101221100091
15. Sulosaari V, Unal E, Cinar FI. The effectiveness of mindfulness-based interventions on the psychological well-being of nurses: A systematic review. Applied Nursing Research. 2022 Apr;64:151565. doi: https://doi.org/10.1016/j.apnr.2022.151565
16. Wang Q, Wang F, Zhang S, Liu C, Feng Y, Chen J. Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis. Front Psychiatry. 2023 Aug 3;14:1218340. doi: https://doi.org/10.3389/fpsyt.2023.1218340
17. Mo X, Qin Q, Wu F, Li H, Tang Y, Cheng Q, Wen Y. Effects of Breathing Meditation Training on Sustained Attention Level, Mindfulness Attention Awareness Level, and Mental State of Operating Room Nurses. American Journal of Health Behavior. 2021 Nov 15;45(6):993-1001. doi: https://doi.org/10.5993/AJHB.45.6.4
18. Li N, Zhu P, Li H, Chen X, Chen L, Chen M. Association Between Role Overload and Sleep Quality Among Chinese First-Line Nurses During the COVID-19 Outbreak: The Moderating Effect of Mindfulness. Journal of Nursing Research. 2022 Dec 1;30(6):e242. doi: https://doi.org/10.1097/jnr.0000000000000531
19. Sulosaari V, Unal E, Cinar FI. The effectiveness of mindfulness-based interventions on the psychological well-being of nurses: A systematic review. Applied Nursing Research. 2022 Apr;64:151565. doi: https://doi.org/10.1016/j.apnr.2022.151565
20. Gentry, J. E., Anna, B. B., & Dunning, K. (2013). ARP: The accelerated recovery program (ARP) for compassion fatigue. In Treating compassion fatigue (pp. 123-137). Routledge.
21. Rees CS, Breen LJ, Cusack L, Hegney D. Understanding individual resilience in the workplace: the international collaboration of workforce resilience model. Front Psychology. 2015 Feb 4;6:73. doi: https://doi.org/10.3389/fpsyg.2015.00073
22. Yusefi AR, Daneshi S, Davarani ER, Nikmanesh P, Mehralian G, Bastani P. Resilience level and its relationship with hypochondriasis in nurses working in COVID-19 reference hospitals. BMC Nursing. 2021 Nov 2;20(1):219. doi: https://doi.org/10.1186/s12912-021-00730-z
23. Ryan BL, Brown JB, Tremblay PF, Stewart M. Measuring Patients' Perceptions of Health Care Encounters: Examining the Factor Structure of the Revised Patient Perception of Patient-Centeredness (PPPC-R) Questionnaire. Journal of Patient-Centered Research and Reviews. 2019 Jul 29;6(3):192-202. doi: https://doi.org/10.17294/2330-0698.1696
24. Hashemi, S.E, Asheghi M, Naami A. Relationship of mindfulness and cognitive defusion to burnout, openness to change and adaptive performance with mediating role of psychological flexibility: A case study of iran south railway company. NeuroQuantology.2019; 17(6), 22-29.
25. Badeleh Shamooshaki M.T. The relationship between Mindfulness and job stress in nurses. Occupational Medicine Quarterly Journal.2021; 13(1), 53-61.
26. Razmpush M, Ramezani K, Maredpour A, Koulivand P. H.The effect of acceptance and commitment training on quality of life and resilience of nurses. The Neuroscience Journal of Shefaye Khatam. 2019; 7(1), 62-51.
27. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82. doi: https://doi.org/10.1002/da.10113
28. Li G, Kong L, Zhou H, Kang X, Fang Y, Li P. Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience. Sleep Medicine. 2016 Sep;25:8-12. doi: https://doi.org/10.1016/j.sleep.2016.02.015
29. Cheraghi F, Hassani P, Yaghmaei F, Alavi-Majed H. Developing a valid and reliable Self-Efficacy in Clinical Performance scale. International Nursing Review. 2009 Jun;56(2):214-21. doi: https://doi.org/10.1111/j.1466-7657.2008.00685.x
30. Ghawadra SF, Abdullah KL, Choo WY, Phang CK. Mindfulness-based stress reduction for psychological distress among nurses: A systematic review. Journal of Clinical Nursing. 2019 Nov;28(21-22):3747-3758. doi: https://doi.org/10.1111/jocn.14987
31. Badeleh Shamooshaki, M. T. (2021). The relationship between Mindfulness and job stress in nurses. Occupational Medicine Quarterly Journal, 13(1), 53-61.
32. Chen SH, Chen PJ, Lee CH, Wu YP, Ahorsu DK, Griffiths MD, Lin CY. Perceived Stress Mediating the Association Between Mindfulness and Resilience Among Registered Nurses. Psychology Research and Behavior Management. 2023 Aug 7;16:3035-3044. doi: https://doi.org/10.2147/PRBM.S412918
33. Zarei S, kazemi A. The Moderating Effect of Perceived Organizational Support and psychological resiliency in the Relationship between Job Stress with Job Productivity among Nurses. Iranian Journal of Nursing Research. 2020; 15 (2) :45-57
34. Kim E.H, Chang S.H. The effects of mindfulness based art therapy on clinical nurses' job stress, self-efficacy, satisfaction with life, and life satisfaction expectancy. The Journal of the Korea Contents Association.2022; 22(1):493-504.
35.Fallah M. Barkhordari-Sharifabad M, Nasiriani K. Effect of mindfulness-based self-care education on the quality of female nurses’ life. Avicenna Journal of Nursing and Midwifery Care. 2022; 30(3): 181-190.
36. Wu YP, Ahorsu DK, Chen JS, Lee CH, Lin CY, Griffiths MD. The role of demographic factors, mindfulness and perceived stress in resilience among nurses: A cross sectional study. Journal of Nursing Management. 2022 Oct;30(7):3093-3101.
doi: https://doi.org/10.1111/jonm.13715
37. Boogar R, Tabatabaee S.M, Tosi J. Attitude towards substance abuse and its outcomes: The predictive role of personality traits and demographical factors. Razi Journal of Medical Sciences.2015; 21(129): 39-50.
38. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology. 2003 Apr;84(4):822-48. doi: https://doi.org/10.1037/0022-3514.84.4.822
39. Lesmana T, Bidangan L. The effect of academic self-efficacy and mindfulness on students academic stress during the Covid-19 pandemic period. In International Conference on Economics, Business, Social, and Humanities. 2021; pp. 91-95. Atlantis Press.
40. Sagone E, De Caroli M.E. Relationships between resilience, self-efficacy, and thinking styles in Italian middle adolescents. Procedia-Social and Behavioral Sciences. 2013; 92: 838-845.