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Anteayer Journal of Advanced Nursing

The Relationship Between Occupational Stressors and Resilience Among Emergency Department Nurses: A Multicenter Cross‐Sectional Network Analysis

ABSTRACT

Background

The global nursing shortage poses a critical challenge to healthcare systems. Emergency department (ED) nurses face high occupational stress due to demanding environments and strained patient-family interactions. Chronic stress impairs resilience and health, contributing to burnout and attrition. Understanding ED nurses' stressors and resilience is vital for workforce stability.

Aims

To identify core elements and interrelationships of occupational stressors and resilience among ED nurses in Zhejiang Province, China, using network analysis, and to explore intervention strategies.

Design

Cross-sectional study.

Methods

From November 2024 to January 2025, data were collected from 990 ED nurses in 26 hospitals across 11 cities. Measures included a demographic questionnaire, the Chinese version of the Stressor Scale of Emergency Nurses, and the Resilience Structure Scale for Healthcare Professionals. Network analysis was conducted to illustrate the interconnections between stressors and resilience factors, while accounting for significant sociodemographic covariates.

Results

A total of 990 nurses participated in the study. Violence-related stressors, such as physical assault and witnessing aggression, were the most prominent nodes in the stressor network. Key resilience elements included reframing patient or family criticism positively and timely emotional regulation. Bridge analysis highlighted ‘viewing criticism as encouragement’ as a crucial link connecting stress and resilience.

Conclusion

ED nurses work under intense stress from violence and scrutiny, which undermines resilience. Strengthening key resilience factors—especially cognitive reframing and emotional regulation—may buffer stress and enhance coping. Bridge nodes offer targeted points for intervention.

Patient or Public Contribution

None.

Impact

This study clarifies the network of occupational stressors and resilience in ED nurses, identifying key intervention targets. It supports interventions focusing on cognitive adjustment, emotional regulation and interpersonal support to build resilience and reduce stress.

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