# Exploring the mediating role of psychological resilience between social support and anxiety in nurses: a cross-sectional study in Chengdu, Sichuan, China

## TL;DR

This study explores how psychological resilience connects social support and anxiety in Chinese nurses, finding that resilience partially mediates this relationship.

## Contribution

The novel contribution is identifying psychological resilience as a partial mediator between social support and anxiety in nurses.

## Key findings

- 35.7% of nurses reported anxiety, with social support and resilience negatively correlated with anxiety.
- Psychological resilience partially mediates the relationship between social support and anxiety, accounting for 21% of the total effect.
- Subjective support's impact on anxiety is 41% mediated by psychological resilience.

## Abstract

Nurse anxiety is a significant public health issue that impacts individual well-being, healthcare system stability, service quality, and patient safety. This study aimed to assess anxiety levels among Chinese nurses and to investigate the association between social support and anxiety, specifically examining the potential mediating role of psychological resilience. The findings are intended to enhance the understanding of mental health mechanisms and inform targeted interventions for nurses.

A cross-sectional online survey was conducted from February to April 2025 with 1,133 nursing staff in Sichuan Province, China, using stratified and snowball sampling. Participants completed the Self-Rating Anxiety Scale (SAS), Social Support Rating Scale (SSRS), and Connor-Davidson Resilience Scale (CD-RISC). Data were analyzed using t-tests, ANOVA, Bayesian Estimates, Pearson correlation, and bootstrap method. The hypothesized mediation model was tested using structural equation modeling (SEM) with latent variables.

A total of 35.7% of nurses reported experiencing anxiety. Both social support (including its sub-dimensions) and psychological resilience (including its sub-dimensions of self-efficacy, hope, and optimism) showed significant negative correlations with anxiety. Mediation analysis confirmed that psychological resilience partially mediated the relationship between social support and anxiety, accounting for 21% of the total effect. The pathway mediated by psychological resilience was strongest for subjective support, with an indirect effect constituting 41% of its total impact. In SEM with latent variables, the mediating effect of psychological resilience on the relationship between social support and anxiety remains statistically significant after separating and controlling for measurement errors.

The research points to the interaction between social environment (support) and individual characteristics (resilience) as a key determinant of nurses’ emotional regulation. This implies that strategies to mitigate anxiety should prioritize cultivating a supportive climate and promoting the functional use of social resources, which in turn bolsters psychological resilience and overall mental health.