*Result*: Overcoming Workplace Struggles: The Mediating Role of Trauma-Informed Climate on Psychological Well-Being, Emotional Resilience and Job Performance Among Critical Care Nurses.
Title:
Overcoming Workplace Struggles: The Mediating Role of Trauma-Informed Climate on Psychological Well-Being, Emotional Resilience and Job Performance Among Critical Care Nurses.
Authors:
Abdallah HMM; Medical Surgical Nursing Department, College of Nursing, Jouf University, Sakaka, Saudi Arabia., Zaky ME; Medical Surgical Nursing Department, College of Nursing, Jouf University, Sakaka, Saudi Arabia.; Medical Surgical Nursing Department, Faculty of Nursing, Cairo University, Giza, Egypt., Amin SM; Department of Psychiatric and Mental Health, and Community Health, College of Nursing, Qassim University, Buraydah, Saudi Arabia., Hammouda EY; Faculty of Nursing, Mansoura University, Mansoura, Egypt., Atta MHR; Nursing Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Wadi Addawasir, Saudi Arabia.; Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria City, Egypt., Alkubati SA; Department of Medical Surgical Nursing, College of Nursing, University of Ha'il, Ha'il City, Saudi Arabia., Abdelaliem SMF; Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria City, Egypt.; Department of Nursing Management and Education, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia., Hamad NIM; Pediatric Nursing Department, Faculty of Nursing, Alexandria University, Alexandria City, Egypt.; Nursing Department, College of Pharmacy, Nursing and Medical Sciences, Riyadh Elm University, Riyadh, Saudi Arabia.
Source:
Nursing in critical care [Nurs Crit Care] 2026 Jan; Vol. 31 (1), pp. e70218.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Wiley Country of Publication: England NLM ID: 9808649 Publication Model: Print Cited Medium: Internet ISSN: 1478-5153 (Electronic) Linking ISSN: 13621017 NLM ISO Abbreviation: Nurs Crit Care Subsets: MEDLINE
Imprint Name(s):
Publication: Oxford : Wiley
Original Publication: London : published for the British Association of Critical Care Nurses by Greycoat Pub.
Original Publication: London : published for the British Association of Critical Care Nurses by Greycoat Pub.
MeSH Terms:
Workplace*/psychology , Nursing Staff, Hospital*/psychology , Resilience, Psychological* , Critical Care Nursing* , Work Performance*, Burnout, Professional/psychology ; Humans ; Cross-Sectional Studies ; Female ; Adult ; Male ; Egypt ; Surveys and Questionnaires ; Middle Aged ; Job Satisfaction ; Organizational Culture ; Psychological Well-Being
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J. J. Gross and O. P. John, “Individual Differences in Two Emotion Regulation Processes: Implications for Affect, Relationships, and Well‐Being,” Journal of Personality and Social Psychology 85, no. 2 (2003): 348–362, https://doi.org/10.1037/0022‐3514.85.2.348.
E. Fink‐Samnick, “Collective Occupational Trauma, Health Care Quality, and Trauma‐Informed Leadership: Intersections and Implications,” Professional Case Management 27, no. 3 (2022): 107–123, https://journals.lww.com/professionalcasemanagementjournal/fulltext/2022/05000/collective_occupational_trauma,_health_care.2.aspx.
A. Goddard, E. Janicek, and L. Etcher, “Trauma‐Informed Care for the Pediatric Nurse,” Journal of Pediatric Nursing 62 (2022): 1–9, https://doi.org/10.1016/j.pedn.2021.11.003.
B. Alshammari, N. F. Alanazi, F. Kreedi, et al., “Exposure to Secondary Traumatic Stress and Its Related Factors Among Emergency Nurses in Saudi Arabia: A Mixed‐Method Study,” BMC Nursing 23, no. 1 (2024): 337, https://doi.org/10.1186/s12912‐024‐02018‐4.
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S. M. Farghaly Abdelaliem, H. M. M. Abdallah, M. E. Abdelgawad, and A. A. I. El‐Sayed, “The Influence of Supportive Work Environment on Work‐Related Stress and Conflict Management Style Among Emergency Care Nurses: A Descriptive Correlational Study,” Worldviews on Evidence‐Based Nursing 21, no. 1 (2024): 45–58, https://doi.org/10.1111/wvn12696.
M. A. Zoromba, H. E. El‐Gazar, M. G. Noaman Malek, M. M. El‐Sayed, M. H. Ramadan Atta, and S. M. Amin, “Career Growth as a Mediator Between Scope of Practice, Importance of Practice, and Emergency Nursing Competency Among School Nurses,” Journal of Advanced Nursing 81 (2025): 6406–6416, https://doi.org/10.1111/jan.16783.
H. M. M. Abdallah, S. M. Amin, E. Y. Hammouda, M. H. R. Atta, A. H. El‐Monshed, and N. I. M. Hamad, “Family Intensive Care Unit Syndrome: Investigating the Mediating Role of Healthcare Communication in Psychological Well‐Being Among Family Members,” Nursing in Critical Care 30 (2025): e70119, https://doi.org/10.1111/nicc.70119.
P. Mowry‐Cavanaugh, “Trauma‐Informed Workplace Climate, Leadership Style, and Employee Outcomes. (30526438 Ed.D.). Southeastern University, United States—District of Columbia. ProQuest Central; ProQuest Dissertations & Theses Global; Publicly Available Content Database Database,” (2023), https://www.proquest.com/dissertations‐theses/trauma‐informed‐workplace‐climate‐leadership/docview/2861536994/se‐2?accountid=34495.
W. Xia, Y. Wang, X. Wu, and X. Yang, “Current Practices and Challenges in Application of Trauma‐Informed Care for Accidentally Injured Patients: An Exploratory Qualitative Study,” Nursing Open 11, no. 1 (2024): e2046, https://doi.org/10.1002/nop2.2046.
H. I. Ali, A. A. Othman, M. H. R. Atta, S. S. Mohamed, and S. H. Mohamed, “Revelation of the Mediation Role of Moral Sensitivity on Safety Attitude and Personality Traits Among Critical Care Nurses,” BMC Nursing 24 (2025): 261, https://doi.org/10.1186/s12912‐025‐02868‐6.
C. Dawson‐Rose, Y. Cuca, S. Kumar, and A. Collins, “Using a Trauma‐Informed Approach to Address Burnout in Nursing: What an Organization Can Accomplish,” Online Journal of Issues in Nursing 28, no. 1 (2023): 1–9, https://doi.org/10.3912/OJIN.Vol28No01Man01.
H. G. Hamzaa, M. H. Abdelaal, M. Hussein Ramadan Atta, H. S. M. Abdelnaby, and A. A. Othman, “Analysis of Compassion Fatigue Among Psychiatric Nurses and Its Effect on Spiritual and Competent Care,” Journal of Psychiatric and Mental Health Nursing (2025), https://doi.org/10.1111/jpm.13174.
G. Yılmaz and B. Üstün, “Professional Quality of Life in Nurses: Compassion Satisfaction and Compassion Fatigue,” Journal of Psychiatric Nursing 9, no. 3 (2018): 205–211, https://doi.org/10.14744/phd.2018.86648.
C. Bradley and T. Traister, “Trauma‐Informed Leadership Strategies to Improve Baccalaureate Nursing Student Engagement and Well‐Being,” Journal of Professional Nursing 57 (2025): 129–132, https://doi.org/10.1016/j.profnurs.2025.02.002.
A. A. I. El‐Sayed, S. A. Alsenany, M. H. R. Atta, A. A. Othman, and M. G. R. Asal, “Navigating Toxicity: Investigating the Interplay Between Workplace Gaslighting, Workaholism, and Agility Among Nurses,” Nursing Inquiry 32, no. 1 (2025): e12697, https://doi.org/10.1111/nin.12697.
M. H. R. Atta, N. Waheed Elzohairy, A. E. D. M. H. Abd Elaleem, et al., “Comprehending the Disruptive Influence of Workplace Gaslighting Behaviours and Mobbing on Nurses' Career Entrenchment: A Multi‐Centre Inquiry,” Journal of Advanced Nursing 81, no. 4 (2025): 1815–1828, https://doi.org/10.1111/jan.16368.
G. M. Weissinger, D. Swavely, H. Holtz, et al., “Critical Care Nurses' Moral Resilience, Moral Injury, Institutional Betrayal, and Traumatic Stress After COVID‐19,” American Journal of Critical Care 33, no. 2 (2024): 105–114, https://doi.org/10.4037/ajcc2024481.
K. Hyde Hensley, “Trauma‐Informed Behavioral Health Leadership Strategies for Enhancing Mental Wellness Among Bereavement Midwives (31560657 Psy.D.). Walden University, United States—Minnesota,” (2024), https://www.proquest.com/dissertations‐theses/trauma‐informed‐behavioral‐health‐leadership/docview/3100750601/se‐2?accountid=34495.
J. M. Keesler, “Promoting Satisfaction and Reducing Fatigue: Understanding the Impact of Trauma‐Informed Organizational Culture on Psychological Wellness Among Direct Service Providers,” Journal of Applied Research in Intellectual Disabilities 33, no. 5 (2020): 939–949, https://doi.org/10.1111/jar12715.
C. R. Figley, “Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder,” in Those Who Treat the Traumatized, 1st ed. (Routledge, 1995).
K. Shoji, M. Lesnierowska, E. Smoktunowicz, et al., “What Comes First, Job Burnout or Secondary Traumatic Stress? Findings From Two Longitudinal Studies From the U.S. and Poland,” PLoS One 10, no. 8 (2015): e0136730, https://doi.org/10.1371/journal.pone.0136730.
J. J. Gross and O. P. John, “Individual Differences in Two Emotion Regulation Processes: Implications for Affect, Relationships, and Well‐Being,” Journal of Personality and Social Psychology 85, no. 2 (2003): 348–362, https://doi.org/10.1037/0022‐3514.85.2.348.
E. Fink‐Samnick, “Collective Occupational Trauma, Health Care Quality, and Trauma‐Informed Leadership: Intersections and Implications,” Professional Case Management 27, no. 3 (2022): 107–123, https://journals.lww.com/professionalcasemanagementjournal/fulltext/2022/05000/collective_occupational_trauma,_health_care.2.aspx.
A. Goddard, E. Janicek, and L. Etcher, “Trauma‐Informed Care for the Pediatric Nurse,” Journal of Pediatric Nursing 62 (2022): 1–9, https://doi.org/10.1016/j.pedn.2021.11.003.
B. Alshammari, N. F. Alanazi, F. Kreedi, et al., “Exposure to Secondary Traumatic Stress and Its Related Factors Among Emergency Nurses in Saudi Arabia: A Mixed‐Method Study,” BMC Nursing 23, no. 1 (2024): 337, https://doi.org/10.1186/s12912‐024‐02018‐4.
S. A. Alkubati, S. H. Alsaqri, G. G. Alrubaiee, et al., “The Influence of Anxiety and Depression on Critical Care Nurses' Performance: A Multicenter Correlational Study,” Australian Critical Care 38, no. 1 (2025): 101064, https://doi.org/10.1016/j.aucc.2024.04.008.
K. Stutzer and A. M. Rodriguez, “Moral Resilience for Critical Care Nurses,” Critical Care Nursing Clinics of North America 32, no. 3 (2020): 383–393, https://doi.org/10.1016/j.cnc.2020.05.002.
E. Goldstein, B. Chokshi, G. J. Melendez‐Torres, A. Rios, M. Jelley, and A. Lewis‐O'Connor, “Effectiveness of Trauma‐Informed Care Implementation in Health Care Settings: Systematic Review of Reviews and Realist Synthesis,” Permanente Journal 28, no. 1 (2024): 135–150, https://doi.org/10.7812/tpp/23.127.
K. S. Bang, S. W. Hong, H. L. Bang, J. H. Choe, and S. Choi, “Korean Nurses' Knowledge, Opinions, and Current Practice of Trauma‐Informed Pediatric Nursing Care in South Korea: A Descriptive Study,” Child Health Nursing Research 30, no. 4 (2024): 309–320, https://doi.org/10.4094/chnr.2024.034.
D. Hammoudi Halat, A. Soltani, R. Dalli, L. Alsarraj, and A. Malki, “Understanding and Fostering Mental Health and Well‐Being Among University Faculty: A Narrative Review,” Journal of Clinical Medicine 12, no. 13 (2023): 4425, https://doi.org/10.3390/jcm12134425.
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Entry Date(s):
Date Created: 20251215 Date Completed: 20251215 Latest Revision: 20251229
Update Code:
20260130
DOI:
10.1111/nicc.70218
PMID:
41392411
Database:
MEDLINE
*Further Information*
*Background: Critical care nurses face persistent high-stress conditions that can compromise their mental health and job performance. In response, there is growing recognition of the value of a Trauma-Informed Climate (TIC), which provides a framework that promotes psychological safety by acknowledging the impact of trauma and fostering supportive practices to enhance emotional resilience, well-being and job functioning in this demanding field.
Aim: This study aimed to examine the mediating role of emotional resilience in the relationship between trauma-informed climate, psychological well-being and job performance among critical care nurses.
Study Design: A cross-sectional descriptive design was employed in Egypt, adhering to the STROBE checklist.
Results: A total of 368 registered critical care nurses completed the Connor-Davidson Resilience Scale (CD-RISC), the Swedish version of Ryff's Psychological Well-Being Scale, the Job Performance Scale and the Trauma-Informed Climate Scale. Data were analysed using SPSS and AMOS version 24.0. The mean scores were 43.11 ± 9.29 for emotional resilience, 76.41 ± 8.54 for psychological well-being, 47.40 ± 5.12 for job performance and 29.58 ± 4.68 for trauma-informed climate. Emotional resilience showed significant positive correlations with psychological well-being (r = 0.432, p < 0.001), job performance (r = 0.413, p < 0.001) and trauma-informed climate (r = 0.195, p < 0.001). Path analysis revealed that emotional resilience mediated the relationship between trauma-informed climate and both job performance (β = 0.159, p < 0.001) and psychological well-being (β = 0.319, p < 0.001). Trauma-informed climate had a significant direct effect on job performance (β = 0.162, p = 0.003) and psychological well-being (β = 0.662, p < 0.001), with total effects of β = -0.321 and β = -0.981, respectively (p < 0.001).
Conclusions: Emotional resilience significantly mediates the effect of trauma-informed climate on psychological well-being and job performance among critical care nurses. Promoting a trauma-informed work climate and resilience-building strategies may enhance nurses' well-being and professional outcomes.
Relevance to Clinical Practice: This study underscores the importance of fostering trauma-informed climates and resilience development in clinical settings. By equipping critical care nurses with emotional resilience and creating psychologically safe environments, healthcare institutions can support improved mental health and performance outcomes. These efforts can lead to better patient care, lower staff burnout and enhanced workforce sustainability.
(© 2025 British Association of Critical Care Nurses.)*