Exploring the mediating role of rumination on empathy and secondary traumatic stress in nurses: a cross-sectional investigation

Secondary traumatic stress (STS) poses a substantial concern within nursing, affecting nurses’ well-being and clinical care quality. While empathy, rumination, and STS are connected, research on their interplay among nurses is limited. The current study investigates how intrusive and purposive rumination mediates the link between empathy and STS in nursing professionals. A cross-sectional survey involving 784 nurses from China was undertaken using convenience sampling. Data collection involved three scales: the Secondary Traumatic Stress Scale, Event-Related Rumination Inventory, and Interpersonal Reactivity Index Scale. The analysis utilized SPSS 25.0 and AMOS 26.0, employing various statistical methods including descriptive statistics, t-tests, ANOVA, Pearson correlation, multiple linear regression and structural equation model. STROBE guidelines were followed. This study found moderate empathy and rumination levels among nurses, highlighting a significant prevalence of secondary traumatic stress. Positive correlations were observed between STS, empathy, and rumination. Linear regression revealed intrusive rumination, empathy, and purposive rumination as primary predictors of STS, explaining 33% of the variance. Empathy’s impact on STS (β = 0.328) included both direct (β = 0.157) and indirect effects (β = 0.171) through intrusive and purposive rumination, with the indirect effect comprising 52.13% of the total. Invasive rumination can exacerbate STS, while purposive rumination can mitigate STS. Intrusive and purposive rumination sequentially mediate the association between empathy and secondary traumatic stress. Therefore, hospital administrators should monitor nurses’ empathy levels and implement personalized interventions to reduce intrusive rumination and enhance purposive rumination, thereby alleviating STS. • During their professional responsibilities, nurses often experience STS as a consequence of their frequent interactions with patients who have undergone trauma. • Empathy and rumination in nurses are each related to secondary traumatic stress, but the internal connections among these three factors have not been investigated. • A notable majority of participants indicated severe to extreme levels of STS, highlighting its significant presence among nurses. • The presence of invasive rumination and heightened empathy may exacerbate STS among nurses. • Purposive rumination has been found to mitigate levels of STS among nurses. • Invasive and purposive rumination mediates between empathy and STS.