Network Analysis of General and Work-Related Resilience and Risk Factors, Mental Health and Stress in Nurses: A Cross-Sectional Analysis

Health care professionals face various stress factors at work, such as staff shortages, physically demanding work, and at times emotionally challenging situations, time pressure, and shift work (McCann et al., 2013; Robertson et al., 2016; Simpson & Grant, 1991). Consequently, this subpopulation carries an increased risk of developing high psychological stress or even a mental disorder, such as depression (Lai et al., 2020; Pospos et al., 2018). Further, the turnover intentions, i.e. considerations to change the work field, are quite high for this profession (Ren et al., 2024), leading to a vicious circle of staff shortage, subsequent high workload, and time pressure, which represent risk factors for the development of mental health issues. Therefore, it is essential to investigate factors and mechanisms that improve resilience among nursing professionals. Resilience is defined as the outcome of adapting to adverse situations and thus to remain mentally healthy, or to regain mental health after experiencing adversity (Kalisch et al., 2017). A cross-sectional study in German health care professionals, using a network analysis approach, has identified important resilience factors influencing stress, mental health, and work-related factors and health outcomes (Pank et al., 2025). In this study, self-compassion and self-care were the most influential resilience factors within a network of general resilience factors but also when considering work-related factors, such as burnout and work engagement. Other work-related risk and resilience factors, such as the appreciation of nurses’ work or work-related rumination have, however, not been investigated in this study. Furthermore, the relationship between general resilience factors, work-related risk and resilience factors, and mental health and stress have not been investigated in this study. However, the identification of such inter-relations might be of particular importance for the mental well-being of nurses (Anderson et al., 2024). The present study aims to conceptually replicate of the study by Pank et al. (2025) as well as to extend Pank et al.’s study by placing a greater focus on various work-related factors and their relation to mental health and stress. To reach this aim and address research questions outlined below, baseline data from the XR²esilience project (https://osf.io/xhm5z) will be analyzed using network analysis.