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Introduction Nurses experience high levels of work-related stress, which can affect their wellbeing and the quality of care they provide. Existing studies often examine stress factors in isolation, overlooking how they interconnect. This study investigates the relationships between nurses' professional quality of life, role stress, work-related rumination, and moral sensitivity, aiming to identify central factors within this network. Methods We surveyed 1,879 clinical nurses using validated scales measuring occupational quality of life, role stress, work rumination, and moral sensitivity. Network analysis was applied to model the interactions among these variables. Results The resulting network illustrates how different dimensions of nurses' occupational well-being are interrelated. Central variables included secondary trauma, emotional rumination, and empathic satisfaction. Key connectors linking different psychological domains were problem-solving rumination, job burnout, and moral distress. The network structure demonstrated good stability. Discussion Nurses' occupational mental health functions as a dynamic system, in which certain factors act as central drivers or bridges between areas of stress. These findings help inform the development of staged and tailored intervention strategies in healthcare settings. They also support a shift toward systemic approaches in nursing psychology research. Future studies could employ longitudinal designs to track changes over time and incorporate multi-source data to further clarify the underlying mechanisms.
Zhou et al. (Tue,) studied this question.