Structural Equation Modeling of the Relationship Between Mindfulness and Self-Efficacy with the Mediating Role of Emotion Regulation and Cognitive Flexibility in Nurses

Background & Aims: Nurses serve as a critical bridge between vulnerable communities and healthcare services, playing a vital role in medical care.Therefore, maintaining their mental health is essential.This study aimed to test a hypothesized model examining the structural relationships between mindfulness and self-efficacy with the mediation of emotion regulation and cognitive flexibility in nurses.Materials & Methods: This study employed a descriptive, structural equation modeling design.The target population included 894 nurses from hospitals in Sari, Iran.Using proportional stratified random sampling by gender, 255 participants were selected based on Klein's model.Data were collected using the General Self-Efficacy Scale (GSE-17) by Sherer et al., the Emotion Regulation Questionnaire (ERQ) by Gross and John, the Five Facet Mindfulness Questionnaire (FFMQ) by Baer et al., and the Cognitive Flexibility Inventory (CFI) by Dennis and Vander Wal.Data were analyzed using SPSS version 27 and AMOS version 24.Results: Structural equation modeling indicated significant relationships between mindfulness and self-efficacy among nurses, mediated by emotion regulation and cognitive flexibility.The conceptual model demonstrated good fit with the data (P < 0.05, /df = 2.843, RMSEA = 0.076, CFI = 0.907, t -1.96-1.96).Positive, significant relationships were observed between mindfulness and self-efficacy (P < 0.05, t = 3.751), mindfulness and emotion regulation (P < 0.05, t = 2.672), mindfulness and cognitive flexibility (P < 0.05, t = 8.699), emotion regulation and self-efficacy (P < 0.05,t = 5.414), and cognitive flexibility and self-efficacy (P < 0.05, t = 2.246).Furthermore, both emotion regulation and cognitive flexibility fully mediated the relationship between mindfulness and self-efficacy (P < 0.05).Conclusion: Mindfulness and self-efficacy, mediated by emotion regulation and cognitive flexibility, play a significant role in enhancing nurses' personal and professional well-being as well as their interpersonal relationships.These factors should be utilized to enhance mental health of nurses.