Occurrence levels of alexithymia in clinical nurses: a systematic review and meta-analysis

Abstract Background Nursing is a profession that involves providing comprehensive care through continuous interactions and reciprocal relationships with patients. Alexithymia among nurses may impair effective nurse–patient communication and interaction. It may not only compromise the quality of clinical care but also impose considerable physical and psychological burdens on nurses. Therefore, this study aimed to assess the level of alexithymia among clinical nurses and to increase awareness of this issue within the healthcare sector. Methods This systematic review and meta-analysis included observational studies. A systematic literature search was conducted in PubMed, Web of Science, Embase, CINAHL, the Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database (CBM), Wanfang Data, and the Chinese Science and Technology Journal Database (VIP) from database inception through October 31, 2024. The methodological quality of the included studies was assessed using the Agency for Healthcare Research and Quality (AHRQ) tool. Statistical analyses were performed using Stata version 15.1. Results A total of 22 studies involving 9,135 clinical nurses were included in the meta-analysis, all of which assessed alexithymia using the 20-item Toronto Alexithymia Scale (TAS-20). The included studies had a mean AHRQ quality score of 7.8. Given the heterogeneity across studies, the mean TAS-20 scores and corresponding standard deviations were pooled using a random-effects model. The pooled mean alexithymia score among clinical nurses was 54.50 (95% CI, 53.56–55.44). Subgroup analyses indicated higher alexithymia scores among male nurses, unmarried nurses, nurses working in intensive care units, nurses with an associate degree or lower, and nurses with fewer than 5 years of work experience, as well as in studies published after 2020. Conclusion The findings of this meta-analysis indicate a moderately high level of alexithymia among clinical nurses. Greater awareness of alexithymia as an important psychosocial concern is warranted, and nurses should be encouraged to take proactive steps to address it. Healthcare institutions and nursing managers should also give greater attention to this issue and implement targeted strategies to reduce alexithymia and promote nurses’ psychological well-being.