Psychological flexibility and psychological distress among nurses: a longitudinal study of the mediating role of second victim experience and the moderating role of self-compassion

Due to the constant exposure of nurses to clinical errors and their ethical and professional consequences, this group is exposed to the experience of second victim, which could affect their mental health. The aim of this study was to investigate the longitudinal relationships between psychological flexibility and psychological distress, considering the mediating role of the second victim experience and the moderating role of self-compassion. This longitudinal study was conducted with two waves of data from 270 nurses in six private hospitals in Tehran (mean age 25.22 years, SD=± 6.78). Data were collected with standardized questionnaires and analyzed using structural equation modeling and cross-sectional panel analysis. The results showed that psychological flexibility and self-compassion negatively predicted psychological distress, while the secondvictim experience positively predicted psychological distress. Mediation analysis showed that low levels of psychological flexibility in the first wave predicted the second victim experience in the second wave, which may contribute to increased psychological distress. Also, self-compassion significantly attenuated the relationship between the second victim experience and psychological distress. The findings suggest that lower levels of psychological flexibility could lead to increased psychological distress in nurses through the second victim experience, while self-compassion plays an important protective role in this relationship.