The empathy and stress mindset of healthcare workers: the chain mediating roles of self-disclosure and social support

 The hospital is a workplace full of stressful events for healthcare workers (HCWs) due to unpredictable changes in their daily routines. Perceptions of stressful events (stress mindset) have a significant impact on an individual’s health and well-being. However, few studies have reported the factors and potential counter mechanisms influencing these perceptions. This study aimed to evaluate the relationship between empathy, self-disclosure, social support, and stress mindset of HCWs, and to explore the mechanism of empathy on stress mindset. Five hundred and eight HCWs (35.2% men and 64.8% women) completed the Interpersonal Reactivity Index (IRI), the Distress Disclosure Index (DDI), the Social Support Rating Scale (SSRS), the Stress Mindset Measure (SMM), and demographic questionnaires online in China. The results showed that empathy was positively linked with stress mindset and positively correlated with self-disclosure and social support. In the multiple mediating model, self-disclosure and social support mediated the association between empathy and stress mindset sequentially. The results imply that empathy, self-disclosure, and social support play a significant role in the formation of HCWs’ stress mindset. These findings have substantial ramifications for reducing stress and creating successful government interventions to fortify stress mindset in healthcare.


Due to unpredictable daily occurrences such as medical emergencies at hospitals, healthcare workers (HCWs) frequently encounter stressful situations, compounded by the lack of understanding of their field of work by patients and their families (1), workplace violence (http://, and long working hours leading to overwork (http://3). Stress is described as the tension that develops when an individual believes an event they encounter will create more complications than they can handle, given available resources (4). Stress has a considerable influence on human health . Research statistics show that, on average, high job stress increases the risk of heart disease by up to 50 percent . However, stress also has beneficial effects on the body. New evidence suggests that holding a specific stress mindset has a beneficial effect on people’s health and performance under stress .

Crum, Salovey, and Anchor  refer to people’s beliefs and impressions of stressful events as the “stress mindset,” which is described as a continuum from “stress is enhancing” to “stress is debilitating.” A high level of stress mindset is representative of a stress-is-enhancing mindset. It is characterized by a positive view of the stressful event and belief that the event will produce a better outcome. This mindset has been shown to boost energy and enhance work performance and life satisfaction . The stress -is-debilitating mindset is characterized by a belief that the stressful event will have a negative effect on oneself. Stress mindset has also been linked to increased disease and mortality ; individuals who believe that “stress is debilitating” are over twice as likely as others to develop coronary heart disease . A negative stress mindset can lead to emotional disorders and affect the quality of care from HCWs . Given China’s limited healthcare resources and strained doctor–patient interaction, how HCWs view stress is particularly important.

The ability to appropriately experience others’ feelings and comprehend the meaning of those feelings is known as empathy . Empathy comprises behavioral , cognitive , and emotional  components, and is directly correlated with one’s personal mindset According to the Russian Doll Model, empathetic individuals utilize various empathy strategies to engage their cognition (e.g., perspective-taking) and emotions (e.g., emotional regulation). These empathy strategies can align with their environment and lead to beneficial outcomes . For example, empathy is linked to support for trauma recovery, greater emotional resilience (, and stronger social ties . In the context of HCWs, empathy can promote a stress-is-enhancing mindset, and thus reduce burnout and their desire to quit . Nurses with high levels of empathy not only make patients feel understood and cared for, but higher empathy allows nurses to reconsider their perceptions of stress and find more meaning in their work, which improves their overall psychological state and a stress-is-enhancing mindset .


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