A Network Analysis of Psychological Distress, Workplace Challenges, and Adaptive Capacity Among ICU Nurses

ABSTRACT Aims This study employs network analysis to examine the interrelationships between psychological distress, workplace challenges and adaptive capacity in ICU nurses. Background ICU nurses experience significant psychosocial challenges due to high‐stress environments, traumatic events and heavy workloads. While prior research has identified high levels of psychological distress, workplace challenges and reduced adaptive capacity among ICU nurses, these factors are often studied in isolation. Methods This cross‐sectional study involved 498 ICU nurses from 18 tertiary hospitals in Jiangsu, Zhejiang and Shanghai, conducted between February 10 and March 15, 2025. The survey employed the Profile of Mood States—Short Form (POMS‐SF), Body Image State Scale (BISS), Perceived Stress Scale‐4 (PSS‐4), Workplace Violence Scale (WVS), Minnesota Satisfaction Questionnaire (MSQ), Connor‐Davidson Resilience Scale (CD‐RISC) and Pittsburgh Sleep Quality Index (PSQI) to measure the mood states, body image, perceived stress, workplace violence, job satisfaction, resilience and sleep quality of ICU nurses. Network analysis was performed using R version 4.3.3 to identify key symptoms within the network. Results Stress (PSS), sleep quality (PSQI) and workplace violence (WVS) were central in the network, with the strongest association between job satisfaction (MSQ) and mood disturbance (TMD) (edge weight = −0.322). Mood disturbance (strength = 1.254) had the greatest impact on the network. Mood disturbance (TMD), job satisfaction (MSQ) and sleep quality (PSQI) had the highest network predictability, indicating they are key targets for interventions. Conclusion Mapping ICU nurses' psychosocial challenges as an interconnected system shifts focus from isolated symptoms to systemic drivers. Stress, sleep quality and workplace violence are high‐yield targets for interventions. Relevance to Clinical Practice Focusing on these key targets can help healthcare organisations develop more effective strategies to support the mental health and resilience of nursing staff, improve patient care and reduce burnout rates among ICU nurses. Patient or Public Contribution No patient or public contribution.