Date of Award

Fall 2022

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Bekhet, Abir

Second Advisor

Johnson, Norah

Third Advisor

Jerofke-Owen, Teresa


Nurses in leadership positions are encountering increasing psychological stressors both due to the nature of their work and the aftermath of the COVID-19 pandemic on health care. Using the lens of the Metatheory of Resilience and Resiliency, some of these stressors (burnout and secondary traumatic stress) and protective factors (compassion satisfaction and resilience) were explored. This exploration involved the use of a Bayesian structural equation model that was evaluated to determine the nature of the relationships between these stressors and protective factors in nurse leaders. In addition, the mediating effects of positive thinking on these relationships was also evaluated. Reaching out to members of the American Nursing Association (ANA) and American Organization of Nursing Leadership (AONL) via email, 199 participants were identified who met the criteria of possessing a degree or diploma in nursing; being in the position of a nurse manager, director, executive director, vice president, executive vice president, chief nursing officer, chief executive officer, or other equivalent leadership position; having at least one person directly reporting to them; belonging to the ANA or AONL; and reading English fluently.This study’s findings demonstrated relationships between burnout-compassion satisfaction (b = -0.765, 95% CrI = -1.165, -0.451), burnout-resilience (b = -0.331, 95% CrI = -0.608, -0.083), positive thinking-compassion satisfaction (b = 0.396, 95% CrI = 0.129, 0.700), positive thinking-resilience (b = 0.555, 95% CrI = 0.300, 0.844), and positive thinking-secondary traumatic stress (b = -0.678, 95% CrI = -0.949, -0.435) in the predicted directions. Mediating effects were observed in the relationships secondary traumatic stress had with compassion satisfaction (ab = -0.269, 95% CrI = -0.693, -0.105) and resilience (ab = -0.376, 95% CrI = -0.487, -0.050). These findings help provide guidance as to how to future interventions might be tailored to address the mental wellness needs of nurses in leadership.

Available for download on Friday, November 08, 2024

Included in

Nursing Commons