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J Multidiscip Care. Inpress.
doi: 10.34172/jmdc.1352
  Abstract View: 1

Original Article

Investigating Nurses' Stress and General Health: The Mediating Role of Metacognitive Beliefs and Negative Social Problem Solving

Mahnaz Shahgholian* ORCID logo, Ali Rasooli ORCID logo, Mojtaba Dehghan ORCID logo
*Corresponding Author: Email: mshahgholian@khu.ac.ir

Abstract

Background and aims: Nurses often face high levels of psychological stress due to the demanding nature of their work, which can impair their mental and physical health. Understanding the psychological mechanisms that mediate this relationship is crucial for improving nurses’ health outcomes. Therefore, the present study aimed to investigate the relationship between perceived stress and general health among nurses, with a focus on the mediating roles of metacognitive beliefs and negative social problem-solving strategies.

Methods: This cross-sectional study was conducted among 414 nurses in Mazandaran province, selected via convenience sampling. Data were collected using the Perceived Stress Scale, Metacognition Questionnaire (MCQ-30), Social Problem-Solving Questionnaire, and General Health Questionnaire (GHQ-28). Structural Equation Modeling (SEM) with Path Analysis was performed.

Results: Perceived stress showed significant correlations (p≤0.05) with metacognitive beliefs (r=0.28), negative problem-solving (r=0.38), and general health components such as physical problems (r=0.35) anxiety (r=0.48), social problems (r=-0.20) and depression (r=0.37). Bootstrap analysis confirmed significant indirect effects of perceived stress, through metacognitive beliefs, on negative social problem-solving (β=0.04), depression (β=0.14), social dysfunction (β=-0.12), anxiety (β=0.05), and physical symptoms (β=0.03) (p<0.05). Also, Metacognitive beliefs also had significant indirect effects on depression (β=0.04) and social dysfunction (β=-0.05) (p<0.05).

Conclusion: According to the results of the present study, it can be stated that Experiencing stress, various components of nurses' general health such as anxiety, depression, and physical health, can be affected by positive and negative metacognitive beliefs in interaction with various social problem-solving strategies. Other negative problem-solving strategies may increase social functioning in these situations.

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Submitted: 03 Dec 2024
Revision: 30 Oct 2025
Accepted: 22 Dec 2025
ePublished: 30 Jun 2026
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