Analysis of the current status of clinical nurses' character strengths, mental health literacy, and work engagement
In this study, clinical nurses were classified as (3.71 ± 0.59), which was slightly higher than the results (3.53 ± 0.58). From the perspective of the current situation, this difference may arise from multiple levels: the first is the difference in the composition of the subjects. This study focused on a female-oriented group of clinical nurses, while the study by Han Shiyu et al. focused more on male nurses. It is well known that male nurses mostly work in emergency department and intensive care. The nature of the work of these departments requires them to be highly vigilant and fully committed to the emergency treatment of patients. In contrast, although female nurses are equally on important nursing tasks, their work environment and responsibility allocation may be more diverse, indicating a slightly different trend in the overall performance of personality strength. Secondly, from the perspective of the social gender role, nursing work has long been regarded as a female-dominated field. The orientation of this social gender role not only shapes the public's general cognition of the nurse profession, but also may affect the personality trait development of the nurse community to a certain extent. Women are often endowed with more delicate and amiable personality traits, which are particularly important in nursing work and help to build a harmonious relationship between nurses and patients and improve the quality of care. Therefore, the main sample of female nurses in this study scored high in the dimension of affinity, matching with this social gender role orientation. Further analysis of the three-dimensional scores, we found that the affinity score is far ahead, while curiosity and self-control are relatively inferior. This result echoes the previous research results of Han Shiyu [
3] and Zhang SE et al [
5] , which jointly reveals some common characteristics of the personality characteristics of nurses. As a direct embodiment of the nurses' caring ability, the affinity plays a pivotal role in the nursing work. However, in a intensive, fast-paced clinical work environment, nurses often face great time pressure and workload. They need to find a balance between their family and their career, which undoubtedly poses a higher challenge to their curiosity and self-control. It is noteworthy that while nurses may show relatively low enthusiasm for pursuing new things, this does not mean that they lack room for innovation or progress. On the contrary, this situation reminds us that more attention should be paid to stimulating nurses' curiosity and innovation consciousness in nursing education and vocational training, so as to help them maintain their desire for new knowledge and the spirit of exploration after their busy work. At the same time, medical institutions should also provide more time and space for nurses to develop their self-control ability and improve their overall professional quality by optimizing the work process and reducing the workload.
In the current medical and health field, clinical nurses, as important providers of medical services, their mental health literacy status directly affects the quality of nursing work and patients' nursing experience. The results of this study showed that the mental health literacy score of clinical nurses (12.01 ± 5.78), which triggered our deep attention to the level of mental health literacy of clinical nurses. It may be closely related to the work characteristics and training experience of clinical nurses. Most of the respondents did not participate in professional training related to psychology, which directly limited their access to mental health knowledge and skills, which led to their relatively low level of mental health literacy. This finding not only reveals the shortcomings of the current nursing education system in the popularization of psychological knowledge, but also reflects the importance of medical institutions to improve the improvement of nurses' mental health literacy. Previous studies have shown that there is a positive correlation between mental health literacy and empathy [
22], that is, individuals with higher mental health literacy tend to better understand and feel the emotions and psychological states of others, and thus show stronger empathy. However, in the current group of clinical nurses, the overall low level of mental health literacy may limit the performance of their empathy, which in turn affects the quality of nursing work and patient satisfaction. At the same time, there is a negative correlation between mental health literacy and job burnout [
23], which means that with the improvement of mental health literacy, clinical nurses' sense of job burnout may decrease accordingly. This finding emphasizes the importance of improving the mental health literacy of the clinical nurses, which not only helps to relieve the personal psychological pressure of the nurses, but also effectively reduces the occurrence of job burnout and improves their job satisfaction and happiness. Therefore, the current mental health literacy level of clinical nurses still needs to be further improved. Managers should be based on the present situation, take effective measures to strengthen training and education, establish mental health education and counseling mechanism, and create a good working atmosphere and interpersonal environment, etc., to improve the mental health literacy level of clinical nurses, and improve their work participation, reduce job burnout, provide more high quality nursing services for patients.
In the current medical and health service system, the degree of work input of clinical nurses is an important indicator to measure their professional attitude, work efficiency and nursing quality. The results of this study showed that the project score of clinical nurses was (3.75 ± 0.74), this result reflects both the active input of clinical nurses in their work and the possibility that there is still room for improvement. The work engagement level of clinical nurses in this study was slightly higher than the study of Juan Jesus Garcia-Iglesias et al. [
24]. This difference may be closely related to the national environment and national policies. In recent years, especially during the COVID-19 pandemic, the Chinese government has attached great importance to the health and well-being of medical workers, and introduced a series of policies and measures to protect the rights and interests of medical staff and enhance their social status and professional honor. These initiatives may have partly stimulated the work enthusiasm and commitment of clinical nurses. However, the work engagement level of clinical nurses in this study was slightly lower compared with the findings of Qin Hui et al. [
25] (4.06 ± 0.46). It is worth noting that the respondents of Qin Hui et al. were specialized nurses. Specialized nurses often have higher professional skills and professional qualities because they receive more professional and systematic training, and therefore may show higher levels of work input. This finding reveals the positive impact of the policy orientation that attaches great importance to the development of specialized nurses on improving the level of nurses' work input. In addition, the National Nursing Development Plan (2021–2025) clearly proposed to strengthen the training of nursing service capacity, which echoes the results of this study, further emphasizing the importance of improving nurses' professional skills and level of work input. The degree of work input is closely related to the work performance of nurses. High level of work input can not only reduce the job burnout of nurses, improve job satisfaction, but also significantly improve the quality of nursing [
26,
27]. Therefore, the current work input level of clinical nurses is at a medium level, which has both a positive side and also needs room for improvement. Nursing managers should be based on the status quo, combined with the national policy guidance and actual demand, take effective measures to strengthen the specialized training, optimize the working environment, establish and improve the incentive mechanism and strengthen mental health education, etc., in order to improve the level of clinical nurses, and improve the quality of nursing, reduce burnout, improve job satisfaction.
This study showed that the mental health literacy of clinical nurses was positively correlated with work engagement and had a positive predictive effect on work engagement (
P < 0.001), indicating that the higher the level of mental health literacy of clinical nurses, the higher the work engagement. On the one hand, mental health literacy directly predicts work engagement, and on the other hand, it indirectly affects work engagement through character strengths. The mediating effect of character strengths on mental health literacy and work engagement accounted for 66.68% of the total impact, indicating that the more obvious the character strengths of clinical nurses, the higher the level of work engagement, which is consistent with previous studies [
6,
7]. Therefore, nursing managers should strengthen psychological training for clinical nurses, improve their mental health awareness and literacy through training, and then promote work engagement. Create a learning-oriented work atmosphere, and provide support and motivation to nurses to promote their learning and work. At present, most studies on character strengths explore their impact on subjective well-being. Nursing managers should apply positive psychology theory, pay attention to the character strengths of nurses in the team, and implement positive psychological intervention measures based on character strengths according to different characteristics.
Implication for nursing management
Nursing managers should attach great importance to the investment level of clinical nurses and take effective measures to improve them. Specifically, we can start from the following aspects: first, to strengthen the specialized training of clinical nurses to improve their professional skills and professional quality, to provide strong support for high quality nursing services; second, to optimize the working environment and conditions, provide nurses with good working atmosphere and necessary facilities and equipment to reduce their work pressure and burden; third, to establish and improve incentive mechanism, give recognition and reward to outstanding nurses, stimulate their enthusiasm and creativity; fourth, to strengthen mental health education and guidance, help nurses effectively cope with the psychological pressure and challenge in work, and maintain a positive attitude.
Limitations
This study also has shortcomings: First, this study is a current study, and the research results can only show a correlation, not a causal relationship. In the future, experimental research can be used to explore the causal relationship between mental health literacy and work engagement. Secondly, the number of samples is limited, and large sample studies can be carried out in the future to prove the universality of the results.Third, the data in this study were collected through self-report by nurses and may introduce bias. To strengthen research, future studies should consider collecting data from various groups, e. g. head nurses, head nurses, patients and physicians.