Correlation between professional resilience, self-efficacy, coping style, and empowering leadership among emergency nurses: a multi-center study

BMC Nursing https://doi.org/10.1186/s12912-026-04754-1 Article in Press Correlation between professional resilience, self-efficacy, coping style, and empowering leadership among emergency nurses: a multicenter study Yinsen Peng, Hanyue Zeng, Yun Li, Tengxia Chen, Cailian Wang, Miao Peng & Shifang Mao Received: 10 December 2025 Accepted: 8 May 2026 Cite this article as: Peng Y., Zeng H., Li Y. et al. Correlation between professional resilience, self-efficacy, coping style, and empowering leadership among emergency nurses: a multi-center study. BMC Nurs (2026). https://doi.org/10.1186/ s12912-026-04754-1 A E R P S S We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. ACCEPTED ARTICLEMANUSCRIPT IN PRESS Title page Correlation Between Professional Resilience, Self-Efficacy, Coping Style, and Empowering Leadership Among Emergency Nurses: A Multi-Center Study Yinsen Peng1,2, Hanyue Zeng2,3, Yun Li4, Tengxia Chen4, Cailian Wang2, Miao Peng4, Shifang Mao4* *Correspondence: Shifang Mao, 1 S S E R P Operating Room, West China Hospital, Sichuan University/West ChinaSchool of Nursing, Sichuan University, Chengdu, China 2 IN School of Nursing, Southwest Medical University, Luzhou, China E L C I T R A Professional Resilience, Self-Efficacy, Correlation Between 3 4 West China Second Hospital, Sichuan University, Chengdu, China The Affiliated Hospital, Southwest Medical University, Luzhou, China Coping Style, and Empowering Leadership Among Emergency Nurses: A Multi-Center Study Abstract Background Emergency nurses typically bear greater work-related stress, and high levels of professional resilience can help them better cope with such pressures while ACCEPTED ARTICLEMANUSCRIPT IN PRESS safeguarding their physical and mental well-being. This study aims to assess the current state of professional resilience among emergency nurses and explore the relationship between self-efficacy, coping style, empowering leadership, and professional resilience. Methods This study surveyed 650 emergency nurses from 20 hospitals in Sichuan, China, between October and November 2024. The following instruments were used to assess the current status of emergency nurses: the General Demographic Information Questionnaire, the Chinese version of the Emergency Nurses' Professional Resilience Tool (ENPRT-C), the Generalized Self-Efficacy Scale (GSES), the Leadership Empowerment Behavior Scale (LEBS), and the Simplified Coping Style Questionnaire S S E R P (SCSQ). Pearson correlation analysis, univariate analysis, and multiple stepwise linear regression analysis were employed to explore the relationships between emergency IN nurses' professional resilience and various influencing factors, including age, E L C I T R A educational levels, professional title, workplace violence experience, self-efficacy, empowering leadership, and coping styles. Results Of 650 emergency nurses surveyed, 623 completed valid questionnaires. Emergency nurses' professional resilience scores averaged (113.05 ± 18.84). The scale dimensions ranked from highest to lowest scores were behavioral strategies, emotional and cognitive characteristics, external support, and professional competence. Correlation analysis revealed that emergency nurses' professional resilience positively correlated with self-efficacy, empowering leadership, and positive coping, while negatively correlating with negative coping. Univariate analysis indicated that age, educational levels, professional title, position, duration of employment in the hospital and emergency department, specialized nurse qualification, and exposure to workplace violence were ACCEPTED ARTICLEMANUSCRIPT IN PRESS factors influencing professional resilience. Multivariate stepwise linear regression analysis revealed that professional title, position, duration of employment in the hospital, duration of employment in the emergency department, specialized nurse qualification, workplace violence experience, self-efficacy ( β = 0.402, P ＜ 0.001), empowering leadership ( β = 0.303, P ＜0.001), positive coping ( β = 0.365, P ＜0.001), and negative coping ( β = -0.301, P ＜ 0.001) were the variables independently associated with emergency nurses' professional resilience, which explained 66.6% of the variance in professional resilience. Conclusions The professional resilience of emergency nurses remains at a moderate level and S S E R P warrants further enhancement. Actionable strategies for management should focus on several key areas, which involve fostering a psychologically safe team climate, IN integrating stress-management into continuing education, and developing responsive E L C I T R A support systems to mitigate the impact of adverse events. Keywords: Emergency Nursing, Resilience, Self-efficacy, Coping, Empowering leadership Clinical trial number: Not applicable. Introduction As the frontline unit responsible for emergency medical services in hospitals, emergency nurses usually faced greater occupational stress compared to nurses in other clinical departments. Research indicated that approximately 82% to 100% of emergency nurses frequently encounter stressful events(1). Roughly 55% to 97% of emergency nurses were suffered the workplace violence globally(2). Relevant studies indicated that due to prolonged exposure to immense work pressure, emergency nurses exhibited ACCEPTED ARTICLEMANUSCRIPT IN PRESS higher rates of anxiety, depression, compassion fatigue, occupational burnout, and turnover tendencies(3, 4, 5). Resilience refers to an individual's ability to (...truncated)