Unraveling the pathways from alexithymia to work engagement among critical care nurses: the mediating effects of social support and organizational trust.

BACKGROUND

Critical-care nurses (CCNs) are exposed to intense emotional demands that may impair work engagement, particularly in the presence of alexithymia. However, the mechanisms that link alexithymia to work engagement remain unclear. This study aimed to determine how organizational trust and social support mediate the relationship between alexithymia and work engagement among CCNs in Hail, Northwest Saudi Arabia.

METHODS

This cross-sectional correlational study involved 308 CCNs in Hail from August to November 2025. Data were collected using the Toronto Alexithymia Scale (TAS-20), Oslo Social Support Scale (OSSS-3), Organizational Trust Scale, and Utrecht Work Engagement Scale (UWES). Data were analyzed using AMOS 24.

RESULTS

More than half of the CCNs (52.3%) exhibited a high level of alexithymia, followed by moderate (36%) and low (11.7%) levels. Higher alexithymia levels were significantly associated with lower levels of social support (β = -0.229, p = 0.001), organizational trust (β = -0.286, p = 0.001), and work engagement (β = -0.287, p = 0.001). By contrast, work engagement was positively impacted by social support (β = 0.185, p = 0.002) and organizational trust (β = 0.236, p = 0.001). Alexithymia negatively impacted work engagement via social support (indirect effect = -0.044, 95% CI: -0.140 to -0.011, p = 0.014) and organizational trust (indirect effect = -0.070, 95% CI: -0.158 to -0.028, p = 0.001). Overall, alexithymia significantly decreased work engagement (β = -0.401, p = 0.001).

IMPLICATIONS FOR PRACTICE: Enhancing organizational trust and strengthening social support may buffer the negative effects of alexithymia on work engagement. Interventions such as leadership development, peer support programs, and emotional skills training may help promote psychological well-being and sustained engagement among CCNs.

CONCLUSION

Alexithymia is a significant psychological barrier to work engagement among CCNs. Organizational trust and social support can effectively mitigate this impact.