Mohammad Mahmoodzadeh

Clinical nurses play a central role in healthcare delivery, yet the psychological demands of clinical settings may threaten their professional identity and adaptability. Organizational dehumanization can diminish nurses' sense of value and motivation, while career adaptability enables them to manage occupational challenges effectively. In this context, self-compassion may serve as a protective psychological resource, and psychological safety may protect nurses' self-compassion in the face of dehumanizing organizational experiences. This study aimed to investigate the association between organizational dehumanization and career adaptability among clinical nurses and to examine whether self-compassion mediates this association and psychological safety moderates the association between organizational dehumanization and self-compassion. This cross‑sectional study was conducted from June 2025 to March 2026. A total of 330 clinical nurses were recruited from five teaching hospitals in Ardabil, Iran, using stratified random sampling. Data were collected through standardized self‑report questionnaires, including the Organizational Dehumanization Scale, the Career Adapt‑Abilities Questionnaire, the Psychological Safety Scale, and the Self‑Compassion Scale. Data were analyzed using SPSS version. 26.0 and Hayes' PROCESS v4.2, applying moderated mediation analysis with 5,000 bias‑corrected bootstrap resamples to examine direct and indirect effects. Organizational dehumanization was negatively associated with self-compassion (β = -0.248, p < .001) and career adaptability (total effect = -0.357, p < .001). Self-compassion partially mediated this relationship (indirect effect = -0.114, 95% CI [-0.167, -0.069]). Psychological safety moderated the indirect effect: the conditional indirect effect was significant at low (effect = -0.148, 95% CI [-0.214, -0.089]) and moderate levels of psychological safety, but was not significant at high levels, suggesting that psychological safety may buffer the negative influence of organizational dehumanization on career adaptability through self-compassion. Organizational dehumanization was negatively associated with nurses' self-compassion and career adaptability. Self-compassion partially mediated this relationship, while psychological safety buffered the negative association between organizational dehumanization and self-compassion, thereby weakening the indirect pathway to career adaptability. These findings highlight the importance of fostering supportive work environments and psychological resources among nurses.

Background: Treatment compliance is a cornerstone of effective heart failure management; however, it remains suboptimal. Identifying modifiable psychosocial factors, such as social support, is crucial for improving patient outcomes. Objectives: This study examined the association between perceived social support and treatment compliance in patients with heart failure. Methods: In this cross-sectional correlational study, 260 hospitalized patients with heart failure were recruited through convenience sampling from a tertiary hospital in Ardabil, Iran. Participants completed the Multidimensional Scale of Perceived Social Support and the Revised Heart Failure Compliance Questionnaire. Data were analyzed using descriptive statistics, correlation coefficients, and hierarchical multiple regression. Results: Participants had a mean age of 65.9 ± 9.3 years; 58.5% were male, and 74.2% were married. Demographic factors significantly associated with higher treatment compliance included being married, having a higher educational level, and living with family (all P < 0.001). Longer disease duration was associated with lower compliance (P < 0.001). Perceived social support was strongly and positively correlated with overall treatment compliance (r = 0.67, P < 0.001) and with all compliance domains. In regression analysis, social support was the strongest independent predictor of compliance (β = 0.58, P < 0.001), explaining an additional 25% of the variance after controlling for demographic factors. Conclusions: Perceived social support, particularly family support, is strongly associated with better treatment compliance in patients with heart failure, underscoring its importance in self-care. Nursing interventions should prioritize family-centered and community-based support strategies to strengthen long-term compliance and improve clinical outcomes.