Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses

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In Jordan, 43% of doctors and nurses suffer from high levels of burnout, around 55% experience high levels of emotional exhaustion, and 33% of doctors and nurses suffer from high levels of psychological pressure and job stress. Others found that 70% of nurses experience stress. these issues can be reduced by practicing self-care and psychological flow which impact in work-related tasks which are important in effectively addressing occupational stress healthily and soundly. This study aims to determine assessing the predictive power of self-care and psychological flow in occupational stress among nurses Methods This study follows the quantitative technique. sample consisting of 476 nurses in Amman Jordan was chosen. Three scales were adapted to meet the study objectives: Occupational stress scale, Self-care scale, and psychological flow scale. There validity and reliability were checked. Results The study results indicate that self-care and psychological flow levels were low with means of 2.32 and 2.13, while the occupational stress level was high with a mean of 3.91. Also, there are a predictive power of self-care and psychological flow in occupational stress among nurses. Conclusions This study shows that of self-care and psychological flow predict occupational stress among nurses, which helps us to manage the occupational stress among them by giving them self-care and psychological flow practices and healing time during work by group counseling and lectures. 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F1000Research 2025, 13 :641 ( https://doi.org/10.12688/f1000research.152259.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] Previously titled: Predictive Ability of Self-Care and Psychological Flow in Occupational Stress Among Nurses Abdallah Salem Almahaireh https://orcid.org/0000-0002-2579-2783 1 , Baha' Suhail Shawaqfeh https://orcid.org/0000-0003-1254-7671 2 Abdallah Salem Almahaireh https://orcid.org/0000-0002-2579-2783 1 , Baha' Suhail Shawaqfeh https://orcid.org/0000-0003-1254-7671 2 PUBLISHED 28 Feb 2025 Author details Author details 1 Counseling, The University of Jordan, Amman, Jordan 2 Counseling, Jordanian Ministry of Education, Amman, Jordan Abdallah Salem Almahaireh Roles: Conceptualization, Data Curation, Investigation, Methodology, Project Administration, Resources, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Baha' Suhail Shawaqfeh Roles: Conceptualization, Formal Analysis, Funding Acquisition, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Health Services gateway. Abstract Background The nursing workforce is crucial in healthcare systems worldwide and contributes to community well-being. also, Nurses experience numerous psychological, social, emotional, and behavioral shocks and challenges in their work. In Jordan, 43% of doctors and nurses suffer from high levels of burnout, around 55% experience high levels of emotional exhaustion, and 33% of doctors and nurses suffer from high levels of psychological pressure and job stress. Others found that 70% of nurses experience stress. these issues can be reduced by practicing self-care and psychological flow which impact in work-related tasks which are important in effectively addressing occupational stress healthily and soundly. This study aims to determine assessing the predictive power of self-care and psychological flow in occupational stress among nurses Methods This study follows the quantitative technique. sample consisting of 476 nurses in Amman Jordan was chosen. Three scales were adapted to meet the study objectives: Occupational stress scale, Self-care scale, and psychological flow scale. There validity and reliability were checked. Results The study results indicate that self-care and psychological flow levels were low with means of 2.32 and 2.13, while the occupational stress level was high with a mean of 3.91. Also, there are a predictive power of self-care and psychological flow in occupational stress among nurses. Conclusions This study shows that of self-care and psychological flow predict occupational stress among nurses, which helps us to manage the occupational stress among them by giving them self-care and psychological flow practices and healing time during work by group counseling and lectures. READ ALL READ LESS Keywords Self-Care, Psychological Flow, Occupational Stress, Nurses Corresponding Author(s) Abdallah Salem Almahaireh ( [email protected] ) Close Corresponding author: Abdallah Salem Almahaireh Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Salem Almahaireh A and Suhail Shawaqfeh B. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Salem Almahaireh A and Suhail Shawaqfeh B. Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.12688/f1000research.152259.2 ) First published: 17 Jun 2024, 13 :641 ( https://doi.org/10.12688/f1000research.152259.1 ) Latest published: 28 Feb 2025, 13 :641 ( https://doi.org/10.12688/f1000research.152259.2 ) Revised Amendments from Version 1 In the new version, the title changed to assessing the predictive power which is the same meaning as the predictive ability but I think the new title is better in giving the right meaning. we deleted some references as the reviewer asked because they were old. In the method section, we add a reference to support the idea that the sample size is good and the study can be generalized. In the new version, the title changed to assessing the predictive power which is the same meaning as the predictive ability but I think the new title is better in giving the right meaning. we deleted some references as the reviewer asked because they were old. In the method section, we add a reference to support the idea that the sample size is good and the study can be generalized. See the authors' detailed response to the review by Ahmad Al-Sagarat See the authors' detailed response to the review by Amal I Khalil READ REVIEWER RESPONSES Introduction Working in hospitals, especially for nursing staff, requires dealing with various cases and direct or indirect interaction and contact with patients. This may put numerous challenges and difficulties for nurses working in hospitals, leading to negative psychological and health consequences due to occupational stress. Therefore, it is highly important to balancing work and life, and practicing self-care to achieve normal psychological flow. These practices could protect from psychological and professional problems and disorders. Occupational Stress is considered one of the key factors pressures in work environment that can lead to psychological, behavioral, or physiological manifestations of stress and long-term health effects. It is the physical and emotional responses that occur when work requirements exceed the capabilities, resources, or needs of the worker ( Levy et al., 2018 ). Occupational stress could lead to developing more severe psychological disorders such as burnout, depression, emotional exhaustion, and others. Therefore, it is crucial to find methods that enable individuals to continue working, reduce human and material losses, and adapt ( Hricova et al., 2020 ). Jachens et al. (2018) identified factors that specifically affect humanitarian work and interact with occupational stress, including emergency culture, rewards (e.g. feelings of achievement and pride, constant and unpredictable changes in work, high job involvement, and the inability to withdraw when needed unrealistic job demands) limited availability of social support networks, and insufficient self-care practices. Self-care practices include activities that help people participate in to maintain, improve, or restore their health, it’s not only for necessities, but helps create a balance among daily activities, pressures, relaxation, and rest, thus enhancing and preserving human life and promoting well-being ( Khademian et al., 2020 ). These practices are closely linked to professions that involve caregiving, such as nursing. This is due to the nature of the work, which requires engagement in environments where they are continually exposed to emergencies and the distressing stories and experiences of the patients they serve. Along with accompanying feelings such as anger, fear, despair, helplessness, and powerlessness that expose them to high levels of occupational stress ( Santana et al., 2020 ; Li et al., 2021 ). The self-care concept involves taking care of oneself, striving for personal well-being, and making healthy decisions that contribute to happiness by addressing emotional, social, spiritual, and professional aspects; which play a significant role in achieving psychological flow by high level of focus and full engagement in life's activities, enjoying them, and feeling challenged. This demonstrates a correlational relationship between self-care and psychological flow, whereby achieving and maintaining self-care enhances the opportunity to reach a state of psychological flow ( Al-Hiary, 2023 ). Psychological flow is defined as a deep state of immersion in enjoyable activities, where individuals perceive their performance as enjoyable and successful, viewing the activity as worthwhile even if it does not lead to further achievement ( Csikszentmihalyi, 2014 ). Psychological flow is an internal psychological state that engulfs the individual in the activity he/she is engaged in, with a sense of accomplishment in dealing with these activities. From this perspective, flow is an aggregate of psychological factors including focus, control, awareness, motivation, self-awareness, clarity of goals, clear feedback, balance, and challenge. Flow is vital in the workplace, where individuals who frequently experience flow tend to have high job satisfaction, more productivity, and less occupational stress ( Martínez-Zaragoza et al., 2017 ). Research problem The nursing workforce plays a crucial role in healthcare systems worldwide and contributes to community well-being. Working in the nursing sector is complex, hazardous, and sometimes unsafe. Those responsible for the nursing sector should create suitable working conditions for nurses and consider their mental health and well-being since the quality of care provided partially depends on the quality of their work environment ( International Labor Organization and World Health Organization, 2017 ). Working in nursing may lead to occupational stress and neglect of self-care practices, affecting their psychological flow. Research has indicated that 43% of doctors and nurses in Jordan suffer from high levels of burnout ( Jordanian Ministry of Health, 2020 ). Additionally, a study by Dehdashti et al. (2018) found that 70% of nurses experience stress. Nurses experience numerous psychological, social, emotional, and behavioral shocks and challenges in their work, which can impact their psychological flow during work-related tasks ( Ekman & Halpern, 2015 ). Furthermore, the importance of self-care for nursing professionals has emerged as a fundamental and necessary component in effectively addressing occupational stress. By providing efficient services to promote mental health, prevent occupational stress, achieve optimal healthcare quality and flow, and develop self-care mechanisms ( Zhang et al., 2021 ). Practicing self-care strategies supports mental health and well-being ( Mills et al., 2018 ). If nurses neglect self-care, it may lead to health problems that can affect their professional and personal life, which sometimes might results in occupational stress and resignation from the nursing profession ( Kelbach, 2021 ). Thus, understanding how self-care and flow experience affect individuals can offer insights on what interventions could be used to improve individuals' quality of life, and consequently impacting their professional lives and work quality, thereby contributing to providing comprehensive care services and reducing the risk of occupational stress among nurses ( Burke et al., 2016 ). This study aims to investigate the predictive power of self-care and psychological flow on occupational stress among nurses in Jordan. Research questions 1. What are the self-care, psychological flow, and occupational stress levels among nurses in Jordan? 2. Is there a predictive power of self-care and psychological flow in occupational stress among nurses in Jordan? Methods Study design This study follows the quantitative technique by prediction method. A sample of 476 nurses in Amman was collected voluntarily; the informed consent was taken verbally and written. Also, the researchers took approval from the institutions. Participants The volunteering sample consisting of 476 nurses in Amman Jordan was chosen, which is 2.6% of the population. According to Thompson (2012) it is a good sample size in an error level of (0.05). Their age ranged between 26-58 (M=35.6 ±9.14). 189 of them was males while 287 was females. Data collection tools Occupational stress scale The researchers adapted a scale of 21 items from ( Kushal et al., 2018 ). Participants rated each item on a five-Likert scale, from 1 (I agree to a very small extent) to 5 (I agree to a very big extent). Higher scores reflect a higher level of occupational stress. The researchers extracted the validity and reliability and found that the discriminate evidence ranged between 0.343 and 0.874. Cronbach's alpha was 0.885 ( Shawaqfeh & Almahaireh, 2024 ). Self-care scale The researchers adapted a scale of 22 items divided into 4 dimensions (physical, psychological, spiritual, and occupational) from ( Lichner et al., 2018 ; Jallad, 2021 ). Participants rated each item on a five-Likert scale, from 1 (strongly disagree) to 5 (strongly agree). Higher scores reflect a higher level of self-care. The researchers extracted the validity and reliability and found that the discriminate evidence ranged between 0.771 and 0.942. Cronbach's alpha ranged between 0.742 and 0.913 ( Shawaqfeh & Almahaireh, 2024 ). Psychological flow scale The researchers adapted a scale of 19 items from ( Alakili, 2015 ; Al-Hiary, 2023 ). Participants rated each item on a five-Likert scale, from 1 (strongly disagree) to 5 (strongly agree). Higher scores reflect a higher level of psychological flow. The researchers extracted the validity and reliability and found that the discrimination evidence ranged between 0.458 and 0.874. Cronbach's alpha was 0.818 ( Shawaqfeh & Almahaireh, 2024 ). Data collection The researchers obtained approval for this study from the Institutional Review Board at the University of Jordan. The registration number is 1546/2024/21. The date was 12/5/2024. Anonymized data was collected by online instruments using Google Forms. The data collected between 13-18/5/2024. Data analysis The researchers entered the data into the SPSS data sheet and used IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA) to analyze the data. Means, standard deviations, Pearson’s correlation, and multi-regression were calculated. There was no missing data because all questions were required to be answered in the Google form. Ethics and consent The researchers obtained verbal and written approval for this study from the Institutional Review Board at the University of Jordan. The registration number is 1546/2024/21. The date was 12/5/2024. The informed consent was taken verbally and written. Also, the researchers took approval from the institutions. Findings and discussion Preliminary analyses Means, standard deviations, and Person correlations between occupational stress, self-care and psychological flow are shown in Table 1 . Table 1. Person correlations between the variables. Variable Mean SD level 1 2 3 Skewness Kurtosis 1. OS 3.91 0.41 High - - - 0.435 -0.071 2. SC 2.32 0.46 Low 0.390 * - - 0.751 -0.010 3. PF 2.13 0.88 Low 0.178 * 0.160 * - 0.366 -0.216 * Correlation is significant at the 0.01 level (2-tailed). Table 1 shows a negative correlation between Occupational stress and each Self-care and Psychological flow. Also, there is a positive correlation between Self-care and Psychological flow. Furthermore, the Self-care and Psychological flow levels were low. The Self-care mean was (2.32±0.46), and the Psychological flow mean (2.13 ±0.88) while the Occupational stress level was high mean was (3.91 ±0.41). The results show that the data is normally distributed. This result can be attributed to work pressures and stress experienced by nurses. According to statistics from the Jordanian Ministry of Health, there are only 37 nurses for every 10,000 citizens ( Jordan News Agency, 2017 ). To cover this shortage, hospitals allow nurses to work multiple shifts in a single day, leading to long working hours, caring for large numbers of patients, and receiving emergency cases. This diminishes their ability to balance home and work requirements and reduces their capacity for self-care ( Suleiman et al., 2019 ). Consequently, nurses may experience feelings of boredom, routine, dissatisfaction, negativity, and disengagement from required tasks ( Zaki, 2018 ), along with an inability to keep up with life demands and a lack of satisfaction due to low-income levels ( Al-Hamdan & Bani Issa, 2022 ). This leads to a decrease in the level state of psychological flow. The high level of Occupational stress can be explained by nurses lacking self-care skills and self-attention, as well as insufficient time for relaxation, experiencing flow state, and engaging in various activities due to work pressures. Additionally, the inability to express emotions, feelings of depletion, exhaustion, and fatigue result from a lack of Psychological flow skills and empathy toward patients. Nurses may also struggle to share their sad feelings and bear their emotional burdens ( Zito et al., 2016 ). The lack of providing self-care programs and recreational activities in hospitals which help nurses cope with and adapt to Occupational stress, along with insufficient social and psychological support ( Suresh, 2013 ), contributes to the low level of self-care. Nurses are assigned multiple quantitative and qualitative duties and tasks that exceed their capabilities, leading to role conflict due to the shortage of nursing staff in Jordanian hospitals ( Jordanian Ministry of Health, 2019 ; World Health Organization, 2020 ). One of the reasons for high Occupational stress levels and low levels of psychological flow among nurses is their lack of involvement in decision-making processes at their workplaces, significant disparities between financial income, rewards, and required tasks, as well as limited opportunities for promotion and career advancement with unclear paths, particularly in private hospitals. Additionally, conflicts and lack of harmony with supervisors and managers in nursing practice exacerbate internal dissatisfaction and decrease self-esteem ( Kumar et al., 2011 ). The work environment in hospitals, in general, is perceived as stressful, and nurses in Jordan express dissatisfaction with the nursing work environment ( Suleiman et al., 2019 ). The multi-regression results To investigate the predictive power of self-care and psychological flow in occupational stress among nurses in Jordan, a regression test was calculated, and Table 2 shows the results. Table 2. Multi-regression test to investigate the predictive power of self-care and psychological flow in occupational stress. Variable R R 2 F F Sig. Beta T T Sig. Psychological flow 0.460 0.212 63.461 0.000 -0.379 -10.386 0.000 Self-care -0.114 5.972 0.000 Table 2 shows the predictive power of self-care and psychological flow in occupational stress among nurses in Jordan was 21.2%, while the correlation was 0.460. Also, The Psychological flow has a more substantial influence on occupational stress, and there is a negative relationship between the variables. The low practice of self-care and relaxation among nurses, along with diminished psychological flow, bring about feelings of sadness, job dissatisfaction, and dissatisfaction with life. This contributes to creating a negative psychological state, negatively impacting quality of life, professional life, and work quality, leading to increased job stress levels. This explains the inverse relationship between psychological flow and self-care with occupational stress. These findings are consistent with studies by ( Jallad, 2021 ). Jachens et al. (2018) clarified that working in the humanitarian field, such as nursing, interacts with occupational stress, and one of the reasons for its increase is the lack of self-care practice, relaxation, and weak social support. Working in nursing is a stressful and traumatic job when exposed to severe medical cases. nurses' sense of enjoyment diminishes, making it difficult for them to perceive their performance as enjoyable and successful, especially when patients die during their shifts. Consequently, psychological flow is unattainable in this negative work environment, thereby increasing their occupational stress. The explanation for 21.2% of the relationship between flow, self-care, and occupational stress can be attributed to the low level of psychological flow and self-care among nurses. They cannot enhance their physical, psychological, emotional, social, spiritual, and professional well-being due to workload burden, time pressure, lack of social and professional support, limited career advancement, and absence of self-care skills such as relaxation, meditation, spiritual practices, self-awareness, and reactive coping. They also struggle with concentration, integration into work, feelings of fatigue, boredom, loss of commitment and perseverance, task diversity, shift work, inability to communicate with others due to work pressure, and lack of work-life balance, resulting in high levels of occupational stress. Conclusion This study shows that there are predictive power of self-care and psychological flow in occupational stress among nurses, which helps us to manage the occupational stress among them by giving them self-care and psychological flow practices and healing time. addition, there is a high level of occupational stress among nurses and the managers and hospital mostly conduct this issue because it affects their job. However, the self-care and psychological flow among them were low which means they don’t give themselves good attention and it may cause many problems and mental illness. Organizations and Hospitals should provide them with more special assistance, support, and training. Thus, future research should consider social support, coping, and job satisfaction as potentially important variables. Limitations and future directions This study was conducted with a sample of nurses in the Capital Amman, Jordan enrolled in 2024. The study results were interpreted from the participants’ responses on self-care, psychological flow, and occupational stress scales. The researchers recommends further research on occupational stress among nurses to define it and to produce a program to decrease it which can give us better quality work. For the managers at the hospitals, it’s important to train the nurses in selfcare and psychological flow to decrease the occupational stress which can help them to be more effective in their jobs. The universities should give the nurses students classes in selfcare and how to improve their psychological flow. Future research might also study coping, work environment, job satisfaction, and resilience variables. The creation of counselling and guidance programs to improve self-care and psychological flow among nurses may use technological applications. Thus, the researchers recommended to applied this research on other types of samples such as: Doctors and pharmacists. The future research may include the type of hospitals to see if there are differences between public and private, also in another areas. Ethics and consent The researchers obtained verbal and written approval for this study from the Institutional Review Board at the University of Jordan. The registration number is 1546/2024/21. The date was 12/5/2024. The informed consent was taken verbally and written after the researchers defined the purpose of the study and that they had free will to accept or reject applying the scales. Also, the researchers took approval from the institutions. Data availability statement Figshare. Assessing the predictive power of self-care and psychological flow in occupational stress among nurses (Dataset.sav). https://doi.org/10.6084/m9.figshare.25892764.v4 ( Shawaqfeh, 2024 ) Data is available under the terms of the CC0. Repository name: Figshare Checklist for Assessing the predictive power of self-care and psychological flow in occupational stress among nurses, at https://doi.org/10.6084/m9.figshare.25892764.v4 ( Shawaqfeh, 2024 ) Acknowledgments The researchers would like to thank the hospitals and nurses for helping them in collecting the data. References Alakili A: Psychological Flow among Gifted High School Students and its Relationship to Self-Regulation. Al-Mustansiriya Journal for Science and Education. 2015; 4 (16): 379–415. Al-Hamdan Z, Bani Issa H: The role of organizational support and self-efficacy on work engagement among registered nurses in Jordan: A descriptive study. J. Nurs. Manag. 2022; 30 (7): 2154–2164. 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PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 17 Jun 2024 ADD YOUR COMMENT Comment Author details Author details 1 Counseling, The University of Jordan, Amman, Jordan 2 Counseling, Jordanian Ministry of Education, Amman, Jordan Abdallah Salem Almahaireh Roles: Conceptualization, Data Curation, Investigation, Methodology, Project Administration, Resources, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Baha' Suhail Shawaqfeh Roles: Conceptualization, Formal Analysis, Funding Acquisition, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 28 Feb 2025, 13:641 https://doi.org/10.12688/f1000research.152259.2 version 1 Published: 17 Jun 2024, 13:641 https://doi.org/10.12688/f1000research.152259.1 Copyright © 2025 Salem Almahaireh A and Suhail Shawaqfeh B. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Salem Almahaireh A and Suhail Shawaqfeh B. Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.12688/f1000research.152259.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 28 Feb 2025 Revised Views 0 Cite How to cite this report: khalifeh A. Reviewer Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.176513.r371452 ) The direct URL for this report is: https://f1000research.com/articles/13-641/v2#referee-response-371452 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 01 Apr 2025 Anas khalifeh , Community of Mental Health Nursing, Faculty of Nursing-Zarqa University, Az-Zarqa, Zarqa Governorate, Jordan Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.176513.r371452 It is my pleasure to review the manuscript entitled "Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses." In this article, the authors conducted a study among nurses in Amman, Jordan, to explore the predictive ... Continue reading READ ALL It is my pleasure to review the manuscript entitled "Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses." In this article, the authors conducted a study among nurses in Amman, Jordan, to explore the predictive relationship of self-care and psychological flow with occupational stress. The study highlights a relevant and timely issue in nursing practice, as occupational stress significantly affects nurses’ well-being, job performance, and the overall quality of healthcare delivery. Investigating psychological factors such as self-care and flow contributes to the understanding of mental health challenges in the nursing workforce and offers potential avenues for intervention and support in clinical settings. I have a few questions and comments for the authors' consideration. General comment: Need to follow author guidelines for Journal in write abstract and the whole paper. My comments are as follows: Title: The revised title is concise and reflects the research aim. It clearly communicates that the study investigates the predictive power of self-care and psychological flow on occupational stress. The change from "predictive ability" to "predictive power" improves clarity and aligns with statistical terminology. However, a more specific version such as “Predictive Roles of Self-Care and Psychological Flow in Occupational Stress Among Nurses in Jordan” could enhance clarity. The title does not reflect the geographic context (Jordan), which may be important for readers seeking region-specific data. Including the population and setting would strengthen specificity. Abstract: While it includes research background, purpose, methodology, and conclusions, the abstract lacks statistical details, instrument characteristics, and specific recommendations. It is also somewhat vague and wordy, which weakens clarity. It also contains grammatical errors and some redundancy. The conclusion in the abstract is general and lacks concrete recommendations for practice. The introduction addresses a significant issue—occupational stress among nurses in Jordan. It includes relevant local and global statistics and highlights the relevance of self-care and psychological flow in addressing stress. However: It is too long and sometimes repetitive. The research gap is not sharply defined. Several references are outdated (>10 years). Some ideas (e.g., burnout, self-care importance) are repeated. The theoretical framework is implicit rather than explicitly stated, although flow theory (Csikszentmihalyi, 2014) is mentioned. Research Problem and Purpose: The problem is identified but not succinctly stated. The significance of the study is highlighted through statistics and citations. Research Questions: Clearly listed. 4- Methods Design: Quantitative, predictive correlational study using a sample of 476 nurses from Amman. The cross-sectional design is appropriate for prediction but limits causal inference. However, no justification is given for selecting this design over other approaches (e.g., structural equation modeling might have offered deeper insights). Setting : No description of hospital type (e.g., public vs. private), work units (e.g., ICU, ER), or shift types (rotational, night), which are major determinants of occupational stress. The reasons for selection. Sample: Inclusion/exclusion criteria are not clearly described. Sampling was voluntary and conducted online via Google Forms, potentially excluding older or less tech-savvy nurses, introducing sampling bias. The recruitment process is vague—no details on how participants were approached or incentivized. Study instrument: Instruments were adapted, not developed, yet authors ambiguously claim both. Cultural validation of tools is not discussed—do the constructs of self-care or psychological flow translate equivalently into Arabic/Jordanian contexts?. Is instrument used in nursing students and valid for this population? Which language they were? Did you get permission to use the instrument? Ethical considerations: How do you protect the identity of participants? Need to mention process of data saving. Did you get permission to use the instrument? IRB approval obtained and informed consent described. This was a strong component. However, verbal consent in online surveys raises concerns. How was this recorded? What mechanisms ensured participants understood their rights? No discussion of scale structure (e.g., subscales, factor structure) limits interpretability. Data collection procedure: I suggest explaining data collection steps. Results: No tables or narrative summaries of key demographic features (years of experience, ward type, education, income) are presented, which severely limits result interpretation. No demographic characteristics of participants are presented in the results—major omission. Examine gender-based differences (the sample was 60% female) Gender, age, and experience might moderate stress levels. Discussion does not explore why psychological flow is a stronger predictor. Nor does it explore interaction effects or control for confounding variables. Limitations are acknowledged vaguely and are not integrated into the interpretation of results. Authors do not engage with potential alternative explanations (e.g., work-life balance, leadership support). No attempt to test for mediation or moderation (e.g., Does self-care mediate the relationship between workload and stress?). 5- Discussion: much more discussion of findings is needed. Wider background reading is required to set the scene and also generalizability to the wider nursing students. There are findings discussed but not present or highlight in result. Justify the reasons may relate to finding and comparing with other studies. A valuable and interesting piece of research that has the opportunity to be expanded to other nations and the discussion points to direct further areas of research. The discussion would benefit from some additional reorganizing. No concrete or evidence-based interventions are proposed (e.g., mindfulness, organizational changes). Implications for “nursing education” and “administration” are mentioned but not elaborated. No link back to theoretical framework—missed opportunity to explain why self-care or flow is protective from a psychological model. The authors missed discussing institutional and policy-level changes, which is important given systemic stressors in Jordanian hospitals. 6- Recommendations: Are broad and lack actionability. “Train nurses in flow” – How? Through workshops, CBT, mindfulness? “Conduct programs” – What type of programs? What content? What frequency? 7- Conclusion: Add critical findings and conclusion. 8- Implications: Add implications. No structured plan for implementation or cost-benefit analysis is provided. 9- Limitation: Briefly acknowledged, but many are missing, including: Lack of subgroup analysis (e.g., by ward type or shift) Non-response bias Use of only self-report tools Theoretical and cultural limitations Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: nursing I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT khalifeh A. Reviewer Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.176513.r371452 ) The direct URL for this report is: https://f1000research.com/articles/13-641/v2#referee-response-371452 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 17 Jun 2024 Views 0 Cite How to cite this report: Al-Sagarat A. Reviewer Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.166997.r349181 ) The direct URL for this report is: https://f1000research.com/articles/13-641/v1#referee-response-349181 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Dec 2024 Ahmad Al-Sagarat , Community and Psychiatric Nursing Department, Faculty of Nursing, Mutah University, AL-Karak, Jordan Approved VIEWS 0 https://doi.org/10.5256/f1000research.166997.r349181 The article is searching one of the most issues that are facing the Jordanian nurses specifically. In some areas I would like the author to use the most recent studies and avoid using old literature older than 10 years old. ... Continue reading READ ALL The article is searching one of the most issues that are facing the Jordanian nurses specifically. In some areas I would like the author to use the most recent studies and avoid using old literature older than 10 years old. I would like the author to expand more on the limitations from different perspectives such as: sample, type of hospital, different geographic areas, mixed method--- etc. Moreover, I would like the author to add the implication of this study for nursing practice, nursing administration, nursing education and future research. Finally, the overall article is highly recommended and approved for indexing. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Mental health nursing I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Al-Sagarat A. Reviewer Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.166997.r349181 ) The direct URL for this report is: https://f1000research.com/articles/13-641/v1#referee-response-349181 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 03 Jan 2025 Abdallah Almahaireh , Counseling, The University of Jordan, Amman, Jordan 03 Jan 2025 Author Response Dear Ahmad Al-Sagarat We wanna thank you for these notes that improve our work. We made the changes you reported and used recent references as we could. Best Regards, Competing Interests: No competing interests were disclosed. Dear Ahmad Al-Sagarat We wanna thank you for these notes that improve our work. We made the changes you reported and used recent references as we could. Best Regards, Dear Ahmad Al-Sagarat We wanna thank you for these notes that improve our work. We made the changes you reported and used recent references as we could. Best Regards, Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 03 Jan 2025 Abdallah Almahaireh , Counseling, The University of Jordan, Amman, Jordan 03 Jan 2025 Author Response Dear Ahmad Al-Sagarat We wanna thank you for these notes that improve our work. We made the changes you reported and used recent references as we could. Best Regards, Competing Interests: No competing interests were disclosed. Dear Ahmad Al-Sagarat We wanna thank you for these notes that improve our work. We made the changes you reported and used recent references as we could. Best Regards, Dear Ahmad Al-Sagarat We wanna thank you for these notes that improve our work. We made the changes you reported and used recent references as we could. Best Regards, Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Khalil AI. Reviewer Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.166997.r301709 ) The direct URL for this report is: https://f1000research.com/articles/13-641/v1#referee-response-301709 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Jul 2024 Amal I Khalil , College of Nursing, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia; psychiatric nursing, king Saud bin Abdelaziz university for health sciences, college of nursing, Jeddah, Makkah Province, Makkah Province, Saudi Arabia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.166997.r301709 thank you for giving the opportunity to review this manuscript let's start with the title: : despite it is concise but it is little bit unclear for the reader so i suggest to be changed into ... Continue reading READ ALL thank you for giving the opportunity to review this manuscript let's start with the title: : despite it is concise but it is little bit unclear for the reader so i suggest to be changed into "Predictive Roles of Self-Care and Psychological Flow in Occupational Stress Among Nurses" or "Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses" Abstract :As a peer reviewer, here are some potential drawbacks and areas for improvement in the abstract: The abstract is slightly wordy and can be more concise. This can be achieved by removing redundant phrases and ensuring each sentence adds new information. The objective of the study could be more clearly stated at the beginning of the abstract. Currently, it is embedded within a broader discussion of the context. The abstract mentions that three scales were developed, but it does not provide any details on their development, validation, or reliability. Including brief information on these aspects would strengthen the abstract. The results section mentions that self-care and psychological flow levels were low, and occupational stress was high, but it does not provide any specific data or statistics to support these claims. Including key statistics would make the results more robust. : The conclusion mentions that self-care and psychological flow practices can help manage occupational stress but does not provide specific recommendations or implications for practice. Adding this information would make the conclusions more actionable. The abstract contains some grammatical insufficiency and awkward phrasing that can be refined for clarity and readability. Introduction :Here are some potential drawbacks of the provided introduction and suggestions for improvement: The introduction is quite lengthy and contains many ideas that could be more concisely presented. A more focused introduction would help readers quickly grasp the main points. The introduction would benefit from clearer structure and organization. It jumps between different concepts without clear transitions. Organizing it into distinct paragraphs for context, problem statement, and the purpose of the study would improve readability. Some points are repeated, such as the importance of self-care and psychological flow, which can be consolidated to avoid redundancy. While the introduction provides a lot of background information, it sometimes strays from the main focus of the study. Keeping the information relevant to the research question would make the introduction more impactful. The introduction includes many references, which, while supporting the points made, can overwhelm the reader. Select the most pertinent references to strengthen the key points. The introduction could benefit from more specific statements about the research gap and the need for this study. It should more clearly highlight what is unknown or understudied about the relationship between self-care, psychological flow, and occupational stress among nurses. research problem it is better to say significance of the study and here some drawbacks: Length and Conciseness : The problem statement is quite long and includes a lot of background information that could be more concisely presented. The main problem could be stated more directly. Clarity and Focus : The statement introduces several related issues (e.g., burnout, emotional exhaustion, psychological pressure, self-care, psychological flow) without clearly connecting them to the main research problem. Focusing on the central issue of how self-care and psychological flow impact occupational stress among nurses would improve clarity. Redundancy : Some points are repeated, such as the impact of occupational stress and the importance of self-care. These could be combined to streamline the text. Lack of Specificity : The problem statement mentions various statistics and studies but does not clearly state the specific gap or need that the current study addresses. More emphasis on what is unknown or understudied would be beneficial. Transition and Structure : The transitions between different points could be smoother. Organizing the statement into distinct paragraphs for background, problem identification, and the purpose of the study would enhance readability. There are many references to other studies, which, while supporting the points made, can make the problem statement Methods: first the definition of variables "self care , psychological flow, occupational stress is important for the readers ,the other thing Sample Representativeness : The sample, while sizable, represents only 2.6% of the nurse population in Amman. This could limit the generalizability of the findings to all nurses in Jordan, and how they calculate the sample size??The study's cross-sectional design limits the ability to draw causal inferences. While predictive relationships can be identified, causal conclusions cannot be definitively made. the scales used were adapted from other studies which may differ culturally as well the authors mention developed which is wrong as they adapted both scales Data Collection Method : Using online instruments such as Google Forms may exclude participants who are less tech-savvy or have limited internet access, potentially introducing sampling bias. Limited Contextual Information : The study might benefit from including more contextual information about the work environment, workload, and other stressors specific to the nursing profession in Jordan. These factors could provide a deeper understanding of occupational stress. Ethical Considerations : While informed consent was obtained verbally and in writing, ensuring that participants fully understand the study's aims and their rights is crucial. Detailed information on how consent was obtained and documented would enhance ethical transparency.he study does not account for other variables that might influence occupational stress, such as personal life stressors, job satisfaction, or organizational support. Including these factors could provide a more comprehensive analysis. as the authors didn't include demographic characteristics of the participants which is very important in interpreting the results also short data collection time (13-18/5/2024) might not capture variations in stress levels that could occur over different times or under different circumstances. results of the study: missed Demographic characteristics of the participants it is better to separate results from discussion for more interpretations and discussions big number of cited references are old and needs updates where is the recommendations and clinical implications of these results a lot of limitations should be recognized in this study such as : self reported tools, lack of generalizability since the study was conducted only on Jordanians living in Amman, mediating variables should be considered as mentioned before Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: psychiatric, psychological and psychosocial research all types of research designs as well child ,adult ,and elderly psychological and psychiatric disorders. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Khalil AI. Reviewer Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.166997.r301709 ) The direct URL for this report is: https://f1000research.com/articles/13-641/v1#referee-response-301709 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 28 Feb 2025 Abdallah Almahaireh , Counseling, The University of Jordan, Amman, Jordan 28 Feb 2025 Author Response Dear Amal I Khalil, We wanna thank you for these notes that improve our work. We made the changes you reported. and Added a reference for the sample size. ... Continue reading Dear Amal I Khalil, We wanna thank you for these notes that improve our work. We made the changes you reported. and Added a reference for the sample size. Best Regards, Dear Amal I Khalil, We wanna thank you for these notes that improve our work. We made the changes you reported. and Added a reference for the sample size. Best Regards, Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 28 Feb 2025 Abdallah Almahaireh , Counseling, The University of Jordan, Amman, Jordan 28 Feb 2025 Author Response Dear Amal I Khalil, We wanna thank you for these notes that improve our work. We made the changes you reported. and Added a reference for the sample size. ... Continue reading Dear Amal I Khalil, We wanna thank you for these notes that improve our work. We made the changes you reported. and Added a reference for the sample size. Best Regards, Dear Amal I Khalil, We wanna thank you for these notes that improve our work. We made the changes you reported. and Added a reference for the sample size. Best Regards, Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 17 Jun 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 2 (revision) 28 Feb 25 read Version 1 17 Jun 24 read read Amal I Khalil , King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia; king Saud bin Abdelaziz university for health sciences, college of nursing, Jeddah, Makkah Province, Saudi Arabia Ahmad Al-Sagarat , Mutah University, AL-Karak, Jordan Anas khalifeh , Faculty of Nursing-Zarqa University, Az-Zarqa, Jordan Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 khalifeh A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 01 Apr 2025 | for Version 2 Anas khalifeh , Community of Mental Health Nursing, Faculty of Nursing-Zarqa University, Az-Zarqa, Zarqa Governorate, Jordan 0 Views copyright © 2025 khalifeh A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions It is my pleasure to review the manuscript entitled "Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses." In this article, the authors conducted a study among nurses in Amman, Jordan, to explore the predictive relationship of self-care and psychological flow with occupational stress. The study highlights a relevant and timely issue in nursing practice, as occupational stress significantly affects nurses’ well-being, job performance, and the overall quality of healthcare delivery. Investigating psychological factors such as self-care and flow contributes to the understanding of mental health challenges in the nursing workforce and offers potential avenues for intervention and support in clinical settings. I have a few questions and comments for the authors' consideration. General comment: Need to follow author guidelines for Journal in write abstract and the whole paper. My comments are as follows: Title: The revised title is concise and reflects the research aim. It clearly communicates that the study investigates the predictive power of self-care and psychological flow on occupational stress. The change from "predictive ability" to "predictive power" improves clarity and aligns with statistical terminology. However, a more specific version such as “Predictive Roles of Self-Care and Psychological Flow in Occupational Stress Among Nurses in Jordan” could enhance clarity. The title does not reflect the geographic context (Jordan), which may be important for readers seeking region-specific data. Including the population and setting would strengthen specificity. Abstract: While it includes research background, purpose, methodology, and conclusions, the abstract lacks statistical details, instrument characteristics, and specific recommendations. It is also somewhat vague and wordy, which weakens clarity. It also contains grammatical errors and some redundancy. The conclusion in the abstract is general and lacks concrete recommendations for practice. The introduction addresses a significant issue—occupational stress among nurses in Jordan. It includes relevant local and global statistics and highlights the relevance of self-care and psychological flow in addressing stress. However: It is too long and sometimes repetitive. The research gap is not sharply defined. Several references are outdated (>10 years). Some ideas (e.g., burnout, self-care importance) are repeated. The theoretical framework is implicit rather than explicitly stated, although flow theory (Csikszentmihalyi, 2014) is mentioned. Research Problem and Purpose: The problem is identified but not succinctly stated. The significance of the study is highlighted through statistics and citations. Research Questions: Clearly listed. 4- Methods Design: Quantitative, predictive correlational study using a sample of 476 nurses from Amman. The cross-sectional design is appropriate for prediction but limits causal inference. However, no justification is given for selecting this design over other approaches (e.g., structural equation modeling might have offered deeper insights). Setting : No description of hospital type (e.g., public vs. private), work units (e.g., ICU, ER), or shift types (rotational, night), which are major determinants of occupational stress. The reasons for selection. Sample: Inclusion/exclusion criteria are not clearly described. Sampling was voluntary and conducted online via Google Forms, potentially excluding older or less tech-savvy nurses, introducing sampling bias. The recruitment process is vague—no details on how participants were approached or incentivized. Study instrument: Instruments were adapted, not developed, yet authors ambiguously claim both. Cultural validation of tools is not discussed—do the constructs of self-care or psychological flow translate equivalently into Arabic/Jordanian contexts?. Is instrument used in nursing students and valid for this population? Which language they were? Did you get permission to use the instrument? Ethical considerations: How do you protect the identity of participants? Need to mention process of data saving. Did you get permission to use the instrument? IRB approval obtained and informed consent described. This was a strong component. However, verbal consent in online surveys raises concerns. How was this recorded? What mechanisms ensured participants understood their rights? No discussion of scale structure (e.g., subscales, factor structure) limits interpretability. Data collection procedure: I suggest explaining data collection steps. Results: No tables or narrative summaries of key demographic features (years of experience, ward type, education, income) are presented, which severely limits result interpretation. No demographic characteristics of participants are presented in the results—major omission. Examine gender-based differences (the sample was 60% female) Gender, age, and experience might moderate stress levels. Discussion does not explore why psychological flow is a stronger predictor. Nor does it explore interaction effects or control for confounding variables. Limitations are acknowledged vaguely and are not integrated into the interpretation of results. Authors do not engage with potential alternative explanations (e.g., work-life balance, leadership support). No attempt to test for mediation or moderation (e.g., Does self-care mediate the relationship between workload and stress?). 5- Discussion: much more discussion of findings is needed. Wider background reading is required to set the scene and also generalizability to the wider nursing students. There are findings discussed but not present or highlight in result. Justify the reasons may relate to finding and comparing with other studies. A valuable and interesting piece of research that has the opportunity to be expanded to other nations and the discussion points to direct further areas of research. The discussion would benefit from some additional reorganizing. No concrete or evidence-based interventions are proposed (e.g., mindfulness, organizational changes). Implications for “nursing education” and “administration” are mentioned but not elaborated. No link back to theoretical framework—missed opportunity to explain why self-care or flow is protective from a psychological model. The authors missed discussing institutional and policy-level changes, which is important given systemic stressors in Jordanian hospitals. 6- Recommendations: Are broad and lack actionability. “Train nurses in flow” – How? Through workshops, CBT, mindfulness? “Conduct programs” – What type of programs? What content? What frequency? 7- Conclusion: Add critical findings and conclusion. 8- Implications: Add implications. No structured plan for implementation or cost-benefit analysis is provided. 9- Limitation: Briefly acknowledged, but many are missing, including: Lack of subgroup analysis (e.g., by ward type or shift) Non-response bias Use of only self-report tools Theoretical and cultural limitations Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise nursing I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) khalifeh A. Peer Review Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.176513.r371452) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-641/v2#referee-response-371452 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Al-Sagarat A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Dec 2024 | for Version 1 Ahmad Al-Sagarat , Community and Psychiatric Nursing Department, Faculty of Nursing, Mutah University, AL-Karak, Jordan 0 Views copyright © 2024 Al-Sagarat A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article is searching one of the most issues that are facing the Jordanian nurses specifically. In some areas I would like the author to use the most recent studies and avoid using old literature older than 10 years old. I would like the author to expand more on the limitations from different perspectives such as: sample, type of hospital, different geographic areas, mixed method--- etc. Moreover, I would like the author to add the implication of this study for nursing practice, nursing administration, nursing education and future research. Finally, the overall article is highly recommended and approved for indexing. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Mental health nursing I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 03 Jan 2025 Abdallah Almahaireh , Counseling, The University of Jordan, Amman, Jordan Dear Ahmad Al-Sagarat We wanna thank you for these notes that improve our work. We made the changes you reported and used recent references as we could. Best Regards, View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Al-Sagarat A. Peer Review Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.166997.r349181) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-641/v1#referee-response-349181 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Khalil A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Jul 2024 | for Version 1 Amal I Khalil , College of Nursing, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia; psychiatric nursing, king Saud bin Abdelaziz university for health sciences, college of nursing, Jeddah, Makkah Province, Makkah Province, Saudi Arabia 0 Views copyright © 2024 Khalil A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions thank you for giving the opportunity to review this manuscript let's start with the title: : despite it is concise but it is little bit unclear for the reader so i suggest to be changed into "Predictive Roles of Self-Care and Psychological Flow in Occupational Stress Among Nurses" or "Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses" Abstract :As a peer reviewer, here are some potential drawbacks and areas for improvement in the abstract: The abstract is slightly wordy and can be more concise. This can be achieved by removing redundant phrases and ensuring each sentence adds new information. The objective of the study could be more clearly stated at the beginning of the abstract. Currently, it is embedded within a broader discussion of the context. The abstract mentions that three scales were developed, but it does not provide any details on their development, validation, or reliability. Including brief information on these aspects would strengthen the abstract. The results section mentions that self-care and psychological flow levels were low, and occupational stress was high, but it does not provide any specific data or statistics to support these claims. Including key statistics would make the results more robust. : The conclusion mentions that self-care and psychological flow practices can help manage occupational stress but does not provide specific recommendations or implications for practice. Adding this information would make the conclusions more actionable. The abstract contains some grammatical insufficiency and awkward phrasing that can be refined for clarity and readability. Introduction :Here are some potential drawbacks of the provided introduction and suggestions for improvement: The introduction is quite lengthy and contains many ideas that could be more concisely presented. A more focused introduction would help readers quickly grasp the main points. The introduction would benefit from clearer structure and organization. It jumps between different concepts without clear transitions. Organizing it into distinct paragraphs for context, problem statement, and the purpose of the study would improve readability. Some points are repeated, such as the importance of self-care and psychological flow, which can be consolidated to avoid redundancy. While the introduction provides a lot of background information, it sometimes strays from the main focus of the study. Keeping the information relevant to the research question would make the introduction more impactful. The introduction includes many references, which, while supporting the points made, can overwhelm the reader. Select the most pertinent references to strengthen the key points. The introduction could benefit from more specific statements about the research gap and the need for this study. It should more clearly highlight what is unknown or understudied about the relationship between self-care, psychological flow, and occupational stress among nurses. research problem it is better to say significance of the study and here some drawbacks: Length and Conciseness : The problem statement is quite long and includes a lot of background information that could be more concisely presented. The main problem could be stated more directly. Clarity and Focus : The statement introduces several related issues (e.g., burnout, emotional exhaustion, psychological pressure, self-care, psychological flow) without clearly connecting them to the main research problem. Focusing on the central issue of how self-care and psychological flow impact occupational stress among nurses would improve clarity. Redundancy : Some points are repeated, such as the impact of occupational stress and the importance of self-care. These could be combined to streamline the text. Lack of Specificity : The problem statement mentions various statistics and studies but does not clearly state the specific gap or need that the current study addresses. More emphasis on what is unknown or understudied would be beneficial. Transition and Structure : The transitions between different points could be smoother. Organizing the statement into distinct paragraphs for background, problem identification, and the purpose of the study would enhance readability. There are many references to other studies, which, while supporting the points made, can make the problem statement Methods: first the definition of variables "self care , psychological flow, occupational stress is important for the readers ,the other thing Sample Representativeness : The sample, while sizable, represents only 2.6% of the nurse population in Amman. This could limit the generalizability of the findings to all nurses in Jordan, and how they calculate the sample size??The study's cross-sectional design limits the ability to draw causal inferences. While predictive relationships can be identified, causal conclusions cannot be definitively made. the scales used were adapted from other studies which may differ culturally as well the authors mention developed which is wrong as they adapted both scales Data Collection Method : Using online instruments such as Google Forms may exclude participants who are less tech-savvy or have limited internet access, potentially introducing sampling bias. Limited Contextual Information : The study might benefit from including more contextual information about the work environment, workload, and other stressors specific to the nursing profession in Jordan. These factors could provide a deeper understanding of occupational stress. Ethical Considerations : While informed consent was obtained verbally and in writing, ensuring that participants fully understand the study's aims and their rights is crucial. Detailed information on how consent was obtained and documented would enhance ethical transparency.he study does not account for other variables that might influence occupational stress, such as personal life stressors, job satisfaction, or organizational support. Including these factors could provide a more comprehensive analysis. as the authors didn't include demographic characteristics of the participants which is very important in interpreting the results also short data collection time (13-18/5/2024) might not capture variations in stress levels that could occur over different times or under different circumstances. results of the study: missed Demographic characteristics of the participants it is better to separate results from discussion for more interpretations and discussions big number of cited references are old and needs updates where is the recommendations and clinical implications of these results a lot of limitations should be recognized in this study such as : self reported tools, lack of generalizability since the study was conducted only on Jordanians living in Amman, mediating variables should be considered as mentioned before Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise psychiatric, psychological and psychosocial research all types of research designs as well child ,adult ,and elderly psychological and psychiatric disorders. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 28 Feb 2025 Abdallah Almahaireh , Counseling, The University of Jordan, Amman, Jordan Dear Amal I Khalil, We wanna thank you for these notes that improve our work. We made the changes you reported. and Added a reference for the sample size. Best Regards, View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Khalil AI. Peer Review Report For: Assessing the Predictive Power of Self-Care and Psychological Flow on Occupational Stress in Nurses [version 2; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :641 ( https://doi.org/10.5256/f1000research.166997.r301709) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-641/v1#referee-response-301709 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. 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