Self-Regulation Mediates the Relationship Between Stress and Quality of Life in Shift-Working Healthcare Professionals: Behavioral Clustering Insights.

Abstract

The psychological mechanisms through which occupational stress impacts quality of life remain underexplored in shift-working healthcare professionals, a population exposed to unique stressors such as circadian disruption, high cognitive demands, and irregular work schedules. This study examined whether executive self-regulation mediates the relationship between perceived stress and quality of life in a sample of 82 shift-working healthcare professionals. Participants completed validated self-report measures, including the Perceived Stress Scale (PSS-4), Executive Skills Questionnaire-Revised (ESQ-R), and Quality of Life Scale (QOLS). Mediation analysis using 5126 bias-corrected bootstrapped samples revealed that perceived stress significantly predicted self-regulation difficulties, which in turn were associated with diminished quality of life. Self-regulation demonstrated an indirect-only mediation effect in both directions, though the forward path (stress → self-regulation → QOL) showed a stronger effect (indirect effect = -0.79; 95% CI: -1.63, -0.17), compared to the reverse path (QOL → self-regulation → stress; indirect effect = -0.04; 95% CI: -0.08, -0.01). Unsupervised K-means clustering identified three distinct behavioral clusters: resilient, low-strain, and high-strain, providing further support for personalized targeted interventions. These findings highlight self-regulation as a central mechanism through which stress affects quality of life and underscore the need for interventions that strengthen executive functioning in shift-based healthcare settings.