The role of professional commitment and resilience in predicting family nursing practice: Iranian nurses’ point of view

Abstract

Introduction

Family Nursing Practice (FNP) is a framework for thinking about and working with families. Despite the recognized importance of family-centered care, few studies have investigated its predictors among Iranian nurses. Therefore, the present study was conducted to determine the role of professional commitment and resilience in predicting family nursing practice in Iranian nurses.

Methods

This cross-sectional correlation study was conducted on 304 nurses in Qazvin, Iran, in 2024–2025. People were included in the study by a simple random method. Having a bachelor’s degree in nursing, working in clinical units, having a direct role in patient care, and at least 6 months of work experience were the criteria for entering the study. Data were collected using the Conor-Davidson Resilience Scale, the Lachman Professional Commitment Questionnaire, and the Family Nursing Practice Scale. Data analysis performed using SPSS v22 software.

Results

The mean age of the participants was 31.98 ± 8 years. The mean scores of professional commitment, resilience, and family nursing practice were 89.56 ± 10.47, 24.66 ± 4.34, and 57.48 ± 10.43, respectively. The results of univariate regression showed that both resilience variables (β = 0.66, P < 0.001) and professional commitment (β = 0.32, P < 0.001) were significantly related to family nursing practice. However, in the multivariate regression model and after adjusting for confounding variables, only the relationship between professional commitment and family nursing practice remained significant (β = 0.24, P < 0.001), and the relationship between resilience and family nursing practice was not significant (β = 0.30, P = 0.065).

Conclusion

Findings indicate that professional commitment is a strong and independent predictor of family nursing practice. Managers and policymakers are expected to take steps to improve family nursing practice by designing educational programs and implementing targeted interventions that promote professional commitment.

Clinical trial number

Not applicable.

Introduction

The illness of a family member affects the health, perceptions, and behaviors of the whole family [1]. Hospitalization of one of the members affects the physical, emotional, cognitive, and social dimensions of the family members [2, 3]. And it can lead to family members experiencing psychological stress, depression, anxiety, and despair [4, 5]. It must be said that the family is the most important human support system, and family members play an important role in caring for each other [6]. Nurses play a central role in supporting and facilitating family-centered care methods [7].

Nurses constitute the largest number of healthcare workers in the hospital [8], and play an important role in care organizations [9]. They are responsible for providing support to family members despite problems such as physical and mental fatigue, burnout, anxiety, depression, and nurse shortages [4, 10]. In today’s treatment systems, care and support of patients’ families are among the duties of the treatment staff, and anticipating, recognizing, and meeting the needs of hospitalized patients’ family members is considered a priority [11]. Therefore, patient-centered care in providing nursing services is moving towards family-centered care [12].

The main goal of family nursing is to meet the health care needs of the family. Family nursing practice (FNP) is defined as a structured framework for understanding and working with families. This framework manifests itself in practice in various ways, including involving family members in care planning, care delivery, and evaluation, and providing psychosocial and informational support to the family [1]. Several reasons have been listed for its importance [13]. However, despite the increasing evidence and encouraging empirical insights about the effectiveness of family participation and support in care during acute and chronic disease processes, the integration of family nursing in the provision of routine care has been slow and partial [14]. This further highlights the importance of identifying factors that can influence the successful implementation of this framework. Resilience is considered one of the key concepts related to the practice of nurses [15].

Resilience, as a vital psychological capital, was first mentioned in the 1970s and 1980s and gradually received attention in the nursing field [16]. Although there are many definitions of resilience, common characteristics include social support, self-efficacy, work-life balance, humor, optimism, and realism. This concept is a combination of activation and decompression. Activation refers to nurses who make a meaningful connection with the purpose of their work. Decompression is the ability of nurses to separate and rejuvenate from work [17]. Resilience capacity is necessary for success in the nursing profession [18]. Studies show that the level of resilience in nurses varies, and this concept is influenced by various factors [19–21]. Although the relationship between resilience and self-efficacy, work engagement, and professional ethics has been investigated and confirmed [20, 22]. However, there is limited research examining the relationship between resilience and family nursing practice, even though resilience itself is related to nursing care, treatment outcomes, and nursing practice [23, 24]. Another remarkable point is that the basis of practice is commitment [25].

Professional commitment means adherence to the goals, values, and ethical principles of the profession [26]. This variable, as a key competence, is considered one of the effective factors in the formation of professional behavior [27]. However, nurses have different levels of professional commitment in different parts of the world [26, 28]. And with global issues such as the Covid-19 pandemic, economic conditions, and various cultural and social factors, the healthcare industry has faced a significant decrease in professional commitment among nurses [29]. Professional commitment is related to various issues such as job satisfaction, fatigue, responsibility, and dedication [27]. Professional commitment leads to performing tasks in the best possible way [27]. Therefore, professional commitment can be considered as one of the effective factors in achieving quality and desirable care [30].

From a theoretical perspective, it can be said that resilience and professional commitment as a capacity [16, 27] can be effective in the implementation of family nursing practice. Resilience, with its numerous characteristics, as a psychological capacity, helps nurses in interacting with families with multiple and complex needs. On the other hand, professional commitment strengthens the motivation and moral responsibility to perform all nursing tasks, including family nursing practice. A nurse who is committed to the values and goals of his profession. Regardless of the problems and challenges faced, it considers itself obligated to better interact with the family and provide proper care to this community. Therefore, it must be said that resilience and professional commitment can be effective in removing physical and psychological barriers to family nursing practice. Therefore, the present study was conducted to determine the role of professional commitment and resilience in predicting family nursing practice in Iranian nurses. According to the literature review, this research is one of the first studies conducted in the field of family nursing practice. The findings of this study can provide valuable evidence for family-centered care policy-making.

Methods

Setting and study design

The present cross-sectional correlation study was conducted among nurses in teaching hospitals in Qazvin (Rajaei, Velayat, and Bu-Ali), Iran (from October 2024 to July 2025). The required sample size was calculated a priori using G*Power 3.1.9.4 software. With an effect size f² of 0.051, eight predictor variables, a regression coefficient of 0.223, power of 80%, and confidence level of 95% the analysis yielded a minimum sample size of 300. Family nursing practice was operationalized as the dependent variable in this study [31]. To accommodate a 10% attrition rate, the final sample size was increased to 330. With a response rate of 92%, data were collected from 304 nurses.

According to the number of nurses in each hospital, 100 nurses from Bu-Ali Hospital, 84 nurses from Rajaei Hospital, and 120 nurses from Velayat Hospital were included in the study by a simple random method. Holding at least a bachelor’s degree in nursing (nurses with higher academic degrees were also eligible), working in clinical departments, having a direct role in patient care, and at least 6 months of work experience were the criteria for entering the study. Although the minimum inclusion criterion was six months of work experience, work experience was reported in yearly categories for descriptive purposes and consistency with previous nursing workforce research. Incomplete completion of the questionnaires and unwillingness to continue the research were the exclusion criteria. Questionnaires were given to nurses in different shifts for sampling. To prevent the interference of nurses’ duties with the process of completing the questionnaires, an attempt was made to complete the questionnaires during the nurses’ break. The process of completing the questionnaires was not limited to a specific situation. However, to prevent interference with nurses’ duties while completing the questionnaires, an attempt was made to complete the questionnaires during nurses’ rest periods. They were requested to answer the questions precisely. The duration of completing the questionnaires was 30–40 min. To ensure data quality, the questionnaires were administered in the presence of the researcher. This allowed for the provision of additional clarification when needed. As a result, the rate of missing data was negligible.

Tools

Part 1: Demographic characteristics checklist

This checklist included information about age, sex, marital status, work experience, unit of the hospital, and shift status.

Part 2: The Connor-davidson Resilience Scale

Campbell-Sills and Stein have designed this scale based on its 25-question version [32]. This scale has ten questions that are scored on a Likert scale between 0 and 4 (Not true at all (0) to True nearly all the time [4]). The range of the scale score is between 0 and 40. The scale has a total score, and a higher score means a higher resilience of the individual. The validity and reliability of the tool have been examined and confirmed in various studies in Iranian society. In the study of Rezaeipandari et al. in Iran, Cronbach’s alpha of 0.89 was reported for the instrument [33, 34]. In the current study, the internal reliability of the tool was acceptable (Cronbach’s alpha = 0.83).

Part 3: Professional commitment questionnaire

The Nurses’ Professional Commitment Questionnaire was compiled for the first time by Lachman et al. in 1968 with 26 items. The questionnaire includes four domains: understanding of the nursing profession (6 items), job satisfaction (4 items), involvement of nursing professionals (6 items), and sacrifice for the nursing profession (10 items). Answering is on a five-point Likert scale (completely agree [5] to completely disagree [1]). The score range is between 26 and 130. And a higher score means a higher professional commitment of the nurse. The scores are divided into ranges as follows: 52 or below indicates a weak level, 53–78 a moderate level, 79–104 an acceptable level, and 105–130 a highly acceptable level. The validity of the Persian version of the tool has been checked and confirmed by 12 faculty members of Tehran University of Medical Sciences, and an acceptable reliability has been reported for this tool (Cronbach’s alpha = 0.74) [25, 27, 35]. The internal reliability of the tool in this study was obtained using Cronbach’s alpha of 0.79.

Part 4: Family Nursing Practice Scale (FNPS)

This scale was developed by Toyama et al. (2017) in Japan [13]. This tool has 15 questions; the answer to each question is on a 5-point Likert scale (always [5] to never [1]). The minimum tool score is 15, and the maximum score is 75. The tool has two components. Questions 1 to 10 of the first factor (active support for the family) and questions 11 to 15 of the second factor (support given with the awareness of the family’s situation) are included. Higher scores indicate a better status of the person in this tool. In the main study, Cronbach’s alpha was calculated to confirm reliability. The reliability of the FNPS was reported to be 0.93 for factor 1, 0.86 for factor 2, and 0.94 overall. The content, face, and known group validity of this tool have been examined and confirmed. Its construct validity has also been confirmed through exploratory factor analysis (explaining 63.2% of the variance) [13]. In addition, the validity and reliability of the tool in Imanipour et al.‘s study have been checked and confirmed (Cronbach’s alpha 0.85) [1]. The content validity of the instrument was assessed by a panel of ten nursing faculty members with expertise in patient care. The instrument was revised based on their feedback and subsequently approved for use. Furthermore, the instrument demonstrated good internal consistency in the present study, with a Cronbach’s alpha of 0.80.

Data analysis

After entering the data in the software and cleaning it, the Kolmogorov-Smirnov test was used to check the normality of the data. Mean, standard deviation, frequency, and percentage were used to describe quantitative and qualitative/nominal variables, respectively. To facilitate direct comparison across the different instruments used, all raw scores were standardized to a 0–100 scale, as the original tools had different numbers of questions. The standardization was computed as follows: first, the minimum possible score was subtracted from the participant’s raw score. This value was then divided by the difference between the maximum and minimum possible scores for that instrument. Finally, the result was multiplied by 100. Regression tests were used to examine the relationship between variables. First, we conducted univariate regression analyses, selecting variables with p-values < 0.2 [36]. These variables were subsequently entered into a multivariate linear regression using the ‘enter’ method to adjust for potential confounders. Data analysis was done using SPSS version 22 software. The significance level of the tests was 0.05.

Results

Out of 304 nurses participating in the study, 186 (61.2%) were female, and the rest were male. The mean age of the participants was 31.98 ± 8 years. 168 (55.3%) nurses were single, and the rest were married (Table 1). The mean scores of nurses’ professional commitment and resilience were 24.66 ± 4.34 and 89.56 ± 10.47, respectively. To compare the sub-domains of professional commitment, the standardization of sub-domain scores out of 100 was done. In the professional commitment variable, the highest score was related to the field of sacrifice for the nursing profession (48.11 out of 100 points). The mean score of family nursing practice among nurses was 57.48 ± 10.43. After standardizing the scores in the range of 0-100, it was found that the mean score of the second factor (support given with the awareness of the family’s situation) is higher than the first factor (Table 2).

Table 1.

Participants’ demographic and professional characteristics (N = 304)

Variables		N (%)
Age, mean (SD)		31.97(8.0)
Sex	Male	118(38.8)
	Female	186(61.2)
Marital Status	Single	168(55.3)
	Married	136(44.7)
Education level	Bachelor	273(89.9)
	Master	31(10.2)
Work Experience (year)	< 1	49(16.1)
	1–5	107(35.2)
	6–10	64(21.1)
	11–15	38(12.5)
	16–20	24(7.9)
	> 20	22(7.2)
Unit of the hospital	Internal	44(14.5)
	Surgery	39(12.8)
	Dialysis	54(17.8)
	Emergency	72(23.7)
	ICU	69(22.7)
	CCU	26(8.6)
Hospital Name	Velayat	120(39.5)
	Rajaei	84(27.6)
	Bou-ali	100(32.9)

Table 2.

Distribution of Scores of Three Variables: Professional Commitment, Resilience and Family Nursing Practice in Nurses (N = 304)

Variables		Mean (SD)			Score of 100
		Male	Female	Total
Resilience		26.20(4.16)	23.69(4.17)	24.66(4.34)	61.15
Professional commitment	Total	90.21(11.16)	89.15(10.01)	89.56(10.47)	38.88
	Understanding of the nursing profession	19.14(3.28)	18.56(2.84)	18.79(3.03)	46.71
	Job satisfaction	14.64(2.22)	14.21(2.61)	14.38(2.47)	35.12
	Involvement of nursing professionals	22.71(3.26)	22.46(2.94)	22.56(3.06)	31.00
	Sacrifice for the nursing profession	33.71(4.76)	33.91(4.09)	33.83(4.36)	48.11
Family nursing practice	Total	58.04(10.37)	57.12(10.48)	57.48(10.43)	29.20
	Active support for the family	37.97(7.12)	37.26(7.37)	37.54(7.27)	31.15
	Support given with the awareness of the family’s situation	20.07(3.65)	19.85(3.52)	19.94(3.57)	33.74

In the present study, univariate and multiple linear regression analyses were performed to determine the relationship between the variables of professional commitment and resilience with family nursing practice. The univariate regression results indicated that for every one-unit increase in resilience, family nursing practice increased by 0.66 units, and this relationship was significant (P < 0.001). After adjusting for confounding variables, this value reached 0.30 units, but the relationship was not significant (P = 0.065). The results of this analysis showed that for every one-unit increase in professional commitment, family nursing practice increased by 0.32 units, and this relationship was significant (P < 0.001). After adjusting for the effect of confounding variables, this value reached 0.24, and the relationship remained significant (P < 0.001). Furthermore, multiple regression results revealed that the performance of cardiac care unit (CCU) nurses was 5.04 units higher compared to that of internal ward nurses (Table 3).

Table 3.

Univariate and multiple linear regression analysis of the association between family nursing practice and professional commitment, resilience and other variables in nurses (N = 304)

Variables		Crud β coefficient (CI: 95%)	Adjusted β coefficient (CI: 95%)
Resilience		0.66(0.40, 0.92) p < 0.001	0.30(0.01, 0.58) p = 0.039
Professional commitment		0.32(0.21, 0.42) p < 0.001	0.24(0.12, 0.35) p < 0.001
Age		0.01(-0.13, 0.16) p = 0.825	-
Sex	Male	1
	Female	1.93(-0.43, 4.29) p = 0.109
Marital Status	Single	1	-
	Married	-0.43(-1.42, 0.55) p = 0.390	-
Education level	Bachelor	1	-
	Master	-2.32(-6.21, 1.56) p = 0.240	-
Unit of the hospital	Internal	1	1
	Surgery	6.43(2.21,10.64) p = 0.003	1.90(-2.47, 6.28) p = 0.393
	Dialysis	-4.04(-7.94, -0.15) p = 0.042	-5.77(-9.52, -2.03) p = 0.003
	Emergency	-2.34(-6.01, 1.32) p = 0.210	-4.76(-8.24, -1.29) p = 0.007
	ICU*	1.13(-2.56, 4.83) p = 0.547	-3.48(-7.23, 0.27) p = 0.069
	CCU*	8.35(3.61, 13.09) p = 0.001	5.04(0.17,9.90) p = 0.043
Hospital name	Velayat	1	1
	Rajaei	7.03(4.22, 9.85) p < 0.001	5.00(2.03, 7.97) p = 0.001
	Bou-ali	2.60(-0.08, 5.29) p = 0.057	0.65(-2.10, 3.41) p = 0.642

ICU: Intensive Care Unit

CCU: Cardiac Care Unit

Discussion

Professional commitment

The present study was conducted to determine the role of professional commitment and resilience in predicting family nursing practice in Iranian nurses. The results showed that the nurses’ professional commitment is at an acceptable level. This is consistent with the findings of some studies in Iran [26, 37]. While a study in Egypt reported low levels of professional commitment among nurses [38]. This finding indicates that professional commitment is not merely a fixed individual trait but can also be significantly influenced by organizational and cultural variables. Because there are many factors, such as religious beliefs, ethics, education level, personality traits, work experience, job satisfaction, working conditions, support systems, and even human resource distribution that can affect individuals’ professional commitment [26]. the working conditions and organizational structure of nursing in Egypt are different from those in Iran. In addition, in the above study, nurses with at least one year of work experience entered the study. While in the present study, the time was six months. This entry criterion itself can influence the difference in results. Considering the appropriate and acceptable level of professional commitment of nurses in the present study, managers and policy makers are expected to help maintain and improve this level by formulating incentive programs and interventions.

In the present study, the lowest mean in the professional commitment variable was related to the domain of job satisfaction. This finding is consistent with the results of some studies conducted in Iran [30, 35, 39]. Gholami et al.‘s study and Judi et al.‘s study also reported the average level of job satisfaction in nurses [40, 41]. Job satisfaction is influenced by several individual elements, such as resilience, and organizational elements such as leadership support and appreciation [40]. This finding and the findings of studies conducted in Iran show that the expectations of nurses in Iran are not fulfilled. In other words, there is a discrepancy between what should be and what is. These results should be considered by policymakers and nursing managers [30]. The concurrent existence of low job satisfaction and a relatively acceptable level of professional commitment indicates that nurses, despite working under pressure, continue to perform their duties in accordance with professional norms. This situation can adversely affect the quality and performance of care and may lead to occupational burnout.

The current study showed that among the dimensions of professional commitment, the highest mean pertained to the dimension of sacrifice for the profession. This finding has also been obtained in some Iranian studies [30, 35, 39]. Considering the nature of their field and the training in humanities and professional ethics that they receive during their education and service, nurses should always fight against difficulties and try to save human lives [39]. The alignment of Iranian studies and the present study shows that the culture of sacrifice is an integral part of nursing. Despite difficult conditions, nurses make sacrifices and do their best to provide quality care and meet the needs of patients [42]. The mean score of this domain in Nasiri et al.‘s study (36.14) was higher than the average of the present study (33.83). This difference in results can be influenced by the prevailing organizational culture in different environments [43]. While a culture of sacrifice is intrinsic to the nursing profession, there is a risk that such sacrifice may become normalized, potentially leading to the neglect of other essential needs of nurses. This issue, if unaddressed, may pose significant long-term challenges to healthcare systems. Furthermore, it is crucial to acknowledge that a culture of sacrifice could also contribute to increased job dissatisfaction [44]. Therefore, managers and policymakers should pay attention to this issue and take steps to improve the job and professional status of these people.

Resilience

The findings of this study showed that nurses’ resilience is higher than the average. This is consistent with the findings of studies conducted in Iran and Iraq [45, 46]. Resilience is influenced by family support, training, organizational support, and counseling [45]. It seems that in the above studies and the present study, this type of support and training was at an appropriate level and increased the resilience of nurses. In Guo et al.‘s study in China, resilience is higher than the mean (63.77) [47], which is in line with the findings of the present study. Although Guo et al. used a different version of the resilience questionnaire, the results are consistent in both studies. The results of the above study and the present study show that nurses in both countries face similar problems and challenges. Poku et al.‘s study on Ghanaian nurses showed that their level of resilience is lower than average, and at an average level [48]. which is not in line with the findings of this study. As mentioned, resilience is influenced by several variables [45]. It seems that the organizational support and working conditions of nurses in Ghana are different from those in Iran, and this difference has affected their resilience level. Although the resilience of nurses in the present study is higher than the mean, it is still at an average level. Considering the relationship between resilience and job performance and the mental state of nurses [49], it is suggested that by improving working conditions, increasing organizational and family support, and adopting educational interventions [17], not only to maintain the current level of their resilience, but also to move towards the promotion of this valuable concept.

Family nursing practice

The findings of the present study showed that family nursing practice is not in good condition. The low scores in this domain may indicate that despite the strong emphasis on the importance of family, a significant gap remains before the full implementation of this type of practice in nursing is achieved. This gap can be influenced by a multitude of factors. In the study of Imanipour and Kiwanuka, who used a similar tool to the present study, the mean score of family nursing practice was 38.7 [1], which is lower than the mean score of this variable in the present study. In explaining this difference, two issues should be mentioned. First, the above study was conducted on intensive care unit nurses. While in the present study, nurses from different departments were included. The complex conditions of patients in the intensive care unit [50] cause nurses to pay more attention to patients, which affects family nursing practice. In addition, it should be noted that the structure of hospitals in different places is different from each other, and this can affect the difference in results. Contrary to the findings of the present study, in the study of Toyama et al. in Japan, the nurses’ scores were higher than the mean [13]. Japan is one of the developed countries in the field of higher education. Nursing education in Japan differs from nursing education in Iran in many aspects [51]. Therefore, this difference in scores could be due to the differences in educational structures in the two countries. An important point in comparing the results of the two studies is that in the above study [13] and the present study, the mean scores of the second factor (support given with the awareness of the family’s situation) are higher than the mean scores of the first factor. In explaining this finding, it should be said that one of the main components of family-centered care is family assessment [52]. This assessment leads to awareness of the family’s situation. And this awareness can lead to family members’ support. This finding shows that, in both studies, nurses support the family consciously and purposefully. Support that can lead to desirable results. In general, family nursing is still in progress, and this concept is influenced by the beliefs, values, and orientations of the organization, managers, and nurses [53]. Issues that require special attention from policymakers.

The predictive role of the variables

The findings of the present study showed that professional commitment has a positive and significant relationship with family nursing practice and is considered a strong predictor of it. Nurses who have a professional commitment have accepted the goals, ethics, and values of the profession [26] and move towards improving the quality of care and job practice [54]. Therefore, it is not far-fetched to say that the attention and care of families as one of the goals of the nursing profession increases with increasing professional commitment. To explain this finding, the concept of professional identity can be referenced. Professional identity is considered a guiding framework for a nurse’s thinking, actions, and interaction with the patient. This concept encompasses nursing values and beliefs [55]. When these values and beliefs are internalized, caring for and paying attention to the patient’s family is not merely an external duty; rather, it can become internalized and transform into an integral part of the nurse’s self. It seems that nurses with a higher level of professional commitment are likely to perceive family care not as an external imposition but as an internalized responsibility. This relationship can also be explained in the framework of family systems theory [56]. This theory is a theoretical framework for individual and family development. According to this theory, interactions between family members affect the development of behavior and individual growth. This theory emphasizes interdependence, mutual influence, and interactions among members [57]. With this explanation, it should be said that the health of one family member both affects and is affected by other members. It seems that nurses with higher professional commitment have understood these interactions and dependencies well. They have a systemic approach, and this systemic approach has been reflected in the practice of family nursing. Commitment to providing the best care is influenced by ethical standards [58]. Therefore, this finding can also be interpreted from the perspective of care ethics. Care ethics serves as a lens through which ethics in nursing can be observed [59]. The higher professional commitment of nurses may indicate their considerable attention to care ethics—an ethics in which family caregiving is considered an inseparable part.

Karimi et al.‘s study showed that professional commitment is related to nurses’ practice and plays an important role in nurses’ care behaviors [30]. Although the above study did not consider family nursing practice, nurse practice includes several caring behaviors within itself, of which attention and care for family members can be a part. Therefore, it can be said that the results of the above study are consistent with the present study. The findings of the present study are also consistent with the theory of planned behavior. According to the theory of planned behavior, an individual’s intention is influenced by attitudes, mental norms, and perceived behavioral control [60]. If we assume that family nursing practice is an intention of nurses, it is not far-fetched that this intention is influenced by a larger concept called professional commitment, which includes numerous norms and beliefs. A study by Ahmadzadeh-Zeidi et al. in Iran showed that with increasing professional commitment, the amount of lost nursing care would be less [26]. Although the above study did not consider family nursing practice, it somewhat supports the findings of the present study. The findings of the present study showed that implementing interventions that promote professional commitment can be considered as a strategy to improve family nursing practice. Because, Higher professional commitment is considered one of the main guarantors of improving the quality of nursing services [61].

The findings of the present study showed that resilience has a positive and significant correlation with family nursing practice. However, after adjusting for confounding variables, this relationship was not statistically significant. In explaining the first part of this finding, it should be said that resilience helps people to deal with stressful situations. Resilience is considered a type of adaptability. This concept is essential in aligning the nurse’s skills to achieve a proper practice and has a positive effect on the nurse’s practice [62]. The findings of the current study also confirm this. This finding is consistent with the results of studies that confirm the relationship between resilience and nursing performance [24, 63–65]. This alignment can be explained as resilience, with its common mechanisms such as reduced burnout, reduced stress, and better management of conditions [66], which provides the basis for improving nurse performance. Therefore, the initial finding of this study is supported by the articles. But the second part of the findings of this study showed that contextual variables play an important role in the relationship between the two variables. In explaining this finding, one should refer to the definition of resilience. Resilience, as a state, refers to multiple potentials that are not only flexible but also capable of development in a socio-ecological context [67]. In other words, resilience is not constant. It is dynamic and changes over time and according to the situation. This concept is also influenced by individual characteristics and external resources [21]. The findings of the present study also confirmed this issue. Although resilience is an important and valuable variable, strengthening this variable alone is not a sufficient strategy to improve family nursing practice. This finding further highlights the importance of contextual variables. It is suggested that future studies examine the interaction of contextual variables with resilience longitudinally. Given the absence of an independent predictive role for resilience, the present study indicates that optimal performance is not solely influenced by resilience, and factors such as organizational support, job status, and available resources must also be provided and examined.

The findings of the present study indicate that family nursing practice among nurses in the Cardiac care unit (CCU) was significantly higher compared to that of nurses in internal units. In contrast, this variable was significantly lower among nurses working in dialysis and emergency departments. These interdepartmental variations can be attributed to the nature of care provided in each unit and the characteristics of the patient population. In the critical and unpredictable condition of CCU patients, along with the potential for sudden clinical changes, continuous nurse-family communication and family involvement in decision-making are commonly observed. Such circumstances are likely to influence family nursing practice positively. Furthermore, family nursing practice was significantly higher among nurses at Rajaei Hospital compared to those at Velayat Hospital. Therefore, it can be inferred that family nursing performance is influenced more by organizational structures, professional values, and beliefs than by psychological characteristics such as resilience. Professional commitment, through the internalization of personal beliefs and values, facilitates family nursing practice, whereas resilience appears to be more affected by organizational conditions and support systems. Hence, foundational and value-driven interventions are emphasized.

Limitations

Due to the cross-sectional nature of this study, the results should be generalized with caution. Due to the self-report form of data, the results are subject to bias. An attempt was made to minimize this issue by explaining the objectives of the study and the necessity of paying attention to accuracy in the answers. The psychological state of the nurses can also affect the results, so an attempt was made to complete the questionnaires when the individuals were in a normal psychological state. Although attempts were made to increase sample diversity by distributing the questionnaire across departments, shifts, and days, participating nurses may have differed from non-participating nurses in terms of motivation, fatigue, or workload, which could impact the generalizability of the findings. Although questionnaire completion occurred primarily during break times so as not to interfere with the nurses’ clinical duties, the process of inviting participation was not limited to a specific group or situation.

Conclusion

The findings of the present study showed that the professional commitment and resilience of nurses are in a suitable and acceptable state. However, family nursing practice is not in a suitable state. The findings showed that professional commitment significantly predicts family nursing practice. This finding emphasizes the need to pay attention to the important role of promoting professional commitment in improving family nursing practice. It is suggested that future studies evaluate interventions that improve family nursing practice by considering contextual variables. It is recommended to conduct studies to investigate causality as well as qualitative studies to examine barriers and facilitators of family nursing practice.

Author contributions

M.S and S.R conceived the study. M.S supervised all evaluation phases and revised the ‎manuscript. ‎A.A, M.A, and N.C participated in data collection, and data were analyzed by Z.H. and M.S. The final report and article were written by M.S. All authors read and approved the final ‎version of the manuscript‏.

Funding

No applicable.

Data availability

Data supporting the findings of this study are available from the corresponding author upon reasonable request.

Declarations

Ethical approval

The process of conducting the present study has been reviewed and approved by the ethics committee of Qazvin University of Medical Sciences, Iran (QUMS.REC.1403.151). After explaining the objectives and before starting the study, written informed consent was obtained from all nurses to participate in the study. To maintain confidentiality, all participants were assigned an identification code. The list of codes and names of individuals was stored on a password-protected computer. In addition, all data were analyzed in an aggregated and anonymous manner. All steps of the study were conducted by the Declaration of Helsinki. This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.