Self-compassion and its association with occupational burnout among young and middle-aged nurses: a cross-sectional study in China.

The transition from the COVID-19 pandemic to the endemic phase has brought a pivotal change to the healthcare environment: the lifting of mandatory mask-wearing policies. For over three years, face masks served as a critical barrier against infection but simultaneously acted as a barrier to communication (). During the pandemic, the occlusion of facial expressions significantly limited nonverbal cues, such as smiles, grimaces, and emotional nuances, which are essential for building rapport and trust between patients and medical staff (). Consequently, healthcare consumers experienced a period of “communication deficit,” where interactions were strictly functional and devoid of emotional depth (). Now, with the restoration of face-to-face interactions without masks, healthcare consumers are re-experiencing the full spectrum of nonverbal communication. While extensive literature has documented the negative impact of masks on communication during the pandemic (, ), there is a paucity of research examining the qualitative restoration of nonverbal communication in the post-pandemic era. Specifically, it remains unclear how the rediscovery of these nonverbal cues influences patients’ evaluation of medical service quality (MSQ) and their psychological engagement. In the context of healthcare, where service quality is often judged by the empathy and responsiveness of providers (), the return of nonverbal communication is not merely a procedural change but a qualitative enhancement of the service environment (). To address this gap, this study applies the Technology Acceptance Model (TAM) and Flow theory to a non-technical service context. While TAM is traditionally used for information systems (), its application here is justified by viewing the “restored medical service encounter” as a new service system that patients must cognitively re-evaluate and “accept.” In this framework, Perceived Usefulness and Ease of Use represent the patient’s cognitive assessment of whether unmasked communication effectively facilitates their treatment process. Furthermore, effective nonverbal engagement is posited as a catalyst for “Flow” a state of optimal immersion where the patient feels a deep emotional connection with the provider.