Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 0 0 2026 11 09 1 14 Walaa Yehya Abed Zead Faculty of Nursing, University of Babylon, Babylon, Iraq. Saleh Ali Abdulrasool Imam Al-Hasan Al-Mujtaba Hospital, Kerbala Health Directorate, Kerbala, Iraq. Ehab Al-Din Haider Saddam Department of Community Health Nursing, College of Nursing, University of Al-Ameed, Kerbala, Iraq. Ali Alaa Al-hashimi Department of Community Health Nursing, College of Nursing, University of Al-Ameed, Kerbala, Iraq. Rabab Khalil Ibrahim Faculty of Nursing, Al-Zahrawi University, Kerbala, Iraq. 2026 08 03 2026 09 22 Objective: To examine the relationships among quality of work life (QWL), compassion fatigue, psychological resilience, and quiet quitting among intensive care unit (ICU) nurses, and to explore the lived experiences of nurses who exhibit quiet quitting behavior. Method: A sequential explanatory mixed-methods design was employed. In the quantitative phase, 400 ICU nurses from six public teaching hospitals in Kerbala and Babylon, Iraq, completed the QWL Scale, Compassion Fatigue Short Scale, Connor-Davidson Resilience Scale (CD-RISC), and Quiet Quitting Scale. Data were analyzed using mediation analysis with PROCESS macro. In the qualitative phase, 30 nurses were purposively selected for in-depth semi-structured interviews based on their quiet quitting scores. Thematic analysis was used to identify key themes. Results: QWL was negatively associated with quiet quitting (β = -0.38, P < 0.001) and compassion fatigue (β = -0.41, P < 0.001), while compassion fatigue was positively associated with quiet quitting (β = 0.42, P < 0.001). Compassion fatigue significantly mediated the relationship between QWL and quiet quitting (indirect effect = -0.14, 95% CI: -0.19 to -0.09), accounting for 43.8% of the total effect. Psychological resilience moderated the QWL-compassion fatigue relationship (interaction β = 0.18, P < 0.01). Qualitative analysis revealed three major themes: erosion of professional identity and meaning, surviving versus thriving in the ICU environment, and the paradox of resilience. Conclusion: Poor QWL was associated with quiet quitting through increased compassion fatigue, while psychological resilience appeared to serve as a protective factor. The qualitative findings provide rich contextual understanding of the processes underlying quiet quitting. Organizational strategies that improve working conditions, foster resilience, and restore professional meaning may help sustain nurses' work engagement and reduce quiet quitting. https://ijps.tums.ac.ir/index.php/ijps/article/view/4752 https://ijps.tums.ac.ir/index.php/ijps/article/download/4752/1359