Applied Nursing Research最新文献

{"title":"The role of artificial intelligence in enhancing triage decisions in healthcare settings: A systematic review","authors":"Hasan Abualruz ,&nbsp;Islam Yasin ,&nbsp;Mohammad A. Abu Sabra ,&nbsp;Hamzeh Yousef Abunab ,&nbsp;Rania Azayzeh ,&nbsp;Yara Zubidi ,&nbsp;Saja Emad ,&nbsp;Baraah alriyati","doi":"10.1016/j.apnr.2025.152024","DOIUrl":"10.1016/j.apnr.2025.152024","url":null,"abstract":"<div><h3>Background</h3><div>Triage is an essential function of healthcare providers in various healthcare settings, such as physicians and nurses, allowing the prioritization of patients based on severity of presenting problem. Artificial intelligence (AI) provides a promising solution by enhancing the accuracy, efficiency, and consistency of triage decisions process. Although AI shows potential in supporting healthcare providers and improving patient outcomes, its role in triage is still developing and requires more research into its effectiveness, challenges, and ethical considerations.</div></div><div><h3>Objectives</h3><div>This systematic review aims to explore the role of AI in enhancing healthcare providers triage decisions process in the various healthcare settings.</div></div><div><h3>Methods</h3><div>We conducted JBI Systematic Reviews and reported results following PRISMA guidelines to screen 211 studies published between January 2020 and May 2025 from databases including Google Scholar, Wiley Online Library, PsycINFO, CINAHL Plus, and Medline.</div></div><div><h3>Results</h3><div>Twenty-two studies met inclusion criteria. Results indicated that AI-based triage systems outperformed traditional methods in diagnostic accuracy, efficiency, and decision support, especially for critical conditions. Additionally, the studies demonstrated statistically significant improvements over clinician-assigned Emergency Severity Index (ESI) scores. AI models used included machine learning, deep learning, natural language processing, and hybrid approaches.</div></div><div><h3>Conclusion</h3><div>AI-based triage systems present a transformative opportunity for enhancing emergency care delivery, with evidence supporting improvements in diagnostic accuracy, triage efficiency, and decision support. Successful implementation depends not only on technical performance but also on trust, usability, ethical governance, and contextual adaptation. A multidisciplinary approach will be required to fully utilize AI in numerous healthcare settings, including triage.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152024"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating role of self-efficacy in the relationship between spirituality and burnout among intensive care unit nurses: a pathway analysis","authors":"Fatin Lailatul Badriyah ,&nbsp;Mundakir Mundakir ,&nbsp;Tita Rohita ,&nbsp;Bih-O Lee ,&nbsp;Santo Imanuel Tonapa","doi":"10.1016/j.apnr.2025.152005","DOIUrl":"10.1016/j.apnr.2025.152005","url":null,"abstract":"<div><h3>Background</h3><div>Burnout is a critical issue among intensive care unit (ICU) nurses, impacting both their well-being and excellence in care. Spiritual wellbeing and self-efficacy have been identified as potential protective factors against burnout, yet their interrelationships remain unclear, particularly in the Indonesian nurse's context.</div></div><div><h3>Objectives</h3><div>This study examines the role of spirituality and self-efficacy in burnout and explores the mediating effect of self-efficacy.</div></div><div><h3>Methods</h3><div>A cross-sectional correlational design with convenience sampling was conducted among 410 ICU nurses in public hospitals in East Java, Indonesia. Participants completed validated measures of burnout, spirituality and self-efficacy. Partial least squares structural equation modelling was employed to test direct and indirect relationships between variables.</div></div><div><h3>Results</h3><div>Most participants were female, with a mean age of around 31 years and more than two years of ICU experience. Higher workload significantly predicted greater burnout (β = 0.21, <em>p</em> &lt; 0.001), while spirituality (β = −0.17, <em>p</em> = 0.001) and self-efficacy (β = −0.24, <em>p</em> &lt; 0.001) negatively predicted burnout. Mediation analysis confirmed that self-efficacy mediated the relationship between spirituality and burnout (β = −0.13, <em>p</em> &lt; 0.001), indicating that ICU nurses with higher levels of spiritual wellbeing reported stronger self-efficacy, which in turn predicted lower burnout.</div></div><div><h3>Conclusion</h3><div>The findings reveal that self-efficacy is a key mechanism through which spirituality mitigates burnout among ICU nurses. These insights may inform the development of healthy work environment initiatives that incorporate spiritual support and self-efficacy training through structured mentorship and organisational systems, ultimately reducing burnout and enhancing nurses' resilience in high-stress settings.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152005"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of evidence-based nursing intervention under quantitative evaluation strategy on psychological resilience and illness perception in lung cancer patients undergoing chemotherapy","authors":"Liwei Zhang ,&nbsp;Haixian Fang ,&nbsp;Xin Su,&nbsp;Yongqian Zhang,&nbsp;Changwen Bo,&nbsp;Jing Liu,&nbsp;Li He,&nbsp;Juan Zhang,&nbsp;Yusha Yan,&nbsp;Zhaohui Xu,&nbsp;Feifei Wang","doi":"10.1016/j.apnr.2025.152013","DOIUrl":"10.1016/j.apnr.2025.152013","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effect of evidence-based nursing intervention guided by a quantitative evaluation strategy on psychological resilience and illness perception in lung cancer patients undergoing chemotherapy.</div></div><div><h3>Methods</h3><div>A total of 142 lung cancer patients receiving chemotherapy from March 2024 to March 2025 were enrolled and randomly divided into a study group (receiving evidence-based nursing intervention under a quantitative evaluation strategy, <em>n</em> = 71) and a control group (receiving routine nursing, n = 71). Psychological resilience, illness perception control, coping styles, and complication rates were compared before and 3 months after intervention.</div></div><div><h3>Results</h3><div>Before intervention, no significant differences were observed in the scores for psychological resilience domains (optimism, tenacity, strength, total score), illness perception domains (emotional, cognitive, comprehension, total score), or coping styles between the two groups (<em>P</em> &gt; 0.05). After 3 months, the study group showed significantly higher scores in optimism, tenacity, strength, and total psychological resilience than the control group (<em>P</em> &lt; 0.05). Similarly, post-intervention, the study group demonstrated superior scores in all illness perception domains (<em>P</em> &lt; 0.05) and showed a significant shift toward more active and less passive coping styles (P &lt; 0.05). The study group also exhibited lower incidences of gastrointestinal reactions and pulmonary infections (<em>P</em> &lt; 0.05), while no significant differences were observed in hepatorenal toxicity, bone marrow suppression, or phlebitis (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Evidence-based nursing intervention guided by quantitative evaluation effectively enhances psychological resilience and illness perception and promotes adaptive coping styles in lung cancer patients undergoing chemotherapy, warranting clinical application.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152013"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained quality-of-life gains following nurse-led cardiac rehabilitation: A longitudinal study to support nursing practice","authors":"María José Ferreira Díaz","doi":"10.1016/j.apnr.2025.152020","DOIUrl":"10.1016/j.apnr.2025.152020","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac rehabilitation (CR) is a key component of secondary prevention in cardiovascular care. While its effects on clinical outcomes are well established, the long-term impact on health-related quality of life (HRQoL) and the specific contribution of nurse-led care remain underexplored in real-world settings.</div></div><div><h3>Aims</h3><div>To evaluate longitudinal changes in HRQoL among patients who completed a structured nurse-led CR program, and to identify subgroup differences and predictors of sustained improvement.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted with 181 patients following myocardial infarction or cardiac surgery. HRQoL was assessed using the SF-36 questionnaire at four time points: baseline, discharge, 6 months, and 12 months. Sociodemographic, clinical, and psychosocial variables were analyzed. Nurse-led interventions were guided by standardized NIC classifications, including health education (NIC 5240), cardiac rehabilitation (NIC 5246), and emotional support (NIC 5270).</div></div><div><h3>Results</h3><div>HRQoL improved significantly across all SF-36 domains over 12 months (<em>p</em> &lt; 0.001), especially in physical functioning, vitality, and general health. Women, patients with low education, and those with baseline anxiety showed lower initial scores but meaningful gains. Adherence to the full program was strongly associated with sustained improvements.</div></div><div><h3>Conclusions</h3><div>Nurse-led CR is effective in promoting sustained HRQoL gains across physical and emotional domains. Standardized interventions based on NIC contribute to structured, person-centered care delivery, especially in vulnerable populations.</div><div>Implications for nursing practice</div><div>Monitoring HRQoL through validated tools and NIC-guided nursing plans enhances long-term cardiovascular recovery. Integration of psychosocial assessment and extended follow-up may improve equity and personalization in post-cardiac care.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152020"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multidimensional assessment of vibration and cold for venipuncture pain in children aged 7 and above: A randomized controlled trial","authors":"Hu Long-yi ,&nbsp;Zhou Zi-yun ,&nbsp;Wang Ming-li ,&nbsp;Zhou Le-shan","doi":"10.1016/j.apnr.2025.152012","DOIUrl":"10.1016/j.apnr.2025.152012","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the effects of cold and vibration on venipuncture pain in children aged 7 and above, evaluating outcomes through subjective and objective child measures, parental feedback, and nurse assessments.</div></div><div><h3>Method</h3><div>This randomized controlled trial enrolled 120 children aged 7 and above undergoing venipuncture between July and November 2023. Participants were allocated into four groups using a random number table: cold, vibration, cold combined with vibration, and a control group. After procedure, pain and parental anxiety were assessed using a self-reported Numerical Rating Scale. Child anxiety was evaluated with the Children's Anxiety Meter Scale, while children's cooperation was evaluated by the operating nurse.</div></div><div><h3>Results</h3><div>External cold, vibration, and cold combined with vibration significantly reduced changes in children's pulse and pain (<em>p</em> &lt; 0.05). Multiple comparisons indicated that the cold and vibration combination group exhibited the smallest pulse changes and the lowest pain scores(<em>p</em> &lt; 0.05). However, it cannot yet be concluded that external cold and vibration effectively reduce children's anxiety, relatives' anxiety, or the cooperation of the children (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Cold and vibration significantly reduced pain and physiological responses during venipuncture in children aged 7 and above, though no benefits were found for anxiety or cooperation. Future multicenter studies with larger sample sizes are recommended to further explore its role in pediatric pain management.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152012"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between anxiety about artificial intelligence and nurses' perceptions of job security: The impact of technological transformation","authors":"Ganime Esra SOYSAL,&nbsp;Mehmet Ali CALIŞKAN,&nbsp;Aykut TURGUT","doi":"10.1016/j.apnr.2025.152023","DOIUrl":"10.1016/j.apnr.2025.152023","url":null,"abstract":"<div><h3>Aim</h3><div>The objective of this study is to evaluate the anxiety levels of nurses regarding artificial intelligence and its impact on their perception of job security.</div></div><div><h3>Background</h3><div>The nursing profession, which is affected by artificial intelligence, has concerns about this transformation.</div></div><div><h3>Design</h3><div>This study employed a cross-sectional and descriptive.</div></div><div><h3>Methods</h3><div>The was conducted with 104 nurses working in a hospital between December 2024 and March 2025. Data was collected using the Descriptive Information Form, Artificial Intelligence Anxiety Scale and Job Security Perception Scale.</div></div><div><h3>Results</h3><div>The nurses participating in this study exhibited moderate anxiety towards artificial intelligence according to the scores they received from the Artificial Intelligence Anxiety Scale. The relationship between nurses' artificial intelligence anxiety and the perception of job security was not statistically significant (<em>p</em> ≥ 0.165). Nurses with ≥10 years' experience had higher AIA scores than those with less experience, but this difference was not significant (<em>p</em> = 0.056). It was stated that 80.8 % (n:84) of the nurses did not use ChatGPT or any other application supported by artificial intelligence in their professional life. The Job Security Perception Scale scores were no different between those who saw artificial intelligence as a threat and those who did not (<em>p</em> = 0.870).</div></div><div><h3>Conclusions</h3><div>It was observed that nurses were inadequate in using artificial intelligence technologies and experienced moderate anxiety, but there was no significant relationship between this anxiety and their perceptions of job security.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152023"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of light intervention on daytime sleepiness, fatigue, and sleep quality among female shift-working nurses - A randomized control trail","authors":"Shu-Fen Niu ,&nbsp;Yu-Ying Lu ,&nbsp;Yu-Chieh Lin ,&nbsp;Kuei-Fen Liu","doi":"10.1016/j.apnr.2025.152017","DOIUrl":"10.1016/j.apnr.2025.152017","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances and fatigue are prevalent among female shift-working nurses, adversely affecting their health and job performance.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the effectiveness of light intervention in reducing daytime sleepiness, fatigue, and improving sleep quality among female shift-working nurses.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted at a medical center in northern Taiwan with 80 female nurses assigned to either an experimental or control group. Baseline assessments included demographics, work characteristics, and measures using the Epworth Sleepiness Scale (ESS), Brief Fatigue Inventory (BFI), and Pittsburgh Sleep Quality Index (PSQI). The experimental group used a wearable light device (<em>Re</em>-Timer®) for 30–40 min daily over four weeks, while the control group continued their usual routines. Follow-up assessments occurred on day 14 (T1) and day 28 (T2).</div></div><div><h3>Results</h3><div>Results from Generalized Estimating Equations (GEEs) analysis showed significant reductions in sleepiness (ESS) at T2 and improvements in sleep quality (PSQI) at T1 and T2 in the experimental group compared to the control (<em>p</em> &lt; .05). No significant changes were found in fatigue (BFI).</div></div><div><h3>Conclusions</h3><div>The study supports light intervention as a safe, low-cost, and non-pharmacological approach to reduce daytime sleepiness and enhance sleep in shift-working nurses, suggesting its integration into occupational health programs for healthcare providers.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152017"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' knowledge and evidence-based practice in pain management for sedated ICU patients: Results of a national cross-sectional study","authors":"Nurdan Yalçın Atar PhD, RN, Asst. Prof. ,&nbsp;Semra Açıksöz PhD, RN, Asst. Prof. ,&nbsp;Öznur Tuğba Çelebi Dursun MSc, RN, Lect.","doi":"10.1016/j.apnr.2025.152022","DOIUrl":"10.1016/j.apnr.2025.152022","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to evaluate intensive care nurses' knowledge and evidence-based practices regarding pain management in sedated patients and to identify influencing factors.</div></div><div><h3>Background</h3><div>Pain management is a critical component of nursing care in intensive care units, yet managing pain in sedated patients remains complex and requires specialized competencies. To date, no study has specifically examined ICU nurses' knowledge and practices related to pain management in this population, nor the factors influencing them.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional study was conducted among 218 ICU nurses using standardized self-report instruments. Data were collected using the “Descriptive Information Form,” the “Pain Management Knowledge Test in Sedated Patients,” and the “Evidence-based Practices Test for Pain Management in Sedated Patients.”</div></div><div><h3>Results</h3><div>The mean knowledge score was 26.48 ± 7.01 (range: 0–35), significantly differing by education and professional background (<em>p</em> &lt; 0.05). The mean evidence-based practice score was 27.47 ± 6.74 (range: 13–39), with no significant demographic differences. Although nurses' knowledge varied according to education and experience, their practices were similar across groups.</div></div><div><h3>Conclusion</h3><div>Given that sedated ICU patients often receive end-of-life care, improving nurses' pain management competencies may directly enhance palliative outcomes. İnstitutional protocols and ongoing training programs are recommended.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152022"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of the sleep quality status of patients who underwent cranial surgery in terms of perceived stress, socio-demographic, and clinical characteristics","authors":"Altun Baksi ,&nbsp;Esra Ertuğrul ,&nbsp;Saadet Çömez ,&nbsp;Furkan Ersen","doi":"10.1016/j.apnr.2025.152019","DOIUrl":"10.1016/j.apnr.2025.152019","url":null,"abstract":"<div><h3>Background</h3><div>Sleep quality is important for both the recovery and quality of life of patients who underwent cranial surgery.</div></div><div><h3>Objectives</h3><div>This study aimed to examine the relationship between sleep quality and perceived stress, as well as the socio-demographic and clinical characteristics of patients who underwent cranial surgical intervention.</div></div><div><h3>Methods</h3><div>A descriptive and correlational research design was employed. The study enrolled 142 patients at the neurosurgery clinic of a university hospital in Türkiye between December 2019 and December 2020. Data were collected using the Descriptive Characteristic Form, Richards–Campbell Sleep Questionnaire, and Perceived Stress Scale.</div></div><div><h3>Results</h3><div>The mean age of patients who underwent cranial surgical intervention was 52.87 ± 14.16 years (range, 18–84). The mean sleep score was 46.68 ± 19.35 (range, 3–93) and the mean perceived stress score was 29.70 ± 4.29 (range, 20–44). Factors associated with lower sleep quality scores, in order of importance, were: presence of sleep problems after hospitalization (β = −0.363), presence of one attached medical equipment (β = −0.209), American Society of Anesthesiologists (ASA) physical status III prior to surgery (β = −0.205), and room occupancy of 2–3 patients (β = −0.134). Factors associated with higher sleep quality scores, in order of importance, were: absence of sleep problems after hospitalization (β = 0.384) and a higher total number of surgeries (β = 0.172).</div></div><div><h3>Conclusions</h3><div>The findings of this study indicate that patients undergoing cranial surgery experience moderate sleep quality and perceived stress levels. Evaluation of sleep quality should account for significant influencing factors, and additional studies in diverse patient samples are warranted.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152019"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizational change fatigue among nurses and its impact on work engagement: A qualitative study","authors":"Hui Duan ,&nbsp;Dongmei He ,&nbsp;Yanli Zeng ,&nbsp;Xiaolin Ma ,&nbsp;Qian Li ,&nbsp;Xinxu Zhou","doi":"10.1016/j.apnr.2025.152018","DOIUrl":"10.1016/j.apnr.2025.152018","url":null,"abstract":"<div><h3>Aim</h3><div>To explore how organizational change fatigue influences nurses' work engagement based on their lived experiences in tertiary hospitals in China.</div></div><div><h3>Background</h3><div>Organizational change fatigue undermines nurse engagement, a factor consistently linked to patient safety and workforce retention. Nurses are frequently positioned at the center of hospital reforms and must adapt to structural, technological, and policy-driven changes. These transitions often create cumulative stress, yet little is known about how nurses subjectively experience change fatigue or how it shapes their professional engagement. Addressing this gap is essential, as understanding lived experiences can inform leadership and policy strategies to sustain nurse well-being and ensure safe, high-quality patient care.</div></div><div><h3>Methods</h3><div>A descriptive phenomenological design was employed. Semi-structured interviews were conducted with 12 registered nurses from three tertiary hospitals using purposive sampling. Data were analyzed using Colaizzi's seven-step method, and reporting followed the Consolidated Criteria for Reporting Qualitative Research.</div></div><div><h3>Results</h3><div>Four themes were identified: perceptions of organizational change, emotional and behavioral responses, coping strategies and perceived support, and impact on work engagement. Nurses described a cyclical trajectory from emotional fatigue to disengagement, with the potential for re-engagement when supported by psychologically safe and inclusive environments.</div></div><div><h3>Conclusions</h3><div>Organizational change fatigue erodes nurses' motivation, professional commitment, and care quality. However, recovery is possible through relational leadership, transparent communication, and recognition of emotional labor. These findings highlight the need for human-centered change strategies to maintain engagement and ensure workforce sustainability during continuous healthcare reform.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152018"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}