Nurses’ work value patterns and their relationship with burnout: a cross-sectional study based on latent profile analysis

The nursing profession occupies an irreplaceable and important position in modern healthcare systems, undertaking critical tasks such as monitoring patient health, performing medical procedures, administering medications, and providing emotional support [1]. Nurses play an important role in health education and disease prevention, promoting public health by communicating information about healthy lifestyles and disease prevention to patients and community members, with particular contributions in the areas of vaccination programs, chronic disease management, and maternal and child care [2]. In interdisciplinary collaboration, nurses work closely with professionals such as physicians, pharmacists, and therapists to ensure the provision of integrated and continuous patient care and play a key role in the coordination of follow-up care and home health care after patient discharge. As healthcare needs continue to grow and become more complex, the nursing profession will become even more important and contribute to global health [3].

Work values are the value orientations and belief systems that individuals exhibit while in the workplace. For nurses, work values reflect the fundamental beliefs and principles they follow in their professional practice and have a profound impact on their behavioral styles, decision-making processes, and strategies for coping with stress [4]. For example, the value of caring for patients can motivate nurses to remain patient and compassionate despite high-pressure situations [5]. In addition, professional responsibility and teamwork not only contribute to nurses’ job satisfaction but also enhance their ability to cope with work challenges and stress [2]. Basinska [5] classified work values into intrinsic and extrinsic work values on the basis of self-determination theory. Hara [6] further subdivided nurses’ work values into four categories, intrinsic, extrinsic, social, and prestige, and classified the group of nurses in the Tohoku region of Japan into five subgroups, self-directed, low, low-moderate, medium-high, and high, through latent profile analysis [7]. Although studies have been conducted to explore the values of nursing students [4], in-depth studies on the work values of working nurse groups remain relatively underdeveloped.

Burnout is a psychological state of emotional exhaustion, depersonalization, and low achievement experienced by individuals in occupational fields that serve people [8]. Studies have shown that 69.21% of family nurses experience moderate to high levels of burnout, while the incidence of burnout among first-line hospital nurses in China ranges from 55.4 to 70.05% [9]. Among them, emotional exhaustion is a core feature of burnout, and prolonged emotional and mental burdens may lead to a gradual loss of empathy and patience with patients. Depersonalization, on the other hand, manifests itself in alienation and indifference toward patients, viewing them as objects of job duties rather than individuals in need of help. In addition, nurses may feel disappointed with their professional achievements and feel that their efforts are not properly recognized, thus reducing their work engagement. Nurses face multiple challenges in high-pressure healthcare environments, including dealing with large numbers of patients, coping with intense work rhythms, and bearing significant emotional burdens, and these pressures continue to accumulate, leading to increased burnout [10]. To address these challenges effectively, burnout needs to be mitigated by improving the work environment, providing psychological support, increasing professional development opportunities, promoting teamwork, and encouraging healthy lifestyles to increase nurses’ job satisfaction and quality of care [11, 12].

Previous research has shown a significant association between work values and burnout [5]. However, this relationship may be moderated by the work environment and individual factors. In addition, most studies have focused on a single influencing factor or assessed the current status of nurses’ work values on the basis of only total scale scores, which lack a comprehensive consideration of the heterogeneity within the nurse population and have not yet clarified the specific associations between different work value patterns and burnout. To overcome this limitation, latent profile analysis (LPA) has been widely used as an effective method [13, 14, 15, 16]. LPA is person-centered and based on the latent variable model to estimate the relationship between exogenous and latent variables and to classify the latent traits of individuals on the basis of their scores on each entry, as well as to estimate the different proportions of different latent groups [17, 18]. This method can deeply explore the characteristics of different latent profile groups and reveal the complex relationship between work values and burnout.

Therefore, this study aims to explore the latent profiles of nurses’ work values via the LPA method and to analyze the associations between these profiles and burnout. Through in-depth analyses of the characteristics of different latent profiles and their influencing factors, this study provides a scientific basis and practical reference for improving nurses’ work values and alleviating burnout.

For the first time, this study used the LPA technique to reveal in depth the structure of the underlying patterns of work values in the Chinese nurse population, explored the complex relationships between these patterns and burnout, and validated the influencing factors associated with the different patterns of work values. Three main findings emerged from the study. First, the work values of nurses can be categorized into three patterns: demand support, intrinsically driven, and overall identification work value patterns. These patterns showed significant differences in group heterogeneity and individual variability. The results differed from those of Hara et al.‘s [7] study of Japanese nurses and were inconsistent with the number of subgroups in studies of Finnish student-to-worker groups and Canadian government workers [26, 27]. This difference may be related to the significant differences between the two countries in terms of cultural background, social systems, education and training systems, work environments, career development opportunities, and policy support [28]. For instance, Chinese nurses often face unique challenges such as a rapidly evolving healthcare system, increasing patient expectations, and a heavy workload. Additionally, the Chinese nursing education and training system emphasizes practical skills and professional ethics, which may shape the work values differently than in other countries [11]. Moreover, the limited career advancement opportunities and the hierarchical nature of the healthcare system in China may also influence the work values of nurses. These factors may have contributed to the fact that Chinese nurses were more inclined to intrinsically drive and fully identify work value patterns, whereas Japanese nurses showed a more diverse range of work value patterns from low to high. Second, the study identified five main influences on nurses’ work value patterns: age, years of working experience, marital status, education level, and form of employment. Finally, the study also revealed significant differences in the three dimensions of burnout among nurses with different work value patterns.

Among the three work value models, the demand support pattern had the smallest percentage at 16.6%. Nurses in this model scored lower on intrinsic and prestige work values and higher on extrinsic and social work values, suggesting that they are more inclined to value realistic rewards at work (e.g., pay, benefits, work environment, etc.) and pay less attention to intrinsic motivation. The motivation of these nurses relies mainly on external support, and they particularly value interaction and collaboration with colleagues, superiors, and organizations. They feel professional value through good teamwork, leadership support, and a harmonious working atmosphere and tend to find job satisfaction in interpersonal relationships. These nurses value sharing experiences, building close relationships with colleagues, and enhancing professional identity through interaction. A distinguishing characteristic of this model is its need for social support, rather than its tendency to provide social support. Demand support nurses emphasize enhancing external support for occupational satisfaction, reflecting their reliance on social needs and interactions at work. Therefore, managers can increase the job satisfaction of such nurses by strengthening external incentives, such as improving remuneration packages, upgrading job security, or increasing team-building activities. Moreover, improving the social support system, especially in terms of teamwork and psychological support, providing psychological counseling, and promoting close teamwork can effectively meet the needs of demand support nurses and thus enhance their sense of professional identity [29].

It was also found in this study that the intrinsically driven work value pattern had the largest percentage of 42.2%. In this pattern, nurses’ intrinsic work value scores were significantly higher than those of the other factors, whereas extrinsic, social, and prestige work value scores were moderate. The core work motivation of intrinsically driven nurses stems from personal fulfillment and love for nursing. They place high value on personal growth, skill enhancement, and enjoyment through their work and particularly seek a sense of responsibility and purpose. These nurses tend to provide high-quality nursing services and gain a sense of achievement through continuous improvement in their professional competence and knowledge. They usually show strong initiative and responsibility, can respond effectively to complex nursing problems, and can maintain a positive attitude in the face of challenges. For intrinsically driven nurses, work is not only a manifestation of their profession but also a realization of their values. Therefore, they are more inclined to derive motivation from the intrinsic satisfaction of nursing work and professional progress. To motivate this group of nurses, managers should focus on providing opportunities for professional development, recognizing their contributions, and encouraging autonomy. Given their high need for self-fulfillment and skill enhancement, providing continuous professional training and promotion opportunities substantially increases their job satisfaction and further enhances their commitment to and identification with their profession [30].

The results revealed that 41.2% of the nurses were in the overall identification work value pattern. In this pattern, nurses’ intrinsic, extrinsic, social, and prestige work values are relatively balanced, which indicates that they do not rely solely on one factor as a motivation for their work but rather that their multifaceted needs need to be met. These nurses usually demonstrate an integrated professional attitude, seek job fulfillment and personal values, and value reasonable financial rewards and support from colleagues. They can balance intrinsic motivation and external incentives and demonstrate a high degree of adaptability and stability in the face of changes in the work environment. Since holistic identity nurses have high expectations of multiple value factors, the absence or unfulfilment of any one factor may affect their overall work experience. Therefore, comprehensive motivational measures for this type of nurse are crucial. Managers should not only focus on their professional growth and the realization of their intrinsic value but also provide a competitive remuneration system and good social support [31]. In addition, enhancing their professional prestige and encouraging and recognizing their work contributions can also effectively increase their job satisfaction and sense of professional achievement. Internal motivation and external recognition can help these nurses maintain positive work attitudes and enhance their professional identity.

This study revealed that age and marital status were significant predictors of the demand support work value pattern. As age increases, nurses’ professional motivation gradually shifts from intrinsic drive to the need for external support. This shift suggests that older nurses place greater value on stability and social interaction at work [32] rather than relying solely on intrinsic accomplishment or skill enhancement. They valued a harmonious work atmosphere, coworker support, and caring leadership to relieve work stress and enhance career satisfaction. Moreover, nurses who were married also reported a greater need for external support. This is closely related to the reality of married nurses balancing dual responsibilities between family and career [33]. Married nurses tend to rely on the support of colleagues in the work environment, caring leadership, and social security provided by the organization to cope with the dual pressures of life and work. Therefore, both married and older nurses show a strong need for social interaction and external support to gain a sense of professional stability and life balance through these external resources, which in turn reflects a more pronounced pattern of socially supportive work values.

Nurses with years of working experience, higher education levels, and career establishment all tended to exhibit intrinsically driven and overall identification work value patterns, which were closely related to their career trajectories. With increasing years of working experience, nurses have gradually accumulated rich clinical experience and professional skills, which has prompted them to focus more on intrinsic motivation, such as personal fulfillment, responsibility, and deep involvement in nursing [34]. Moreover, these nurses not only seek a high degree of autonomy and professional self-confidence but also identify with external motivation, team support, and professional prestige, reflecting a balance of multiple work values. Highly educated nurses, especially those with bachelor’s and master’s degrees and stronger professional knowledge and skills, demonstrate strong internal drive, pursue professional growth and self-actualization, and focus on external social support, prestige, and financial rewards, demonstrating a comprehensive sense of professional identity [35]. In addition, through the welfare protection and social recognition provided by the establishment, nurses with career establishment further stimulate their intrinsic motivation, as they enjoy career stability and clear promotion opportunities while realizing the satisfaction of multifaceted career needs, reflecting the dual values of intrinsic drive and comprehensive identity.

The results of this study revealed that there were significant differences in burnout levels among nurses with different work value patterns, further highlighting the profound impact of work values on burnout [5]. Nurses in the demand support pattern scored the highest in emotional exhaustion and depersonalization, but had the lowest score in low sense of achievement, indicating they are most prone to psychological fatigue and burnout when external support, coworker collaboration, or leadership care is insufficient [36]. Comparatively, overall identification nurses had the lowest scores in emotional exhaustion and depersonalization, but had the highest score in low sense of achievement, suggesting they have achieved a better balance between intrinsic motivation and external incentives, demonstrating high occupational stability and adaptability. Intrinsically driven nurses scored intermediate levels in emotional exhaustion and depersonalization, but had the second-highest score in low sense of achievement, indicating they experience moderate levels of burnout but still maintain a relatively high sense of achievement. These nurses have a greater pursuit of self-growth and professional advancement but may experience increased burnout when resources are limited or the workload is too heavy due to excessive self-requirement. Therefore, nurses with different work value patterns cope with burnout differently. For demand support nurses, strengthening teamwork and organizational support can reduce burnout, whereas for intrinsically driven and fully identified nurses, providing more career development opportunities and recognition can further reduce the risk of burnout.

This study used person-centered analysis to identify three work value patterns of Chinese nurses, namely, demand support, intrinsically driven, and overall identification, demonstrating significant heterogeneity. The findings also indicated that age, years of working experience, marital status, education level, and career establishment were the main predictors of different work value patterns. In addition, this study further revealed the potential impact of these work value patterns on nurse burnout, providing an important basis for understanding the relationship between different work values and burnout. Subsequent studies can further explore how to develop individualized intervention strategies based on different work value patterns to effectively alleviate nurses’ burnout and enhance their job satisfaction and career stability.