Introduction
Nurses have always played an important role in providing health care services that affect patient health outcomes, particularly during the recent pandemic of infectious diseases, such as COVID-19 [1, 2]. Changes in the healthcare system require more nurses to improve their awareness of health and disease and provide care to critically ill patients. However, there were only 3.34 registered nurses per 1,000 people in China, which is much lower than the 11.9 in the United States [3]. The increasing workload of nurses and the shortage of nurses have created a burdensome environment, and nurses are often prone to burnout in this high-pressure environment for a long time without relief. Burnout is a psychological syndrome characterized by emotional exhaustion, cynicism, and reduced personal accomplishment or inefficacy in response to unmanaged chronic stress [4]. Recent statistics indicate that 31.1% of nurses reported experiencing burnout [5]. Newly graduated nurses inherently lack practical experience and confidence that are unable to navigate dynamic and stressful clinical environments, with burnout levels as high as 46% [6]. According to the Chinese Nursing Development Plan, newly graduated nurses were defined as those who had been in the hospital for 1 to 2 years [3]. Toward the beginning of their career, as they learn to cope with the demands of their new professional roles, in addition to the heavy clinical work tasks, newly graduated nurses must cope with the pressure of standardized training assessment and high levels of work stress and are more prone to burnout [7]. In healthcare, the negative effects of job burnout are profound, affecting the mental health of nurses and threatening the quality of patient care, including healthcare-related infections, quality of care, adverse events [8, 9]. Recent statistics also show that burnout among newly graduated nurses not only negatively affects their role adaptation transition and subjective well-being, but also affects their job satisfaction and the quality of patient care [10, 11]. Given the damaging effects of burnout on patients and newly graduated nurses with a high risk of developing burnout early in their careers, understanding how burnout develops and how newly graduated nurses can prevent it is important.
Eisenberger, an American psychologist, proposed an organizational support hypothesis from which the concept of perceived organizational support (POS) emerged, including two dimensions of emotional support and instrumental support [12]. Previous research has indicated that nurse burnout is negatively correlated with their POS, providing a new perspective to analyze the causes of nurse burnout at the organizational level [13]. Psychological capital (PsyCap), an important concept in organizational psychology, is formed during the growth and development of an individual [14]. This four-part positive psychological state scale includes self-efficacy, hope, resilience, and optimism. One study found that PsyCap in nurses plays a mediator role in POS and burnout, suggesting that improving POS effectively enhanced nurses’ PsyCap and then decreased their burnout [15].
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Work engagement (WE) is a concept opposite to burnout, including three dimensions of vigor, dedication, and absorption [16]. A recent meta-analysis showed a negative correlation between nurses’ WE and burnout [17]. At the same time, PsyCap and WE as positive job-related variables affect the behavior of nurses in the organization [18]. Nurses who have just graduated can experience stressful work environments and emotional exhaustion. Positive psychological resources, such as PsyCap and WE, can alleviate nurses’ burnout and promote retention [19]. To sum up, previous studies have shown that POS, PsyCap, and WE can affect burnout, but their specific pathways are unclear [13, 15, 17].
Theoretical background and research hypothesis
Job demand-resource theory
To structure the arguments on how POS affects the burnout of newly graduated nurses, we draw on the Job Demands-Resources Theory (JD-R) [20]. Job demands include external physical, social, and psychological stressors that cause burnout, job stress, and the intention to leave the job. Job resources include physical, psychological, social, and organizational facilitators at work, which are used to alleviate the negative impact of job demands and play an important role in alleviating job burnout. According to the JD-R theory, job resources (e.g., organizational support) and personal resources (e.g., PsyCap and WE) are necessary job resources for people. Burnout is the result of intricate interactions. The combination of job resources, personal resources, and job demands must operate in such a way as to provide employees with the opportunity to overcome burnout. In this study, POS was used to represent the resources of the job, and PsyCap and WE were the representatives of the personal resources of newly graduated nurses. Using POS as an independent variable, burnout as a dependent variable, and PsyCap and WE as mediating variables, a chain mediation model was drawn (Fig. 1).
Fig. 1
The theoretical mediation model. POS: perceived organizational support, PsyCap: psychological capital, WE: work engagement
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Hypothesis 1 (H1): POS will significantly predict burnout (POS > burnout)
In this study, the POS was considered the nurses’ perception that the hospital valued their achievements and was concerned about their well-being and physical and mental health, increasing their belief in responsibility for their work and positive rewards. When nurses’ sense of POS is higher, they perceive that their work has gained more recognition and rewards, and their corresponding positive psychological feelings and work engagement have increased [21]. It also simultaneously decreases work stress and burnout [22]. Therefore, increasing POS will gradually reduce the level of burnout of nurses and the degree of POS of newly graduated nurses will negatively predict their level of burnout.
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Hypothesis 2 (H2): PsyCap mediates the relationship between POS and burnout (POS > PsyCap > burnout)
PsyCap is an important part of organizational psychological behavior and an available psychological resource that can be created and inculcated. Research has shown that PsyCap has positive and negative relationships with nurses’ work outcomes [18]. Higher PsyCap has been associated with better WE and positive organizational citizenship behavior. On the contrary, a lower PsyCap has been associated with increased stress, anxiety, burnout, and turnover intention [23, 24]. An increasing number of people are becoming aware of the importance of PsyCap. Research has shown that PsyCap can improve participation by regulating organizational support [25]. A more immediate result is that the psychological capital of nurses can alleviate job burnout by regulating their sense of organizational support [15]. Therefore, we hypothesized that POS improves burnout by increasing PsyCap, which mediates POS and burnout.
Hypothesis 3 (H3): WE mediate the relationship between POS and burnout (POS > WE > burnout)
WE, which stands for active and vigorous, reflect the qualities of vital work ability and professional identity, which involve dedication (love of work and a sense of honor), vigour (high vitality and resilience at work) and absorption (dedication to work and reluctance to put work aside) [16]. One study showed that the POS of nurses could directly or indirectly affect WE [26]. Furthermore, Tian et al. have revealed that both POS and PsyCap could directly increase WE of Chinese infection control nurses [21]. Another previous study revealed a significant direct effect of WE on burnout [17]; these studies led us to predict that WE will positively affect newly graduated nurses’ burnout (H3).
Hypothesis 4 (H4): PsyCap and WE mediate the relationship between POS and burnout (POS > PsyCap > WE > burnout)
Studies have found that PsyCap and all its dimensions have positive predictive effects on WE [27]. As an important antecedent variable, PsyCap may have a positive predictive effect on WE [28]. This suggests that the higher the level of PsyCap, the stronger the sense of WE. This phenomenon can be explained using the JD-R theory, whereby high PsyCap is considered a job resource that positively impacts job demands within the motivational process leading to high WE. This finding is supported by subsequent studies by Maung et al. [29]. Kong et al. also found a significantly positive association between PsyCap and WE among nursing teacher groups [30]. Combined with the above speculation, PsyCap and WE may have a chain- mediating effect between POS and burnout.
Purpose of this study
Based on the analysis presented above, the aim of this study was to explore the relationship between POS, PsyCap, WE, and burnout in newly graduated nurses, thus shedding light on the mechanism of the effect of POS on burnout in newly graduated nurses.
Materials and methods
Setting and participants
This study was conducted from October 2023 to November 2023 in nine tertiary hospitals in Sichuan Province, Southwest China. These hospitals are standardized training medical institutions for newly graduated nurses certified by the Sichuan Postgraduate Continuing Education Office, including 8 comprehensive hospitals with beds > 1000 and 1 specialized hospital of traditional Chinese medicine with beds 600. Sichuan province is the first pilot province in China to start standardized training for newly graduated nurses. Selecting hospitals in Sichuan province for investigation allows an in-depth exploration of how POS and PsyCap affect the burnout of newly graduated nurses in the standardized training policy.
A convenience sampling method was used to select participants. According to the criterion suggested by Kendall [31] that 10 ~ 20 fold the number of items and 10%~20% missed visit rate, a sample size of not less than 748 was calculated, since the total of items from four scales in this study is 68. All participants must meet the following inclusion criteria: (a) registered nurses, (b) entry time was greater than 3 months and less than 2 years, (c) completed the trial and orientation period, and (d)volunteered to participate in this study. The exclusion criteria were as follows: (a) had a major traumatic event within the last 6 months, such as the death of an immediate family member, major surgery, or major illness themselves, (b) currently receive psychotherapy or psychotropic medication, (c) more than half of the items were answered repetitively, (d) answer time less than 120 s. We designed the entry in the preface of the questionnaire, if the answer of the new nurse is “yes”, then the questionnaire will be excluded. The present study used an electronic questionnaire and participants were administered online in a confidential manner with the help of hospital administrators. Participants had the right to withdraw from the study at any time. A total of 1013 newly graduated nurses completed and returned questionnaires. However, 18 questionnaires were disqualified for regular responses throughout the questionnaire and excluded from the overall analysis. Consequently, 995 participants participated in the study, generating a response rate of 98.22%. This study was reviewed and approved by the Ethics Committee of Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China (Code: S20230218-01). An online informed consent form was obtained from all participants before they completed this survey.
Instruments
Sociodemographic information questionnaire
The demographic characteristics of the participants included age, gender, training grade, educational level, categories of clinical departments, night shift (per week) and satisfaction with income status.
Perceived organizational support scale (POSS)
The Chinese POSS was adjusted and applied by Ma et al. [32]. to evaluate subjective perceived organizational support among nurses. The scale comprises 13 items in two dimensions: emotional (7 items) and instrumental supports (6 items). Each item is rated on a 5-point Likert scale, with higher scores indicating higher POS levels. The reliability of the instrument used in this study was 0.981.
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Burnout inventory general survey (MBI-GS)
The Chinese version of MBI-GS, revised by Li et al. [33]. , comprises three dimensions: emotional exhaustion (five items), depersonalization (four items) and inefficiency (six items). Response options for each item in the MBI-GS were rated from 0 (never) to 6 (daily) based on the frequency of occurrence of specific work feelings of the respondent. In this study, we calculated the dimension score using the following formula: Burnout = 0.4* emotional exhaustion + 0.3* cynicism + 0.3* inefficacy [34]. Participants could be divided into three groups according to the burnout score: no burnout (0-1.49), moderate burnout (1.50–3.49) and severe burnout (3.5-6.0). Participants with moderate or severe burnout were considered to have experienced burnout.
Psychological capital scale
The Nurse Psychological Capital Questionnaire was adapted from Luthans et al. [14]. The scale consisted of four dimensions with a total of 20 items and was scored on a 6-point Likert scale with scores ranging from 1 (strongly disagree) to 6 (strongly agree). The Cronbach’s α coefficient of reliability of the scale in this study was 0.899–0.956.
Utrecht work engagement scale (UWEs)
The Chinese version of UWE was used to assess the WE of the respondents [35]. The total reliability coefficient of the translated scale, Cronbach’s α, was 0.947. The scale includes three dimensions with a total of 15 items, which are divided into vitality (6 items), dedication (4 items), and focus (5 items). Using the Likert-7 scoring method, the total score on the scale ranged from 0 to 90. The higher the score, the higher the level of WE.
Data collection
We imported the questionnaire into an online platform called WenJunXing (https://www.wjx.cn/). After obtaining consent from the director of the hospital’s nursing department, newly graduated nurses who met the inclusion criteria were selected and completed the questionnaire and submitted it through a computer or smartphone. Only completed questionnaires were used for further evaluation. The same IP address was only allowed to be filled once.
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Data analysis
SPSS Statistics 26.0 (IBM Corp.) was used to analyze the data collected. The normal distribution of the data was tested using the Kolmogorov-Smirnov (K-S) single sample test. Categorical variables were described by numbers with percentages. Continuous variables that conform to a normal distribution were described by means with standard deviation (SD), while those that do not fit are expressed by median and interquartile spacing. Pearson’s correlation analysis was used to explore the correlations between burnout, POS, PsyCap, and WE. AMOS 26.0 (IBM Corp.) was applied to build the structural equation modelling. Where POS is the independent variable and burnout is the dependent variable, both PsyCap and WE are the mediating variables, and training grade, number of residents cared for per day, the night shift, satisfaction with income and the number of training sessions are a control variable in this model. We investigated the chain-mediating effect of PsyCap and WE on POS and burnout using the 5000 bootstrap resamples method to test and validate the mediation effect, adopting 95% confidence intervals (CI) to test the direct and indirect effects. To evaluate the fitness of the hypothetical model, the chi-square / degree-of-freedom ratio (χ2/df), root mean square error of the approximation (RMSEA), the goodness-of-fit index (GFI), the normed fit index (NFI) and the comparative fit index (CFI) were used. The following threshold values were recommended as criteria for an adequate model: χ2/df < 3.00, RMSEA < 0.08, GFI > 0.90, NFI > 0.90, and CFI > 0.90 [36]. The inspection level was established at α = 0.05. A value of P less than 0.05 was considered statistically significant.
Results
Sociodemographic information of newly graduated nurses
The baseline demographic characteristics of the 995 participants are presented in Table 1. Newly graduated nurses had an average age of 23.46 (SD = 2.28, range 20 to 29), with 12.4% of males and 87.6% of females, most of them had received a bachelor’s degree (727, 73.1%), followed by a diploma education (268, 26.9%). No significant differences were found in burnout scores when participants were grouped according to gender and number of beds in the hospital. However, significant differences were found in some variables between the groups according to training grade, educational level, number of residents cared for per day, night shifts (per week), satisfaction with income status, and number of training sessions.
Table 1
Sociodemographic characteristics of newly graduated nurses (N = 995)
Variables | N (%) | Burnout | t/F | P |
|---|---|---|---|---|
Gender | ||||
Male | 123 (12.4) | 2.42 ± 1.08 | -0.607 | 0.544 |
Female | 872 (87.6) | 2.46 ± 1.05 | ||
Training grade* | ||||
Grade 1 | 451 (45.3) | 2.15 ± 0.99 | -7.217 | < 0.001 |
Grade 2 | 544 (54.7) | 2.65 ± 1.04 | ||
Education background | ||||
Junior college | 268 (26.9) | 1.99 ± 1.01 | 19.621 | < 0.001 |
Bachelor and above | 727 (73.1) | 2.58 ± 1.04 | ||
Categories of clinical departments | -0.557 | 0.087 | ||
Internal medicine | 395 (39.7) | 2.39 ± 0.99 | ||
Surgery | 297 (29.9) | 2.44 ± 1.01 | ||
Intensive care unit | 82 (8.2) | 2.48 ± 1.12 | ||
Emergency | 73 (7.3) | 2.46 ± 1.04 | ||
Others | 148 (14.9) | 2.37 ± 0.89 | ||
Number of residents cared for per day | 6.434 | < 0.001 | ||
<8 | 391 (39.3) | 2.35 ± 0.96 | ||
8–10 | 368 (36.9) | 2.40 ± 0.97 | ||
>10 | 236 (23.8) | 2.65 ± 1.27 | ||
Night shift (per week) | 24.269 | < 0.001 | ||
None | 86 (8.6) | 1.89 ± 0.94 | ||
1 | 152 (15.3) | 2.22 ± 0.90 | ||
1–2 | 632 (63.5) | 2.58 ± 1.05 | ||
≥3 | 125 (12.6) | 2.80 ± 1.11 | ||
Satisfaction with income | 79.968 | < 0.001 | ||
Strong satisfaction | 25 (2.5) | 1.50 ± 1.20 | ||
Satisfaction | 143 (14.4) | 1.71 ± 0.88 | ||
Neutral | 520 (52.3) | 2.31 ± 0.86 | ||
Dissatisfaction | 210 (21.1) | 2.89 ± 0.99 | ||
Strong dissatisfaction | 97 (9.7) | 3.56 ± 1.08 | ||
Number of training sessions (1 year) | 3.694 | < 0.001 | ||
<1 | 130 (13.0) | 2.22 ± 1.03 | ||
1–3 | 165 (16.6) | 2.41 ± 0.96 | ||
>3 | 700 (70.4) | 2.49 ± 1.08 |
Common method bias analysis
In this study, the influence of common method bias was minimized by anonymous filling, concealing variable names, and item mismatches. To inspect the common method biases caused by self-reported scales, Harman’s single factor test was performed. The first factor accounted for 38.21% of the total variation, which was less than the 40% value raised by Podsakoff et al. [37]. It indicated that the bias of the common method was unlikely to confuse the interpretation of the results of the data analysis.
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Correlation between burnout and POS, PsyCap, and WE
The average scores of newly graduated nurses were 2.45 (1.06) on burnout, in which 17.4% had no burnout, 68.5% had moderate burnout, and 14.1% had severe burnout, and the incidence of burnout was 82.6%. Correlation analysis showed that burnout was negatively correlated with POS (r = − 0.624, p < 0.05), PsyCap (r = -0.685, p < 0.05), and WE (r = -0.638, p < 0.05), respectively. POS was positively associated with PsyCap (r = 0.655, p < 0.05) and WE (r = 0.679, p < 0.05). PsyCap was also positively associated with WE (r = 0.716, p < 0.05) (Table 2).
Table 2
Pearson’s correlation analyses between burnout and POS, PsyCap and WE (N = 995)
Mean (SD) | Burnout | POS | PsyCap | WE | |
|---|---|---|---|---|---|
Burnout | 2.45 (1.06) | 1 | |||
POS | 43.72 (11.17) | − 0.624* | 1 | ||
PsyCap | 4.11 (0.97) | − 0.685* | 0.655* | 1 | |
WE | 49.68 (22.26) | − 0.638* | 0.679* | 0.716* | 1 |
Construction of mediation models
Under the condition of controlling training grade, educational level, number of residents cared for per day, night shift, satisfaction with income, and number of training sessions, the mediating effect of PsyCap and WE on the relationship between POS and burnout in newly graduated nurses was analyzed. This study showed that the total indirect effect, which included three different pathways, was statistically significant and represented 56.96% of the total effect, with a value of -0.320 (95% CI: [-0.404, -0.243], p < 0.05). Indirect effects were observed via PsyCap and WE and chain mediation via PsyCap and WE. POS→PsyCap→Burnout, POS→WE→Burnout, and POS→PsyCap→WE→Burnout explained 33.8% (95% CI: [-0.028, -0.019], p < 0.05), 13.01% (95% CI: [-0.009, -0.004], p < 0.05), and 10.12% (95% CI: [-0.008, -0.003], p < 0.05) of the total effect, respectively (Table 3). The model fitting index of the model is acceptable (χ2/DF = 3.010, RMSEA = 0.071, CFI = 0.938, GFI = 0.914, NFI = 0.945) (Fig. 2).
Table 3
The chain mediating effect of psychological capital and work engagement in perceived organizational support and burnout (n = 995)
Paths | β | Boot SE | Bootstrap 95%CI (bias corrected) | P | proportion of the total effect (%) | |
|---|---|---|---|---|---|---|
Lower | Upper | |||||
POS→PsyCap→burnout | -0.187 | 0.002 | -0.028 | -0.019 | 0.000 | 28.64 |
POS→WE→burnout | -0.072 | 0.001 | -0.009 | -0.004 | 0.021 | 11.02 |
POS→PsyCap→WE→burnout | -0.056 | 0.001 | -0.008 | -0.003 | 0.012 | 9.34 |
Direct effects (POS→burnout) | -0.233 | 0.052 | -0.429 | -0.226 | 0.001 | 50.99 |
Indirect effect (POS→burnout) | -0.320 | 0.041 | -0.404 | -0.243 | 0.000 | 49 |
Total effects | -0.553 | 0.029 | -0.706 | -0.590 | 0.002 | 100 |
Fig. 2
Chain mediating models of psychological capital and work engagement between perceived organizational support and burnout among the newly graduated nurses. All P values < 0.05. POS: perceived organizational support, PsyCap: psychological capital, WE: work engagement.CV_1: training grade, CV_2: educational level, CV_3: number of residents cared for per day, CV_4: night shifts (per week), CV_5: satisfaction with income status, CV_6: number of training sessions
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Discussion
This study investigated the incidence of job burnout among newly graduated nurses in southwest China and found that there was a high incidence of burnout among them. In this study, the prevalence of newly graduated nurses with burnout was much higher than reported by Wang et al. [38] and Zhang et al. [39] in China, indicating that burnout among newly graduated nurses was very common. Newly graduated nurses who transition to professional nursing roles often experience greater direct and indirect stress, emotional strain related to patient care, lack of practical experience, and a mismatch in work-life balance than active nurses [40]. Furthermore, to ensure the improvement of the competency of newly graduated nurses, newly graduated nurses will complete rotation training in internal medicine, surgery, obstetrics and gynecology, pediatrics, and intensive care in 2 years and pass the examination to obtain the standardized training certificate and officially enter the hospital; otherwise, some of them will not reach the third level in the hospital. Under internal and external pressure, newly graduated nurses cannot receive enough support and positive guidance, leading to emotional exhaustion and inefficacy, high burnout, and increased turnover of nurses [41]. Furthermore, our study showed that the burnout score was lower than that in the study by Shi et al. [42]. This may be because in China there is no regulation on the training time of newly graduated nurses. In Sichuan Province, the training time is 2 years, while in Hunan Province, where Shi et al. worked, newly graduated nurses must complete 3 years of training. Longer training cycles for newly graduated nurses mean that they must deal with training pressures and low salaries for longer periods, which can lead to higher levels of burnout. Nursing managers should pay attention to the burnout of newly graduated nurses, give them sufficient support, especially newly graduated nurses with long training cycles, help them establish positive psychology, cope with work pressure, alleviate job burnout, and reduce the loss of newly graduated nurses.
This study also investigated the association between POS and burnout among newly graduated nurses, with a focus on investigating whether PsyCap and WE act as a chain intermediary variable. Our study found that the POS of newly graduated nurses directly and negatively predicts burnout, confirming hypothesis 1. According to the JD-R model, POS is an important external resource that can help individuals cope with the negative impacts of the environment and reduce job burnout levels [43]. Previous studies reported a negative association between POS and burnout among nurses and that when nurses perceived that the organization did not consider the importance of employees and their well-being, there was a decrease in their professional job autonomy, job commitment and job satisfaction [44, 45]. In contrast, the perception of a pleasant working environment and a sense of receiving organizational care could reduce work-related burnout. In other words, hospital leaders must provide more emotional and material support to newly graduated nurses entering the workplace to gain recognition, increase professional identity, and reduce burnout.
Secondly, the sense of POS by newly graduated nurses can indirectly affect burnout through PsyCap, validating Hypothesis 2. PsyCap is an important part of organizational psychological behavior, and it is an available psychological resource that can be created and inculcated. An increasing number of people are becoming aware of the importance of psychological capital. As a positive internal work resource, PsyCap directly reduces stress and burnout at work [46]. According to the JD-R model, when an inefficient demand for work is perceived, employees tend to mobilize their personal resources (for example, PsyCap) and are more likely to dedicate themselves to work to cope with the negative effects of work, thus reducing burnout [47]. Moreover, PsyCap can not only directly and negatively predict burnout, but can also be a moderating variable between burnout and its various influencing factors. There is a positive correlation between PsyCap and POS, and recent studies have shown directly that POS can alleviate nurses’ burnout by increasing PsyCap [15]. In other words, the development of measures to improve PsyCap at the hospital organizational level can be useful in alleviating burnout among newly graduated nurses.
Furthermore, POS may indirectly influence burnout through WE, and Hypothesis 3 was confirmed. Previous research has shown that POS is positively correlated with WE and significantly predicts WE through happiness and well-being [48]. WE reveal the extent to which an employee vigorously assigns personal resources to his or her work. For an engaged workforce, the support of the organization is especially important, whether emotionally or materially. In other words, WE will increase when there is adequate organizational support, which in turn reduces burnout. The study by Tian et al. found that POS and PsyCap, as important antecedent variables, affect the WE of nurses, and PsyCap plays an intermediary role [21]. Newly graduated nurses with a high level of POS have abundant work resources to drive energetic work behaviors (for example, engagement), which in turn reduce mental health (for example, burnout). Hospital managers can alleviate burnout by fostering a supportive culture that makes newly graduated nurses feel supported, thus increasing their WE.
The most important finding is that PsyCap and WE play a chain-mediating role in the sense of POS and burnout of newly graduated nurses. This specific chain mediation pathway, ‘POS→ PsyCap→WE→burnout’ contributed 9.34% of the total effect. The discernibility of this nuanced effect underscores the adequacy of the sample size. On a broader scale, cumulative indirect effects, which constitute 49% of the total, emphasize substantial clinical relevance. Previous studies have shown that psychological capital and job participation are particularly important in alleviating burnout and promoting retention among newly graduated nurses [19]. However, the specific mechanism of action remained unclear; therefore, we explored this possible pathway. Newly graduated nurses with higher POS tend to mobilise positive personal resources (for example, PsyCap) and exhibit greater motivation for work, greater confidence in overcoming work-related challenges, and improved WE [27]. Furthermore, higher POS levels stimulate nurses to engage more actively in their work, promoting greater motivation for work and greater allocation of energy and concentration. This manifests itself in them being more active, diligent, and precise in their work, ensuring greater commitment and accuracy at work, and ultimately reducing burnout behaviour. Taken together, these factors mitigate burnout. Managers can develop relevant measures to improve psychological capital and increase engagement at the organizational level to alleviate job burnout and promote the retention of newly graduated nurses.
Recommendations for practice
As the backbone of the nursing workforce, newly graduated nurses are prone to burnout when faced with heavy clinical nursing work, leading to a decline in the quality of nursing services, and in severe cases, even the intention to leave or leave the profession. Therefore, it is particularly important to alleviate burnout among newly graduated nurses. To improve the job performance of newly graduated nurses, we give some suggestions with the results of this study. First, for individual nurses, it is very important to adjust their own positive psychology, understand some methods to develop positive PsyCap, and maintain a calm and optimistic attitude in the face of work load. Second, for nursing managers, it is necessary to pay attention to the positive PsyCap of newly graduated nurses, help them develop positive personal resources, increase WE to cope with the growing Job demands and prevent burnout. Finally, hospital management should pay attention to the dual role of PsyCap and WE, not only to provide a supportive working environment by providing employee benefits for young nurses, but also to pay attention to their career development, provide newly graduated nurses with diversified training opportunities, link nurses’ individual career development goals with hospital development goals, and stimulate their motivation to deepen the level of WE of young nurses.
Limitations
This study had some limitations. First, this cross- sectional survey was conducted in Sichuan, China, which may limit the extension of these results to other populations. Second, data in this study were collected from participants using self- report measures, and these data may not reflect their true feelings. Future studies could be considered to interview nurses and collect data from multiple sources, such as hospital chief nurses and hospital managers. Third, although we analyzed the study data based on a theoretical model, the cross-sectional design precluded the inference of causality. More longitudinal and interventional studies should be conducted to confirm the findings.
Conclusions
This study confirmed that burnout is a common problem among newly graduated nurses in southwest China. Special attention should be paid to the role of PsyCap and WE in POS and burnout. When training newly graduated nurses, nursing managers should consider nurses with different educational levels. At the same time, they should increase their POS and cultivate positive psychological resources by rationally organizing night shifts and raising the salary levels of newly graduated nurses to increase WE and alleviate burnout.
Acknowledgements
The authors would like to thank all newly graduated nurses who participated in this study.
Declarations
Ethics approval and consent to participate
All research methods were used in accordance with the relevant rules and regulations of the Declaration of Helsinki. All procedures in this study were carried out with the approval of the Ethics Committee of Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China (Code: S20230218-01). Informed consent was obtained from all participants in this study.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
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