A new study links burnout among neuro-oncology nurses to a higher risk of missed nursing care, with professional identity playing a key role in that relationship. The research, published in Nursing Open, also found that psychological capital—nurses’ resilience and optimism—weakened the connection between burnout and missed care.
Burnout’s direct and indirect effects
The study surveyed 446 neuro-oncology nurses across 10 major oncology hospitals in six Chinese provinces between April and June 2024. About 36.4% of nurses reported missing care, a rate the authors called consistent with broader trends in oncology nursing.
Burnout had a strong overall effect on missed care (β = −0.605; P < .001). But professional identity acted as a partial mediator, explaining 57.7% of that effect. Nurses experiencing burnout tended to have lower professional identity (β = −0.646; P < .001), and lower identity was tied to more missed care (β = 0.540; P < .001). Even after accounting for this mediation, burnout’s direct effect on missed care remained significant (β = −0.256; P < .001).
Psychological capital as a buffer
Psychological capital moderated all three pathways in the study’s model. As nurses’ psychological capital increased, the indirect effect of burnout on missed care through professional identity weakened—dropping from −0.23 at low levels to −0.12 at high levels. The authors noted that neuro-oncology nurses face unique stressors, including complex symptom management and the emotional toll of caring for patients with poor prognoses.
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Zhihuan Zhou, the study’s lead author and a researcher at Sun Yat-sen University Cancer Center, described these pressures as “multidimensional,” depleting nurses’ psychological resources over time. The findings suggest that interventions targeting both professional identity and psychological capital—such as peer support groups, better staffing, and greater nurse involvement in safety discussions—could be more effective than focusing on burnout alone.
If hospitals treat burnout as a standalone problem, they might overlook the deeper issues shaping how nurses see their roles. The study’s data shows that even small improvements in professional identity or psychological capital could reduce missed care, but those changes require systemic support—not just individual resilience.
The authors acknowledged limitations, including the study’s cross-sectional design, which can’t track changes over time, and its reliance on convenience sampling from a limited number of cancer centers. They called for longitudinal research to better understand how these relationships evolve.
“Enhancing psychological capital and professional identity may be beneficial in addressing burnout and missed nursing care in this population,” Zhou and colleagues concluded. They also emphasized the need for further study to confirm whether these interventions work in practice.