Assessing the Impact of Burnout on Nurse Safety Behaviors and Patient Safety Competence: A Latent Profile Analysis Study

Abstract

Aim: This study examines the association between burnout, nurse safety behaviors, and patient safety competency among nurses working in cancer hospitals using person-centered and variable-centered methodologies. Background: Burnout is prevalent among nurses worldwide, with cancer hospital nurses exhibiting high levels of burnout. Burnout correlates with a higher incidence of adverse events and diminished patient safety. Nurse safety behaviors and patient safety competency play protective roles in ensuring patient safety. Methods: This study used a cross-sectional online survey and included 2092 eligible nurses, with 95.0% being female. We invited nurses from cancer hospitals in 12 provinces in China to complete an online survey from April to June 2023. Through the online Questionnaire Star platform, invited nurses provided demographic information and completed the Maslach Burnout Inventory, the Nurse Safety Behaviors Scale, and the Patient Safety Competency Scale. Latent profile analysis was used to identify heterogeneous characteristics of nurse burnout. Results: From a person-centered perspective, nurse burnout was categorized into three latent profiles: "high achievement stable type" (70.3%), "high-efficiency contradictory type" (6.6%), and "high-pressure adaptive type" (23.1%). From a variable-centered perspective, patient safety competency partially mediated the relationship between burnout profiles and nurse safety behaviors. Conclusion: This study identified three heterogeneous latent profiles of burnout among cancer hospital nurses and highlighted the significant impact of excessive working hours and lack of safety training on burnout across different job titles and income levels. Additionally, it verified the mediation effect of patient safety competency between burnout profiles and nurse safety behaviors. Future treatments should focus on high-risk populations by offering improved safety training and suitable work schedules to reduce burnout. Furthermore, personalized measures to enhance nurses' safety competencies should be adopted to improve burnout and safety behaviors. This study integrates person-centered and variable-centered methods, offering new insights and underscoring the critical role of safety in mitigating burnout.

Keywords: burnout; cancer hospitals; latent profile; nurse safety behaviors; nurses; patient safety competency.

Figure 1

Graphical representation of latent profiles of nurse burnout. Note: EE = emotional exhaustion; DP = depersonalization; PA = personal performance; Class 1 = high achievement stable type; Class 2 = high-efficiency contradictory type; Class 3 = high-pressure adaptive type.

Figure 2

Diagrammatic representation of the mediating effect. Note: Class 2 = high-efficiency contradictory type; Class 3 = high-pressure adaptive type; M = patient safety competency; Y = nurse safety behaviors.