Associations of psychological resilience and change fatigue with innovative behavior among hemodialysis nurses in Chinese public hospitals: a cross-sectional mediation analysis
Abstract
Against the backdrop of continuously rising demand for healthcare services and an increasingly scarce nursing workforce, innovation and development within the nursing profession have become particularly urgent. Enhancing nurses’ capacity for innovative practice is not only crucial for optimizing nursing efficiency but also directly impacts patient safety and the sustainable development of hospitals. This represents a critical issue that requires urgent attention in China’s healthcare management sector. This study examined the associations of psychological resilience and change fatigue with innovative behavior among hemodialysis nurses in Chinese public hospitals, and explored whether change fatigue was statistically indirectly associated with the relationship between psychological resilience and innovative behavior, aiming to provide evidence for developing strategies to enhance nurses’ innovative practices. This cross-sectional study recruited 338 hemodialysis nurses from 14 public hospitals in Sichuan Province, China, between March and June 2024. Data collection employed a demographic questionnaire, the Simplified Psychological Resilience Scale, the Change Fatigue Scale, and the Nurse Innovation Behavior Scale. An exploratory cross-sectional mediation analysis was performed using the SPSS PROCESS macro developed by Hayes. Innovative behaviors among hemodialysis nurses showed a positive correlation with total psychological resilience scores ( r = 0.558, p < 0.001) and a negative correlation with total change fatigue scores ( r = −0.383, p < 0.001). Psychological resilience itself exhibited a negative correlation with change fatigue ( r = −0.467, p < 0.001). Within the specified statistical model, the unstandardized indirect association between psychological resilience and innovative behavior through change fatigue was 0.113, and this indirect association accounted for 24.4% of the total association. Psychological resilience was not only associated with the innovative behavior of hemodialysis nurses in public hospitals, but was also statistically indirectly associated with this behavior through change fatigue. Measures should be implemented at both the individual and managerial levels to enhance nurses’ psychological resilience and reduce their change fatigue, which may be linked to strengthened proactive innovative behavior and the high-quality development of nursing services.