Burnout Linked to Missed Nursing Care in Neuro-Oncology Nurses

A study published in Nursing Open found that burnout among neuro-oncology nurses is associated with a higher likelihood of missed nursing care (MNC), with professional identity accounting for more than half of that relationship. Additionally, psychological capital further moderated the association, weakening the link as nurses' psychological resources increased.¹

The cross-sectional survey included 446 neuro-oncology nurses from 10 Grade A oncology hospitals across six Chinese provinces, surveyed between April and June 2024 using the Maslach Burnout Inventory, the Oncology Missed Nursing Care Self-rating Scale (OMNCS), the Professional Identification Scale, and the Psychological Capital Scale. The incidence of MNC in the sample was 36.4%, a rate the study authors described as consistent with prior reports in oncology nursing more broadly.

Burnout showed a significant total effect on MNC (β = −0.605; P < .001), and professional identity partially mediated that relationship, accounting for 57.7% of the total effect through two linked pathways: burnout was associated with lower professional identity (β = −0.646; P < .001), and lower professional identity was, in turn, associated with more missed care (β = 0.540; P < .001).¹ The direct effect of burnout on MNC remained significant even after accounting for this mediation (β = −0.256; P < .001).¹

Psychological capital moderated all three pathways in the model. As nurses' psychological capital rose from low to high, the indirect effect of burnout on MNC through professional identity weakened, from −0.23 at low levels to −0.12 at high levels, with all conditional effects remaining statistically significant across the range. Study author Zhihuan Zhou, of Sun Yat-sen University Cancer Center, and colleagues wrote that neuro-oncology nurses face "multidimensional stressors stemming from caring for brain tumour patients," including complex symptom management and the emotional demands of a population with poor prognoses, all of which can deplete psychological resources over time.¹

The authors suggested that interventions targeting both professional identity and psychological capital, such as peer support groups, adequate staffing, and greater nurse involvement in unit-level safety discussions, may be more effective at reducing MNC than efforts focused on burnout alone.

"Enhancing psychological capital and professional identity may be beneficial in addressing burnout and MNC in this population," Zhou and coauthors concluded.¹ They also noted several limitations, including the study's cross-sectional design, its reliance on convenience sampling across a limited number of cancer centers, and its inability to capture how these relationships evolve over time, all of which the authors said warrant longitudinal follow-up.

REFERENCE
1. Ying L, Duan Y, Luo H, Zhang P, Su Y, Zhang X, Zhou Z. Association of Burnout With Missed Nursing Care Among Neuro-Oncology Nurses: The Mediating Role of Professional Identity and the Moderating Role of Psychological Capital. Nurs Open. 2026;13(4):e70527. doi:10.1002/nop2.70527. https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.70527