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This cluster randomized controlled trial evaluates the efficacy of an integrated empowerment and narrative nursing (I-ENP) program compared to usual care for neonatal nurses. The study aims to determine if the 6-month I-ENP, which includes empowerment education and narrative nursing sessions, can enhance professional identity, reduce burnout symptoms, and lower turnover intention among neonatal nurses.
Neonatal nurses are at high risk for professional burnout and weakened professional identity due to chronic workplace stressors. This study was designed to test a novel, integrated intervention combining empowerment education and narrative nursing practices. Four hospitals (clusters) were randomized to either the intervention or control group. A total of 172 neonatal nurses were included. The intervention group (n=85) participated in a structured 6-month program consisting of four empowerment education modules (covering topics like stress management and communication) and six narrative nursing sessions (involving story sharing and reflective writing). The control group (n=87) received usual care. The primary hypothesis was that the I-ENP group would show significantly greater improvement in professional identity scores compared to the control group at the end of the intervention. Secondary objectives included assessing the program's impact on burnout dimensions (emotional exhaustion, depersonalization, personal accomplishment) and turnover intention. Assessments were conducted at baseline, 6 months, and 9 months to evaluate the sustainability of the effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Integrated Empowerment and Narrative Nursing Program (I-ENP) Group | Experimental | Nurses in this group received a 6-month structured program in addition to usual care. The program included four monthly 2-hour empowerment education workshops and six bi-weekly 1.5-hour narrative nursing sessions, delivered in small groups. |
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| Control Group | Active Comparator | Nurses in this group received usual care, which included standard hospital-provided continuing education and access to employee assistance programs, without any additional specific intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Integrated Empowerment and Narrative Nursing Program (I-ENP) | Behavioral | A multi-component program combining empowerment education (modules on professional competence, stress management, effective communication, teamwork) and narrative nursing (sessions for story sharing, reflective writing, and peer support) delivered over 6 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Professional Identity Score | Change from baseline in total score on the Professional Identity Scale for Nurses (PISN). The scale ranges from 30 to 150, with higher scores indicating stronger professional identity. | Baseline, 6 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Professional Identity Score at Follow-up | Change from baseline in total score on the Professional Identity Scale for Nurses (PISN). | Baseline, 9 Months |
| Change in Burnout: Emotional Exhaustion Score |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shijiazhuang Fourth Hospital | Shijiazhuang | Hebei | 050000 | China |
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| ID | Term |
|---|---|
| D002055 | Burnout, Professional |
| ID | Term |
|---|---|
| D000073397 | Occupational Stress |
| D009784 | Occupational Diseases |
| D000077062 | Burnout, Psychological |
| D013315 | Stress, Psychological |
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| Usual Care | Behavioral | Standard hospital-provided support, including routine continuing education and access to employee assistance programs. |
|
Change from baseline in the Emotional Exhaustion subscale score of the Maslach Burnout Inventory (MBI). Higher scores indicate greater exhaustion.
| Baseline, 6 Months, 9 Months |
| Change in Burnout: Depersonalization Score | Change from baseline in the Depersonalization subscale score of the MBI. Higher scores indicate greater depersonalization. | Baseline, 6 Months, 9 Months |
| Change in Burnout: Personal Accomplishment Score | Change from baseline in the Personal Accomplishment subscale score of the MBI. Higher scores indicate a greater sense of personal accomplishment. | Baseline, 6 Months, 9 Months |
| Nurse Turnover Intention | Percentage of nurses reporting serious consideration of leaving their current position in the next 12 months. | 6 Months |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |