Integrated Program to Enhance Professional Identity and Reduce Burnout in Neonatal Nurses

November 17, 2025 updated by: Zeyang Zhang, The Fourth Hospital of Shijiazhuang

The Efficacy of an Integrated Empowerment and Narrative Nursing Program on Enhancing Professional Identity and Alleviating Burnout Among Neonatal Nurses: A Cluster Randomized Controlled Trial

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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

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.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
172

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Hebei
      • Shijiazhuang, Hebei, China, 050000
        • Shijiazhuang Fourth Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Registered nurses working full-time in the Neonatal Intensive Care Units (NICUs) of the participating hospitals.
  • At least 1 year of work experience.

Exclusion Criteria:

  • Nurses on long-term leave (e.g., maternity leave).
  • Nurses in managerial positions.
  • Nurses planning to leave their position during the study period.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Integrated Empowerment and Narrative Nursing Program (I-ENP) Group
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.
Behavioral: Integrated Empowerment and Narrative Nursing Program (I-ENP)
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.
Active Comparator: Control Group
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.
Behavioral: Usual Care
Standard hospital-provided support, including routine continuing education and access to employee assistance programs.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Professional Identity Score
Time Frame: Baseline, 6 Months
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

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Change in Professional Identity Score at Follow-up
Time Frame: Baseline, 9 Months
Change from baseline in total score on the Professional Identity Scale for Nurses (PISN).
Baseline, 9 Months
Change in Burnout: Emotional Exhaustion Score
Time Frame: Baseline, 6 Months, 9 Months
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
Time Frame: Baseline, 6 Months, 9 Months
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
Time Frame: Baseline, 6 Months, 9 Months
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
Time Frame: 6 Months
Percentage of nurses reporting serious consideration of leaving their current position in the next 12 months.
6 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
The Fourth Hospital of Shijiazhuang

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 1, 2023

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 1, 2023

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 1, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 17, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 17, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 21, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 21, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 17, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 20260974

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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