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

Completed

Conditions

Intervention / Treatment

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

Interventional

Enrollment (Actual)

172

Phase

  • 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

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
Intervention / Treatment
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

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

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

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)

January 1, 2023

Primary Completion (Actual)

July 1, 2023

Study Completion (Actual)

October 1, 2023

Study Registration Dates

First Submitted

November 17, 2025

First Submitted That Met QC Criteria

November 17, 2025

First Posted (Actual)

November 21, 2025

Study Record Updates

Last Update Posted (Actual)

November 21, 2025

Last Update Submitted That Met QC Criteria

November 17, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID 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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