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Identifying High-Performance Advanced Practice Profile of Specialist Nurses in Mainland China: A Mixed-Methods

Wenjuan Zhao1,2, Jie Zhong3, Xiaobin Lai4

  • 1Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China, shca.org.cn.

Journal of Nursing Management
|March 2, 2026
PubMed
Summary

High-performing specialist nurses in China demonstrate distinct profiles, influenced by career ladder and leadership support. Understanding these factors optimizes advanced practice nursing roles for better workforce deployment and sustainability.

Keywords:
advanced practice nursinglatent profile analysismixed-methods design

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Area of Science:

  • Nursing Science
  • Health Workforce Research
  • Organizational Behavior

Background:

  • Optimizing advanced practice nursing (APN) roles is crucial for professional development and sustainable nursing workforce.
  • Identifying high-performing APN profiles and contributing factors is essential for strategic workforce management.

Purpose of the Study:

  • To identify latent profiles of advanced practice nursing among specialist nurses in China.
  • To quantitatively assess individual and contextual factors linked to high performance.
  • To qualitatively validate key factors influencing high performance.

Main Methods:

  • A mixed-methods sequential explanatory design was employed.
  • Latent profile analysis (LPA) classified nurses into performance profiles.
  • Multinomial logistic regression and backpropagation neural network (BPNN) analysis identified determinants; qualitative interviews validated findings.

Main Results:

  • Three profiles emerged: high (26.1%), moderate (46.3%), and low (27.6%) performance.
  • Higher professional career ladder and APN status were associated with high performance.
  • BPNN identified career ladder and job position as key predictors; qualitative data highlighted leadership support and individual attributes.

Conclusions:

  • Distinct advanced practice nursing profiles exist, with high performers influenced by career progression and supportive environments.
  • Targeted management and policy strategies can optimize APN performance.
  • High-performing specialist nurses integrate individual capabilities, collaboration, and institutional support.