Pediatric clinical nurses' role conflict and adaptation status: time for improvement

Pediatric nurses face unique clinical challenges that increase their risk of role conflict, which may adversely affect role adaptation and care quality. However, the mechanisms underlying the relationship between role conflict and adaptation, as well as targeted interventions, remain understudied.

This study aimed to investigate the current status of role conflict and adaptation among pediatric clinical nurses, identify influencing factors, and explore mediating and moderating mechanisms to inform clinical practice.

A cross-sectional survey was conducted at a tertiary grade A specialized children's hospital in China. Data were collected using the Nurse Role Conflict Scale (NRCS), Nurse Role Adaptation Scale (NRAS). Statistical analyses included descriptive statistics, Pearson correlation analysis, multiple linear regression, and mediation/moderation tests using the Hayes PROCESS macro with 5000 Bootstrap samples.

A total of 426 pediatric clinical nurses were included. The mean scores of role conflict and role adaptation among pediatric nurses were 52.46 ± 7.55 and 85.20 ± 10.48, respectively. Role conflict was significantly negatively correlated with role adaptation (r=-0.728, P<0.001). Multiple regression identified gender, age, department, work experience, professional title, number of children, and psychological support training as independent predictors of role conflict, while gender, age, department, marital status, and psychological support training predicted role adaptation. Role cognition mediated the relationship between role conflict and adaptation (indirect effect=-0.407, 95%CI: -0.503 to -0.312), accounting for 55.91% of the total effect. Psychological support training moderated this relationship (β=0.153, P<0.001), buffering the negative impact of role conflict on adaptation. Significant interdepartmental differences were observed, with pediatric ICU and emergency nurses reporting the highest role conflict and lowest adaptation.

Pediatric nurses experience moderate role conflict and relatively good adaptation, with multiple demographic and occupational factors influencing these constructs. The mediating role of role cognition and moderating role of psychological support training highlight the need for targeted interventions.