Growth and burnout in NICU nurses after experiencing adverse event trauma: A multicenter cross-sectional study

The primary objective of this study was to evaluate the association between posttraumatic growth (PTG) and occupational burnout among neonatal intensive care unit (NICU) nurses.

This multicenter cross-sectional study (February-April 2026) enrolled 660 registered NICU nurses across 18 Chinese provinces. PTG was quantified using the Posttraumatic Growth Inventory (PTGI; 0-100), and burnout was assessed via the Maslach Burnout Inventory-Human Services Survey (MBI-HSS; 0-132). Multivariable linear regression, smooth curve fitting, and two-piecewise linear regression characterized the exposure-outcome relationship, adjusting for demographic, workload, and event-specific covariates.

After multivariable adjustment, PTG exhibited a significant inverse association with burnout (adjusted β = -0.42; 95% CI: -0.48 to -0.35). Threshold analysis identified an inflection point at a PTGI score of 46; below this threshold, PTG was not significantly associated with burnout (β = 0.13; P = 0.16). At or above 46 points, each 1-point increase in PTGI score was associated with a 0.60-point lower burnout score (adjusted β = -0.60; 95% CI: -0.69 to -0.52), with a slope 43% steeper than the conventional linear estimate.

PTG was associated with lower burnout scores in a threshold-dependent pattern among NICU nurses. The 46-point PTGI score should be considered provisional and requires longitudinal and interventional validation before clinical use.