Network analysis of the relationship between change fatigue and work withdrawal behavior among Chinese nurses

Abstract

Nurse change fatigue and work withdrawal behavior significantly impact global healthcare systems, especially within the ever-changing healthcare system and working environment. This study used network analysis to explore change fatigue and work withdrawal behavior among Chinese nurses, identifying their interdependencies and intervention points. A multi-center cross-sectional study was conducted. From April to July 2025, convenience sampling was used to recruit 1,427 clinical nurses from six tertiary grade-A hospitals in Guangdong Province, China. Data were collected using the General Information Scale, Change Fatigue Scale and Work Withdrawal Behavior Scale. Network analysis was employed to visualize the interactive relationships among variables. The basic analysis was performed using SPSS 27.0 software, and the network structure analysis was constructed using RStudio platform to calculate the relationship between the nodes and the centrality index. The mean scores for the change fatigue scale and the work withdrawal behavior scale were 26.01 ± 8.59 and 20.68 ± 6.61, respectively. Network analysis revealed that nurses’ change fatigue and work withdrawal behavior were mainly positively correlated. The strongest correlation was found between “weariness toward all organizational changes” and “frequent reluctance to go to work”, with edge weight value of 0.097. The strongest influence was observed for “being required to change too many things within the organization”, which had the highest expected influence coefficient. Bridging connections included “weariness toward all organizational changes”, “frequent reluctance to go to work”, “often discussing non-work topics with colleagues”, and “considering resignation”. These findings highlighted critical pathways linking change fatigue and work withdrawal behavior in nursing teams. The study revealed moderate levels of change fatigue and work withdrawal behavior among Chinese nurses, highlighting critical pathways linking these two constructs in nursing teams. These findings underscore the potential for targeted interventions aimed at reinforcing these key dimensions to mitigate nurses’ change fatigue, which ultimately reduces the negative impacts associated with work withdrawal behavior. Not applicable.

The authors' abstract, as published at the source. BMC Nursing, 2026 · DOI ↗