Association of Burnout With Missed Nursing Care Among Neuro‐Oncology Nurses: The Mediating Role of Professional Identity and the Moderating Role of Psychological Capital

ABSTRACT Aim The aims of this study were to examine whether professional identity mediates the association between burnout and missed nursing care (MNC), and to test whether psychological capital moderates this mediation model. Design A cross‐sectional study. Methods The Oncology Missed Nursing Care Self‐rating Scale (OMNCS), Maslach Burnout Inventory (MBI), Professional Identification Scale (PIS) and Psychological Capital Scale (PCS) were used to assess 446 neuro‐oncology nurses from 10 Grade A oncology hospitals in six Chinese provinces between April and June 2024. Mediation and moderated mediation models were constructed using structural equation modelling. Results The incidence of MNC among 446 neuro‐oncology nurses was 36.4%. The mean score on the OMNCS was 104.95 ± 26.70 (note: the OMNCS is reverse‐scored, with higher scores indicating fewer missed care occurrences). MBI showed a negative association with MNC (total effect: β = −0.605, p  < 0.001), with a significant direct effect (β = −0.256, p  < 0.001). PIS partially mediated this relationship (indirect effect: β = −0.349, p  < 0.001), accounting for 57.7% of the total effect, through the paths ‘burnout → professional identity’ (β = −0.646, p  < 0.001) and ‘professional identity → MNC’ (β = 0.540, p  < 0.001). PCS moderated all three paths (β = −0.015, p  < 0.001; β = −0.018, p  < 0.05; β = 0.071, p  < 0.05). As psychological capital increased from low to high, the indirect effect diminished in magnitude from −0.23 to −0.12. The moderated mediation model demonstrated good fit (GFI = 0.98, CFI = 0.97, RMSEA = 0.06, χ 2 /df = 4.8). Conclusion The direct correlation between burnout and heightened risk of MNC was evident, with burnout also exhibiting an indirect connection to MNC through the enhancement of professional identity in neuro‐oncology nurses. Psychological capital was identified as a potential moderator in offsetting the mediating impact of professional identity and in regulating the association between burnout and MNC. Future intervention strategies aimed at mitigating MNC among neuro‐oncology nurses experiencing burnout may benefit from enhancing professional identity and psychological capital. Such approaches could potentially improve care quality and patient outcomes. Patient or Public Contribution No patient or public involvement occurred in the design, conduct, or reporting of this study. The study participants were neuro‐oncology nurses, and the research focused on their experiences and perceptions.