Profiles of Extra-Task Workload Among Clinical Nurses and Associations With Narrative Cognitive Ability: A Latent Profile Analysis.

BACKGROUND

In addition to providing direct care, clinical nurses often undertake teaching, research, quality improvement and care coordination responsibilities. However, whether these extra-task demands form distinct workload patterns, and how such patterns relate to narrative cognitive ability, remains unclear.

AIM: To identify distinct extra-task workload patterns among clinical nurses and compare narrative cognitive ability across the identified profiles.

METHODS

A cross-sectional survey was conducted among 1081 clinical nurses at a tertiary general hospital in Henan Province, China, between March and April 2025. Data were collected using a demographic questionnaire, the Clinical Nurse Extra-Task Workload Scale and the Narrative Cognitive Ability Scale. Latent profile analysis was performed to identify extra-task workload profiles, and covariate-adjusted Bolck-Croon-Hagenaars (BCH) analysis was used to compare narrative cognitive ability across the identified profiles.

RESULTS

Four profiles were identified: moderate demands-minimal constraints (12.40%), high demands-high constraints (18.59%), moderate demands-low constraints (25.16%) and elevated demands-moderate constraints (43.85%). Profile membership differed according to several demographic and work-related characteristics, including night-shift frequency, work-related mood, leisure activities and narrative training experience. After covariate adjustment, significant differences remained in overall narrative cognitive ability, life and health narrative awareness and professional narrative thinking. Nurses in the moderate demands-minimal constraints profile demonstrated the highest levels of narrative cognitive ability.

CONCLUSION

Extra-task workload among clinical nurses exhibited distinct profile heterogeneity. Different combinations of work environment demands and behavioural constraints were associated with narrative cognitive ability.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should adopt profile-informed strategies rather than uniform workload interventions for clinical nurses. Identifying nurses with different extra-task workload profiles may help guide targeted management measures, including optimisation of work demands, clarification of role expectations and tailored narrative training and professional support programmes.