Perceived Organizational Support and Nurses' Pressure Injury Care Behaviors: The Serial Mediating Roles of Self-Efficacy and Change Fatigue.

AIM: To examine the relationship between perceived organizational support and nurses' pressure injury care behaviors and to test the serial mediating roles of self-efficacy in pressure injury management and change fatigue.

BACKGROUND

Pressure injuries are largely preventable, and nurses' care behaviors are critical to prevention. Perceived organizational support may influence these behaviors, but the mediating mechanisms remain unclear.

METHODS

From November 2025 to June 2026, 524 nurses from three tertiary-level A hospitals in Xinjiang were recruited using purposive sampling. Data were collected using the Perceived Organizational Support Scale, the Pressure Ulcer Management Self-Efficacy Scale, the Change Fatigue Scale, and the Pressure Injury Care Behavior Questionnaire. Path analysis was conducted using AMOS 26.0, with serial mediation tested using bias-corrected bootstrapping (5000 resamples).

RESULTS

Perceived organizational support was positively associated with self-efficacy in pressure injury management (β = 0.590, p < 0.001) and pressure injury care behaviors (β = 0.387, p < 0.001). Self-efficacy was negatively associated with change fatigue (β = -0.268, p < 0.001), and change fatigue was negatively associated with pressure injury care behaviors (β = -0.187, p < 0.001). The serial indirect effect was 0.021 (95% CI: 0.012-0.032).

CONCLUSIONS

The findings are consistent with a serial indirect pathway in which perceived organizational support is associated with nurses' pressure injury care behaviors through self-efficacy and change fatigue. Longitudinal studies are needed to confirm this pathway.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should strengthen organizational support, cultivate nurses' self-efficacy in pressure injury management, and monitor change fatigue during organizational change to support preventive care behaviors.