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

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.