Occupational burnout mediates the association between team climate and nurses’ safety behaviours: a multicentre cross-sectional study

Background In contemporary healthcare, nurses are pivotal to patient safety, and their behaviours are integral to care quality and adverse event prevention. However, escalating organisational complexity and sustained workload demands have made burnout prevalent among nurses, with demonstrable adverse effects on performance and patient safety. Although prior research indicates that a positive team climate fosters desirable nursing behaviours, the extent to which it promotes safety behaviours by alleviating burnout remains unclear. Clarifying whether and how burnout mediates the association between team climate and nurses’ safety behaviours would refine theoretical accounts of behavioural formation in nursing practice and provide actionable evidence to guide organisational strategies and managerial interventions that optimise workforce well-being and enhance the quality and safety of care. Objective To examine whether occupational burnout mediates the association between team climate and nurses’ safety behaviours. Methods Between March and April 2025, we conducted a multicentre cross-sectional survey using convenience sampling among registered nurses from three tertiary grade A hospitals in Anhui and Jiangsu provinces, China. Data were collected using self-administered questionnaires comprising a sociodemographic form, the Nurses’ Safety Behaviours Scale, the Maslach Burnout Inventory–General Survey (MBI–GS), and the short form of the Team Climate Inventory (TCI). Results Among 925 nurses, the mean (SD) safety behaviours score was 52.89 (9.14). Safety behaviours correlated positively with team climate and negatively with overall burnout and each burnout dimension (all p < 0.05). In regression analyses, burnout negatively predicted safety behaviours, whereas team climate positively predicted them; the model explained 45.6% of the variance ( R 2 = 0.456). Mediation analysis indicated a partial mediation effect of burnout in the association between team climate and safety behaviours: the total effect was B = 0.599 (95% CI 0.552–0.646; p < 0.001), and the indirect effect via burnout was B = 0.084 (95% CI 0.058–0.114; p < 0.001). Conclusion Occupational burnout undermines nurses’ safety behaviours, whereas a favourable team climate strengthens them. Moreover, team climate indirectly enhances safety behaviours by mitigating burnout. These findings have practical implications for nursing management and training. Interventions should prioritise mitigating burnout and cultivating a positive team climate to strengthen nurses’ safety behaviours.

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Journal
Frontiers in Public Health
Published
2026-03-13
DOI
https://doi.org/10.3389/fpubh.2026.1744333
Primary Topic
Healthcare professionals’ stress and burnout
Type
article
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article

Occupational burnout mediates the association between team climate and nurses’ safety behaviours: a multicentre cross-sectional study

Fei Xu, Yang Wang, Liqun Zhu, Chenxi Li
Frontiers in Public Health
Healthcare professionals’ stress and burnout
article

Occupational burnout mediates the association between team climate and nurses’ safety behaviours: a multicentre cross-sectional study

Fei Xu, Yang Wang, Liqun Zhu, Chenxi Li
article en

Abstract

Background In contemporary healthcare, nurses are pivotal to patient safety, and their behaviours are integral to care quality and adverse event prevention. However, escalating organisational complexity and sustained workload demands have made burnout prevalent among nurses, with demonstrable adverse effects on performance and patient safety. Although prior research indicates that a positive team climate fosters desirable nursing behaviours, the extent to which it promotes safety behaviours by alleviating burnout remains unclear. Clarifying whether and how burnout mediates the association between team climate and nurses’ safety behaviours would refine theoretical accounts of behavioural formation in nursing practice and provide actionable evidence to guide organisational strategies and managerial interventions that optimise workforce well-being and enhance the quality and safety of care. Objective To examine whether occupational burnout mediates the association between team climate and nurses’ safety behaviours. Methods Between March and April 2025, we conducted a multicentre cross-sectional survey using convenience sampling among registered nurses from three tertiary grade A hospitals in Anhui and Jiangsu provinces, China. Data were collected using self-administered questionnaires comprising a sociodemographic form, the Nurses’ Safety Behaviours Scale, the Maslach Burnout Inventory–General Survey (MBI–GS), and the short form of the Team Climate Inventory (TCI). Results Among 925 nurses, the mean (SD) safety behaviours score was 52.89 (9.14). Safety behaviours correlated positively with team climate and negatively with overall burnout and each burnout dimension (all p < 0.05). In regression analyses, burnout negatively predicted safety behaviours, whereas team climate positively predicted them; the model explained 45.6% of the variance ( R 2 = 0.456). Mediation analysis indicated a partial mediation effect of burnout in the association between team climate and safety behaviours: the total effect was B = 0.599 (95% CI 0.552–0.646; p < 0.001), and the indirect effect via burnout was B = 0.084 (95% CI 0.058–0.114; p < 0.001). Conclusion Occupational burnout undermines nurses’ safety behaviours, whereas a favourable team climate strengthens them. Moreover, team climate indirectly enhances safety behaviours by mitigating burnout. These findings have practical implications for nursing management and training. Interventions should prioritise mitigating burnout and cultivating a positive team climate to strengthen nurses’ safety behaviours.

Frontiers in Public HealthVol. 14
Wannan Medical College (CN), Jiangsu University (CN), Affiliated Hospital of Jiangsu University (CN), First Affiliated Hospital of Wannan Medical College (CN)
Climate action
Openalex Percentile: Top 27%
Healthcare professionals’ stress and burnout
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