Effects of burnout and work engagement in the relationship between self‐efficacy and safety behaviours—A chained mediation modelling analysis

Abstract Aims To explore the current situation, influencing factors and pathways of safety behaviour of nurses in tumour specialized hospitals, in order to provide a theoretical basis for managers to manage and train nurses, improve their safety behaviour level and ensure medical safety. Design An anonymous cross‐sectional survey. Method A total of 2147 nurses from Grade A cancer hospitals in 15 provinces of China were selected by a convenient sampling method. Questionnaires were collected through the Questionnaire Star platform. Nurses' safety behaviour was measured using the nurse Safety Behaviour Scale, Self‐efficacy by the General Self‐efficacy Scale, and nurses' occupational burnout was measured by the occupational Burnout Scale, and work engagement through the the Work Engagement Scale. Structural equation modelling was used to test the relationship among nurses' safety behaviour, general self‐efficacy, occupational burnout and work engagement. SPSS25.0 software was used to test the relationship among the safety behaviour of nurses, general self‐efficacy, occupational burnout and work engagement. Results The total score of safety behaviour of nurses was 55.45 ± 6.879, the total score of general self‐efficacy was 31.39 ± 5.729, the total score of occupational burnout was 44.99 ± 26.587, and the total score of work engagement was 38.48 ± 13.433; the scores of the Nurse Safety Behaviour Scale, Self‐Efficacy Scale, and Work Engagement Scale were positively correlated (all p < .001); the occupational burnout scale was negatively correlated with the scores of self‐efficacy scale, work engagement scale and nurse safety behaviour scale (all p < .001); Structural equation model analysis shows that self‐efficacy and work engagement have a direct positive impact on nurse safety behaviour( β = .103, β = .096, all p < .001); Occupational burnout has a direct negative impact on self‐efficacy, work engagement and nurse safety behaviour( β = −.371, β = −.413, β = −.328 all p < .001). Bootstrap analysis showed that occupational burnout and job involvement had a significant chain mediating effect between self‐efficacy and the safety behaviour of nurses (95% CI: 0.148–0.21). The total effect of self‐efficacy on the safety behaviour of nurses was 0.283 ( p < .001, 95% CI: 0.225–0.301), the direct effect was 0.096 ( p < .001, 95% CI: 0.042–0.15), and the indirect effect was 0.179 ( p < .001, 95% CI: 0.085–0.215), The mediating effect accounted for 63.3% of the total effect size. Conclusion Occupational burnout and work engagement play a partial mediating role between self‐efficacy and nurse safety behaviour. It is necessary to strengthen training on nurse safety culture awareness, improve the nurse self‐efficacy and work engagement, reduce nurse occupational burnout, and thereby improve the level of nurses' safety behaviour.