Childhood experience profiles and their impact on depression–burnout networks among nurses: a latent class and network analysis

BACKGROUND: This study aimed to use a person-centered approach to differentiate types of childhood experiences among nurses and explore whether the relationship between depression and burnout differs across these groups. METHODS: This study employed a cross-sectional design and conducted a questionnaire survey of 866 nurses using convenience sampling. Nurses in a general hospital were surveyed using the Adverse Childhood Experience (ACE) and Benevolent Childhood Experience (BCE) scales, Patient Health Questionnaire-9 (PHQ-9), and Maslach Burnout Inventory (MBI). Latent class analysis in Mplus 8.3 classified nurses by ACEs/BCEs patterns, and network analysis was conducted using the bootnet package in R 4.3.2 to visualize complex interactions between depression and burnout by constructing network diagrams. RESULTS: Latent class analysis identified two childhood experience profiles: Low ACEs/High BCEs (n = 648) and Moderate ACEs/Low BCEs (n = 218). Network analysis revealed stronger overall connections between depression and burnout symptoms in the Moderate ACEs/Low BCEs group, with Emotional Exhaustion acted as a bridge symptom, transmitting distress between depression and burnout, and thus representing a critical target for intervention. while Cynicism was also a key bridging symptom specifically in the Moderate ACEs/Low BCEs group. CONCLUSIONS: These findings demonstrate that Chinese nurses’ childhood experiences cluster into distinct patterns, with Emotional Exhaustion and Cynicism representing critical intervention targets. Hospital administrators should prioritize monitoring emotional exhaustion and reducing cynicism, particularly among nurses with moderate ACEs/low BCEs, to safeguard workforce stability and patient care. CLINICAL TRIAL NUMBER: Not applicable.