ABSTRACT
Aims
The main purpose of this hypothesis‐driven study was to assess levels of change fatigue, adaptive performance and organisational support among ICU nurses; to explore the effects of change fatigue and organisational support on adaptive performance; and to examine the mediating role of organisational support in the relationship between change fatigue and adaptive performance.
Design
A multi‐site, cross‐sectional survey.
Methods
From February to April 2025, 621 ICU nurses from 12 public secondary and tertiary hospitals in Guizhou, Zhejiang, Anhui and Hebei Provinces were recruited via convenience sampling. A questionnaire assessed their change fatigue, perceived organisational support and adaptive performance.
Results
The surveyed ICU nurses in this study exhibited moderate change fatigue, adaptive performance and perceived organisational support. Change fatigue was negatively correlated with both adaptive performance and perceived organisational support (both p < 0.05), while adaptive performance was positively correlated with perceived organisational support (p < 0.05). Perceived organisational support mediated between change fatigue and adaptive performance, accounting for 29.17% of the total effect.
Conclusion
The level of change fatigue can directly affect adaptive performance and influence it indirectly through the mediating role of organisational support. Managers should establish a multidimensional organisational support system to enhance the adaptive performance of ICU nurses.
Impact
The findings of this cross‐sectional study suggest administrators provide both instrumental and emotional support to ICU nurses to mitigate change fatigue, and recommend implementing resource depletion alert systems and adopting targeted interventions.
Patient or Public Contribution
No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.
Keywords: adaptive performance, change fatigue, ICU nurses, mediating effect, organisational support
1. Background
In recent years, the healthcare industry has undergone frequent organisational changes, including technological innovations, workflow adjustments, performance reforms, implementation of evidence‐based programs and accreditation of ranked hospitals, which also places new demands on the ability of medical staff to cope with change, solve new problems and deal with complexity (Mylopoulos et al. 2022). However, while such changes enhance the competitiveness of hospitals and improve healthcare services, they may also lead to employees suffering from severe change fatigue (Karlsson et al. 2024), which is mainly manifested as exhaustion, powerlessness, apathy and burnout (Beaulieu et al. 2023). Research has shown that nurses are often viewed as ‘implementers’ rather than ‘decision makers’ in the process of change and are more likely to develop a ‘passive acceptance’ mentality, which reduces the sense of change identity; their level of change fatigue is higher than that of other healthcare workers. Fatigue levels are three times higher than those of other healthcare workers (Sarıgül and Uğurluoğlu 2023). High workload intensity is a primary factor contributing to change fatigue, particularly among ICU nurses (Han and Guo 2024). These nurses face long‐term high work pressure, must quickly master complex equipment technologies that are frequently updated (with extremely low error tolerance), and are simultaneously exposed to high‐frequency stressful events. Under such multiple stressors, their risk of experiencing change fatigue may be even higher.
Adaptive performance is the ability of an individual to adjust his/her behaviour to changes in the environment or the demands of new events; those with lower adaptive performance may be less able to quickly adapt to changes in the workplace, leading to lower work efficiency and thus affecting work quality (Gorostiaga et al. 2022).
Perceived organisational support (POS) is defined as an employee's perception of the extent to which his or her organisation values his or her contributions and cares about his or her well‐being, and an increase in POS may help to improve nurses' work engagement (Zhu et al. 2023).
Sun et al. conducted an anonymous questionnaire survey among 525 full‐time employees via WeChat and questionnaire platforms. The results showed a significant positive correlation between change fatigue and work withdrawal behaviour (β = 0.19, p < 0.001), which exerts potential adverse effects on employee and organisational performance, and may even lead to resistance to change and change failure (Sun and Li 2023). It can even cause adverse impacts such as anxiety, occupational burnout, increased sick leave rate and turnover rate (Cao et al. 2024). Liu et al. adopted the form of offline anonymous responses to explore the psychological mechanism of employees' turnover intention. The results revealed a significant negative relationship between adaptive performance and turnover intention (t = −2.79, p < 0.01); that is, a decrease in adaptive performance would enhance employees' turnover intention (Liu 2022). However, when individuals perceive good organisational support, they will increase work input and work enthusiasm out of the psychology of repaying the organisation, thereby promoting the improvement of adaptive performance (Zhou et al. 2025; Jing et al. 2019; Park et al. 2020).
The above evidence indicates obvious correlations among change fatigue, organisational support and adaptive performance. However, regarding the ICU's unique working scenario, the nurses' perceived organisational support, change fatigue and adaptive performance remain unclear. There is also a lack of research on the impact of change fatigue and organisational support on adaptive performance, as well as the mediating role of organisational support between change fatigue and adaptive performance. This study aims to investigate the levels of change fatigue, organisational support and adaptive performance among ICU nurses, explore the impacts of change fatigue and organisational support on adaptive performance and analyse the mediating role of organisational support between change fatigue and adaptive performance. It is expected to provide references for formulating plans to improve ICU nurses' adaptive performance, facilitating successful change implementation and enhancing the quality of care for critically ill patients. Based on these objectives, we put forward the following hypotheses: (i) Change fatigue will directly impact the sense of organisational support and the level of adaptive performance; (ii) The sense of organisational support will directly impact adaptive performance; and (iii) The sense of organisational support will mediate between change fatigue and adaptive performance.
2. Methods
2.1. Participants and Setting
This cross‐sectional study was conducted in accordance with the STROBE guidelines. From February to April 2025, convenience sampling was used to select ICU nurses from 12 secondary and tertiary hospitals located in Guizhou Province, Zhejiang Province, Anhui Province and Hebei Province as the research participants. Inclusion criteria: (1) registered nurses on duty; (2) ICU continuous working time ≥ 6 months. Exclusion criteria: (1) Nurses undergoing further training, rotation and internship for nurses. The respondents gave informed consent and participated voluntarily.
2.2. Sample Size
The sample size was calculated according to the number of scale entries (Pu et al. 2025), which was 5–10 times the scale containing the most entries, taking into account the 20% failure rate, (44 × 10) × (1 + 20%) = 528, i.e., the minimum sample size was 528. A total of 621 ICU nurses were surveyed in this study. The Ethics Committee of Affiliated Hospital of Zunyi Medical University approved this study, and all respondents gave informed consent (NO. KLL‐2023‐374).
2.3. Measures
2.3.1. Demographic Characteristics
This study's general demographic information questionnaire incorporated 13 variables of general demographic and work‐related information, such as gender, age, marital status, department, years of experience, educational attainment, number of night shifts per month, nature of employment, professional title, level of hospital, whether they are specialised nurses, duties and parental status.
2.3.2. Change Fatigue Scale (CFS)
This scale was compiled by Bernerth et al. in 2011, and was Chineseized and tested for reliability by Zhang et al. in 2024 to assess change fatigue among domestic nurses (Zhang et al. 2024). It consists of six items and is assessed using a 7‐point Likert scale, where one represents ‘strongly disagree’ and seven signifies ‘strongly agree’. The total score ranges from 6 to 42, with higher scores indicating stronger feelings of change fatigue in employees. The overall Cronbach's α coefficient of the scale is 0.918. In this study, the Cronbach's α coefficient of the scale is 0.919, indicating that the scale has good reliability and validity.
2.3.3. The Adaptive Performance Scale (APS)
APS was developed by Tao et al. in 2006 and contains 25 entries in four dimensions: stress and emergency management, interpersonal and cultural adaptation, innovative problem solving and continuous learning on the job (Tao 2006). A 7‐point Likert scale was used, with one being ‘strongly disagree’ and seven being ‘strongly agree’. The total score ranges from 25 to 175, where a higher score indicates better adaptive performance of ICU nurses. The overall Cronbach's α coefficient of the scale is 0.88, and the coefficients for each dimension range from 0.85 to 0.94. In this study, the scale's overall Cronbach's α coefficient is 0.97, with the coefficients for each dimension ranging from 0.87 to 0.94, indicating that the scale possesses good reliability and validity.
2.3.4. The Perceived Organisational Support Scale (POSS)
POSS was revised by Zuo and Yang in 2009, which consists of 13 items, including two dimensions of emotional support and instrumental support (Zuo and Yang 2009), and is based on a 5‐point Likert scale, with one being ‘strongly disagree’ and five being ‘strongly agree’. The total score ranges from 13 to 65, where a higher score suggests a higher level of perceived organisational support among nurses. The scale's overall Cronbach's α coefficient is 0.92; in this study, the Cronbach's α coefficient is 0.98.
2.4. Pre‐Test
To test the structure and language of the questionnaire and whether the content is concise, appropriate and straightforward. Before the survey, 40 nurses who met the inclusion–exclusion criteria were randomly selected for pre‐testing, and these nurses no longer participated in the later formal survey. After completing the survey, according to the feedback questions, the expression of some items was slightly adjusted for understanding, and the time required to complete the questionnaire ranged from 200 to 435 s. Following group discussions and referring to relevant literature (Pu et al. 2025), it was decided that in the subsequent formal survey, questionnaires completed in < 180 s would be excluded. The pre‐test showed that the overall Cronbach's α coefficient of the scale was 0.951.
2.5. Data Collection
Data were collected via the Questionnaire Star online platform. The questionnaire home page sets up a unified guide to inform the purpose of the survey and fill out the notes; each item is required. Submission of the questionnaire is considered informed consent. In the past 6 months, participating hospitals have experienced changes (e.g., performance reform, implementation of evidence‐based programs, technological innovations in hospital accreditation, workflow adjustments, etc.). The research team contacted hospital administrators who were willing to participate, explaining that the survey would not adversely affect the respondents' hospitals and nurses. The nurse manager sent the QR code of the questionnaire to the WeChat group of nurses in their departments, and the nurses voluntarily and anonymously filled in the questionnaire to complete the data collection. Excluding the questionnaires that took < 180 s to fill out and the questionnaires with identical scores for all entries, a total of 662 questionnaires were recovered in this study, and finally, 621 valid questionnaires were obtained, with an effective recovery rate of 93.8%.
2.6. Data Analyses Strategy
Statistical analysis was performed using SPSS 29.0 software. Measurement information was expressed by (x ± s), and count information was expressed by frequency and percentage. Normality test was conducted by analysing the skewness and kurtosis values (within ±2) (Demirel and Ayaz‐Alkaya 2025). If the data were distributed normally, Pearson correlation was used to analyse the relationship between change fatigue, sense of organisational support and adaptive performance; the mediated effect model 4 of the Process plug‐in in SPSS software was used to construct the structural model, and the Bootstrap method (with 5000 samples drawn) was applied for model testing. The mediating effect was statistically significant, with a 95% confidence interval excluding zero (bias‐corrected bootstrap method), and the test level of α = 0.05.
3. Results
3.1. ICU Nurses' Total Organisational Support, Change Fatigue, and Adaptive Performance Scores and Scores for Each Dimension
See Table 1.
TABLE 1.
ICU nurses' organisational support, change fatigue, adaptive performance total scores and mean scores for each dimension (n = 621).
| Variables/dimensions | Number of items | Scoring range | Mean ± SD | |
|---|---|---|---|---|
| Total score | Each scale dimension | |||
| Change fatigue | 6 | 6–42 | 26.25 ± 7.06 | 4.38 ± 1.18 |
| Adaptive performance | 25 | 25–175 | 119.63 ± 24.06 | 4.79 ± 0.96 |
| Stress and emergency management | 7 | 7–49 | 33.61 ± 7.53 | 4.8 ± 1.08 |
| Innovative problem solving | 8 | 8–56 | 37.07 ± 7.73 | 4.63 ± 0.97 |
| Continuous learning on the job | 4 | 4–28 | 19.5 ± 4.3 | 4.87 ± 1.07 |
| Interpersonal and cultural adaptation | 6 | 6–42 | 29.46 ± 6.31 | 4.91 ± 1.05 |
| Organisational support | 13 | 13–65 | 45.33 ± 10.53 | 3.49 ± 0.81 |
| Emotional support | 10 | 10–50 | 34.5 ± 8.25 | 3.45 ± 0.82 |
| Instrumental support | 3 | 3–15 | 10.83 ± 2.51 | 3.61 ± 0.84 |
3.2. One‐Way Analysis of the Adaptive Performance of ICU Nurses
The entries with statistically significant differences are shown in Table 2.
TABLE 2.
Comparison of adaptive performance mean scores for nurses with different demographic characteristics (n = 621).
| Variables | N (%) | Mean scores | t/F value | p |
|---|---|---|---|---|
| Age (years) | 6.598 b | 0 | ||
| ≤ 25 | 44 (7.09%) | 4.42 ± 0.98 | ||
| 26–35 | 440 (70.85%) | 4.73 ± 0.94 | ||
| 36–45 | 124 (19.97%) | 5.05 ± 0.96 | ||
| > 45 | 13 (2.09%) | 5.17 ± 0.99 | ||
| Marital status | 2.91 a | 0.004 | ||
| Married | 439 (70.69%) | 4.86 ± 0.97 | ||
| Unmarried/divorced/widowed | 182 (29.31%) | 4.61 ± 0.93 | ||
| Parental status | −3.79 a | 0.000 | ||
| Has child | 393 (63.29%) | 4.88 ± 0.95 | ||
| No children | 216 (36.71%) | 4.57 ± 0.95 | ||
| Years of experience (years) | 8.15 b | 0.000 | ||
| ≤ 5 | 156 (25.12%) | 4.67 ± 0.89 | ||
| 6–10 | 276 (44.44%) | 4.69 ± 0.98 | ||
| 11–15 | 142 (22.87%) | 4.91 ± 0.99 | ||
| > 16 | 47 (7.57%) | 5.35 ± 0.82 | ||
| Education attainment | 3.85 b | 0.022 | ||
| Three‐year college | 68 (10.95%) | 4.51 ± 0.97 | ||
| Undergraduate | 543 (87.44%) | 4.83 ± 0.95 | ||
| Master's degree or above | 10 (1.61%) | 4.49 ± 1.17 | ||
| Duties | 15.55 b | 0.000 | ||
| Physiotherapists | 489 (78.74%) | 4.7 ± 0.94 | ||
| Nursing Team Leader/Teaching Secretary | 80 (12.88%) | 4.84 ± 1.06 | ||
| Nurse Manager/Deputy Nurse Manager | 52 (8.37%) | 5.46 ± 0.77 | ||
| Number of night shifts per month (times) | 3.77 b | 0.011 | ||
| ≥ 5 | 450 (72.46%) | 4.71 ± 0.93 | ||
| 2–4 | 64 (10.31%) | 4.87 ± 1 | ||
| 1 | 14 (2.25%) | 5.1 ± 0.85 | ||
| 0 | 93 (14.98%) | 5.04 ± 1.05 |
The value of t.
The value of F.
3.3. Correlation Analysis of Change Fatigue, Adaptive Performance and Organisational Support Among ICU Nurses
Correlation analysis revealed a moderate negative correlation between change fatigue and adaptive performance (r = −0.335, p < 0.001), which supports Hypothesis 1; a moderate positive correlation between adaptive performance and organisational support (r = 0.360, p < 0.001), which supports Hypothesis 2; and a moderate negative correlation between change fatigue and organisational support (r = −0.330, p < 0.001).
3.4. Analysis of the Mediating Effect of Organisational Support Between Change Fatigue and Adaptive Performance
A hypothesised model was developed with ICU nurses' change fatigue as the independent variable, adaptive performance as the dependent variable, and organisational support as the mediating variable. To control for confounding factors among demographic variables and ensure that the mediation effect analysis focuses on the causal relationships between core variables, variables that were statistically significant in the univariate analysis of variance (age, marital status, parental status, years of experience, education attainment, duties and number of night shifts per month) were used as control variables for the analysis of mediated effects. The results showed that change fatigue negatively predicted adaptive performance, with a direct effect of −0.18. Additionally, change fatigue indirectly predicted adaptive performance through organisational support, and the indirect effect was −0.07. The 95% confidence interval for the direct effect of change fatigue on adaptive performance did not include 0; in the change fatigue → organisational support → adaptive performance pathway, all 95% confidence intervals for the mediated paths excluded zero, indicating statistically significant mediation effects. The indirect effect accounted for 29.17% of the total effect, which supported Hypothesis 3 (Table 3 and Figure 1).
TABLE 3.
Mediating effects of organisational support in ICU nurses' change fatigue and adaptive performance.
| Variables | Effect value | Standardised errors (SE) | p | 95% CI | Percentage of effect (%) | |
|---|---|---|---|---|---|---|
| Lower value | Upper value | |||||
| Total effect | −0.25 | 0.31 | < 0.001 | −0.31 | −0.19 | |
| Direct effect | −0.18 | 0.32 | < 0.001 | −0.24 | −0.11 | 70.83 |
| Indirect effect | −0.07 | 0.02 | < 0.001 | −0.11 | −0.04 | 29.17 |
FIGURE 1.
Model of the mediating effect of organisational support on change fatigue and adaptive performance of ICU nurses.
4. Discussion
4.1. Status of Change Fatigue, Adaptive Performance and Organisational Support Among ICU Nurses
The mean change fatigue score of nurses in this study was 4.38 ± 1.18, which falls at a moderate level within the 1–7 scoring range. This score was higher than the findings of Brown et al. for emergency nurses (Brown et al. 2018) and Yu et al. for general nurses (Yu et al. 2025). This difference may be attributed to the difference in the study population, where critical care nurses are not only burdened with heavy nursing tasks, but also need to constantly adapt to more changes, such as new workflows, technological updates and changes in information systems, thus being more prone to change fatigue. Previous studies have mostly focused on the status of change fatigue among the nursing population as a whole, without distinguishing the impact of specialty setting complexity on fatigue levels. This study is the first to clarify the ‘ICU specialty setting–change fatigue’ association, providing a precise population‐targeting basis for subsequent interventions addressing change fatigue in nurses from high‐risk departments.
In this study, the mean score of nurses' adaptive performance was 4.79 ± 0.96, which falls at a moderately high level within the 1–7 scoring range, with the highest score observed in the dimension of ‘interpersonal and cultural adaptation’, this is consistent with the research results of Li et al. (2023). On one hand, this may be related to the fact that most nurses in this study have over 5 years of work experience and hold a bachelor's degree or above. Their stress response and ability to handle complex problems have gradually improved, and their interpersonal communication skills have been enhanced, affecting the scores of the ‘stress and emergency management’ dimension (Wei et al. 2018). On the other hand, intensive care nursing is characterised by cumbersome operations and strict technical requirements. Based on this, nurses' initiative in learning has been fully stimulated, and their continuous learning ability has increased, which further promotes the continuous improvement of their clinical adaptability and professional technical level.
The mean score of organisational support was 3.49 ± 0.81, with the average score of items in each dimension slightly higher than the theoretical median of three points. This score was slightly lower than the overall score of the staff's sense of organisational support in Guangzhou's public health institutions. However, it was consistent with the results of the study conducted by Pu et al., which may be related to the different organisational environments in different hospitals and the different degrees of implementation of the incentive system (Pu et al. 2025). In this study, the mean scores of emotional support dimensions were lower than the mean scores of instrumental support dimensions, which may be related to the fact that instrumental support is ‘controllable and convenient’ as well as ‘visible’, which makes it easier to realise, quantify, and be perceived compared with emotional support (Pu et al. 2025).
4.2. Correlation Analysis of Change Fatigue, Adaptive Performance and Organisational Support Among ICU Nurses
4.2.1. Change Fatigue and Adaptive Performance: Negative Correlation
The results of this study showed that as the level of change fatigue among ICU nurses increases, their adaptive performance scores decrease accordingly. It may be related to the fact that change fatigue leads to the depletion of nurses' cognitive resources, preventing them from efficiently integrating new information and adjusting behaviours. This association is more prominent in the ICU setting because the error tolerance for nursing operations in the ICU is extremely low, and even minor delays in adaptation may affect patient safety. Managers need to focus on the change fatigue status of ICU nurses and alleviate their fatigue through targeted interventions to ensure that nurses maintain good adaptive performance in complex and ever‐changing work scenarios.
4.2.2. Adaptive Performance and Organisational Support: Positive Correlation
The results of this study indicated that when nurses perceive more adequate organisational support, they can more effectively improve their coping abilities and adjust their behaviours to adapt to new changes in work. Organisational support provides multidimensional support for nurses' adaptive performance. It also suggests that nurses' ‘adaptability’ is not an uncontrollable “talent”; managers can proactively shape it through organisational‐level support (such as resources, emotions, cognition and culture), directly empowering nurses to maintain efficient adaptability in dynamic work environments.
4.2.3. Change Fatigue and Organisational Support: Negative Correlation
The results of this study indicate that insufficient organisational support directly exacerbates nurses' physical and mental exhaustion when facing frequent changes. This is because frequent organisational changes, without corresponding resource allocation and emotional support, tend to leave nurses feeling isolated and experiencing accumulated stress. For instance, the lack of necessary skills training leads to competence anxiety when adapting to new processes; furthermore, the absence of an emotional counselling mechanism prevents the timely release of their negative emotions, which further increases their physical and mental burden. In turn, this reminds nursing management to provide nurses with instrumental and emotional support through resource supply (such as human resources and equipment), emotional care (such as recognition and communication) and institutional guarantees (such as training and feedback mechanisms) (McMillan and Perron 2020a).
4.3. Organisational Support Mediates Change Fatigue and Adaptive Performance in ICU Nurses
The results of this study indicate that organisational support plays a mediating role between change fatigue and adaptive performance among ICU nurses. The mediating effect value is −0.07, accounting for 29.17% of the total effect, which implies that organisational support assumes an important ‘transmitting role’ in the process by which change fatigue impacts adaptive performance. By implementing targeted organisational support measures to improve nurses' adaptive performance, we can not only effectively mitigate the negative impact of change fatigue, but these measures can also cover nearly 30% of the improvement potential, thereby demonstrating high practical feasibility and value.
The Conservation of Resources Theory posits that individuals preserve positive ‘resources’ such as energy, time and psychological well‐being. When these resources are excessively depleted due to stressful events (e.g., frequent changes) and cannot be replenished promptly, individuals enter a state of ‘resource depletion’, leading to behavioural withdrawal and decreased efficacy. When nurses experience change fatigue (resource loss), it triggers a ‘resource protection motivation’, manifested as work withdrawal behaviours, which in turn reduces adaptive performance, forming a vicious cycle of ‘resource loss—performance decline—further resource loss’ (Tang et al. 2024).
Existing literature has reported that perceived organisational support, as a primary source of social support in the workplace, can exert an adverse buffering effect on the negative emotions caused by change fatigue (Sun and Li 2023; Gao et al. 2024), which is consistent with the findings of this study. According to the Social Exchange Theory, when employees perceive care and support from the organisation, they will recognise the existence of a reciprocal social exchange relationship and emotional connection with the organisation, thereby developing a sense of responsibility and mission towards the organisation, increasing work input, improving innovative behaviours (Yang et al. 2022) and work performance (Tian and Liu 2020).
However, when organisational support is insufficient, nurses may feel that their role in the change process is undervalued, that they lack decision‐making power, and that they have little influence on the development of events, which leads them to be more inclined to remain silent in their work (Wei et al. 2024; Wozniak et al. 2020). Their motivation and willingness to participate in changes will also weaken, their self‐efficacy will decrease, and they will be unable to adapt to changes in work promptly, resulting in reduced participation in changes, decreased adaptive performance and may even lead to the failure of changes (McMillan and Perron 2020b; Cox et al. 2022).
This also suggests that managers, on the one hand, should actively create resources (workforce and skills), improve communication and team relationships for clinical nurses in their daily work, enhance the sense of organisational support and increase individual or collective adaptive reserves. On the other hand, in the process of change management practice, timely and dynamic resource compensation, early identification of possible negative impacts of change on nurses, attention to the expression of nurses' identity value, and improvement of nurses' decision‐making power and participation are required. Managers should avoid the stereotypical behaviour of ‘self‐sacrifice’ among nurses, which covers up the phenomenon of insufficient organisational support. Maintaining the effective cycle of ‘virtuous resource preservation‐investment‐regeneration’ for ICU nurses increases the likelihood of successful and sustainable change.
5. Limitations
This study has the following limitations. Firstly, self‐reported data collected via online platforms, along with inherent biases in participants' perceptions, may introduce response bias; additionally, biases in participants' understanding of the questionnaire items may lead to discrepancies between their responses and true feelings. In future studies, combining individual interviews with nurses and observations of their work status may help obtain a more comprehensive understanding of the real experiences of ICU nurses. Secondly, although this study reveals the potential impacts of organisational support and change fatigue on the adaptive performance of ICU nurses, other uncontrolled potential confounding factors may also play important roles. Future intervention studies are still needed to verify the results of this study. Finally, due to practical constraints (e.g., limited human resources and time), this study employed a convenience sampling method, which potentially resulted in the inclusion of a higher proportion of easily accessible nurses. This has, to a certain extent, limited the generalizability of the study findings. Furthermore, cross‐sectional data are insufficient to infer causal relationships; thus, longitudinal studies are warranted to further examine the relationships among variables and the dynamic changes in events over their transformation cycles.
6. Conclusion
The results of this study show that ICU nurses' adaptive performance is at a moderate level, and organisational support plays a mediating role in ICU nurses' change fatigue and adaptive performance. Managers should build a multidimensional organisational support system. Additionally, a resource depletion early warning mechanism should be established to promptly identify high‐risk groups through dynamic assessments and implement targeted measures. Future studies could employ longitudinal or interventional designs to further explore the causal relationships between change fatigue, adaptive performance and organisational support among ICU nurses.
Author Contributions
Wang Chaoping and Yuan Xiaoli conceived the study, Wang Chaoping and Chen Junxi developed the study design; all authors contributed to the data collection, data analysis and interpretation. Wang Chaoping drafted the manuscript, Chen Junxi, Yuan Weiwei and Yuan Xiaoli critically revised the manuscript; all authors read and approved the final manuscript. Wang Chaoping is the guarantor of this research.
Conflicts of Interest
The authors declare no conflicts of interest.
Acknowledgements
The authors gratefully acknowledge the time and insights provided by all survey respondents, and extend thanks to the institutional liaisons who enabled this multicenter study.
Chaoping, W. , Junxi C., Weiwei Y., and Xiaoli Y.. 2026. “The Mediating Effect of Organisational Support Between Change Fatigue and Adaptive Performance Among ICU Nurses: A Cross‐Sectional Study.” Journal of Advanced Nursing 82, no. 8: 8229–8236. 10.1111/jan.70376.
Funding: This study was supported by grants from the Zunyi Nursing Association (HZ‐2023‐441) and the Health Commission of Guizhou Province.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.