Nurses' experiences of change fatigue during healthcare reforms: a qualitative study of psychological distress, impacts, and adaptation.

BACKGROUND: Global healthcare systems are undergoing continuous and rapid transformations aimed at improving service quality and efficiency. As frontline care providers, clinical nurses are directly exposed to frequent organizational changes. Change fatigue has emerged as a significant concern. However, most existing studies have employed quantitative approaches, offering limited insight into nurses' subjective experiences of this phenomenon. This qualitative study, therefore, seeks to explore clinical nurses' lived experiences of change fatigue and the coping strategies they adopt in response. The findings are expected to inform the optimization of reform implementation, facilitate targeted support for nursing staff, and promote nurse well-being and workforce stability. METHODS: A qualitative descriptive study was adopted. Semi-structured, in-depth interviews were conducted with 17 clinical nurses between December 2025 and February 2026. Data were analyzed using Colaizzi's seven-step method to progressively develop themes and subthemes. Participants were recruited via purposive sampling. RESULTS: Four overarching themes with eight subthemes were identified: (i) Change-related physical and psychological experiences; (ii) Multiple triggering factors; (iii) Negative impacts of change fatigue; (iv) Coping strategies. CONCLUSION: Clinical nurses' experiences of change fatigue are multidimensional and complex. Management should monitor nurses' current levels of change fatigue, optimize the implementation process of reforms, strengthen support measures and nurses' psychological resources, and promote the stability of the nursing workforce and the orderly progress of healthcare reforms.