When personal resources may not be enough: burnout, psychological capital, and empathy among pediatric nurses in a Chinese tertiary hospital - an explanatory sequential mixed methods study.

AIMS: Healing workplaces require evidence on how personal resources are experienced under demanding clinical conditions and what forms of support nurses perceive as useful. This study examined burnout, psychological capital, and empathy among pediatric nurses in a Chinese tertiary hospital and used qualitative findings from nurses with extreme burnout profiles to clarify burnout-related support and training needs. METHODS: An explanatory sequential mixed methods design was used. In the quantitative phase, 218 pediatric nurses completed an online survey including the Maslach Burnout Inventory-Human Services Survey, the Chinese Revised Nurses' Psychological Capital Scale, and the Jefferson Scale of Empathy-Health Professionals. In the qualitative phase, 11 nurses with extreme burnout profiles participated in one 120-min focus group. Quantitative data were analyzed using descriptive statistics, unadjusted Pearson correlations, and 95% confidence intervals. Qualitative data were analyzed using inductive thematic analysis and integrated with quantitative findings through a joint display. RESULTS: Reduced personal accomplishment was the most prevalent burnout dimension (54.6%), whereas emotional exhaustion and depersonalization were low in most participants (75.0% and 84.0%, respectively). Psychological capital was low in 76.0% of nurses and was not significantly correlated with any burnout dimension. Empathy was high in 62.0% of participants and was positively correlated with personal accomplishment (r = 0.405) and negatively correlated with emotional exhaustion (r = -0.184) and depersonalization (r = -0.313). Qualitative findings identified perceived support needs related to burnout recognition, psychological guidance, career development, professional enhancement, case-based learning, confidentiality, and follow-up evaluation. CONCLUSION: Pediatric nurses showed a burnout profile dominated by diminished personal accomplishment. The non-significant psychological capital-burnout associations suggest that personal resources alone may not fully explain burnout patterns in this single-center context. Burnout support in high-acuity pediatric settings may need to combine psychological support with career-development pathways, team learning, and reflective practice.