Current status and influencing factors of role clarity among junior nurses in tertiary hospitals: a cross-sectional study

Current status and influencing factors of role clarity among junior nurses in tertiary hospitals: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Current status and influencing factors of role clarity among junior nurses in tertiary hospitals: a cross-sectional study Tingyao Nie, Xiuwen Chen, Huiqiong Chen, Qiang Peng, Liqing Yue, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6294537/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Aim This study aim to explore the current situation of role clarity of junior nurses and the study of influencing factors. Methods A descriptive cross-sectional online study was conducted during April 2024 - May 2024, targeting 499 junior nurses working in six tertiary hospitals, Hunan Province, China. Data collection was conducted employing a sociodemographic questionnaire, the Compulsory Citizenship Behavior Scale, and the Role Clarity Scale. Data were analyzed statistically using SPSS 25.0, incorporating descriptive statistics, independent-samples t-tests, one-way ANOVA, Pearson correlation, and multiple linear regression analysis. Results The junior nurses' role clarity score (31.13 ± 5.32) and compulsory citizenship behavior score (15.13 ± 4.01). Role clarity was negatively correlated with compulsory citizenship behavior ( r = -0.132, P < 0.05), and multiple linear regression analysis showed that number of external training sessions the near 3 month, whether they have suffered from workplace violence the near month, baseline education, and their compulsory citizenship behavior were the influencing factors of role clarity for junior nurses (all P < 0.05). Conclusions Junior nurses exhibited the upper level overall of role clarity and the lower level overall compulsory citizenship behavior. Additionally, the role clarity was negatively correlated with the compulsory citizenship behavior. The main factors affecting the role clarity of junior nurses are number of external training sessions the near 3 month, whether they have suffered from workplace violence the near month, baseline education, and compulsory citizenship behavior. Recamendation To mitigate compulsory citizenship behavior (CCB) and enhance role clarity among junior nurses, nursing managers should adopt proactive management strategies—such as reducing rigid policies and improving transparent communication—can minimize coercive pressures and also integrating burnout prevention measures, including workload monitoring and stress management, ensures sustainable role clarity. junior nurses role clarity compulsory citizenship behavior career planning A cross-sectional survey Background In 2020, the World Health Organization, in collaboration with the International Council of Nurses and the global campaign " Nursing Now, " released the " State of the World's Nursing 2020 " report [ 1 ]. The report highlighted that the current number of nurses worldwide is far from sufficient to meet global healthcare demands, emphasizing the urgent need for younger nurses to join the nursing workforce. However junior nurses are in a critical transition phase from students to professional practitioners. They are burdened with extensive and complex clinical responsibilities, frequent night shifts, and high work intensity, while simultaneously facing various professional training and assessment requirements [ 2 ]. Due to their limited work experience, and inadequate ability to handle unexpected clinical events, they are more prone to nursing disputes and adverse incidents. These challenges often lead to difficulties in role adaptation and a sense of professional frustration, ultimately impacting both the quality of nursing care and their personal career development [ 3 ]. Role clarity is an individual's understanding of the degree of work standards and organizational expectations, when the individual assumes the work role in the workplace and receives the expectations from the organization for the role they play match, the individual can obtain a sense of control over the work and internal motivation in the work autonomy, which is conducive to the improvement of the individual's job satisfaction. At the same time, role clarity as the process of socialization, which can reduce the stress level of the nurses of the lower years of seniority levels, promote workplace adaptation, and gain a sense of decency in career development [ 4 , 5 ]. Compulsory citizenship behaviors are involuntary or forced behaviors performed by individuals due to external pressure [ 6 ]. With the change of people's medical concepts, patients' demands for nursing care and service satisfaction have been increasing, and the work pressure faced by junior nurses has also increased. Some studies have shown that in a high-demand, high-risk work environment, compulsory citizenship behaviors and decreased job satisfaction tend to occur due to the inherent power imbalance and high work pressure in nurses' professional roles [ 7 ]. Junior nurses, as a primary source and emerging force within the nursing workforce, it is important to guide them to establish positive career development and firm confidence [ 8 ].Terefore, this study aimed to investigate the current situation of role clarity and influencing factors of junior nurses, and to explore the relationship between role clarity and compulsory citizenship behaviors, with the aim of providing nursing managers with better guidance for junior nurses' career planning, reducing compulsory citizenship behaviors of junior nurses, forming a clear and positive perception of nurses' roles, and creating a better understanding of the role of nurses and the relationship between role clarity and compulsory citizenship behaviors and to develop the nursing team. Methods Study design This study employed a cross-sectional, descriptive, and correlational design, adhering to the STROBE guidelines [ 9 ]. The research aimed to investigate the role clarity of junior nurses and its association with compulsory citizenship behavior (CCB), while identifying key influencing factors. Participants A convenience sampling method was used to recruit 499 junior nurses from six tertiary hospitals in Hunan Province, China, between April and May 2024. Inclusion criteria were: (1) registered nurses with 3 months to 3 years of clinical experience; (2) willingness to participate voluntarily. Exclusion criteria included nurses in administrative roles or those undergoing further training. The sample size was determined using Kendall’s principle of 5–10 participants per variable, adjusted for a 20% attrition rate, resulting in an initial target of 108–216 participants. The final sample size (N = 499) exceeded projections, enhancing statistical power. Data collection Data were collected electronically via the Questionnaire Star platform. The nursing department heads of participating hospitals distributed the survey link. After removing incomplete or inconsistent responses (N = 11), 499 valid questionnaires were retained, yielding a 97.84% response rate. The survey comprised three sections: Sociodemographic Questionnaire: Included variables such as age, first-obtained degree, workplace violence exposure, training frequency and so on. Role Clarity Scale (RCS): Adapted from Rizzo [ 10 ] and translated to Chinese by Zhang Yanhong [ 11 ], this 6-item scale used a 7-point Likert scale (Cronbach'sα = 0.816). Higher scores indicated clearer role perception. Compulsory Citizenship Behavior Scale (CCB): Developed by Vigoda-Gad [ 12 ] and translated to Chinese by Qiao Lulu [ 13 ], this 5-item scale employed a 5-point Likert scale (Cronbach'sα = 0.809). Higher scores reflected greater CCB. Data analysis Data were analyzed using SPSS 25.0. Descriptive statistics summarized sociodemographic characteristics and scale scores. Independent-samples t-tests and one-way ANOVA assessed group differences in role clarity. Pearson correlation examined the relationship between CCB and role clarity. Multiple linear regression identified predictors of role clarity, with significance set at α = 0.05. Ethical considerations Approval was obtained from the ethics committee of the First Hospital of Hunan University of Chinese Medicine (No. HN-LL-YJSLW-2022-261). Participants provided electronic informed consent, and data were anonymized to ensure confidentiality. Rationale for Methodology The cross-sectional design aligns with similar studies exploring work values and burnout, while latent profile analysis (LPA) was avoided to differentiate from Wang et al.’s approach [ 14 ]. The focus on CCB as a novel factor expands existing frameworks, to explain role clarity dynamics [ 15 ]. Results The levels of junior nurses’ CCB and role clarity Table 1 and Table 2 details the prevalence of junior nurses’ role clarity and CCB. The scores for the role clarity was 31.13 ± 5.32, indicating a upper level overall. Junior nurses’ CCB, the scores was 15.13 ± 4.00, indicating a lower level overall. Table 1 Total and individual entry scores for role clarity for junior nurses (N = 499) Items Score Role clarity score 31.13 ± 5.32 I am well aware of the rights I have at work. 4.90 ± 1.51 I know my job responsibilities. 5.29 ± 1.39 I think that in itself it is already a reasonable allocation of time for personal work. 6.04 ± 0.98 I have clear and precise goals and requirements for the job I hold. 5.38 ± 1.37 I clearly understand the expectations I place on my work. 5.46 ± 1.30 I'm not sure if personal work is acceptable to my superiors. 4.05 ± 1.65 Table 2 Total and individual entry scores for CCB for junior nurses (N = 499) Items Score Compulsory citizen behavior score 15.13 ± 4.00 Pressure from my superiors to go the extra mile to meet their demands 2.95 ± 1.51 There is a culture of mandatory overtime in the department 2.89 ± 1.16 My superiors always expect me to put more effort into my work. 3.47 ± 0.99 Even if I don't want to, I have to volunteer to help other colleagues. 2.83 ± 1.07 Even if I don't want to, I have to volunteer to do work that is beyond the duties of my job but can assist my superiors. 2.99 ± 1.09 Socio-demographic characteristics and CCB association with junior nurses’ role clarity The online survey collected 510 completed questionnaires, with 499 valid responses retained for analysis, achieving a response rate of 97.84%. Table 3 presents the socio-demographic characteristics and univariate analysis of role clarity among junior nurses. Female nurses accounted for 96.7% of the junior nursing staff in the sample, and 63.3% held a bachelor's degree or higher. Notably, 72.1% reported attending external training sessions no more than once in the preceding three months, while 77.8% were employed as unorganized staff. Additionally, 67.7% worked no more than four night shifts per month. Statistical analysis revealed no significant differences in role clarity scores based on gender, employment mode, weekly overtime, or the number of night shifts per month ( P > 0.05). However, significant variations in role clarity were observed among groups categorized by the number of external training sessions attended in the past three months, exposure to workplace violence in the preceding month, and the first-obtained degree ( P > 0.05). Table 3 The socio-demographic characteristics and univariate analysis of role clarity of junior nurses (N = 499) Socio-demographic data Number (percentage, %) Character Clarity score t/F score P value Number of external training sessions the near 3 month 8.632 4 29 (5.8) 33.55 ± 4.47 Baseline education 10.045 < 0.001 three-year college 183 (36.7) 30.09 ± 5.21 undergraduate 254 (50.9) 32.00 ± 4.74 Master's degree or above 62 (12.4) 33.48 ± 4.51 Suffered from workplace violence the near month 1.997 0.046 yes 368 (73.7) 31.41 ± 5.35 no 131 (26.3) 30.34 ± 5.17 Gender 0.235 0.815 male 16 (3.3) 31.44 ± 4.37 women 483 (96, 7) 31.12 ± 5.35 Employment mode 0.537 0.592 within the establishment 111 (22.2) 31.37 ± 5.50 unorganized 388 (77.8) 31.06 ± 5.27 Weekly overtime (h) 0.933 0.425 8 76 (15.2) 30.79 ± 5.55 Night shifts per month (number) 1.633 0.181 8 44 (8.8) 30.14 ± 5.01 Correlation analysis between junior nurses’ role clarity and CCB Junior nurses’ role clarity was negatively correlated with compulsory citizenship behaviors ( r = -0.132, P < 0.05) Regression model for the role clarity The hierarchical regression model examining predictors of role clarity among junior nurses accounted for 9.1% of the variance ( F = 12.320, P < 0.001), demonstrating statistically significant explanatory power. Three key variables emerged as significant predictors of role clarity: frequency of external training participation during the 3-month observation period. recent exposure to workplace violence incidents, first-obtained degree (all P 0.05): biological sex, employment classification, weekly overtime hours, monthly night shift frequency. The negative coefficient for workplace violence exposure suggests that nurses experiencing recent violent incidents demonstrated reduced role clarity, while greater training participation and higher educational attainment were positively associated with clearer role perception. Table 4 Linear regression analysis of role clarity for junior nurses (N = 499) Items B SE β t P value Constant term (math.) 36.068 1.383 - 26, 087 0.000 Number of external training sessions the near 3 month 1.659 0.396 0.182 4.188 < 0.001 Suffered from workplace violence the near month -1.340 0.524 -0.111 -2.558 0.011 first-obtained degree 1.393 0.340 0.177 4.098 < 0.001 Compulsory citizenship behavior -0.165 0.058 -0.125 -2.841 0.005 Discussion Our investigation yields important discoveries: first, it establishes CCB as an innovative factor influencing role clarity in junior nurses; second, it uncovers significant associations between these constructs. These outcomes create fresh opportunities for implementing evidence-based approaches to optimize role clarity. The role clarity of junior nurses was in the upper level overall Role clarity is typically divided into role conflict (where individuals experience competing demands from distinct roles or contexts) and role ambiguity (characterized by a lack of clarity due to unstable role conditions. The results of this study showed that the role clarity score of junior nurses was ( 31.13 ± 5.32 ), and the mean score of the entries was ( 5.19 ± 0.89 ), which was in the upper level overall compared to the middle score of the scale of 4, but lower than the score of Sang Ming's [ 16 ] study on ICU nurses in China ( 34.90 ± 3.75 ), which may be related to the difference in the subjects of the study, and that junior nurses are at the the early stage of career exploration, not only face the impact of multi-directional transition, but also need to bear the heavy task of rotating departmental assessment as well as high occupational pressure, which is prone to poor role adaptation [ 17 , 18 ]. In addition, Xu studies have shown that when nurses encounter duties or instructions that lack clarity in their work, they may be prevented from performing their work correctly or find it difficult to control their work, which ultimately leads to ambiguous self-perception of their roles [ 19 ]. The highest scoring item in this study was " I think I have allocated my working time appropriately ", which may be due to the fact that there are more nurses with bachelor's degree and above in this study, and some studies have shown that nurses with higher education have higher cognitive ability and solid theoretical foundation, and have a high level of enthusiasm for their work due to their higher level and systematic education. They have a high degree of enthusiasm and curiosity for their work, and can adapt to nursing work quickly; in addition, highly educated nurses have higher expectations for future promotion, and they will take the initiative and reasonably plan their career until their goals are realized, so the individual's cognition of their self-role is more positive and clear [ 20 ]. In addition, other studies have shown that the higher the educational level of nurses, the greater their creativity and feedback behavior, good at feedback in the work of the moral pressure felt by the relatively stable, can better adapt to the organizational environment, faster and better acceptance by colleagues recognized, and their role clarity is also stronger [ 21 ]. The relatively low score of " I am not sure if my work can be accepted by my superiors " may be due to the fact that junior nurses are in the early stage of their employment, and due to the lack of work experience, professional confidence, and clinical thinking, coupled with psychological violence from senior colleagues or leaders, they are prone to psychological discrepancies and role ambiguity. Therefore, nursing managers can implement structured onboarding programs complemented by regular role clarification meetings and open feedback channels to optimize communication. Furthermore, establishing positive reinforcement mechanisms alongside quantifiable performance metrics and strengthened team collaboration serves to reinforce role perception. In addition, individual nurses should vent their negative emotions in a timely manner, strengthen their psychological construction, and do a good job of career planning, so as to improve their knowledge of their own roles. The relationship between CCB and role clarity The results of this study showed that junior nurses' role clarity was negatively correlated with compulsory citizenship behavior ( r = -0.132, P < 0.05), and multivariate linear regression found that nurses' compulsory citizenship behavior was an influencing factor for role clarity ( P < 0.05). CCB, as an obstructive stressor in the workplace, are more prominent when junior nurses are forced to perform duties or tasks that are not related to their work roles, leading to poor workplace adjustment, which in turn leads to low role clarity for junior nurses [ 22 ]. In addition additional tasks undertaken by junior nurses can disrupt the nurse's original planning and perception of the work role, further exacerbating role ambiguity [ 23 , 24 ]. Affective event theory states that events occurring in the workplace affect the psychological and emotional responses of employees, and negative role perceptions are likely to occur when employees experience an unpleasant work atmosphere [ 15 ]. Liang studies have shown that individuals with compulsory citizenship behaviors continuously deplete their emotional and cognitive resources, and when this depletion exceeds what the individual can tolerate, emotional exhaustion occurs, making it difficult for the individual to focus on clarifying his or her own work roles and responsibilities, and thus ambiguous work role perceptions occur [ 25 ]. Therefore, nursing managers should give bonus performance support to nurses who undertake non-work related tasks as a way to promote nurses' work well-being and motivation, and can also adopt a transformational leadership style to create a supportive organizational climate in the department [ 26 ]. In addition, individual nurses should define role boundaries clearly and tactfully decline non-essential tasks and optimize time management by prioritizing core responsibilities. Influences on role clarity for junior nurses Number of external training sessions the near 3 month The results of this study showed that the more the number of study trips in the near 3 month, the higher the role clarity score of junior nurses. Junior nurses need to continuously learn new knowledge and skills to improve the quality of care and meet patients' needs, and it has been pointed out that nurses who have more opportunities for further education or learning have stronger core competencies and self-efficacy, and nurses with stronger self-efficacy have a clearer understanding of what they really want and the responsibilities they take on [ 27 ]. In addition, nurses who study abroad more often have their enthusiasm for their work stimulated, their willingness to take the initiative strengthened, and their internal motivation level increased, which strengthens their sense of professional identity and happiness [ 28 ]. Therefore, nursing managers should encourage junior nurses to go out to study and provide resources and platforms, and for individuals who do not meet the standards for further training, relevant courses can be set up in hospitals for training and guidance, so as to promote the work of junior nurses while also continuously improving their professional abilities. Suffered from workplace violence the near month The results of this study showed that the lower the role clarity scores of junior nurses who had suffered workplace violence, the lower the role clarity scores. Liao Liwen [ 29 ] pointed out that nurses who have suffered from workplace violence have reduced work enthusiasm, physical and mental health is affected, resulting in negative attitudes and perceptions of the nurse's role perception of nursing; in addition, nurses who have suffered from violent attacks in the workplace will feel that they are not accepted and recognized in their social life or at work, so that their work attitudes and behaviors change, and the emotional experience of nursing becomes worse, and their identification with the profession they are engaged in decreases, which ultimately leads to the blurring of their own roles. Therefore, nursing managers should guide junior nurses to correctly recognize their own professional value, stimulate their work enthusiasm, and avoid the emergence of occupational fatigue. Baseline education Junior nurses with higher initial academic qualifications typically demonstrate greater role clarity due to several key factors. First, their systematic professional training provides comprehensive theoretical knowledge and clinical guidance, enabling a clearer definition of their professional responsibilities. Second, their stronger self-directed learning and adaptability allow them to quickly assimilate complex information and establish well-defined functional boundaries within healthcare teams [ 30 , 31 ]. Third, their heightened professional identity and self-efficacy drive proactive engagement in role exploration, reducing ambiguity in responsibilities [ 32 ]. Finally, greater access to continuing education and career development resources enables ongoing refinement of their understanding of nursing roles. In contrast, nurses with lower academic qualifications often face challenges in role clarity due to more limited foundational training, restricted access to professional development opportunities, and potential self-doubt stemming from educational disparities. To improve role clarity among junior nurses with lower academic qualifications, managers should implement a comprehensive strategy. First, structured onboarding programs should integrate not only technical skill development but also explicit role delineation, utilizing case simulations and role-playing exercises to clarify responsibilities in complex clinical scenarios. Second, clearly documented job descriptions and competency-based evaluation criteria should be established to reinforce expectations. Third, targeted professional development initiatives and equitable access to continuing education opportunities. Limitations While this investigation established important relationships between CCB and role clarity, its scope was necessarily constrained by two key methodological factors: (a) the exclusive focus on correlational analysis precludes causal inferences, and (b) the dependence on self-report measures leaves open the possibility of common method variance influencing the observed effects. Future studies would benefit from incorporating objective behavioral measures alongside psychometric assessments. Conclusions The role clarity of junior nurses was in the upper level overall, the compulsory citizenship behavior was in the lower level overall, and role clarity was negatively correlated with the compulsory citizenship behavior. The main factors affecting role clarity of junior nurses are number of external training sessions the near 3 month, whether you have suffered from workplace violence the near month, first-obtained degree, and compulsory citizenship behavior. Managers should pay attention to the compulsory citizenship behavior of junior nurses and take measures to reduce the compulsory citizenship behavior, so as to promote junior nurses' positive and correct perception of their own roles. Declarations Ethics approval and informed consent This study was approved by ethics committee of the First Hospital of Hunan University of Chinese Medicinethe, with ethical approval number HN-LL-YJSLW-2022-261 and all procedures were conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the article. Consent for publication Not applicable. Availability of data and materials All data generated or analyzed during this study are included in this published article. Competing interests The authors confirmed that they have no competing interests. Funding This work was supported by the Chinese Nursing Association Research Project (ZHKY202418), Hunan Nursing Association Project on the Development of the First Curriculum Group for Professional Competence of Newly Recruited Nurses: Xiang Nursing Association Document No. [2024] 170. The authors alone are responsible for the design, writing, and content of this paper. The funding body was not involved in the decision to submit this research for publication. Authors' contributions Tingyao Nie have made substantial contributions to the conception and design, or acquisition of data, or analysis and interpretation of data. Tingyao Nie, Xiuwen Chen, Huiqiong Chen, Qiang Peng, Ping Zhang, and Liqing Yue were involved in drafting the manuscript or revising it critically for important intellectual content. Tingyao Nie, Xiuwen Chen, Huiqiong Chen, Qiang Peng, Ping Zhang, and Liqing Yue gave final approval for the version to be published. Tingyao Nie, Xiuwen Chen, Huiqiong Chen, Qiang Peng, Ping Zhang, and Liqing Yue agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Acknowledgement Not applicable. References World Health Organization (WHO) & International Council of Nurses (ICN) (2020). State of the World’s Nursing 2020. Geneva: World Health Organization. Seo EH, Lee JH, MacDougall A, Liu N, Hofkirchner A, Sharma S, Elfakhani M, Yoon HJ. Anxiety symptoms and associated psychological and job-related factors among hospital nurses [J]. Psychiatry Investig. 2024 Jan;21(1):100-108. Pesonen T, Nurmeksela A, Hult M. The relationships between precarious employment, having a calling, and occupational well-being among young nurses: a cross-sectional study [J]. BMC Health Serv Res. 2024 Jun 24;24(1):762. Ning CC,Li YL, Gao KX. A study of feedback-seeking behavior and role clarity among newly recruited nurses [J]. Journal of Nursing, 2018,33(9):63-65. Fukui S, Salyers MP, Morse G, Rollins AL. Factors that affect quality of care among mental health providers: Focusing on job stress and resources [J]. Psychiatr Rehabil. 2021 Sep;44(3):204-211. Li Z, Yang L, Xi Z, Yi W, Fu Y, Chang C, Lei Y. The relationship between compulsory citizenship behavior and nurses' silence: a cross-sectional study [J]. BMC Nurs. 2025 Jan 6;24(1):14. Liu Z, Chen C, Cui H, Hu Y. The relationship between nurses' social network degree centrality and organizational citizenship behavior: The multiple mediating effects of job satisfaction and work engagement [J]. Heliyon. 2023 Aug 29;9(9):e19612. Orgambídez A, Almeida H. Social support, role clarity and job satisfaction: a successful combination for nurses [J]. Int Nurs Rev. 2020 Sep;67(3):380-386. Smith J, Jones M. Application of STROBE guidelines in nursing research: A practical guide [J]. Journal of Nursing Scholarship, 2018, 50(3):321-329. Rizzo JR, House RJ, Lirtzman SI. Role conflict and ambiguity in complex organizations [M]. Thousand Oaks,California: SAGE Publications, 1970:150. Zhang YH, Liao JQ. Team authentic leadership, new employee feedback seeking behavior, and socialization outcomes [J]. Management Science, 2015,28(2):126-136. Vigoda-Gadot E. Redrawing the boundaries of OCB? An empirical examination of compulsory extra-role behavior in the workplace [J]. Bus Psychol, 2007;21(3):377–405 Qiao LL. The effect of employees' compulsory citizenship behavior on job burnout [D]. Xi'an: Northwest University, 2021. Wang Y, Wang X, Gao L, Ge Y, Xue M, Ji Y. Nurses' work value patterns and their relationship with burnout: a cross-sectional study based on latent profile analysis. BMC Nurs. 2025 Feb 12;24(1):164. [15] Weiss HM, Cropanzano R. Affective events theory: a theoretical discussion of the structure, causes and consequences of affective experiences at work [J]. Research in Organizational Behavior, 1996. 18.(3):1-74. Sang M, Wei J, Li XF, et al. The effects of ICU nurses' role clarity and moral dilemmas on spiritual caregiving competence [J]. Journal of Nursing, 2022,37(22):1-5. Liu Q, Yih B. Role adaptation of nurses caring for older adults with terminal diseases in geriatric hospitals [J]. Int Nurs Rev. 2024 Nov 13. Xue Y, Zhang W, Wang J, Zhu Y, Li D, Sun J, Gao L, Zhang Y. Relationships among growth mindset, turnover tendency, workplace adaptability and essentials of magnetism of new nurses: a moderated mediation model [J]. Adv Nurs. 2024 Nov 25. Xu Z, Ye Y, Wang Y, Qian Y, Pan J, Lu Y, Fang L. Primary care practitioners' barriers to and experience of COVID-19 epidemic control in china: a qualitative study [J]. Gen Intern Med. 2020 Nov;35(11):3278-3284. Xue YL, Nie TY, Zhang P, et al. A study of the impact of role clarity on the sense of decent labor among oncology nurses [J]. Journal of Nursing, 2023,38(22):73-76. Zhou X, Zhang S, Zhao X R , et al. How mentors inspire affective commitment in newcomers: the roles of servant leadership, psychological capital, and feedback-seeking behavior. [J]. International Journal of Hospitality Management, 2024, 118(000):9. Li ZF, Xi ZY, Wang C, et al. A study on the correlation between nurses' compulsory citizenship behavior and willingness to leave [J]. Journal of Nursing, 2023,11, 38(22):69-73. Yildiz B, Elibol E. Turnover intention linking compulsory citizenship behaviours to social loafing in nurses: a mediation analysis [J]. Nurs Manag. 2021 May;29(4):653-663. Zhang S, Liang XH, Wang XY, et al. Analysis of the mediating effect of role clarity between reality shock and workplace adaptation in newly recruited nurses [J]. Journal of Nursing Advancement, 2025,40(2):113-117. Liang HL, Yeh TK, Wang CH. Compulsory citizenship behavior and its outcomes: two mediation models. Front Psychol [J]. 2022 Feb 4;13:766952. Song H, Yin Q, Zhang Q, Li Y. The impact of compulsory citizenship behavior on job performance of new-generation knowledge workers: the roles of ego depletion and relational energy [J]. Psychol Res Behav Manag [J]. 2023 Jun 28;16:2367-2381. Guo J, Dai Y, Chen Y, Liang Z, Hu Y, Xu X, Xiao Y. Core competencies among nurses engaged in pallative care: a scoping review [J]. Clin Nurs. 2024 Oct;33(10):3905-3922. Tong Y, Wang T, Tong S, Tang Z, Mao L, Xu L, Shi X. Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study [J]. BMJ Open. 2024 Apr 3;14(4):e082865. Liao L, Wu Q, Su Y, Li R, Wang L. Coping styles mediated the association between perceived organizational support and resilience in emergency nurses exposed to workplace violence: a cross-sectional study [J]. Nurs Health Sci. 2025 Mar;27(1):e70018. Wang X, Guo QZ, Yan JJ. A study of the relationship between innovation ability and achievement motivation and psychological health of full-time graduate master's degree clinical nurses [J]. Journal of Nursing Management , 2023,23(8):629-633. Chen Y, Liu Y. A study of the correlation between feedback-seeking behavior, career success and willingness to leave among surgical nurses in four tertiary hospitals in Sichuan Province [J]. Occupation and Health , 2024,40(6):796-801. Alexander L, Toomey N, Foster K. Nurses' career choice and satisfaction with mental health transition-to-practice programs: a cross sectional study [J]. Psychiatr Ment Health Nurs. 2024 Oct;31(5):825-835. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 30 Apr, 2025 Editor assigned by journal 25 Apr, 2025 Editor invited by journal 04 Apr, 2025 Submission checks completed at journal 03 Apr, 2025 First submitted to journal 03 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6294537","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":450349481,"identity":"9f7a3863-6105-4b70-8bca-6c75e88d2a3b","order_by":0,"name":"Tingyao Nie","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYDACZiBOALMYGw4k8Njw8PM3ENTC2ADRwtz44INMmozkjAME7WGEmsrebDjD5rCNAdQEnMCcnfn4g4c7ahP72xvbpHlyzvMYMBxg/PAxB7cWy2a2xIbEM8cTZ5w5CNRy5jaPOXMDs+TMbbi1GBzmMWxIbDuW2HAjsU2at+c2j2XDATZmXrxa+D+CtcwHa/l3jsfgQAIhLTyMQC01iRtuJAK9z3OAGC1shjMS2w4YbzxzEBjIPMk8kjMONuP3y/nDDz7+bKuTnXe8/QEwKu3s+fmbD374iEcLFBx2bEBwGBtwKUMGdfbEqBoFo2AUjIIRCgDIo11MVg4t7QAAAABJRU5ErkJggg==","orcid":"","institution":"Xiangya School of Nursing, Central South University","correspondingAuthor":true,"prefix":"","firstName":"Tingyao","middleName":"","lastName":"Nie","suffix":""},{"id":450349482,"identity":"b92f488e-0a43-4824-8b92-c3e093ceb0b6","order_by":1,"name":"Xiuwen Chen","email":"","orcid":"","institution":"Xiangya School of Nursing, Central South University","correspondingAuthor":false,"prefix":"","firstName":"Xiuwen","middleName":"","lastName":"Chen","suffix":""},{"id":450349483,"identity":"859d9324-65a8-4c67-aef4-0ed170c694db","order_by":2,"name":"Huiqiong Chen","email":"","orcid":"","institution":"Xiangya School of Nursing, Central South University","correspondingAuthor":false,"prefix":"","firstName":"Huiqiong","middleName":"","lastName":"Chen","suffix":""},{"id":450349484,"identity":"59b57e2d-04ea-485b-9847-7bdb50babf22","order_by":3,"name":"Qiang Peng","email":"","orcid":"","institution":"Xiangya School of Nursing, Central South University","correspondingAuthor":false,"prefix":"","firstName":"Qiang","middleName":"","lastName":"Peng","suffix":""},{"id":450349485,"identity":"43f12769-ee6f-44a3-8bdb-6193041cdb18","order_by":4,"name":"Liqing Yue","email":"","orcid":"","institution":"Department of Orthopedics and Traumatology, the First Hospital of Hunan University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Liqing","middleName":"","lastName":"Yue","suffix":""},{"id":450349486,"identity":"b864a458-ae8a-4e88-802e-3c27781eba9e","order_by":5,"name":"Ping Zhang","email":"","orcid":"","institution":"Department of Orthopedics and Traumatology, the First Hospital of Hunan University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Ping","middleName":"","lastName":"Zhang","suffix":""}],"badges":[],"createdAt":"2025-03-24 10:53:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6294537/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6294537/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82037620,"identity":"22405c1f-839f-4f6e-8c01-eb3c38cf1ffc","added_by":"auto","created_at":"2025-05-06 08:28:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1071385,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6294537/v1/97edc047-13a1-418f-ab42-43e2f918f069.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eCurrent status and influencing factors of role clarity among junior nurses in tertiary hospitals: a cross-sectional study\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eIn 2020, the World Health Organization, in collaboration with the International Council of Nurses and the global campaign \" Nursing Now, \" released the \" State of the World's Nursing 2020 \" report [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The report highlighted that the current number of nurses worldwide is far from sufficient to meet global healthcare demands, emphasizing the urgent need for younger nurses to join the nursing workforce. However junior nurses are in a critical transition phase from students to professional practitioners. They are burdened with extensive and complex clinical responsibilities, frequent night shifts, and high work intensity, while simultaneously facing various professional training and assessment requirements [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Due to their limited work experience, and inadequate ability to handle unexpected clinical events, they are more prone to nursing disputes and adverse incidents. These challenges often lead to difficulties in role adaptation and a sense of professional frustration, ultimately impacting both the quality of nursing care and their personal career development [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRole clarity is an individual's understanding of the degree of work standards and organizational expectations, when the individual assumes the work role in the workplace and receives the expectations from the organization for the role they play match, the individual can obtain a sense of control over the work and internal motivation in the work autonomy, which is conducive to the improvement of the individual's job satisfaction. At the same time, role clarity as the process of socialization, which can reduce the stress level of the nurses of the lower years of seniority levels, promote workplace adaptation, and gain a sense of decency in career development [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCompulsory citizenship behaviors are involuntary or forced behaviors performed by individuals due to external pressure [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. With the change of people's medical concepts, patients' demands for nursing care and service satisfaction have been increasing, and the work pressure faced by junior nurses has also increased. Some studies have shown that in a high-demand, high-risk work environment, compulsory citizenship behaviors and decreased job satisfaction tend to occur due to the inherent power imbalance and high work pressure in nurses' professional roles [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eJunior nurses, as a primary source and emerging force within the nursing workforce, it is important to guide them to establish positive career development and firm confidence [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].Terefore, this study aimed to investigate the current situation of role clarity and influencing factors of junior nurses, and to explore the relationship between role clarity and compulsory citizenship behaviors, with the aim of providing nursing managers with better guidance for junior nurses' career planning, reducing compulsory citizenship behaviors of junior nurses, forming a clear and positive perception of nurses' roles, and creating a better understanding of the role of nurses and the relationship between role clarity and compulsory citizenship behaviors and to develop the nursing team.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy design\u003c/h2\u003e\n \u003cp\u003eThis study employed a cross-sectional, descriptive, and correlational design, adhering to the STROBE guidelines [\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e]. The research aimed to investigate the role clarity of junior nurses and its association with compulsory citizenship behavior (CCB), while identifying key influencing factors.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eA convenience sampling method was used to recruit 499 junior nurses from six tertiary hospitals in Hunan Province, China, between April and May 2024. Inclusion criteria were: (1) registered nurses with 3 months to 3 years of clinical experience; (2) willingness to participate voluntarily. Exclusion criteria included nurses in administrative roles or those undergoing further training. The sample size was determined using Kendall\u0026rsquo;s principle of 5\u0026ndash;10 participants per variable, adjusted for a 20% attrition rate, resulting in an initial target of 108\u0026ndash;216 participants. The final sample size (N\u0026thinsp;=\u0026thinsp;499) exceeded projections, enhancing statistical power.\u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eData were collected electronically via the Questionnaire Star platform. The nursing department heads of participating hospitals distributed the survey link. After removing incomplete or inconsistent responses (N\u0026thinsp;=\u0026thinsp;11), 499 valid questionnaires were retained, yielding a 97.84% response rate. The survey comprised three sections:\u003c/p\u003e\n\u003ch3\u003eSociodemographic Questionnaire:\u003c/h3\u003e\n\u003cp\u003eIncluded variables such as age, first-obtained degree, workplace violence exposure, training frequency and so on.\u003c/p\u003e\n\u003ch3\u003eRole Clarity Scale (RCS):\u003c/h3\u003e\n\u003cp\u003eAdapted from Rizzo [\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e] and translated to Chinese by Zhang Yanhong [\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e], this 6-item scale used a 7-point Likert scale (Cronbach\u0026apos;s\u0026alpha;\u0026thinsp;=\u0026thinsp;0.816). Higher scores indicated clearer role perception.\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003cp\u003e\u003cstrong\u003eCompulsory Citizenship Behavior Scale (CCB):\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eDeveloped by Vigoda-Gad [\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e] and translated to Chinese by Qiao Lulu [\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e], this 5-item scale employed a 5-point Likert scale (Cronbach\u0026apos;s\u0026alpha;\u0026thinsp;=\u0026thinsp;0.809). Higher scores reflected greater CCB.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003eData analysis\u003c/h2\u003e\n \u003cp\u003eData were analyzed using SPSS 25.0. Descriptive statistics summarized sociodemographic characteristics and scale scores. Independent-samples t-tests and one-way ANOVA assessed group differences in role clarity. Pearson correlation examined the relationship between CCB and role clarity. Multiple linear regression identified predictors of role clarity, with significance set at \u0026alpha;\u0026thinsp;=\u0026thinsp;0.05.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003eApproval was obtained from the ethics committee of the First Hospital of Hunan University of Chinese Medicine (No. HN-LL-YJSLW-2022-261). Participants provided electronic informed consent, and data were anonymized to ensure confidentiality.\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003cp\u003e\u003cstrong\u003eRationale for Methodology\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe cross-sectional design aligns with similar studies exploring work values and burnout, while latent profile analysis (LPA) was avoided to differentiate from Wang et al.\u0026rsquo;s approach [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. The focus on CCB as a novel factor expands existing frameworks, to explain role clarity dynamics [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eThe levels of junior nurses\u0026rsquo; CCB and role clarity\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e details the prevalence of junior nurses\u0026rsquo; role clarity and CCB. The scores for the role clarity was 31.13\u0026thinsp;\u0026plusmn;\u0026thinsp;5.32, indicating a upper level overall. Junior nurses\u0026rsquo; CCB, the scores was 15.13\u0026thinsp;\u0026plusmn;\u0026thinsp;4.00, indicating a lower level overall.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTotal and individual entry scores for role clarity for junior nurses (N\u0026thinsp;=\u0026thinsp;499)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScore\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRole clarity score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e31.13\u0026thinsp;\u0026plusmn;\u0026thinsp;5.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI am well aware of the rights I have at work.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI know my job responsibilities.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.29\u0026thinsp;\u0026plusmn;\u0026thinsp;1.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI think that in itself it is already a reasonable allocation of time for personal work.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e6.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI have clear and precise goals and requirements for the job I hold.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI clearly understand the expectations I place on my work.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.46\u0026thinsp;\u0026plusmn;\u0026thinsp;1.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI'm not sure if personal work is acceptable to my superiors.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTotal and individual entry scores for CCB for junior nurses (N\u0026thinsp;=\u0026thinsp;499)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScore\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompulsory citizen behavior score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e15.13\u0026thinsp;\u0026plusmn;\u0026thinsp;4.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePressure from my superiors to go the extra mile to meet their demands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThere is a culture of mandatory overtime in the department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.89\u0026thinsp;\u0026plusmn;\u0026thinsp;1.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMy superiors always expect me to put more effort into my work.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEven if I don't want to, I have to volunteer to help other colleagues.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;1.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEven if I don't want to, I have to volunteer to do work that is beyond the duties of my job but can assist my superiors.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.99\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic characteristics and CCB association with junior nurses\u0026rsquo; role clarity\u003c/h2\u003e \u003cp\u003eThe online survey collected 510 completed questionnaires, with 499 valid responses retained for analysis, achieving a response rate of 97.84%. Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the socio-demographic characteristics and univariate analysis of role clarity among junior nurses. Female nurses accounted for 96.7% of the junior nursing staff in the sample, and 63.3% held a bachelor's degree or higher. Notably, 72.1% reported attending external training sessions no more than once in the preceding three months, while 77.8% were employed as unorganized staff. Additionally, 67.7% worked no more than four night shifts per month.\u003c/p\u003e \u003cp\u003eStatistical analysis revealed no significant differences in role clarity scores based on gender, employment mode, weekly overtime, or the number of night shifts per month (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, significant variations in role clarity were observed among groups categorized by the number of external training sessions attended in the past three months, exposure to workplace violence in the preceding month, and the first-obtained degree (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe socio-demographic characteristics and univariate analysis of role clarity of junior nurses (N\u0026thinsp;=\u0026thinsp;499)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocio-demographic data\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003cp\u003e(percentage, %)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCharacter Clarity score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003et/F score\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of external training sessions the near 3 month\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le; 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e360 (72.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.54\u0026thinsp;\u0026plusmn;\u0026thinsp;5.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e110 (22.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e32.41\u0026thinsp;\u0026plusmn;\u0026thinsp;4.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt; 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e33.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ethree-year college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e183 (36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.09\u0026thinsp;\u0026plusmn;\u0026thinsp;5.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eundergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e254 (50.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e32.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaster's degree or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (12.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e33.48\u0026thinsp;\u0026plusmn;\u0026thinsp;4.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSuffered from workplace violence the near month\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.997\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e368 (73.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.41\u0026thinsp;\u0026plusmn;\u0026thinsp;5.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131 (26.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.34\u0026thinsp;\u0026plusmn;\u0026thinsp;5.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.815\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.44\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ewomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e483 (96, 7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.12\u0026thinsp;\u0026plusmn;\u0026thinsp;5.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment mode\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.537\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.592\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ewithin the establishment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.37\u0026thinsp;\u0026plusmn;\u0026thinsp;5.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eunorganized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e388 (77.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.06\u0026thinsp;\u0026plusmn;\u0026thinsp;5.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeekly overtime (h)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.933\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e116 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.76\u0026thinsp;\u0026plusmn;\u0026thinsp;5.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e231 (46.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.56\u0026thinsp;\u0026plusmn;\u0026thinsp;5.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.71\u0026thinsp;\u0026plusmn;\u0026thinsp;5.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt; 8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.79\u0026thinsp;\u0026plusmn;\u0026thinsp;5.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNight shifts per month\u003c/b\u003e (number)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.633\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.181\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (24.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.97\u0026thinsp;\u0026plusmn;\u0026thinsp;5.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e218 (43.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.00\u0026thinsp;\u0026plusmn;\u0026thinsp;5.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e117 (23.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.89\u0026thinsp;\u0026plusmn;\u0026thinsp;5.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt; 8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.14\u0026thinsp;\u0026plusmn;\u0026thinsp;5.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation analysis between junior nurses\u0026rsquo; role clarity and CCB\u003c/h2\u003e \u003cp\u003eJunior nurses\u0026rsquo; role clarity was negatively correlated with compulsory citizenship behaviors (\u003cem\u003er\u003c/em\u003e = -0.132, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eRegression model for the role clarity\u003c/h2\u003e \u003cp\u003eThe hierarchical regression model examining predictors of role clarity among junior nurses accounted for 9.1% of the variance (\u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12.320, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), demonstrating statistically significant explanatory power. Three key variables emerged as significant predictors of role clarity: frequency of external training participation during the 3-month observation period. recent exposure to workplace violence incidents, first-obtained degree (all \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). Notably, the following demographic and work-related factors showed no significant association with role clarity (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05): biological sex, employment classification, weekly overtime hours, monthly night shift frequency.\u003c/p\u003e \u003cp\u003eThe negative coefficient for workplace violence exposure suggests that nurses experiencing recent violent incidents demonstrated reduced role clarity, while greater training participation and higher educational attainment were positively associated with clearer role perception.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLinear regression analysis of role clarity for junior nurses (N\u0026thinsp;=\u0026thinsp;499)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant term (math.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.383\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26, 087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of external training sessions the near 3 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.659\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuffered from workplace violence the near month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.558\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efirst-obtained degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompulsory citizenship behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.058\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.841\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur investigation yields important discoveries: first, it establishes CCB as an innovative factor influencing role clarity in junior nurses; second, it uncovers significant associations between these constructs. These outcomes create fresh opportunities for implementing evidence-based approaches to optimize role clarity.\u003c/p\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eThe role clarity of junior nurses was in the upper level overall\u003c/h2\u003e \u003cp\u003eRole clarity is typically divided into role conflict (where individuals experience competing demands from distinct roles or contexts) and role ambiguity (characterized by a lack of clarity due to unstable role conditions. The results of this study showed that the role clarity score of junior nurses was ( 31.13\u0026thinsp;\u0026plusmn;\u0026thinsp;5.32 ), and the mean score of the entries was ( 5.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89 ), which was in the upper level overall compared to the middle score of the scale of 4, but lower than the score of Sang Ming's [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] study on ICU nurses in China ( 34.90\u0026thinsp;\u0026plusmn;\u0026thinsp;3.75 ), which may be related to the difference in the subjects of the study, and that junior nurses are at the the early stage of career exploration, not only face the impact of multi-directional transition, but also need to bear the heavy task of rotating departmental assessment as well as high occupational pressure, which is prone to poor role adaptation [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In addition, Xu studies have shown that when nurses encounter duties or instructions that lack clarity in their work, they may be prevented from performing their work correctly or find it difficult to control their work, which ultimately leads to ambiguous self-perception of their roles [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The highest scoring item in this study was \" I think I have allocated my working time appropriately \", which may be due to the fact that there are more nurses with bachelor's degree and above in this study, and some studies have shown that nurses with higher education have higher cognitive ability and solid theoretical foundation, and have a high level of enthusiasm for their work due to their higher level and systematic education. They have a high degree of enthusiasm and curiosity for their work, and can adapt to nursing work quickly; in addition, highly educated nurses have higher expectations for future promotion, and they will take the initiative and reasonably plan their career until their goals are realized, so the individual's cognition of their self-role is more positive and clear [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In addition, other studies have shown that the higher the educational level of nurses, the greater their creativity and feedback behavior, good at feedback in the work of the moral pressure felt by the relatively stable, can better adapt to the organizational environment, faster and better acceptance by colleagues recognized, and their role clarity is also stronger [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The relatively low score of \" I am not sure if my work can be accepted by my superiors \" may be due to the fact that junior nurses are in the early stage of their employment, and due to the lack of work experience, professional confidence, and clinical thinking, coupled with psychological violence from senior colleagues or leaders, they are prone to psychological discrepancies and role ambiguity. Therefore, nursing managers can implement structured onboarding programs complemented by regular role clarification meetings and open feedback channels to optimize communication. Furthermore, establishing positive reinforcement mechanisms alongside quantifiable performance metrics and strengthened team collaboration serves to reinforce role perception. In addition, individual nurses should vent their negative emotions in a timely manner, strengthen their psychological construction, and do a good job of career planning, so as to improve their knowledge of their own roles.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eThe relationship between CCB and role clarity\u003c/h2\u003e \u003cp\u003eThe results of this study showed that junior nurses' role clarity was negatively correlated with compulsory citizenship behavior (\u003cem\u003er\u003c/em\u003e = -0.132, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and multivariate linear regression found that nurses' compulsory citizenship behavior was an influencing factor for role clarity (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). CCB, as an obstructive stressor in the workplace, are more prominent when junior nurses are forced to perform duties or tasks that are not related to their work roles, leading to poor workplace adjustment, which in turn leads to low role clarity for junior nurses [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. In addition additional tasks undertaken by junior nurses can disrupt the nurse's original planning and perception of the work role, further exacerbating role ambiguity [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Affective event theory states that events occurring in the workplace affect the psychological and emotional responses of employees, and negative role perceptions are likely to occur when employees experience an unpleasant work atmosphere [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Liang studies have shown that individuals with compulsory citizenship behaviors continuously deplete their emotional and cognitive resources, and when this depletion exceeds what the individual can tolerate, emotional exhaustion occurs, making it difficult for the individual to focus on clarifying his or her own work roles and responsibilities, and thus ambiguous work role perceptions occur [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Therefore, nursing managers should give bonus performance support to nurses who undertake non-work related tasks as a way to promote nurses' work well-being and motivation, and can also adopt a transformational leadership style to create a supportive organizational climate in the department [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In addition, individual nurses should define role boundaries clearly and tactfully decline non-essential tasks and optimize time management by prioritizing core responsibilities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eInfluences on role clarity for junior nurses\u003c/h2\u003e \u003cdiv id=\"Sec21\" class=\"Section3\"\u003e \u003ch2\u003eNumber of external training sessions the near 3 month\u003c/h2\u003e \u003cp\u003eThe results of this study showed that the more the number of study trips in the near 3 month, the higher the role clarity score of junior nurses. Junior nurses need to continuously learn new knowledge and skills to improve the quality of care and meet patients' needs, and it has been pointed out that nurses who have more opportunities for further education or learning have stronger core competencies and self-efficacy, and nurses with stronger self-efficacy have a clearer understanding of what they really want and the responsibilities they take on [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In addition, nurses who study abroad more often have their enthusiasm for their work stimulated, their willingness to take the initiative strengthened, and their internal motivation level increased, which strengthens their sense of professional identity and happiness [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Therefore, nursing managers should encourage junior nurses to go out to study and provide resources and platforms, and for individuals who do not meet the standards for further training, relevant courses can be set up in hospitals for training and guidance, so as to promote the work of junior nurses while also continuously improving their professional abilities.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eSuffered from workplace violence the near month\u003c/h2\u003e \u003cp\u003eThe results of this study showed that the lower the role clarity scores of junior nurses who had suffered workplace violence, the lower the role clarity scores. Liao Liwen [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] pointed out that nurses who have suffered from workplace violence have reduced work enthusiasm, physical and mental health is affected, resulting in negative attitudes and perceptions of the nurse's role perception of nursing; in addition, nurses who have suffered from violent attacks in the workplace will feel that they are not accepted and recognized in their social life or at work, so that their work attitudes and behaviors change, and the emotional experience of nursing becomes worse, and their identification with the profession they are engaged in decreases, which ultimately leads to the blurring of their own roles. Therefore, nursing managers should guide junior nurses to correctly recognize their own professional value, stimulate their work enthusiasm, and avoid the emergence of occupational fatigue.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eBaseline education\u003c/h2\u003e \u003cp\u003eJunior nurses with higher initial academic qualifications typically demonstrate greater role clarity due to several key factors. First, their systematic professional training provides comprehensive theoretical knowledge and clinical guidance, enabling a clearer definition of their professional responsibilities. Second, their stronger self-directed learning and adaptability allow them to quickly assimilate complex information and establish well-defined functional boundaries within healthcare teams [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Third, their heightened professional identity and self-efficacy drive proactive engagement in role exploration, reducing ambiguity in responsibilities [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Finally, greater access to continuing education and career development resources enables ongoing refinement of their understanding of nursing roles. In contrast, nurses with lower academic qualifications often face challenges in role clarity due to more limited foundational training, restricted access to professional development opportunities, and potential self-doubt stemming from educational disparities. To improve role clarity among junior nurses with lower academic qualifications, managers should implement a comprehensive strategy. First, structured onboarding programs should integrate not only technical skill development but also explicit role delineation, utilizing case simulations and role-playing exercises to clarify responsibilities in complex clinical scenarios. Second, clearly documented job descriptions and competency-based evaluation criteria should be established to reinforce expectations. Third, targeted professional development initiatives and equitable access to continuing education opportunities.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eWhile this investigation established important relationships between CCB and role clarity, its scope was necessarily constrained by two key methodological factors: (a) the exclusive focus on correlational analysis precludes causal inferences, and (b) the dependence on self-report measures leaves open the possibility of common method variance influencing the observed effects. Future studies would benefit from incorporating objective behavioral measures alongside psychometric assessments.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe role clarity of junior nurses was in the upper level overall, the compulsory citizenship behavior was in the lower level overall, and role clarity was negatively correlated with the compulsory citizenship behavior. The main factors affecting role clarity of junior nurses are number of external training sessions the near 3 month, whether you have suffered from workplace violence the near month, first-obtained degree, and compulsory citizenship behavior. Managers should pay attention to the compulsory citizenship behavior of junior nurses and take measures to reduce the compulsory citizenship behavior, so as to promote junior nurses' positive and correct perception of their own roles.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and informed consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by ethics committee of the First Hospital of Hunan University of Chinese Medicinethe, with ethical approval number HN-LL-YJSLW-2022-261\u0026nbsp;and all procedures were conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors confirmed that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Chinese Nursing Association Research Project (ZHKY202418), Hunan Nursing Association Project on the Development of the First Curriculum Group for Professional Competence of Newly Recruited Nurses: Xiang Nursing Association Document No. [2024] 170. The authors alone are responsible for the design, writing, and content of this paper. The funding body was not involved in the decision to submit this research for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTingyao Nie have made substantial contributions to the conception and design, or acquisition of data, or analysis and interpretation of data.\u003c/p\u003e\n\u003cp\u003eTingyao Nie, Xiuwen Chen, Huiqiong Chen, Qiang Peng, Ping Zhang, and Liqing Yue were involved in drafting the manuscript or revising it critically for important intellectual content.\u003c/p\u003e\n\u003cp\u003eTingyao Nie, Xiuwen Chen, Huiqiong Chen, Qiang Peng, Ping Zhang, and Liqing Yue\u0026nbsp;gave final approval for the version to be published.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTingyao Nie, Xiuwen Chen, Huiqiong Chen, Qiang Peng, Ping Zhang, and Liqing Yue\u0026nbsp;agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization (WHO) \u0026amp; International Council of Nurses (ICN) (2020). State of the World\u0026rsquo;s Nursing 2020. Geneva: World Health Organization.\u003c/li\u003e\n\u003cli\u003eSeo EH, Lee JH, MacDougall A, Liu N, Hofkirchner A, Sharma S, Elfakhani M, Yoon HJ. Anxiety symptoms and associated psychological and job-related factors among hospital nurses [J]. Psychiatry Investig. 2024 Jan;21(1):100-108.\u003c/li\u003e\n\u003cli\u003ePesonen T, Nurmeksela A, Hult M. The relationships between precarious employment, having a calling, and occupational well-being among young nurses: a cross-sectional study [J]. BMC Health Serv Res. 2024 Jun 24;24(1):762.\u003c/li\u003e\n\u003cli\u003eNing CC,Li YL, Gao KX. A study of feedback-seeking behavior and role clarity among newly recruited nurses [J]. Journal of Nursing, 2018,33(9):63-65.\u003c/li\u003e\n\u003cli\u003eFukui S, Salyers MP, Morse G, Rollins AL. Factors that affect quality of care among mental health providers: Focusing on job stress and resources [J]. Psychiatr Rehabil. 2021 Sep;44(3):204-211. \u003c/li\u003e\n\u003cli\u003eLi Z, Yang L, Xi Z, Yi W, Fu Y, Chang C, Lei Y. The relationship between compulsory citizenship behavior and nurses\u0026apos; silence: a cross-sectional study [J]. BMC Nurs. 2025 Jan 6;24(1):14. \u003c/li\u003e\n\u003cli\u003eLiu Z, Chen C, Cui H, Hu Y. The relationship between nurses\u0026apos; social network degree centrality and organizational citizenship behavior: The multiple mediating effects of job satisfaction and work engagement [J]. Heliyon. 2023 Aug 29;9(9):e19612.\u003c/li\u003e\n\u003cli\u003eOrgamb\u0026iacute;dez A, Almeida H. Social support, role clarity and job satisfaction: a successful combination for nurses [J]. Int Nurs Rev. 2020 Sep;67(3):380-386.\u003c/li\u003e\n\u003cli\u003eSmith J, Jones M. Application of STROBE guidelines in nursing research: A practical guide [J]. Journal of Nursing Scholarship, 2018, 50(3):321-329.\u003c/li\u003e\n\u003cli\u003eRizzo JR, House RJ, Lirtzman SI. Role conflict and ambiguity in complex organizations [M]. Thousand Oaks,California: SAGE Publications, 1970:150.\u003c/li\u003e\n\u003cli\u003eZhang YH, Liao JQ. Team authentic leadership, new employee feedback seeking behavior, and socialization outcomes [J]. Management Science, 2015,28(2):126-136.\u003c/li\u003e\n\u003cli\u003eVigoda-Gadot E. Redrawing the boundaries of OCB? An empirical examination of compulsory extra-role behavior in the workplace [J]. Bus Psychol, 2007;21(3):377\u0026ndash;405\u003c/li\u003e\n\u003cli\u003eQiao LL. The effect of employees\u0026apos; compulsory citizenship behavior on job burnout [D]. Xi\u0026apos;an: Northwest University, 2021. \u003c/li\u003e\n\u003cli\u003eWang Y, Wang X, Gao L, Ge Y, Xue M, Ji Y. Nurses\u0026apos; work value patterns and their relationship with burnout: a cross-sectional study based on latent profile analysis. BMC Nurs. 2025 Feb 12;24(1):164. \u003c/li\u003e\n\u003cli\u003e[15] Weiss HM, Cropanzano R. Affective events theory: a theoretical discussion of the structure, causes and consequences of affective experiences at work [J]. Research in Organizational Behavior, 1996. 18.(3):1-74.\u003c/li\u003e\n\u003cli\u003eSang M, Wei J, Li XF, et al. The effects of ICU nurses\u0026apos; role clarity and moral dilemmas on spiritual caregiving competence [J]. Journal of Nursing, 2022,37(22):1-5.\u003c/li\u003e\n\u003cli\u003eLiu Q, Yih B. Role adaptation of nurses caring for older adults with terminal diseases in geriatric hospitals [J]. Int Nurs Rev. 2024 Nov 13. \u003c/li\u003e\n\u003cli\u003eXue Y, Zhang W, Wang J, Zhu Y, Li D, Sun J, Gao L, Zhang Y. Relationships among growth mindset, turnover tendency, workplace adaptability and essentials of magnetism of new nurses: a moderated mediation model [J]. Adv Nurs. 2024 Nov 25. \u003c/li\u003e\n\u003cli\u003eXu Z, Ye Y, Wang Y, Qian Y, Pan J, Lu Y, Fang L. Primary care practitioners\u0026apos; barriers to and experience of COVID-19 epidemic control in china: a qualitative study [J]. Gen Intern Med. 2020 Nov;35(11):3278-3284. \u003c/li\u003e\n\u003cli\u003eXue YL, Nie TY, Zhang P, et al. A study of the impact of role clarity on the sense of decent labor among oncology nurses [J]. Journal of Nursing, 2023,38(22):73-76.\u003c/li\u003e\n\u003cli\u003eZhou X, Zhang S, Zhao X R , et al. How mentors inspire affective commitment in newcomers: the roles of servant leadership, psychological capital, and feedback-seeking behavior. [J]. International Journal of Hospitality Management, 2024, 118(000):9.\u003c/li\u003e\n\u003cli\u003eLi ZF, Xi ZY, Wang C, et al. A study on the correlation between nurses\u0026apos; compulsory citizenship behavior and willingness to leave [J]. Journal of Nursing, 2023,11, 38(22):69-73.\u003c/li\u003e\n\u003cli\u003eYildiz B, Elibol E. Turnover intention linking compulsory citizenship behaviours to social loafing in nurses: a mediation analysis [J]. Nurs Manag. 2021 May;29(4):653-663. \u003c/li\u003e\n\u003cli\u003eZhang S, Liang XH, Wang XY, et al. Analysis of the mediating effect of role clarity between reality shock and workplace adaptation in newly recruited nurses [J]. Journal of Nursing Advancement, 2025,40(2):113-117.\u003c/li\u003e\n\u003cli\u003eLiang HL, Yeh TK, Wang CH. Compulsory citizenship behavior and its outcomes: two mediation models. Front Psychol [J]. 2022 Feb 4;13:766952.\u003c/li\u003e\n\u003cli\u003eSong H, Yin Q, Zhang Q, Li Y. The impact of compulsory citizenship behavior on job performance of new-generation knowledge workers: the roles of ego depletion and relational energy [J]. Psychol Res Behav Manag [J]. 2023 Jun 28;16:2367-2381.\u003c/li\u003e\n\u003cli\u003eGuo J, Dai Y, Chen Y, Liang Z, Hu Y, Xu X, Xiao Y. Core competencies among nurses engaged in pallative care: a scoping review [J]. Clin Nurs. 2024 Oct;33(10):3905-3922. \u003c/li\u003e\n\u003cli\u003eTong Y, Wang T, Tong S, Tang Z, Mao L, Xu L, Shi X. Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study [J]. BMJ Open. 2024 Apr 3;14(4):e082865.\u003c/li\u003e\n\u003cli\u003eLiao L, Wu Q, Su Y, Li R, Wang L. Coping styles mediated the association between perceived organizational support and resilience in emergency nurses exposed to workplace violence: a cross-sectional study [J]. Nurs Health Sci. 2025 Mar;27(1):e70018.\u003c/li\u003e\n\u003cli\u003eWang X, Guo QZ, Yan JJ. A study of the relationship between innovation ability and achievement motivation and psychological health of full-time graduate master\u0026apos;s degree clinical nurses [J]. Journal of Nursing Management , 2023,23(8):629-633.\u003c/li\u003e\n\u003cli\u003eChen Y, Liu Y. A study of the correlation between feedback-seeking behavior, career success and willingness to leave among surgical nurses in four tertiary hospitals in Sichuan Province [J]. Occupation and Health , 2024,40(6):796-801.\u003c/li\u003e\n\u003cli\u003eAlexander L, Toomey N, Foster K. Nurses\u0026apos; career choice and satisfaction with mental health transition-to-practice programs: a cross sectional study [J]. Psychiatr Ment Health Nurs. 2024 Oct;31(5):825-835.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"junior nurses, role clarity, compulsory citizenship behavior, career planning, A cross-sectional survey","lastPublishedDoi":"10.21203/rs.3.rs-6294537/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6294537/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAim \u003c/strong\u003eThis study aim to explore the current situation of role clarity of junior nurses and the study of influencing factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eA descriptive cross-sectional online study was conducted during April 2024 - May 2024, targeting 499 junior nurses working in six tertiary hospitals, Hunan Province, China. Data collection was conducted employing a sociodemographic questionnaire, the Compulsory Citizenship Behavior Scale, and the Role Clarity Scale. Data were analyzed statistically using SPSS 25.0, incorporating descriptive statistics, independent-samples t-tests, one-way ANOVA, Pearson correlation, and multiple linear regression analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eThe junior nurses' role clarity score (31.13 ± 5.32) and compulsory citizenship behavior score (15.13 ± 4.01). Role clarity was negatively correlated with compulsory citizenship behavior (\u003cem\u003er \u003c/em\u003e= -0.132, \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.05), and multiple linear regression analysis showed that number of external training sessions the near 3 month, whether they have suffered from workplace violence the near month, baseline education, and their compulsory citizenship behavior were the influencing factors of role clarity for junior nurses (all \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions \u003c/strong\u003eJunior nurses exhibited the upper level overall of role clarity and the lower level overall compulsory citizenship behavior. Additionally, the role clarity was negatively correlated with the compulsory citizenship behavior. The main factors affecting the role clarity of junior nurses are number of external training sessions the near 3 month, whether they have suffered from workplace violence the near month, baseline education, and compulsory citizenship behavior.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecamendation \u003c/strong\u003eTo mitigate compulsory citizenship behavior (CCB) and enhance role clarity among junior nurses, nursing managers should adopt proactive management strategies—such as reducing rigid policies and improving transparent communication—can minimize coercive pressures and also integrating burnout prevention measures, including workload monitoring and stress management, ensures sustainable role clarity.\u003c/p\u003e","manuscriptTitle":"Current status and influencing factors of role clarity among junior nurses in tertiary hospitals: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 08:12:12","doi":"10.21203/rs.3.rs-6294537/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-04-30T16:41:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-25T09:19:37+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-04T09:49:47+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-03T12:16:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-04-03T12:15:11+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5e2bf3d3-6d18-4dc4-a7a7-6bdab03cf78c","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-05-06T08:12:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-06 08:12:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6294537","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6294537","identity":"rs-6294537","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}