Psychological resilience and burnout in nursing interns versus registered nurses: a systematic review and meta-analysis
- 1Second Ward, Department of Traditional Chinese Medicine, The First Affiliated Hospital of Anhui Medical University
Abstract
Background: Burnout is a common, serious occupational mental-health problem in nursing, and psychological resilience is a modifiable factor that may be associated with lower burnout. Whether this association holds equally across the education-to-practice transition, from interns to registered nurses, is unclear, and the most comparable prior meta-analysis excluded nursing students and the Chinese-language literature.
Objective: We aimed to pool the resilience–burnout association in nurses and nursing interns. Two coprimary outcomes were prespecified: the resilience–emotional-exhaustion (EE) correlation, and a concept-matched intern-versus-registered-nurse comparison on total burnout. Secondary outcomes were depersonalization and personal accomplishment.
Methods: Nine databases, five English-language and four Chinese-language, were searched from inception to 2026 with no language filter applied inside any database; eligibility was limited to reports published in English or Chinese. Eligible studies were cross-sectional and reported a correlation between a validated resilience measure and burnout in nurses or nursing interns. Two reviewers independently screened, extracted data, and appraised quality (AHRQ 11-item). Correlations were pooled via Fisher’s z under random-effects models (REML; metafor), with subgroup, sensitivity, and small-study analyses.
Results: Seventy-eight occupational-burnout studies were analyzed (29,292 participants); five academic-burnout studies were out of scope. Resilience was inversely associated with emotional exhaustion ( r = − 0.36, 95% CI = − 0.42 to − 0.31; k = 49; I ² = 95%), total burnout (− 0.44), and depersonalization (− 0.30), and positively associated with personal accomplishment (+ 0.43). On the concept-matched comparison (total burnout), registered nurses showed a numerically stronger association than interns ( r = − 0.46 vs. − 0.28; Q _between p = 0.025); with only five intern studies and instability in sensitivity analyses, this difference is preliminary. Estimates were stable across leave-one-out, model-choice, and PET-PEESE analyses, and no weaker in the nine studies scoring AHRQ ≥ 8 ( r = − 0.43, − 0.59 to − 0.24); no funnel-plot asymmetry was detected (Egger’s p = 0.49).
Conclusions: Psychological resilience is a moderate, consistent protective correlate of nurse burnout, but a wide prediction interval reflecting high heterogeneity means its practical benefit likely varies across settings. Resilience-building should complement, not replace, organizational measures. Whether the correlate is stronger in registered nurses than in interns remains preliminary.
Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261427008 , identifier CRD420261427008.
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BibTeX
@article{chen2026psychological,
title = {{Psychological resilience and burnout in nursing interns versus registered nurses: a systematic review and meta-analysis}},
author = {Xiaomei Chen and Yiyun Zhang and Fangfang Zhang and Xiaodi Zhu},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1920134},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1920134/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Psychological resilience and burnout in nursing interns versus registered nurses: a systematic review and meta-analysis
AU - Xiaomei Chen
AU - Yiyun Zhang
AU - Fangfang Zhang
AU - Xiaodi Zhu
PY - 2026
DA - 2026/10/14
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1920134
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1920134/full
AB - Background: Burnout is a common, serious occupational mental-health problem in nursing, and psychological resilience is a modifiable factor that may be associated with lower burnout. Whether this association holds equally across the education-to-practice transition, from interns to registered nurses, is unclear, and the most comparable prior meta-analysis excluded nursing students and the Chinese-language literature. Objective: We aimed to pool the resilience–burnout association in nurses and nursing interns. Two coprimary outcomes were prespecified: the resilience–emotional-exhaustion (EE) correlation, and a concept-matched intern-versus-registered-nurse comparison on total burnout. Secondary outcomes were depersonalization and personal accomplishment. Methods: Nine databases, five English-language and four Chinese-language, were searched from inception to 2026 with no language filter applied inside any database; eligibility was limited to reports published in English or Chinese. Eligible studies were cross-sectional and reported a correlation between a validated resilience measure and burnout in nurses or nursing interns. Two reviewers independently screened, extracted data, and appraised quality (AHRQ 11-item). Correlations were pooled via Fisher’s z under random-effects models (REML; metafor), with subgroup, sensitivity, and small-study analyses. Results: Seventy-eight occupational-burnout studies were analyzed (29,292 participants); five academic-burnout studies were out of scope. Resilience was inversely associated with emotional exhaustion ( r = − 0.36, 95% CI = − 0.42 to − 0.31; k = 49; I ² = 95%), total burnout (− 0.44), and depersonalization (− 0.30), and positively associated with personal accomplishment (+ 0.43). On the concept-matched comparison (total burnout), registered nurses showed a numerically stronger association than interns ( r = − 0.46 vs. − 0.28; Q _between p = 0.025); with only five intern studies and instability in sensitivity analyses, this difference is preliminary. Estimates were stable across leave-one-out, model-choice, and PET-PEESE analyses, and no weaker in the nine studies scoring AHRQ ≥ 8 ( r = − 0.43, − 0.59 to − 0.24); no funnel-plot asymmetry was detected (Egger’s p = 0.49). Conclusions: Psychological resilience is a moderate, consistent protective correlate of nurse burnout, but a wide prediction interval reflecting high heterogeneity means its practical benefit likely varies across settings. Resilience-building should complement, not replace, organizational measures. Whether the correlate is stronger in registered nurses than in interns remains preliminary. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261427008 , identifier CRD420261427008.
SN - 1664-0640
ER -