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Abstract
Objectives To understand the current status of emotional intelligence, professional identity and humanistic care ability among standardised training nurses (STNs); to explore the mediating role of professional identity in the relationship between emotional intelligence and humanistic care ability; and to explore the potential mechanisms among these variables.
Design A cross-sectional study.
Setting A tertiary hospital in Chengdu, China.
Participants A total of 134 STNs were recruited through convenience sampling.
Methods Using convenience sampling, 134 STNs were recruited. Participants completed the Nurse Professional Identity Scale (5-point Likert), the Humanistic Care Ability Scale (7-point Likert) and the Emotional Intelligence Scale (7-point Likert) to assess their levels of professional identity, humanistic care ability and emotional intelligence. Structural equation modelling was used to test the mediation model.
Primary and secondary outcome measures Participants completed the Nurses’ Professional Identity Rating Scale, the Caring Ability Inventory and the Emotional Intelligence Scale. Pearson correlation and mediation analyses were performed using the PROCESS macro for SPSS.
Results STNs demonstrated low levels of humanistic care ability, moderate levels of professional identity and low levels of the ability to assess others’ emotions. Emotional intelligence had a significant positive direct effect (0.798) on humanistic care ability and professional identity partially mediated (0.109) this relationship.
Conclusion Emotional intelligence directly enhances humanistic care ability, and professional identity plays a partial mediating role. Integrating emotional intelligence and professional identity training into standardised nurse education may strengthen humanistic care competencies. Targeted emotional intelligence training for STNs may enhance empathy and professional identity, thereby improving humanistic care ability and contributing to better doctor-patient relationships.
- Emotional Intelligence
- Surveys and Questionnaires
- Observational Study
- MEDICAL EDUCATION & TRAINING
- Education, Medical
Data availability statement
Data are available upon reasonable request. The datasets generated and/or analysed during the current study are not publicly available due they are also part of the ongoing study but are available from the corresponding author on reasonable request.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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- Emotional Intelligence
- Surveys and Questionnaires
- Observational Study
- MEDICAL EDUCATION & TRAINING
- Education, Medical
STRENGTHS AND LIMITATIONS OF THIS STUDY
A cross-sectional design and mediation model were used to explore the relationships between key constructs.
Validated and reliable tools were used to assess professional identity, emotional intelligence and humanistic care ability, which ensures the accuracy and consistency of the data collected.
Statistical analysis employed the PROCESS macro with bootstrapping to rigorously test mediation effects.
The use of convenience sampling may affect the generalisability of the results to broader nursing populations or different regions.
This study was conducted in a single tertiary hospital in Chengdu, which may not fully represent the experiences or characteristics of standardised training nurses in other geographic or clinical contexts across China.
Introduction
In China, standardised training nurses (STNs) are newly graduated nurses who are currently undergoing a mandatory 2-year clinical training programme after completing their university or college education. This standardised training programme bridges the gap between academic education and real-world clinical demands, preparing novice nurses to competently assume their professional roles in health humanistic care settings. According to the former National Health and Family Planning Commission’s Training Outline for Newly Entered Nurses (for Trial Implementation) and the Standardized Training Standards for Nurses in Sichuan Province (for Trial Implementation), this programme emphasises not only theoretical knowledge and practical skills but also the ability to independently and competently deliver standardised nursing humanistic care.1 2 The training aims to foster clinical thinking, enhance professional competency and instil a strong sense of professionalism. It plays a critical role in cultivating qualified medical professionals, improving health humanistic care service quality and supporting the continuous development of nursing practice.3
Humanistic care is a core component of nursing that emphasises the holistic treatment of patients, addressing not only their physical needs but also their emotional, psychological and social well-being. It is rooted in values such as empathy, respect and dignity, and aims to recognise and honour the individual experiences of patients.4 Humanistic care not only improves clinical outcomes but also enhances patients’ satisfaction and adherence to treatment plans.5 It promotes a therapeutic nurse-patient relationship based on trust and effective communication, which is essential for delivering high-quality humanistic care.6 For nurses, practising humanistic care contributes to professional fulfilment and reduces burnout, fostering a sense of meaning and engagement in their work.7 For STNs, cultivating empathy early in their humanistic careers is particularly important, as it helps them navigate the emotional demands of patient humanistic care, build therapeutic relationships and reduce burnout during this formative stage of their professional development.
Emotional intelligence (EI) refers to an individual’s ability to perceive, understand, regulate and use emotions to facilitate thought and interpersonal functioning. Based on Salovey and Mayer’s ability model, EI comprises four core components: self-emotional appraisal, others’ emotional appraisal, regulation of emotion, and use of emotion to enhance performance.8 In the nursing profession, EI is essential for building therapeutic relationships, managing stress and delivering empathetic humanistic care. Emotionally intelligent nurses are better able to recognise and respond to their own emotions and those of their patients, thereby enhancing communication, teamwork and resilience in challenging clinical environments.9
Professional identity represents an individual’s self-concept and internalisation of professional values, roles and responsibilities. In nursing, it involves adopting the ethical standards, values and practices of the profession and developing a commitment to providing high-quality patient humanistic care.10 A well-developed professional identity strengthens a nurse’s dedication to their role, improves performance and supports job satisfaction and resilience.11 It also fosters collaboration within multidisciplinary teams and enhances the public image and influence of the nursing profession.12 13
In recent years, research has increasingly focused on humanistic care, emotional intelligence and professional identity among STNs. However, studies examining the interrelationships among these variables in this specific population remain limited. As standardised training is a critical transition phase from student to practising nurse, understanding the current status of humanistic care, emotional intelligence and professional identity—as well as how they interact—is crucial. These factors are not only integral to nursing quality and patient humanistic care but also impact the development and well-being of the nursing workforce. Investigating their associations can offer empirical evidence to inform and optimise the content and structure of training programmes. Ultimately, this research supports the development of tailored interventions that enhance STNs’ competencies, promote their professional growth and improve health humanistic care delivery.
Methods
Study participants
Convenience sampling was used to randomly select 134 STNs from a tertiary hospital in Chengdu, Sichuan Province, as study participants. Criteria of this study: (1) inclusion criteria: registered trainees of the standardised training programme for nurses in Sichuan Province, voluntary participation in this study, working in the field; (2) exclusion criteria: individuals who declined to participate or withdrew consent during the process.
Research instruments
General information
Demographic information collected included gender, age, years of working experience, professional title, residence, educational background and department of current practice.
Nurse Professional Identity Scale
Professional identity among STNs was assessed using the Nurses’ Professional Identity Rating Scale (NPIRS), originally developed by Liu Ling and colleagues in 2011.14 This scale is widely used in Chinese nursing research and practice and is designed to measure the degree to which nurses internalise and identify with the values, ethics and professional roles of nursing. The NPIRS consists of 30 items, distributed across five key dimensions that reflect different facets of professional identity: professional perception assessment (PPA), assesses a nurse’s cognitive understanding and personal beliefs about the nursing profession; professional social support (OSS) evaluates the level of support nurses perceive from colleagues, superiors and the wider social environment; professional social skills (PSSs) measures interpersonal and communication abilities necessary for effective professional interaction; professional frustration coping (PFC) reflects a nurse’s capacity to deal with professional stress, pressure or disillusionment; professional self-reflection (PS) gauges the extent to which nurses reflect on their work, values and sense of professional responsibility. Each item is scored using a 5-point Likert scale, ranging from 1 = ‘very inconsistent’ to 5 = ‘very consistent’, where higher scores indicate stronger professional identity. In this study, the Chinese version of the NPIRS was used, which has demonstrated strong psychometric properties in previous research. The total scale achieved an excellent Cronbach’s α reliability coefficient of 0.978, indicating a high degree of internal consistency.
The Humanistic Care Ability Scale
Humanistic care ability was measured using the Caring Ability Inventory (CAI), a widely recognised tool developed by Nkongho in 199015 and later translated and culturally adapted into Chinese by Ma Yulian in 2012.16 This scale was specifically chosen for its comprehensive assessment of caring behaviours and attitudes, which align closely with the conceptual framework of humanistic nursing care emphasised in this study. The CAI comprises a total of 37 items distributed across three core dimensions: understanding (U): evaluates the nurse’s capacity to recognise patients’ needs and situations empathetically and cognitively; courage (C): assesses the nurse’s willingness and ability to confront and deal with difficult humanistic care situations; patience (P): measures the extent to which a nurse can remain calm, composed and tolerant in the face of patients’ needs and challenges. Each item is scored on a 7-point Likert scale, ranging from 1 = ‘strongly disagree’ to 7 = ‘strongly agree’. Thus, the total score ranges from 37 to 259, with higher scores indicating stronger humanistic caring ability. In this study, the Chinese version of the CAI demonstrated good internal consistency, with a Cronbach’s α reliability coefficient of 0.835, confirming its suitability and reliability for use with Chinese STNs.
Emotional Intelligence Scale
EI was measured using the Wong and Law Emotional Intelligence Scale (WLEIS),17 an instrument grounded in the ability-based model of emotional intelligence originally proposed by Salovey and Mayer. The WLEIS is particularly well-suited for nursing and healthcare contexts and has demonstrated strong psychometric properties in both Western and Eastern populations. The scale comprises a total of 16 items, divided into four dimensions, each representing a core facet of emotional intelligence: self-emotional appraisal (SEA) (four items): assesses an individual’s ability to understand and express their own emotions; others’ emotional appraisal (OEA) (four items): evaluates the capacity to perceive and understand the emotions of others, particularly relevant for empathetic patient care; regulation of emotion (ROE) (four items): measures the ability to regulate one’s own emotional states effectively; use of emotion (UOE) (four items): captures the extent to which an individual can harness emotions to facilitate adaptive behaviours and performance. Each item is rated on a 7-point Likert scale, ranging from 1 = ‘strongly disagree’ to 7 = ‘strongly agree’, yielding a total score range of 16 to 112, with higher scores indicating a higher level of emotional intelligence. The WLEIS has been widely validated across cultural contexts and professions, including nursing. In the present study, the scale demonstrated excellent internal consistency, with a Cronbach’s α reliability coefficient of 0.981 for the total scale. All four subscales also exhibited strong reliability.
Statistical methods
SPSS V.24.0 software was used for data analysis. Descriptive statistics (frequency, percentages, mean and SD) were used to summarise demographic and scale data. Pearson correlation analysis was conducted to examine associations between professional identity, emotional intelligence and humanistic care ability. Mediation analysis was performed using PROCESS macro V.3.3 for SPSS, developed by Hayes (Model 4),18 to test the mediating role of professional identity.
Patient or public contribution
This study investigated professional identity, emotional intelligence and humanistic care ability among STNs. No patient or public involvement was included.
Results
The total number of people included in the study in this survey was 134, and the average age (23.089±1.271). The total score of humanistic care ability was (189.672±24.133), and the scores of the three dimensions are understanding (74.865±10.399), courage (58.059±14.461) and patience (56.746±8.051). The total score of the professional identity of the STNs in this study was (117.127±18.261), the lowest score was the PPA (34.075±6.287), and the highest score was the PS (12.209±1.900). The STNs’ emotional intelligence score is (86.149±15.476), the highest rate of SEA score is (22.269±4.017) and the lowest rate of OEA is (21.090±4.158). The detailed results are shown in table 1.
Humanity humanistic care ability, professional identity and emotional intelligence of standardised training nurses and their scores on each dimension (n=134)
After correlation analysis, the results showed that there was a positive correlation between humanistic care ability, professional identity and emotional intelligence of STNs, and the difference was statistically significant. The detailed results are shown in online supplemental table 1.
Supplemental material
With emotional intelligence as the independent variable, professional identity as the mediating variable and humanistic care ability as the dependent variable, the mediation model was constructed as shown in figure 1. As shown in table 2, the results of the regression analysis of the mediating effect of professional identity on emotional intelligence and humanistic care ability were tested for significance using the Bootstrap procedure, and the number of samples chosen was 5000 and the mediation model fit index R2 was good, with emotional intelligence having a positive prediction for professional identity (β=0.442，p<0.001), professional identity having a positive prediction for humanistic care ability (β=0.247, p<0.05) and emotional intelligence having a positive prediction for humanistic care ability (β=0.798, p<0.001). The results are shown in table 2, and the effects of the mediating model variables are shown in table 3.
The mediating effect model of professional identity in emotional intelligence and humanistic care ability. This figure illustrates the hypothesised mediation model examining the associations between emotional intelligence, professional identity and humanistic care ability among nurses. Emotional intelligence positively predicts both professional identity (β=0.442, p<0.001) and humanistic care ability (β=0.798, p<0.001). Professional identity, in turn, has a positive effect on humanistic care ability (β=0.247, p<0.05), indicating a partial mediating role. Note: * indicates p<0.05, ** indicates p<0.001.
Significance of mediating effect model fitting index and regression coefficient of professional identity between emotional intelligence and humanistic care ability
Effects of intermediary models
Discussion
Humanistic care ability among standardised training nurses: current status and implications
Humanistic care, encompassing empathy, compassion and holistic patient humanistic care, is essential in nursing and has been linked to improved patient satisfaction and outcomes.5 Our study found that the humanistic care ability of STNs was at a relatively low level, with a total score (189.672±24.133) below the average benchmark, especially in the courage dimension. This reflects limited preparedness in advocating for patients and navigating complex clinical scenarios. Such findings may be influenced by systemic differences in medical education, where Chinese programmes traditionally place less emphasis on humanistic education than their Western counterparts. Lower scores in understanding and patience dimensions compared with large-scale surveys in China19 may be attributable to limited exposure to humanistic care courses, low awareness and reduced clinical experience. These competencies are not innate but are cultivated over time through reflective practice, clinical immersion and mentorship. Hence, curriculum development should combine theory with practice, emphasising experiential learning and reflective activities. Instructors should guide trainees to internalise humanistic care through real-world encounters and promote a learning environment that supports patient-centred values.20 Additionally, organisational culture should reinforce the importance of humanistic care in everyday clinical practice.21
Professional identity: moderate level and developmental needs
A strong professional identity is foundational to job satisfaction, clinical efficacy and resilience.22 In our study, STNs demonstrated a moderate level of professional identity, with professional self-reflection scoring highest and professional cognitive evaluation lowest. This indicates that while STNs reflect on their roles, they may lack a solid internalised understanding of nursing as a profession, possibly due to their transitional humanistic career stage, recent graduation and emotional adjustment to the demands of professional practice. This ‘identity change’, referring to the formation of professional identity, can be emotionally and cognitively demanding.23 Support from instructors and management, including psychological counselling and humanistic career coaching, may ease this transition and help nurses adapt more effectively. Furthermore, nursing programmes should better integrate the development of professional identity into their training, going beyond clinical skills to include emotional and ethical aspects.24 A supportive clinical environment and recognition of nurses’ contributions are also vital in reinforcing professional identity. Encouraging self-reflection and fostering a sense of belonging within the nursing community can empower nurses to take an active role in shaping their professional values and commitment.25
Emotional intelligence: strengths and weaknesses in STNs
EI is a core competency in nursing, directly affecting patient humanistic care quality, communication and emotional resilience.26 Our results revealed that STNs had moderate EI levels, with strengths in self-emotional appraisal and weaknesses in the ability to assess others’ emotions, a crucial component of empathy. This aligns with previous research findings.27 28 Several factors may contribute to this pattern. Many STNs are recent graduates with limited workplace exposure and focus more on their own emotions than those of others. Clinical settings are fast-paced and stressful, often limiting time and space for empathetic engagement.29 Additionally, nursing education in many institutions focuses heavily on technical skills, offering insufficient training in emotional competencies.30 The absence of emotionally intelligent role models may also limit observational learning opportunities.31 Enhancing EI, especially the ability to assess others’ emotions, should be a key focus of STN training. This could be achieved through simulation exercises, reflective writing, emotional communication workshops and consistent mentorship. Strengthening EI may also reduce burnout, increase job satisfaction and support better nurse-patient relationships.32
Humanistic care as a mediator between EI and professional identity
This study reveals that humanistic care ability partially mediates the relationship between EI and professional identity in STNs. This suggests that emotionally intelligent nurses are more capable of engaging in humanistic care, which in turn reinforces their professional identity, a mechanism quantified by a notable indirect effect. This mediation effect emphasises the interconnectedness of emotional, ethical and professional development in nursing. Emotional intelligence enhances awareness of patient needs, which deepens humanistic care interactions and fosters a stronger sense of professional purpose.33 34 Educational settings and clinical experiences that emphasise empathy and ethical practice likely contribute to this connection.35 These findings advocate for an integrative model of nurse training, where emotional intelligence and professional identity are developed concurrently through experiential, reflective and interactive learning methods. Creating immersive practice environments that emphasise patient-centred humanistic care and emotional engagement can help nurses internalise these values and apply them in practice.
Ultimately, this study proposes that strengthening emotional intelligence and humanistic care competencies can significantly support the development of professional identity. Such a holistic approach to nursing education will better prepare trainees for the complex interpersonal and emotional realities of health humanistic care practice.
Conclusion
This study underscores the critical role of emotional intelligence in enhancing humanistic care abilities among medical staff, highlighting its direct positive influence. More importantly, our analysis reveals the nuanced function of professional identity, not only as an indirect positive predictor of humanistic care ability but also as a key mediator that bridges the gap between emotional intelligence and humanistic care. This dual role of professional identity, both as a standalone factor and as a conduit through which emotional intelligence exerts its influence, marks a meaningful theoretical advancement in understanding the complex dynamics at play in nursing education and practice.
By integrating these findings, this research contributes to the theoretical landscape in several ways. First, it delineates a clearer pathway through which emotional intelligence impacts humanistic care ability, thereby providing a more structured framework for future investigations into the emotional competencies of health humanistic care professionals. Second, the identification of professional identity as a mediating variable offers a novel lens through which to examine the development of humanistic care abilities, suggesting that efforts to enhance professional identity could be a strategic avenue to bolster humanistic care. To operationalise these insights, we propose implementing targeted emotional intelligence training for nurses during their standardised education. Such training—designed to foster higher levels of empathy and strengthen professional identity—is expected to improve nurses’ humanistic care abilities and better prepare them for the emotional and interpersonal challenges of professional practice. Establishing a foundation rooted in emotional competence and strong professional identity can support the development of a culture of humanistic care within clinical settings. Furthermore, by advocating for the joint development of emotional intelligence and professional identity, this study highlights the potential for cultivating a more empathetic, compassionate and ultimately more effective health humanistic care workforce. The implications extend beyond individual interactions, offering a pathway towards enhancing doctor–patient relationships and improving the broader social health humanistic care environment. However, this study is not without limitations. The use of convenience sampling may limit the generalisability of findings, and the sample was drawn from a single tertiary hospital in Chengdu, Sichuan Province, which may not be representative of all STNs in China. Future research should aim to employ random sampling across multiple institutions and regions to increase the representativeness and robustness of the results.
Despite these limitations, this study provides valuable insights into the current status and interrelationships of emotional intelligence, professional identity and humanistic care ability among STNs. Addressing these limitations in future work will help build a more comprehensive evidence base and inform the design of effective, targeted interventions to enhance these critical attributes in nursing professionals.
Data availability statement
Data are available upon reasonable request. The datasets generated and/or analysed during the current study are not publicly available due they are also part of the ongoing study but are available from the corresponding author on reasonable request.
Ethics statements
Patient consent for publication
Ethics approval
Ethical approval was taken from the Ethics Committee of West China Second University Hospital, Sichuan University (No. Lun 2021233). Informed consent was obtained from all the subjects. We only administered the electronic questionnaire to subjects who are under standardized nursing training, and a verbal explanation was given to each participant describing the questionnaire in simple language and assuring confidentiality and volunteer participation. All methods carried out were in accordance with West China Second University Hospital, Sichuan University guidelines and regulations and in accordance with the Declarations of Helsinki. They were fully informed about the study before giving consent and had the right to withdraw at any time.
Acknowledgments
The authors thank all the participants and institutions that participated in this study and gave their contribution. Thanks to Professor Wentao Peng for organising standardised training nurses to fill in the questionnaire and data support for this study.
Footnotes
HY and XW are joint first authors.
HY and XW contributed equally.
WP and HL contributed equally.
Contributors HY: conceptualisation, drafting and writing; XW, HZ: data collection and arrangement, analysis and interpretation of data; HL: conceptualisation, revision and editing; XW, TB, JZ, WP: data collection, critical revision and editing. The authors also gave final approval of the version to be published. HL is the guarantor.
Funding This work was supported by Chengdu Medical Research Project (Project Number: 2023256); Sichuan Nursing Research Project (Project Number: H22052); Sichuan Province Education Research Project (Project Number: SCJG23A026); Sichuan University Higher Education Teaching Reform Project (11th) (project number: SCU11140); National Key R&D Program of China (Project Number: 2022YFC2703400); Key R&D Projects of the Sichuan Provincial Department of Science and Technology (Project Number: 2024YFFK0266); Key R&D Support Program of the Chengdu Science and Technology Bureau (Project Number: 2024-YF05-00627-SN); Sichuan Medical Association Medical Research Project (Project Number: S2024012).
Competing interests The authors declare that there are no competing interests associated with this manuscript. The funder had no role in the study design, data collection, analysis, or interpretation, nor in the writing of the manuscript. The opinions expressed in this paper are solely those of the authors.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.