Nurses’ Ability to Apply the Nursing Process Falls into Three Distinct Profiles

A cross-sectional study of nurses in three Grade III Class A hospitals in Hebei Province, China, has found that competence in applying the nursing process varies widely across individuals and clusters into three distinct latent profiles. The research, published as an open-access article in BMC Nursing, analyzed data from 371 nurses drawn from an initial convenience sample of 380, collected between January and March 2025. On the Competency of Nursing Process Questionnaire, the nurses recorded an average item score of 3.71 with a standard deviation of 0.84, indicating a moderate overall level of competence but with substantial heterogeneity among individuals.

Latent profile analysis revealed three subgroups: 12.1% of nurses showed low-level application of the nursing process, 53.1% showed moderate-level application, and 34.8% showed high-level application. In other words, roughly one in eight nurses in the sample fell into the lowest category, while about a third applied the nursing process at a high level. To understand what separated these groups, the researchers combined a general information questionnaire with three additional instruments: the Nurses' Clinic Communication Competence Scale, the Fatigue Scale-14, and the Critical Thinking Diagnostic of Frontline Nurses.

Univariate analysis was followed by multivariate logistic regression to identify factors associated with membership in the different profile categories while accounting for other variables. The regression analysis identified five significant influencing factors: clinical communication competence, professional title, age, fatigue, and critical thinking disposition, each associated with profile membership at a statistical threshold of P < 0.05. Within the study's design, these are associations rather than established causes, but they indicate that profile membership is intertwined with how well nurses communicate in clinical settings, how experienced they are as reflected in title and age, how fatigued they are, and their critical thinking disposition.

The authors conclude that nurses demonstrated moderate competence in applying the nursing process overall, with clear individual differences, and they recommend that nurse managers pay particular attention to staff in the low- and moderate-level groups. Rather than applying uniform training, they suggest tailoring interventions and support to the characteristics and influencing factors specific to each profile, addressing factors such as fatigue or communication competence where those are relevant. Several methodological features shape how these findings should be read.

The study used a convenience sample rather than random sampling, was limited to three hospitals in a single province, and relied on self-reported questionnaire data collected at one point in time. As a cross-sectional design, it can identify associations between factors and profile membership but cannot establish causal direction—for instance, whether fatigue accompanies lower competence in applying the nursing process or whether struggling with the framework is itself tiring. The published version is also an early-access, peer-reviewed accepted manuscript that remains subject to further editorial edits before the final Version of Record.

Readers should therefore treat the reported figures and factor associations as current findings that may be refined in the final published article. By quantifying the distribution of competence into low, moderate, and high profiles—and linking those profiles to communication ability, seniority, fatigue, and critical thinking disposition—the research provides a basis for targeting professional development where the moderate-level majority, which accounted for more than half of the sample, can be moved toward higher-level application of the nursing process.

Subject of Research: Latent profile analysis and influence factors study of nurses’ ability to apply Nursing Process: a cross-sectional study

Article Title: Latent profile analysis and influence factors study of nurses’ ability to apply Nursing Process: a cross-sectional study

Article References: Wang, Z., Zhu, F., Song, Y., Li, Y., Zhang, S., Chen, S., Cheng, C., Li, Z., Chen, X., & Bi, Z. (2026). Latent profile analysis and influence factors study of nurses’ ability to apply Nursing Process: a cross-sectional study. BMC Nursing. https://doi.org/10.1186/s12912-026-05145-2

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05145-2

Keywords: Latent, profile, analysis, influence, factors, nurses, ability, apply, Nursing, Process, cross-sectional, scientific research