{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T02:09:04Z","timestamp":1794622144059,"version":"4.9.1"},"reference-count":47,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72232002"],"award-info":[{"award-number":["72232002"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72271172"],"award-info":[{"award-number":["72271172"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,29]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, work rumination is a common phenomenon related to nurse burnout. However, most existing studies focus on the single negative impacts of rumination, with less exploration of its dual effects and antecedents. Therefore, comprehensively exploring the effect of nurse work rumination and its influencing factors is crucial for enhancing the accuracy of nursing management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Identify the antecedents and dual effects of nurse work rumination to deepen understanding of this phenomenon and provide references for formulating interventions that enhance nurses\u2019 well-being and improve the quality of nursing work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Included studies were original research articles focusing on work-related rumination of nurses in clinical settings. Excluded studies were those involving nurses without patient contact, rumination unrelated to work, studies not addressing the effects or influencing factors of rumination and non-Chinese or non-English language publications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sources of evidence<\/jats:title>\n                    <jats:p>CINAHL, Cochrane, EMBASE, MEDLINE, Pubmed, Scopus, Web of Science, Sinomed, Wanfang, VIP and CNKI were searched to identify articles about nurse work rumination which were published up to January 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Charting methods<\/jats:title>\n                    <jats:p>A scoping review of the published articles of nurse work rumination was performed with the methodological process guided by the framework proposed by Arksey and O\u2019Malley. A three-step coding procedure was used to synthesise the impacts and antecedents of nurse work rumination, which were subdivided into four categories individually based on the conservation of resources theory, the three-dimension theory of happiness and the distinctive features of the nursing profession.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>30 articles from 12 countries were included. The findings indicate that nurse work rumination has 28 kinds of impacts, including positive, negative and double-edged sword effects, in four aspects: nursing quality and safety (n=7), happiness (n=7), health (n=10) and relationship (n=4) from 29 articles. The findings also suggest that from 26 articles, work rumination will be influenced by 31 factors, which are based on conservation of resources theory classified into four categories: resource depletion (n=14), resource protection (n=4), consequences of resource depletion (n=5) and behaviour and cognition (n=8).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This scoping review constructs a conceptual framework of \u2018antecedent factors-nurse work rumination-dual impacts\u2019 by systematically synthesising 30 studies. Rooted in the conservation of resources theory, three-dimensional theory of happiness and nursing professional characteristics, the framework clarifies the classification logic and internal connections of 31 influencing factors and 28 bidirectional impacts. The positive effect of work rumination can promote nurses\u2019 personal development by facilitating the problem-solving pondering. Nursing managers can leverage this integrated framework to design targeted intervention strategies, maximising the constructive effects of rumination while mitigating its adverse impacts. Classifying the factors affecting nurse work rumination according to the conservation of resources theory provides an important basis for exploring the influence mechanism of nurse work rumination. Future research should focus more on empirical studies on rumination to reduce nurses\u2019 burnout and improve the quality of nursing work.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106481","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T13:40:35Z","timestamp":1771335635000},"page":"e106481","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Unravelling antecedents and bidirectional impacts of nurse work rumination: a scoping review to enhance nurses\u2019 well-being and improve nursing quality"],"prefix":"10.1136","volume":"16","author":[{"given":"Wenjun","family":"Hu","sequence":"first","affiliation":[{"name":"West China School of Nursing, Sichuan University\/Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7484-847X","authenticated-orcid":false,"given":"Xiaofeng","family":"Xie","sequence":"additional","affiliation":[{"name":"West China School of Nursing\/West China Hospital, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Xu","sequence":"additional","affiliation":[{"name":"Lucas College and Graduate School of Business, San Jos\u00e9 State University, San Jos\u00e9, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siying","family":"Wei","sequence":"additional","affiliation":[{"name":"West China School of Nursing\/West China Hospital, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhu","sequence":"additional","affiliation":[{"name":"West China School of Nursing\/West China Hospital, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"An","sequence":"additional","affiliation":[{"name":"West China School of Nursing\/West China Hospital, Sichuan University, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"2026021705402561000_16.2.e106481.1","doi-asserted-by":"crossref","first-page":"104252","DOI":"10.1016\/j.nepr.2025.104252","article-title":"The experience of transition from student nurse to registered nurse among newly graduated nurses in the paediatric setting: An integrative literature review","volume":"83","author":"Asseiri","year":"2025","journal-title":"Nurse Educ Pract"},{"key":"2026021705402561000_16.2.e106481.2","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1111\/apps.12507","article-title":"How customer mistreatment hinders employee sleep quality and next\u2010morning vigor: The effects of affective rumination and mindfulness","volume":"73","author":"Zhang","year":"2024","journal-title":"Applied Psychology"},{"key":"2026021705402561000_16.2.e106481.3","doi-asserted-by":"crossref","DOI":"10.1155\/jonm\/2439568","article-title":"Nurses\u2019 Work Interruptions and Responses: Multitasking During Medication Tasks and Differences by Nursing Delivery System","volume":"2025","author":"Hong","year":"2025","journal-title":"J Nurs Manag"},{"key":"2026021705402561000_16.2.e106481.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-023-01209-9","article-title":"Workflow interruption and nurses\u2019 mental workload in electronic health record tasks: An observational study","volume":"22","author":"Shan","year":"2023","journal-title":"BMC Nurs"},{"key":"2026021705402561000_16.2.e106481.5","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1177\/0018720819838090","article-title":"Interruptions and Delivery of Care in the Intensive Care Unit","volume":"61","author":"Drews","year":"2019","journal-title":"Hum Factors"},{"key":"2026021705402561000_16.2.e106481.6","doi-asserted-by":"crossref","DOI":"10.1111\/inr.13069","article-title":"Patient safety management activities and perceived workload of shift-work nurses, moderated by the perceived importance of patient safety management","volume":"72","author":"Hong","year":"2025","journal-title":"Int Nurs Rev"},{"key":"2026021705402561000_16.2.e106481.7","doi-asserted-by":"crossref","first-page":"105017","DOI":"10.1016\/j.ijnurstu.2025.105017","article-title":"Night and shift work and incidence of physician-diagnosed sleep disorders in nursing staff: A prospective cohort study","volume":"164","author":"Nilsson","year":"2025","journal-title":"Int J Nurs Stud"},{"key":"2026021705402561000_16.2.e106481.8","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1111\/jonm.12756","article-title":"Work schedule characteristics and fatigue among rotating shift nurses in hospital setting: An integrative review","volume":"27","author":"Min","year":"2019","journal-title":"J Nurs Manag"},{"key":"2026021705402561000_16.2.e106481.9","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/smi.1397","article-title":"The relation of post-work ruminative thinking with eating behaviour","volume":"28","author":"Cropley","year":"2012","journal-title":"Stress Health"},{"key":"2026021705402561000_16.2.e106481.10","doi-asserted-by":"crossref","unstructured":"Cropley M , Zijlstra FRH . Work and Rumination. Handbook of Stress in the Occupations. New Horizons in Management. Northampton, MA, US: Edward Elgar Publishing, 2011:487\u2013501.","DOI":"10.4337\/9780857931153.00060"},{"key":"2026021705402561000_16.2.e106481.11","doi-asserted-by":"crossref","unstructured":"Shao Y , Jiang W , Zhu H , et al . The relationship between work stress and well-being among Chinese primary and secondary school teachers: The chain mediation of affective rumination and work engagement. BMC Psychol 2025;13. doi:10.1186\/s40359-025-02628-w","DOI":"10.1186\/s40359-025-02628-w"},{"key":"2026021705402561000_16.2.e106481.12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1002\/smi.2538","article-title":"The relationship between work-related rumination and evening and morning salivary cortisol secretion","volume":"31","author":"Cropley","year":"2015","journal-title":"Stress Health"},{"key":"2026021705402561000_16.2.e106481.13","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/s11031-025-10122-4","article-title":"Off-work work-related rumination and psychological detachment: the predictive role of workload and need frustration","volume":"49","author":"Paquette","year":"2025","journal-title":"Motiv Emot"},{"key":"2026021705402561000_16.2.e106481.14","first-page":"143","article-title":"The Mediation Effect of Work-Related Rumination Between Perceived Job Stress and Recovery Experience, and Moderated Mediation Effect of Well-Being","volume":"17","author":"Young","year":"2022","journal-title":"Journal of Competency Development & Learning"},{"key":"2026021705402561000_16.2.e106481.15","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1080\/10615806.2020.1866174","article-title":"A person-centered perspective on the factors associated with the work recovery process","volume":"34","author":"Gillet","year":"2021","journal-title":"Anxiety Stress Coping"},{"key":"2026021705402561000_16.2.e106481.16","doi-asserted-by":"crossref","DOI":"10.1186\/s40560-017-0209-0","article-title":"Psychological rumination and recovery from work in intensive care professionals: associations with stress, burnout, depression and health","volume":"5","author":"Vandevala","year":"2017","journal-title":"J Intensive Care"},{"key":"2026021705402561000_16.2.e106481.17","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1111\/inm.13337","article-title":"Risk factors and consequences of mental health problems in nurses: A scoping review of cohort studies","volume":"33","author":"Yang","year":"2024","journal-title":"Int J Ment Health Nurs"},{"key":"2026021705402561000_16.2.e106481.18","doi-asserted-by":"crossref","first-page":"103889","DOI":"10.1016\/j.ijnurstu.2021.103889","article-title":"Towards a better understanding of the relationship between feedback and nurses\u2019 work engagement and burnout: A convergent mixed-methods study on nurses\u2019 attributions about the \u201cwhy\u201d of feedback","volume":"117","author":"Suzanne Giesbers","year":"2021","journal-title":"Int J Nurs Stud"},{"key":"2026021705402561000_16.2.e106481.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.103933"},{"key":"2026021705402561000_16.2.e106481.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2014.07.001"},{"key":"2026021705402561000_16.2.e106481.21","doi-asserted-by":"crossref","unstructured":"Ma F , Zhu Y , Liu L , et al . Assessing the Impact of Burnout on Nurse Safety Behaviors and Patient Safety Competence: A Latent Profile Analysis Study. J Nurs Manag 2025;2025. doi:10.1155\/jonm\/3793927","DOI":"10.1155\/jonm\/3793927"},{"key":"2026021705402561000_16.2.e106481.22","doi-asserted-by":"crossref","unstructured":"Yao L , Li S , Yao L , et al . The Dual Effect of Work Rumination in the Relationship Between Challenge Stress and Innovative Behavior: A Moderated Mediation Model of Information Literacy. Eval Health Prof 2025. doi:10.1177\/01632787251316854","DOI":"10.21203\/rs.3.rs-4466653\/v1"},{"key":"2026021705402561000_16.2.e106481.23","doi-asserted-by":"crossref","DOI":"10.1177\/23779608221095432","article-title":"Cultivating Innovative Work Behavior of Nurses Through Diversity Climate: The Mediating Role of Job Crafting","volume":"8","author":"Baig","year":"2022","journal-title":"SAGE Open Nurs"},{"key":"2026021705402561000_16.2.e106481.24","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jbusres.2019.10.012","article-title":"Time to recover: The moderating role of psychological detachment in the link between perceptions of high-involvement work practices and burnout","volume":"108","author":"Kilroy","year":"2020","journal-title":"J Bus Res"},{"key":"2026021705402561000_16.2.e106481.25","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-079931","article-title":"Physician and nurse well-being, patient safety and recommendations for interventions: cross-sectional survey in hospitals in six European countries","volume":"14","author":"Aiken","year":"2024","journal-title":"BMJ Open"},{"key":"2026021705402561000_16.2.e106481.26","unstructured":"ICN . ICN puts wellbeing of nurses at centre of international nurses day 2025. 2025. Available: https:\/\/www.icn.ch\/news\/icn-puts-wellbeing-nurses-centre-international-nurses-day-2025"},{"key":"2026021705402561000_16.2.e106481.27","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.43059","article-title":"Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis","volume":"7","author":"Li","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026021705402561000_16.2.e106481.28","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.44.3.513"},{"key":"2026021705402561000_16.2.e106481.29","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-orgpsych-032117-104640"},{"key":"2026021705402561000_16.2.e106481.30","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"2026021705402561000_16.2.e106481.31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-1842.2009.00848.x"},{"key":"2026021705402561000_16.2.e106481.32","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-69"},{"key":"2026021705402561000_16.2.e106481.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-018-0611-x","article-title":"Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach","volume":"18","author":"Munn","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"2026021705402561000_16.2.e106481.34","doi-asserted-by":"crossref","first-page":"51","DOI":"10.5465\/amp.2007.26421238","article-title":"Happiness, Health, or Relationships? Managerial Practices and Employee Well-Being Tradeoffs","volume":"21","author":"Grant","year":"2007","journal-title":"AMP"},{"key":"2026021705402561000_16.2.e106481.35","unstructured":"Tao Y . Post traumatie growth status and occurrence modelof nurses experiencing workplace violence [Master\u2019s thesis]. Central South University, 2022"},{"key":"2026021705402561000_16.2.e106481.36","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1111\/jonm.13660","article-title":"Factors influencing posttraumatic growth among nurses caring for COVID-19 patients: A path analysis","volume":"30","author":"Yim","year":"2022","journal-title":"J Nurs Manag"},{"key":"2026021705402561000_16.2.e106481.37","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0023138","article-title":"Regrets associated with providing healthcare: qualitative study of experiences of hospital-based physicians and nurses","volume":"6","author":"Courvoisier","year":"2011","journal-title":"PLoS One"},{"key":"2026021705402561000_16.2.e106481.38","first-page":"21","article-title":"The Double-edged Sword Effect of Performance Pressure onThriving at Work:The Role of Work Rumination and PerceivedOrganizational Support","volume":"41","author":"Niu","year":"2024","journal-title":"Human Resources Development of China"},{"key":"2026021705402561000_16.2.e106481.39","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2016.01524","article-title":"Is Work-Related Rumination Associated with Deficits in Executive Functioning?","volume":"7","author":"Cropley","year":"2016","journal-title":"Front Psychol"},{"key":"2026021705402561000_16.2.e106481.40","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-023-01346-1","article-title":"The relationship between psychological resilience and professional quality of life among mental health nurses: a cross-sectional study","volume":"22","author":"Alonazi","year":"2023","journal-title":"BMC Nurs"},{"key":"2026021705402561000_16.2.e106481.41","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2022.2079796"},{"key":"2026021705402561000_16.2.e106481.42","doi-asserted-by":"publisher","DOI":"10.1080\/00224540109600569"},{"key":"2026021705402561000_16.2.e106481.43","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-059146","article-title":"Mediating role of emotional labour strategy in the association between patient\/visitor incivility and nurses\u2019 fatigue: a cross-sectional study","volume":"12","author":"Bai","year":"2022","journal-title":"BMJ Open"},{"key":"2026021705402561000_16.2.e106481.44","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1080\/16506073.2016.1201848","article-title":"Clicking away at co-rumination: co-rumination correlates across different modalities of communication","volume":"45","author":"Keshishian","year":"2016","journal-title":"Cogn Behav Ther"},{"key":"2026021705402561000_16.2.e106481.45","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.134.2.163"},{"key":"2026021705402561000_16.2.e106481.46","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1177\/00332941231168783","article-title":"Exploring the Relationship Between Work Stress and Work-related Rumination","volume":"127","author":"Zhang","year":"2024","journal-title":"Psychol Rep"},{"key":"2026021705402561000_16.2.e106481.47","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1037\/ocp0000331","article-title":"Adding fuel to the fire: The exacerbating effects of calling intensity on the relationship between emotionally disturbing work and employee health","volume":"27","author":"Andel","year":"2022","journal-title":"J Occup Health Psychol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-106481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T13:40:42Z","timestamp":1771335642000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-106481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":47,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,17]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-106481"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-106481","relation":{"has-part":[{"id-type":"doi","id":"https:\/\/doi.org\/10.1136\/bmjopen-2025-106481.supp1","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1136\/bmjopen-2025-106481.supp2","asserted-by":"subject"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}