{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:15:06Z","timestamp":1793214906469,"version":"4.5.0"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72271196"],"award-info":[{"award-number":["72271196"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Eval Health Prof"],"abstract":"<jats:p>This 18-month longitudinal mixed-methods study employed an explanatory sequential design QUAN\u2192qual examining 412 healthcare workers (nurses and physicians) from four tertiary hospitals in China to explore the bidirectional relationships between organizational climate, individual resilience, and career compromise. Quantitative data were collected at baseline, 9 months, and 18 months using validated instruments: Practice Environment Scale-Nursing Work Index, Connor-Davidson Resilience Scale-10, and Career Compromise Scale. Random-intercept cross-lagged panel models (RI-CLPM) examined bidirectional relationships. Semi-structured interviews (n = 45) conducted at the third timepoint explored mechanisms underlying quantitative patterns, analyzed via thematic analysis. RI-CLPM revealed significant bidirectional effects. Organizational climate at baseline predicted increased resilience at 9 months and reduced career compromise at 18 months. Resilience predicted improved perceptions of organizational climate and lower career compromise. Career compromise predicted decreased resilience and more negative climate perceptions. Qualitative themes highlighted support mechanisms, resilience adaptation, and decision-making dynamics, showing that positive organizational climates enhance resilience through psychological safety and development opportunities, reducing career compromise. Organizational climate, resilience, and career compromise demonstrate reciprocal relationships over time, supporting a dynamic systems perspective. Interventions should simultaneously target organizational factors and individual capacities to optimize healthcare workforce retention. Findings inform evidence-based policies for tertiary hospital management.<\/jats:p>","DOI":"10.1177\/01632787261470858","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T03:41:58Z","timestamp":1784778118000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Organizational Climate and Individual Resilience as Bidirectional Predictors of Career Compromise: A Longitudinal Mixed-Methods Investigation in Tertiary Healthcare Settings"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2235-4968","authenticated-orcid":false,"given":"Yulin","family":"Zeng","sequence":"first","affiliation":[{"name":"Xi\u2019an Jiaotong University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Han","sequence":"additional","affiliation":[{"name":"Xi\u2019an Jiaotong University"},{"name":"The Key Lab of the Ministry of Education for Process Management & Efficiency Engineering"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"crossref","unstructured":"Aiken L. H. Sermeus W. Van den Heede K. Sloane D. M. Busse R. McKee M. Bruyneel L. Rafferty A. M. Griffiths P. Moreno-Casbas M. T. Tishelman C. Scott A. Brzostek T. Kinnunen J. Schwendimann R. Heinen M. Zikos D. Sjetne I. S. Smith H. L. Kutney-Lee A. (2012). Patient safety satisfaction and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 344(7851) Article e1717. https:\/\/doi.org\/10.1136\/bmj.e1717","DOI":"10.1136\/bmj.e1717"},{"key":"e_1_3_6_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2017.1406803"},{"key":"e_1_3_6_4_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.52.1.1"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258471"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2009.01.013"},{"key":"e_1_3_6_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.88.4.605"},{"key":"e_1_3_6_9_1","doi-asserted-by":"crossref","unstructured":"Chen D. Ni Y. Lu J. Wang Y. Qi Q. Zhai H. (2023). Examining the impact of perceived stress anxiety and resilience on depression among medical staff after COVID-19 quarantine: A chain mediation analysis. Frontiers in Public Health 11 Article 1250623. https:\/\/doi.org\/10.3389\/fpubh.2023.1250623","DOI":"10.3389\/fpubh.2023.1250623"},{"key":"e_1_3_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4878-3"},{"key":"e_1_3_6_11_1","doi-asserted-by":"crossref","unstructured":"Cheng Z. Tao Y. Liu T. He S. Chen Y. Sun L. Chen Z. (2023). Psychology stress insomnia and resilience of medical staff in China during the COVID-19 policy opening: A cross-sectional survey. Frontiers in Public Health 11 Article 1249255. https:\/\/doi.org\/10.3389\/fpubh.2023.1249255","DOI":"10.3389\/fpubh.2023.1249255"},{"key":"e_1_3_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.10113"},{"key":"e_1_3_6_13_1","volume-title":"Designing and conducting mixed methods research","author":"Creswell J. W.","year":"2018","unstructured":"Creswell J. W., Plano Clark V. L. (2018). Designing and conducting mixed methods research (3rd ed.). Sage.","edition":"3"},{"key":"e_1_3_6_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.1.1.16"},{"key":"e_1_3_6_15_1","doi-asserted-by":"crossref","unstructured":"Elgueta J. A. Grill M. (2025). The bidirectional relationship between destructive leadership and organizational commitment. Frontiers in Psychology 16 Article 1653061. https:\/\/doi.org\/10.3389\/fpsyg.2025.1653061","DOI":"10.3389\/fpsyg.2025.1653061"},{"key":"e_1_3_6_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000727"},{"key":"e_1_3_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12117"},{"key":"e_1_3_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqae113"},{"key":"e_1_3_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.riob.2008.04.002"},{"key":"e_1_3_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960-024-00958-1"},{"key":"e_1_3_6_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0038889"},{"key":"e_1_3_6_22_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.44.3.513"},{"key":"e_1_3_6_23_1","doi-asserted-by":"crossref","unstructured":"Hossny E. K. Alotaibi H. S. Mahmoud A. M. Elcokany N. M. Seweid M. M. Aldhafeeri N. A. Abdelkader A. M. Abd Elhamed S. M. (2023). Influence of nurses' perception of organizational climate and toxic leadership behaviors on intent to stay: A descriptive comparative study. International Journal of Nursing Studies Advances 5 Article 100147. https:\/\/doi.org\/10.1016\/j.ijnsa.2023.100147","DOI":"10.1016\/j.ijnsa.2023.100147"},{"key":"e_1_3_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.14504"},{"key":"e_1_3_6_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-022-00821-5"},{"key":"e_1_3_6_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705519909540118"},{"key":"e_1_3_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/inr.13054"},{"key":"e_1_3_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/0470013192.bsa156"},{"key":"e_1_3_6_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-12003-x"},{"key":"e_1_3_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.10032"},{"key":"e_1_3_6_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-12150-1"},{"key":"e_1_3_6_32_1","volume-title":"Longitudinal structural equation modeling","author":"Little T. D.","year":"2013","unstructured":"Little T. D. (2013). Longitudinal structural equation modeling. Guilford Press."},{"key":"e_1_3_6_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-025-03214-6"},{"key":"e_1_3_6_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8624.00164"},{"key":"e_1_3_6_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-52887-7"},{"key":"e_1_3_6_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-023-01077-7"},{"key":"e_1_3_6_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2020.1784738"},{"key":"e_1_3_6_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/nuf.12513"},{"issue":"1","key":"e_1_3_6_39_1","first-page":"48","article-title":"The validity issue in mixed research","volume":"13","author":"Onwuegbuzie A. J.","year":"2006","unstructured":"Onwuegbuzie A. J., Johnson R. B. (2006). The validity issue in mixed research. Research in the Schools, 13(1), 48\u201363.","journal-title":"Research in the Schools"},{"key":"e_1_3_6_40_1","doi-asserted-by":"publisher","DOI":"10.1037\/pspp0000358"},{"key":"e_1_3_6_41_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0029315"},{"key":"e_1_3_6_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16034"},{"key":"e_1_3_6_43_1","doi-asserted-by":"crossref","unstructured":"Santana S. P\u00e9rez-Rico C. (2023). Dynamics of organizational climate and job satisfaction in healthcare service practice and research: A protocol for a systematic review. Frontiers in Psychology 14 Article 1186567. https:\/\/doi.org\/10.3389\/fpsyg.2023.1186567","DOI":"10.3389\/fpsyg.2023.1186567"},{"key":"e_1_3_6_44_1","doi-asserted-by":"crossref","unstructured":"Sim\u00f5es de Almeida R. Costa A. Teixeira I. Trigueiro M. J. Dores A. R. Marques A. (2023). Healthcare professionals' resilience during the COVID-19 and organizational factors that improve individual resilience: A mixed-method study. Health Services Insights 16(1) Article 11786329231198991. https:\/\/doi.org\/10.1177\/11786329231198991","DOI":"10.1177\/11786329231198991"},{"key":"e_1_3_6_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-01898-w"},{"key":"e_1_3_6_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-022-00924-z"},{"key":"e_1_3_6_47_1","doi-asserted-by":"crossref","unstructured":"Uccella L. Mascherona I. Semini S. Uccella S. (2024). Exploring resilience among hospital workers: A Bayesian approach. Frontiers in Public Health 12 Article 1403721. https:\/\/doi.org\/10.3389\/fpubh.2024.1403721","DOI":"10.3389\/fpubh.2024.1403721"},{"key":"e_1_3_6_48_1","doi-asserted-by":"crossref","unstructured":"Unjai S. Forster E. M. Mitchell A. E. Creedy D. K. (2024). Interventions to promote resilience and passion for work in health settings: A mixed-methods systematic review. International Journal of Nursing Studies Advances 7 Article 100242. https:\/\/doi.org\/10.1016\/j.ijnsa.2024.100242","DOI":"10.1016\/j.ijnsa.2024.100242"},{"key":"e_1_3_6_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000003291"},{"key":"e_1_3_6_50_1","doi-asserted-by":"crossref","unstructured":"Wang Y. Zhang J. Feng X. Liang Y. Guan Z. Meng K. (2023). The development and validation of the hospital organizational environment scale for medical staff in China. Frontiers in Public Health 11 Article 1118337. https:\/\/doi.org\/10.3389\/fpubh.2023.1118337","DOI":"10.3389\/fpubh.2023.1118337"},{"key":"e_1_3_6_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02346-5"},{"key":"e_1_3_6_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11872-6"},{"key":"e_1_3_6_53_1","first-page":"1567583","article-title":"Turnover intention and the moderating role of career shocks: An empirical study of medical staff in public hospitals in Guangzhou, China","volume":"16","author":"Yang F.","year":"2025","unstructured":"Yang F., Duarte H., Chen J., Zu C. (2025). Turnover intention and the moderating role of career shocks: An empirical study of medical staff in public hospitals in Guangzhou, China. Frontiers in Psychology, 16, Article 1567583. https:\/\/doi.org\/10.3389\/fpsyg.2025.1567583","journal-title":"Frontiers in Psychology"}],"container-title":["Evaluation &amp; the Health Professions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01632787261470858","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01632787261470858","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01632787261470858","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T16:17:04Z","timestamp":1784996224000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01632787261470858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":52,"alternative-id":["10.1177\/01632787261470858"],"URL":"https:\/\/doi.org\/10.1177\/01632787261470858","relation":{},"ISSN":["0163-2787","1552-3918"],"issn-type":[{"value":"0163-2787","type":"print"},{"value":"1552-3918","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"01632787261470858"}}