Mapping assessment practices in DanceSport: a Human-In-The-Loop systematic review.

In recent years, the Chinese government has been committed to healthcare optimization reforms. With the implementation of the”Healthy China 2030”Plan, policies such as the tiered diagnosis and treatment system, Diagnosis-Related Group (DRG) payment reform, and smart hospital construction have been rolled out in earnest (). Moreover, the increasingly evident trend of cross-disciplinary integration between medicine and other fields has ushered in the era of Modern Medicine Development 4.0 (). In 2024, the State Council issued the “Key Tasks for Deepening the Healthcare Reform in 2024,” indicating that China will continue to advance its profound healthcare reforms. In 2025, China launched pilot programs for accompanied care exemption services, placing nurses in a leading care role. It is evident that nurses are undergoing significant changes. These reforms encompass several interrelated areas, such as the introduction of new nursing equipment; the expansion and relocation of hospital facilities; updates to health insurance reimbursement models; reforms to nursing performance evaluation; and the consolidation or reorganization of nursing units within wards, as well as staff reassignments (, ). As frontline implementers of these reforms, clinical nurses are required to frequently adapt to changes in work processes, management systems, operational protocols, and assessment methods, leaving them in a prolonged state of high-intensity adaptation. The concept of change fatigue has thus emerged. The concept of change fatigue originated in management studies and was initially used to explore organizational change and its associated successes and failures (). Chinese scholars have defined change fatigue as an inability to adapt to continuous change and as occupational burnout (). However, the underlying mechanism of change fatigue differs from that of burnout. Change fatigue is triggered by “dynamic and continuous organizational change,” rather than by reaching the limits of tolerance for “routine workload.” Furthermore, while burnout focuses on “long-term stress accumulation,” change fatigue places greater emphasis on the notion that the “frequency and speed of change exceed an individual’s adaptive threshold (). For clinical nurses, change fatigue is a condition in which they fail to adapt to persistent alterations in the clinical nursing work environment, leading to burnout, exhaustion, and a misalignment between their thoughts, behaviors, and the expectations of organizational leaders (). As noted by Dilkers, when individuals frequently encounter organizational change, their capacity to cope with it and their enthusiasm for engaging with it gradually diminish (). Sustained change-related stress leads to excessive depletion of psychological resources and energy reserves, thereby giving rise to change fatigue. This well explains the formation mechanism of change fatigue. Research by several scholars has shown that nurses generally report moderate to high levels of change fatigue, which is significantly negatively correlated with job satisfaction and psychological resilience and positively correlated with perceived stress. The hospital scale has also been identified as a significant predictor of nurses’ change fatigue, with fatigue levels rising as the number of hospital beds increases (–). Change fatigue typically manifests in nurses’emotional changes or behavioral responses. In terms of emotional changes, nurses may experience feelings of apathy, withdrawal, stress, and moral dilemmas ().In terms of behavioral responses, nurses often exhibit silent resistance to new initiatives and a reduced sense of organizational commitment (), which leads to decreased life and job satisfaction (). In the long term, this may increase nurses’ burnout and turnover rates. This has a series of negative impacts on nurses’ psychological and physical health, as well as on the development of the healthcare industry.