The study, published in the open-access journal Nursing Open, set out to fill a specific gap. Change fatigue has mostly been studied in relation to resilience, job satisfaction and organizational commitment, while innovation climate, the shared perception that an organization welcomes new ideas, tolerates constructive dissent and provides the time, personnel and material resources to pursue them, has usually been linked to innovative work behaviour, psychological empowerment and leadership. Few investigations had measured both constructs in the same nursing sample, and none had tested whether the relationship between them survives adjustment for relevant demographic and work characteristics. The Turkish research team hypothesized, drawing on the Job Demands-Resources model, that the two would be inversely related: repeated change acts as a job demand requiring sustained adaptation, while an innovation-supportive climate signals the availability of resources that can buffer that demand.

The Job Demands-Resources framework, first articulated by Demerouti and colleagues in 2001, provides the theoretical spine of the analysis. In this model, every occupation carries demands, physical, cognitive and emotional requirements that consume energy, and resources, features of the job that fuel engagement and buffer strain. Continuous organizational change is a textbook demand: it forces nurses to abandon familiar routines, master new technologies and reconfigure documentation systems while still delivering uninterrupted patient care. Autonomy, supervisory support, adequate time and material resources are textbook resources. An innovation climate that visibly supplies those resources, the researchers reasoned, should therefore mark workplaces where the demand of change is met with greater capacity to absorb it. Importantly, the authors are careful to note that this cross-sectional design cannot prove a buffering mechanism; it can only establish that the association exists and persists after adjustment.

The methods were unusually thorough for a survey study. Because the entire eligible population of 194 nurses at the two centres was approached, the researchers conducted what amounts to a census rather than a sample, and 186 returned complete questionnaires between April and June 2022, a response rate of 95.9 percent with no missing scale-item data. Change fatigue was measured with the six-item Change Fatigue Scale developed by Bernerth and colleagues, in a Turkish version validated for healthcare workers, rated on a five-point agreement scale. Innovation climate was assessed with a 14-item Turkish nursing adaptation of the Innovation Climate Scale, which captures three dimensions: support for innovation, low barriers to innovation, and resource provision. Internal consistency was strong throughout, with Cronbach’s alpha values of 0.836 for change fatigue, 0.812 for the total innovation climate score, and between 0.756 and 0.886 for the subscales.

The participants were predominantly young and female, with a mean age of 29.69 years, 80.1 percent women, 60.2 percent single, and 55.4 percent working shifts. Nearly half worked in surgical units, and the sample was strikingly positive about the profession itself: 97.8 percent liked nursing, 89.8 percent had voluntarily chosen their current department, 90.9 percent were satisfied with it, and 83.9 percent would recommend the career to others. On the study’s core measures, nurses reported change fatigue near the midpoint of the scale, with a mean item score of 2.85, and innovation climate somewhat above the midpoint at 3.21. Within the innovation climate construct, support for innovation scored highest at 3.47, while resource provision scored lowest at 2.99, a pattern suggesting that even in supportive environments, tangible resources for innovation lag behind attitudinal encouragement.

The group comparisons revealed telling patterns. Shift-working nurses reported significantly higher change fatigue than their day-working colleagues, with mean scores of 3.00 versus 2.66, and also perceived a less favourable overall innovation climate and more barriers to innovation. Income mattered as well: nurses whose income fell short of their expenses reported more fatigue and a weaker innovation climate across every subscale than those whose income covered or exceeded expenses, although the highest-income group contained only eight nurses and must be interpreted with caution. Nurses who had chosen their unit voluntarily, who were satisfied with it, or who would recommend the profession reported significantly stronger innovation climate and resource provision, though their change fatigue scores did not differ significantly. Marital status, education level and clinical unit showed no significant relationship with fatigue.

The central statistical result was a robust inverse correlation between the two constructs. Change fatigue and innovation climate correlated at r = -0.438, a moderate association corresponding to roughly 19 percent shared variance, with a 95 percent confidence interval of -0.547 to -0.314 and a p value below 0.001. More importantly, the relationship survived multivariable scrutiny. In a hierarchical multiple linear regression that entered age, gender, income, work schedule and institutional tenure first, adding innovation climate explained an additional 13.1 percent of the variance in change fatigue, an incremental effect size of Cohen’s f² = 0.182, which conventionally qualifies as a large incremental effect. In the final model, each one-point increase on the innovation climate scale was associated with a 0.528-point decrease in change fatigue, with a standardized beta of -0.400. The full model accounted for 28.1 percent of the variance in fatigue, and heteroscedasticity-robust sensitivity analyses left the estimate essentially unchanged.

Several independent predictors emerged alongside the headline finding. Male nurses reported lower change fatigue than female nurses, an unadjusted-then-adjusted difference of 0.370 scale points. Shift work remained associated with 0.280 points more fatigue after adjustment, and longer institutional tenure predicted slightly higher fatigue, 0.027 points per year, perhaps reflecting accumulated exposure to successive rounds of change. Age and professional tenure were so highly correlated, at r = 0.897, that only age could enter the model. The researchers ran careful diagnostics, checking multicollinearity, homoscedasticity and influential cases, and reported the analysis in line with the STROBE guidelines for observational studies, with a sensitivity power analysis showing the sample was sufficient to detect even modest incremental effects.

What do these numbers mean for the people who run hospitals? The authors frame the results as identifying organizational conditions that merit structured assessment rather than prescribing interventions. During change initiatives, nursing managers can monitor workload, the quality of communication, opportunities for staff participation, and access to time and material resources, the very ingredients that an innovation climate captures. They can communicate the rationale, timeline and expected workflow consequences of each change, invite nurses’ input early, and document whether training and resources are genuinely sufficient. Organizations can also track change fatigue and innovation-climate indicators alongside staffing, retention and patient-safety measures, using repeated measurement to spot units that need support. The study itself cannot confirm that strengthening the climate would reduce fatigue; that question demands longitudinal and intervention research.

The limitations are candidly acknowledged. Exposure and outcome were measured at the same moment, so the direction of influence is unknown: a supportive climate may ease fatigue, exhausted nurses may perceive their workplace more negatively, or both may reflect unmeasured organizational conditions such as leadership quality, staffing ratios or the sheer volume of change. All data were self-reported in a single questionnaire, leaving room for common-method and social-desirability bias, and the two centres came from a single region, limiting generalizability across health systems. The five-point response format used for the Change Fatigue Scale also differs from the seven-point format in its validation study. Still, the study’s contribution is clear: it links innovation climate, usually studied as a driver of innovation output, to a change-specific strain construct, and it does so with a near-complete census, complete data and confounder-adjusted estimates. In an era when healthcare organizations must adapt continuously to technology, patient expectations and regulation, the finding suggests that how change is resourced and supported may matter as much as the change itself, and that the nurses absorbing that change deserve workplaces built to sustain them.

Subject of Research: The relationship between nurses' perceived innovation climate and change fatigue in hospital settings

Article Title: Determining the Relationship Between Change Fatigue and Innovation Climate Among Nurses: A Cross‐Sectional Study

Article References: Uslu, Y., Hancioğlu Başköy, Y., Yeşilaydin, G., Gedikli, E., & Yilmaz, E. (2026). Determining the Relationship Between Change Fatigue and Innovation Climate Among Nurses: A Cross‐Sectional Study. Nursing Open, 13(9), Article e70820. https://doi.org/10.1002/nop2.70820

Image Credits: AI Generated

DOI: 10.1002/nop2.70820

Keywords: change fatigue, innovation climate, nurses, cross-sectional study, Job Demands-Resources model, organizational change, shift work, nursing management, occupational strain, regression analysis, healthcare workforce, Turkey