The Mediating Model of Medicine Narrative Competence of Nurses in the Pneumoconiosis Department between Managerial Care and Caring Ability

Background: Building humanistic care in healthcare organizations is receiving increasing attention, and evidence is emerging on how to develop nurses' humanistic care competencies in clinical settings. As China's leading occupational disease killer, pneumoconiosis is incurable and progressively debilitating, imposing a heavy disease burden. Nurses' humanistic care plays a pivotal role in alleviating patients' psychological distress, enhancing treatment adherence and outcomes, and facilitating social reintegration.Currently, nurses' managerial caring perceptions play an important positive influence on nurses' own humanistic caring competence, and training nurses in narrative medicine can also significantly improve nurses' humanistic caring competence; however, few studies have simultaneously focused on the relationship between managerial caring perceptions, medical narrative competence, and humanistic caring competence. Research objective: This study aimed to examine the mediating effect of narrative medicine competence among perceptions of managerial caring and humanistic competence among nurses in a pneumoconiosis unit. Research design: A cross-sectional design used acceptable validity scales. The hypothesised moderated mediation model was tested in the SPSS PROCESS macro. Participants and research context: This survey collected data from 352 nurses working in the occupational disease departments of Hunan Prevention and treatment Institute for occupational diseases and Hunan Chest Hospital, as well as 107 pneumoconiosis rehabilitation centers in Hunan Province, China. Ethical considerations: This study was pre-approved by the ethics committee of the hospital （No.2025032501）. Informed consent was obtained from all of the participants in the study. Results: Pneumatology nurses' perceptions of managerial caring (β= 0.527, 95% CI = [0.446, 0.609 ]) had a direct positive effect on humanistic caring competence (β = 0.518, 95% CI = [0.447, 0.589]), and perceptions of managerial caring had a similarly positive effect on medical narrative competence (β = 0.565, 95% CI = [0.469, 0.662]). In addition, managerial caring perceptions of pneumoconiotic nurses could positively influence humanistic caring competence through narrative medicine competence (β = 0.293, 95% CI = [0.224, 0.363]). Conclusions: Narrative medicine competence partially mediates the relationship between perceptions of managerial caring and humanistic caring competence in pneumoconiosis nurses. This study highlights the importance of strengthening narrative medicine competencies and improving organizational support in developing humanistic caring competencies among pneumoconiosis nurses.