Role perceptions and reported actual role content of hospital nurses in Mainland China


  • Hong Lu,

  • Alison E While,

  • K Louise Barriball

Alison E While
Florence Nightingale School of Nursing and Midwifery
King's College London
James Clerk Maxwell Building
57 Waterloo Road
London SE1 8WA
Telephone: 0044 20 7848 3022


Aim.  The study aimed to explore nurses’ views and experiences regarding their working roles in Mainland China.

Background.  Ministry of Health guidance relating to the hospital nurse's role has been widely used in Mainland China since 1982 but it does not adequately cover the development of new roles arising from recent health care system reforms. This has led to increasing concerns about the potential of role conflict and role ambiguity for nurses especially where role expectations are not reflected in actual role content leading to job dissatisfaction and higher turnover.

Methods.  A cross-sectional survey design using postal questionnaires comprising demographic questions and four scales measuring role perception and actual role content, job satisfaction, occupational stress, role conflict and role ambiguity was used. Five hundred and twelve hospital nurses in Beijing participated representing a response rate of 81%.

Results.  Most respondents reported that staff nurses should undertake most of the roles described in the domain of patients’ physical care, psychosocial and communication and professional aspects of patient care and patient care management and there was overall consensus regarding the roles of other health care personnel. Further, they reported that nurses always or sometimes carried out these roles. Different role perceptions were reported across educational groups. Additionally, nurses’ ratings of role perception and actual role content were related to their ratings of job satisfaction, occupational stress, role conflict and role ambiguity (p < 0·05).

Conclusions.  There was relative consensus regarding role perceptions but the role boundary between nursing and non-nursing work lacked clarity. The importance of role expectations is highlighted regarding job satisfaction and other components of working lives.

Relevance to clinical practice.  Acknowledgement of a potential gap between expectations and actual role of nurses provides the basis for developing strategies to reduce resulting occupational stress, role conflict and role ambiguity and increase job satisfaction. Additionally the findings provide a basis for international comparison of actual nurse role content and the potential support needs of nurses from Mainland China who move to work in other health care systems.