Abstract
BACKGROUND: Many newly graduated nurses experience transition shock when they move to a real work environment. Although previous research has identified some factors influencing transition shock, no study has explored it from the perspective of social interactions. This study aims to investigate factors influencing transition shock among new nurses within three years of graduation and explore the relationship between social inhibition and transition shock and its mechanisms. METHODS: This was a cross-sectional study. A total of 547 nurses in China completed an assessment of the study variables. Data were analyzed using multiple linear regression and mediation models with the PROCESS macro in SPSS. RESULTS: The higher the behavioral inhibition and interpersonal sensitivity scores, the higher the transition shock score (β = 0.14, p = 0.015; β = 0.42, p < 0.001). Higher interpersonal communication and emotion regulation scores were associated with lower transition shock scores (β = -0.09, p = 0.011; β = -0.09, p = 0.006). Interpersonal communication and emotion regulation mediate the relationship between social inhibition and transition shock (β = 0.06, 95% confidence interval (CI): 0.039, 0.087). CONCLUSIONS: New nurses with higher social inhibition, particularly those who fear receiving negative judgment from others, experience elevated transition shock. Targeted interventions to reduce social inhibition, improve interpersonal communication, and enhance emotion regulation are critical to mitigating transition shock. These findings emphasize integrating individualized support programs into nursing education and clinical onboarding processes. CLINICAL TRIAL NUMBER: Not applicable.