In recent years, the increasing incidence and high mortality rate of cancer have imposed significant work pressure and physical as well as mental health challenges on oncology nurses (Challinor et al., 2020). Due to their unique working environment, oncology nurses frequently encounter intense emotional fluctuations and diverse needs from terminally ill patients and their families. Moreover, they usually experience demanding professional requirements, heavy workloads, and increased risks of teratogenic and carcinogenic exposure (Bradford et al., 2024; Hetzel-Riggin et al., 2020). These factors may result in fatigue or absenteeism, consequently leading to elevated levels of job withdrawal and an increased turnover rate among nurses (De la Fuente-Solana et al., 2020).

Job withdrawal refers to a range of behaviors in which individuals proactively avoid unsatisfactory work environments, which encompasses a series of negative sequences of work behavior, including physical and psychological withdrawal behaviors (Gupta & Jenkins, 1991). A previous study has shown that nurses with high levels of job withdrawal exhibit negative attitudes and behaviors at work, displaying aggression to some extent, which could easily generate aversion among colleagues and leaders, and so undermine the overall working atmosphere in hospitals (Yi et al., 2023). Therefore, addressing the issue of job withdrawal and enhancing enthusiasm and engagement among clinical nurses has become an urgent concern for nursing managers (Li et al., 2022).

The nurses' job withdrawal can be influenced by individual characteristics, work environment, and family factors (García-Sierra et al., 2016; Labrague & Obeidat, 2022). Workplace incivility is a prevalent issue in healthcare, which originates from various sources, including colleagues, leaders, patients, and other medical professionals, and is significantly associated with job withdrawal (Santosa et al., 2023). It refers to low-intensity behaviors that violate respect and workplace norms, intended to harm the target and resulting in distress for those involved (Clark, 2013). The American Nurses Association has identified various forms of incivility including rude actions, gossiping, spreading rumors, refusing to assist coworkers, using derogatory language or adopting a patronizing manner (American Nurses Association, 2015; Crawford et al., 2019). A systematic review found that nurses experience an incidence rate of 67.5 % to 90.4 % of workplace incivility incidents (Bambi et al., 2018). Incivility can create hostile work environments hindering innovation and collaboration while potentially leading to unsafe clinical settings (Babchenko et al., 2020; Santosa et al., 2023). Simulated clinical scenarios revealed that even short-lived incidents of low-level incivility could escalate medical errors as more than half of the teams exposed to such behavior administered two consecutive shocks compared to none in control groups who made this error less frequently (Johnson et al., 2020). Workplace incivility has a negative impact on nursing practices, patient care, and overall nursing quality (Joseph et al., 2025). It also reduces job satisfaction and increases turnover and absenteeism (Taşkaya & Aksoy, 2021; Durmuş et al., 2024), leading to nurses perceiving increased job withdrawal and decreased work involvement (Li et al., 2019; Waltz et al., 2020). Research shows that the more nurses are exposed to workplace incivility, the stronger their withdrawal becomes (Santosa et al., 2023). Although numerous studies have already confirmed the relationship between workplace incivility and job withdrawal, there is a lack of studies on this impact specifically in Chinese oncology nurses as well as an unclear understanding of the underlying mechanism of their interaction.

Resilience refers to the ability to adapt, recover from, or overcome change or disasters when facing significant stressors (Foster et al., 2019). According to Richardson's resiliency model, psychological resilience is a dynamic and multifaceted concept associated with an individual's capacity to overcome adversity and promote personal growth in the face of challenges (Richardson, 2002; Li & Hasson, 2020). Nurses encountering uncivil behaviors need to engage in resilience reintegration by adjusting their internal and external resources. This process can lead to positive coping strategies or negative responses like withdrawal. Recent researches have focused on resilience as a strategy for alleviating workplace stress among nurses (Badu et al., 2020; Delgado et al., 2017; Sukut et al., 2022). Personal resilience helps nursing students recover from negative stressors and protects them from the harmful impacts of workplace incivility (Lee et al., 2019). Additionally, psychological resilience plays a crucial role in nurses' job withdrawal behavior, those with high levels of resilience are less likely to withdraw from their jobs (Wu et al., 2021). Studies have shown that psychological resilience acts as a mediator in various work-related variables such as work stress and work engagement (Jeong et al., 2022), perceived stress and work engagement (Li et al., 2023), and work-family conflict and work withdrawal (Wu et al., 2021). Previous studies have revealed that psychological resilience has certain correlations respectively with workplace incivility and job withdrawal, but scarce studies expound the specific role of psychological resilience between workplace incivility and job withdrawal.

Organizational commitment refers to a state in which people identify with the organization, combined with their willingness and desire to remain a member of this organization in order to facilitate organizational objectives (Meyer & Allen, 1990). Notably, study has indicated that there is a positive correlation between organizational commitment and job engagement, indicating that nurses with higher levels of organizational commitment tend to exhibit greater job engagement and lower job withdrawal (Alammar et al., 2016). It has been shown that exposure to higher levels of uncivil behavior in the workplace was associated with a decrease in their loyalty toward the organization and a lower level of organizational commitment. The findings indicated a negative correlation between workplace incivility and organizational commitment (Guo et al., 2020). Experiencing higher levels of workplace incivility is also linked to work engagement, especially taking a significant toll on individuals who are deeply devoted to their organizations (Santosa et al., 2023). Based on the prior research findings, organizational commitment appears to play a significant role in the relationship between workplace incivility and job withdrawal.

In conclusion, psychological resilience and organizational commitment play a single mediating role between workplace incivility and job withdrawal, respectively. However, when both psychological resilience and organizational commitment are considered as mediators, their relationship remains ambiguous and requires further investigation for clarification.

This study aimed to explore the relationship between workplace incivility and job withdrawal of oncology nurses and the chain mediating effects of psychological resilience and organizational commitment. This exploration will assist nursing managers in implementing effective and targeted measures for reducing job withdrawal among nurses.

Hypothesis 1

There is a positive correlation between workplace incivility experienced by oncology nurses and Job withdrawal.

Hypothesis 2

Psychological Resilience mediates the relationship between workplace incivility and job withdrawal.

Hypothesis 3

Organizational commitment mediates the relationship between workplace incivility and job withdrawal.

Hypothesis 4

Psychological resilience and organizational commitment play a chain mediation role between workplace incivility and job withdrawal.

According to the job demand-resource (JD-R) model, individuals need to invest a significant amount of job resources (e.g., psychological resilience and organizational commitment) when dealing with obstructive work demands (e.g., workplace incivility), which weakens work motivation and increases job withdrawal (Bakker & Demerouti, 2007). However, it is unclear how individual resources are interconnected to lead to the outcome, as no empirical research has identified to validate this relationship. Therefore, this study intends to delve into the discussion on the relationships between these variables by establishing a chain mediating model. The hypothesized framework for this study is presented in Fig. 1.