Author Affiliations: Vice President of Quality (Dr Rainer), Medical City Arlington Hospital, Texas; and Professor of Nursing (Dr Schneider), Saint Louis University, Missouri.
J Nurs Adm. 2020 Jun;50(6):349-354. doi: 10.1097/NNA.0000000000000896.
Speaking up is using one's voice to alert those in authority of concerns. Failure to speak up leads to moral distress; speaking up leads to moral courage.
The purpose of this study was to explore the influences of organizational culture, personal culture, and workforce generation on speaking-up behaviors among RNs.
We distributed a cross-sectional electronic survey to several thousand RNs, resulting in 303 usable surveys.
Organizational culture was a strong predictor of speaking-up behaviors; speaking up partially mediated the relationship between organizational culture and moral distress but was not a mediator between organizational culture and moral courage. Workforce generation did not explain speaking up.
The role of organizational culture supports efforts toward healthy work environments. Because not speaking up is related to moral distress, efforts must be escalated to empower nurses to use their voices.
直言不讳是指用自己的声音提醒当权者关注某些问题。如果不直言不讳，就会导致道德困境；而直言不讳则需要道德勇气。
本研究旨在探讨组织文化、个人文化和劳动力代际对注册护士直言行为的影响。
我们向数千名注册护士发放了一份横断面电子调查问卷，最终得到 303 份有效问卷。
组织文化是直言行为的强有力预测因素；直言行为部分中介了组织文化与道德困境之间的关系，但不是组织文化与道德勇气之间的中介。劳动力代际并不能解释直言行为。
组织文化的作用支持营造健康工作环境的努力。由于不直言不讳与道德困境有关，因此必须加紧努力，赋予护士发言权。
