Lee Seung Eun, Seo Ja-Kyung, MacPhee Maura
College of Nursing, Yonsei University, Seoul, South Korea.
Mo-Im KIM Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, South Korea, 03722, South Korea.
BMC Nurs. 2025 May 20;24(1):567. doi: 10.1186/s12912-025-03217-3.
Nurses' promotive voice behavior, or the act of proactively suggesting improvements in the workplace, is crucial for enhancing healthcare services. Despite its importance, the factors that influence promotive voice, particularly within hierarchical environments, remain insufficiently explored. Understanding these factors is essential to creating work environments that encourage open communication and innovation among nursing staff. This study aimed to investigate the individual-level and unit-level factors that influence promotive voice among nurses, with a particular focus on the roles of age, unit tenure, power distance orientation, leadership style, and work climate.
This study, employing a cross-sectional and correlational design, analyzed data from 1,255 registered nurses with over six months of clinical experience, all of whom were involved in direct patient care across 145 nursing units. Multilevel analysis was employed to examine the relationships between individual-level characteristics (age, unit tenure, power distance orientation) and unit-level factors (leadership style, work climate) on promotive voice behavior. The analysis accounted for the hierarchical structure of the data, with nurses nested within nursing units.
The analysis revealed that individual nurse's age (B = 0.04, 95% CI [0.03, 0.05]) and unit tenure (B = 0.01, 95% CI [0.01, 0.02]) were positively associated with promotive voice, while power distance orientation was negatively associated with promotive voice (B = -0.08, 95% CI [-0.15, -0.01]). At the unit level, inclusive leadership style (B = 0.23, 95% CI [0.08, 0.38]) and a positive speaking-up work climate (B = 0.34, 95% CI [0.11, 0.57]) were significantly related to higher levels of promotive voice.
This study highlights the significant influence of both individual characteristics and unit-level factors on promotive voice among nurses. The findings suggest that fostering inclusive leadership and a supportive speaking-up climate, while addressing hierarchical barriers, can enhance the propensity of nurses to engage in promotive voice. This, in turn, has the potential to improve patient outcomes and enhance overall organizational performance by promoting a culture of open communication and continuous improvement.
Not applicable.
护士的促进性建言行为，即主动提出改进工作场所的行为，对于提升医疗服务至关重要。尽管其重要性不言而喻，但影响促进性建言的因素，尤其是在层级环境中，仍未得到充分探索。了解这些因素对于营造鼓励护士之间开放沟通和创新的工作环境至关重要。本研究旨在调查影响护士促进性建言的个人层面和科室层面因素，特别关注年龄、科室任期、权力距离取向、领导风格和工作氛围的作用。
本研究采用横断面相关设计，分析了1255名具有超过六个月临床经验的注册护士的数据，这些护士均参与了145个护理单元的直接患者护理工作。采用多水平分析来检验个人层面特征（年龄、科室任期、权力距离取向）与科室层面因素（领导风格、工作氛围）对促进性建言行为的关系。该分析考虑了数据的层级结构，护士嵌套在护理单元内。
分析显示，护士个人的年龄（B = 0.04，95%置信区间[0.03，0.05]）和科室任期（B = 0.01，95%置信区间[0.01，0.02]）与促进性建言呈正相关，而权力距离取向与促进性建言呈负相关（B = -0.08，95%置信区间[-0.15，-0.01]）。在科室层面，包容性领导风格（B = 0.23，95%置信区间[0.08，0.38]）和积极的建言工作氛围（B = 0.34，95%置信区间[0.11，0.57]）与更高水平的促进性建言显著相关。
本研究强调了个人特征和科室层面因素对护士促进性建言的重大影响。研究结果表明，培养包容性领导和支持性的建言氛围，同时消除层级障碍，可以提高护士进行促进性建言的倾向。反过来，这有可能通过促进开放沟通和持续改进的文化来改善患者结局并提升整体组织绩效。
不适用。
