Lu Miaoji, Xia Ruinan, Wang Rui, Zou Xiaofang
School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China.
Traditional Chinese Medical Hospital of Huangpu District, Guangzhou, China.
BMC Nurs. 2025 Jul 1;24(1):794. doi: 10.1186/s12912-025-03388-z.
Nurse voice behavior is a critical factor in ensuring patient safety. Although there is a correlation between voice behavior and psychological safety within nurse teams, the intricate relationship between them has not been sufficiently explored in the literature.
A multi-center cross-sectional study was conducted.
From April to June 2022, clinical nurses were recruited from five cities in Guangdong Province, China using convenience sampling. Data were collected using validated scales, including the Voice Behavior Scale and Team Psychological Safety Climate Scale. Network analysis was employed to visualize the interactive relationships among variables. Statistical analysis was performed using SPSS 26.0 for baseline characteristics description. Network analysis was conducted on the RStudio platform, with network visualization implemented using the "qgraph" package, network centrality metrics calculated via the "qgraph" and "networktools" package, and network accuracy estimation along with stability testing performed using the "bootnet" package.
This study included a total of 812 nurses, with a mean age of 33.94 ± 7.95 years, of whom 96.6% were female. The mean scores for the voice behavior scale and the team psychological safety scale were 37.04 ± 5.88 and 58.01 ± 7.57, respectively. Network analysis revealed that the edges between nurses' voice behavior and team psychological safety were primarily positively correlated. Thestrongest influence was observed for "team members respect the suggestions and perspectives of others", which had the highest expected influence coefficient. Bridging connections included " if there is a problem with the work of the unit, dare to put forward opinions and suggestions ", " express your opinion on phenomena that affect work efficiency in the unit, without fear of embarrassment ", " timely dissuade other employees in the unit from bad behavior that affects work efficiency ", " most team members are receptive to new ideas or ways of thinking ", and " collaborate with team members to develop skills and expertise ". These findings highlighted critical pathways linking voice behavior and psychological safety in nursing teams.
The study revealed moderate levels of voice behavior and team psychological safety among Chinese nurses. Utilizing network analysis, we elucidated the intricate dynamics between these two constructs, identifying six pivotal influencing factors: (1) team members respect the suggestions and perspectives of others, (2) if there is a problem with the work of the unit, dare to put forward opinions and suggestions, (3) express your opinion on phenomena that affect work efficiency in the unit, without fear of embarrassment, (4) timely dissuade other employees in the unit from bad behavior that affects work efficiency, (5) most team members are receptive to new ideas or ways of thinking, and (6) collaborate with team members to develop skills and expertise. These findings underscore the potential for targeted interventions aimed at strengthening these key dimensions to enhance psychological safety and promote voice behavior within nursing teams, ultimately improving team dynamics and organizational outcomes.
Not suitable.
护士发声行为是确保患者安全的关键因素。尽管护士团队中发声行为与心理安全之间存在相关性，但它们之间的复杂关系在文献中尚未得到充分探讨。
进行了一项多中心横断面研究。
2022年4月至6月，采用便利抽样法从中国广东省五个城市招募临床护士。使用经过验证的量表收集数据，包括发声行为量表和团队心理安全氛围量表。采用网络分析来可视化变量之间的互动关系。使用SPSS 26.0进行统计分析以描述基线特征。在RStudio平台上进行网络分析，使用“qgraph”包实现网络可视化，通过“qgraph”和“networktools”包计算网络中心性指标，并使用“bootnet”包进行网络准确性估计和稳定性测试。
本研究共纳入812名护士，平均年龄为33.94±7.95岁，其中96.6%为女性。发声行为量表和团队心理安全量表的平均得分分别为37.04±5.88和58.01±7.57。网络分析显示，护士发声行为与团队心理安全之间的边主要呈正相关。观察到“团队成员尊重他人的建议和观点”的影响最强，其预期影响系数最高。桥梁连接包括“如果单位工作有问题，敢于提出意见和建议”、“对单位中影响工作效率的现象表达意见，不怕尴尬”、“及时劝阻单位其他员工影响工作效率的不良行为”、“大多数团队成员接受新想法或思维方式”以及“与团队成员合作发展技能和专业知识”。这些发现突出了护理团队中连接发声行为和心理安全的关键途径。
该研究揭示了中国护士发声行为和团队心理安全处于中等水平。利用网络分析，我们阐明了这两个构念之间的复杂动态关系，确定了六个关键影响因素：（1）团队成员尊重他人的建议和观点；（2）如果单位工作有问题，敢于提出意见和建议；（3）对单位中影响工作效率的现象表达意见，不怕尴尬；（4）及时劝阻单位其他员工影响工作效率的不良行为；（5）大多数团队成员接受新想法或思维方式；（6）与团队成员合作发展技能和专业知识。这些发现强调了有针对性干预的潜力，旨在加强这些关键维度，以提高护理团队中的心理安全并促进发声行为，最终改善团队动态和组织成果。
不适用。
