The Relationship Between Personality Traits And Voice Behaviour Among Clinical Nurses And The Mediating Moderating Effect

BackgroundNursing service is an important part of the construction of Healthy China,which is closely related to people’s health rights and life safety.During the"13th Five-Year Plan"period,China’s nursing quality control work develops rapidly and faces new situations and challenges brought by population aging.The National Health Commission of the People’s Republic of China has put forward clear requirements for promoting the high-quality development of nursing in the National Nursing Development Plan（2021-2025）.As the largest labor force in the medical care field,nurses keep close contact with patients and continuously observe patient care in hospitals,playing a key role in improving patient safety and nursing quality.Nurse voice behavior is a low-cost behavior that can effectively improve the quality of care.However,it is reported that they have low confidence in voice behavior for patient safety and concern about negative consequences,and they offered less voice behavior than other health care providers,such as doctors.However,according to the International Council of Nurses Code of Ethics for Nurses,nurses need to speak up when patient safety is threatened,and nurses should advocate for patients and cooperate with others to reduce potential errors.Therefore,it is very important to take effective measures to reduce the occurrence of nurses’silence behavior and promote their positive suggestions.Some of the existing research results of personality traits on voice behavior are relatively scattered and still controversial.Only a few scholars have explored the emotional and motivational mechanisms of personality traits affecting the voice behavior of clinical nurses,and most of them focus on the discussion of leader-related contextual factors,but ignore the potential role of other organizational factors on the relationship between personality traits and voice behavior of clinical nurses.Based on this,this study has established the perspective of emotional experience,achievement motivation,and organizational atmosphere to explore the impact of personality traits on clinical nurses’voice behavior,based on a review and summarization of relevant literature at home and abroad.ObjectivesTo understand the status quo and relationship of personality traits,emotional experience,achievement motivation,organizational climate and voice behavior of clinical nurses.To explore the influencing factors of voice behavior and the mechanism of emotional experience,achievement motivation and organizational climate between personality traits and voice behavior of clinical nurses,in order to provide new ideas for nursing managers to improve the voice behavior of clinical nurses and provide reference for improving the level of hospital management.MethodsThe methods of literature research,questionnaire survey and statistical analysis were used.A total of652 clinical nurses from seven public hospitals in Zhengzhou and Kaifeng of Henan Province were selected by convenience sampling method and investigated by questionnaire.The research tools mainly included the general demographic data questionnaire,personality trait scale,emotional experience scale,achievement motivation scale,organizational climate scale and voice behavior scale.Descriptive analysis,univariate analysis,pearson correlation analysis,multiple linear regression analysis and moderated mediation test were used for data analysis.Results（1）The scores of neuroticism,conscientiousness,agreeableness,openness and extraversion were（25.14±7.01）,（33.89±6.51）,（33.12±5.71）,（32.40±7.12）,and（29.70±5.42）,respectively.The score of positive emotion was（30.18±7.36）,and the score of negative emotion was（23.78±7.92）.The score of pursuing success motivation was（42.04±8.35）,and the score of avoiding failure motivation was（40.75±8.25）.The score of organizational climate was（90.81±17.10）.The score of voice behavior was（35.58±7.50）.（2）Single factor analysis showed that there were significant differences in neuroticism scores between positions,professional titles,departments and average working hours（P<0.05）.Marital status,hospital type,professional title and employment method had significant differences in the score of rigor（P<0.05）.Marital status,highest education,hospital type,professional title,working years and average monthly income had significant differences in agreeability scores（P<0.05）.There was a significant difference in the score of openness of employment method（P<0.05）.There were significant differences in extraversion scores of gender,position and employment method（P<0.05）.Gender,position,employment method and average working hours were significantly different in the score of positive emotions.There were significant differences in negative emotion scores among hospital types,employment methods and average working hours（P<0.05）.There were significant differences in the scores of achievement motivation in gender,age,highest education,position,different professional titles,employment methods and working years（P<0.05）.Gender,age,marital status,highest education,hospital type,position,professional title,department,employment method,average working hours,working years,and average monthly income had no significant differences in organizational climate（P>0.05）.There were significant differences in the score of voice behavior between the patients with or without position,professional title,employment method,average daily working hours,and working years（P<0.05）.（3）Pearson correlation analysis showed that clinical nurses’neuroticism was significantly positively correlated with negative emotions（r=0.40,P<0.01）,and was significantly negatively correlated with positive emotion（r=-0.16,P<0.01）,achievement motivation（r=-0.30,P<0.01）,organizational climate（r=-0.22,P<0.01）and voice behavior（r=-0.26,P<0.01）.Conscientiousness,agreeableness,openness and extroversion were negatively correlated with positive emotion（r=0.44,P<0.01;r=0.25,P<0.01;r=0.56,P<0.01;r=0.49,P<0.01）,achievement motivation（r=0.22,P<0.01;r=0.14,P<0.01;r=0.26,P<0.01;r=0.28,P<0.01）,organizational climate（r=0.60,P<0.01;r=0.38,P<0.01;r=0.57,P<0.01;r=0.63,P<0.01;r=0.39,P<0.01）and voice behavior（r=0.58,P<0.01;r=0.28,P<0.01;r=0.52,P<0.01）,and negatively correlated with negative emotions（r=-0.22,P<0.01;r=-0.34,P<0.01;r=-0.11,P<0.01;r=-0.10,P<0.05）,（4）Multiple linear regression analysis showed that neuroticism,conscientiousness,extroversion,achievement motivation,emotional experience,organizational climate,and professional title had significant effects on voice behavior of clinical nurses（P<0.05）,which together accounted for 59.6%of the variation.（5）The mediating effect with moderating analysis showed that emotional experience and achievement motivation played a partial mediating role in the relationship between the Big five personality and voice behavior of clinical nurses.Specifically,neuroticism,conscientiousness,openness,and extraversion could affect voice behavior of clinical nurses through the independent mediating role of positive emotions and achievement motivation.It can also play a role in the voice behavior of clinical nurses through the chain mediating effect of emotional experience→achievement motivation.Agreeableness can not only indirectly affect the voice behavior of clinical nurses through positive emotions,but also play a role in the chain mediating effect of emotional experience→achievement motivation.In addition,organizational climate had a significant moderating effect on the paths of neuroticism,conscientiousness,openness→positive emotion(β_int=-0.09,P<0.05;β_int=0.12,P<0.01;β_int=0.10,P<0.01)and conscientiousness,openness→achievement motivation(β_int=0.10,P<0.01;β_int=0.06,P<0.05)and neuroticism,conscientiousness→negative emotion(β_int=0.20,P<0.001;β_int=-0.11,P<0.01),neuroticism,agreeableness,extraversion→voice behavior(β_int=-0.07,P<0.05;β_int=-0.13,P<0.001;β_int=-0.07,P<0.05).ConclusionsThe voice behavior of clinical nurses is affected by many factors.Positive emotion and achievement motivation played a partial mediating role between big five personality and voice behavior of clinical nurses,and four personality traits except agreeableness and voice behavior of clinical nurses respectively.Emotional experience and achievement motivation played a chain mediating role between big five personality and voice behavior of clinical nurses.The process by which neuroticism,conscientiousness and openness affect the voice behavior of clinical nurses through emotional experience and achievement motivation is positively moderated by organizational climate.Therefore,nursing managers should pay attention to the differences in personality traits of clinical nurses,improve the positive emotions and achievement motivation of clinical nurses,and pay attention to the inconsistency of organizational climate in moderating the relationship between different personality traits and voice behavior of clinical nurses,so as to effectively cultivate organizational climate and promote positive voice behavior of clinical nurses with different personality traits.