Clinical Ethics:147775092199428 (forthcoming)

Abstract
Background Workplace silence behavior is a social collective phenomenon. It refers to nurses choosing to withhold their ideas, opinions and concerns about critical issues in their workplace. Workplace silence behavior poses a threat to organizational ethics and success. It also has adverse effects on the performance of nurses in health organizations. Underlying nursing causes of silence behaviors could be related to individual, social and organizational attributes in health care settings. Objectives The study aimed to develop a new Egyptian validation scale for measuring nursing motives of workplace silence behavior and identify consequences of workplace silence behavior on nurses. Methods A cross-sectional correlational study was implemented using questionnaires on workplace silence behavior, nursing motives and nurses' consequences, collected from 332 nurses working in critical and toxicology care settings of Alexandria Main University Hospital. Results Egyptian scale was shown to be a good fit model of exploratory and confirmatory factor analysis tests. It also had high reliability tests with coefficient of alpha, Pearson and Kendall coefficient of 0.72. High level of workplace silence behaviors showed a negative association with organizational dis-identification, fair citizenship behavior, and fair nurses' performance and declined reporting of patient adverse events. It also appeared to be in a positive association with higher levels of cynicism. Conclusion The Egyptian scale was proved to be reliable and valid for measuring the underlying nursing causes of silence behaviors in the hospital workplace. Measuring nursing motives of workplace silence behaviors will help nurse managers to reduce negative outcomes of workplace silence behaviors and improve organizational outcomes.
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DOI 10.1177/1477750921994284
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