The Relationship Between Work Environment and Missed Nursing Care in Nurses: The Moderator Role of Profession Self-Efficacy

Aims: This study aimed to examine the relationship between work environment and missed nursing care (MNC) in nurses and determine whether profession self-efficacy has a moderator role in this relationship. Design: A quantitative, cross-sectional, correlational study design was used to test the study model. Methods: The study was conducted with 433 nurses in 2 city hospitals in Istanbul, Turkey. Data were collected between November 2022 and February 2023 using the "MISSCARE Survey-Turkish," the "Work Environment Scale," and the "Nursing Profession Self-Efficacy Scale." Results: The participants had a mean Nursing Profession Self-Efficacy Scale score of 66.67 +/- 14.37, a mean Work Environment Scale score of 84.96 +/- 13.62, a mean elements of MNC score of 1.30 +/- 0.73, and a mean reason for MNC score of 3.18 +/- 0.78. Nursing profession self-efficacy was determined to be positively related to the work environment of the participants and their reasons for MNC (respectively, r = 0.276 and r = 0.114) and negatively related to elements of MNC (r = -0.216) (P < 0.05). There was also a negative relationship between the work environment and elements of MNC (r = -0.249; P < 0.05). Profession self-efficacy had a significant moderator role in the relationship between the work environment and elements of MNC. Having low or moderate levels of profession self-efficacy moderated the negative effects of the work environment on elements of MNC. Conclusions: There is a need for interventions to reduce elements of missed nursing care in nurses. Especially nurses and/or nurse managers may have difficulties in improving their work environment, considering its multifaceted structure. In such cases, administrators can reduce missed nursing care by increasing the profession self-efficacy of nurses. Therefore, profession self-efficacy should be considered in addition to interventions for the work environment to improve care.