ReviewFrontiers in psychiatry2023
An integrative systematic review of employee silence and voice in healthcare: what are we really measuring?
Review in Frontiers in psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Exploring Students' Perceptions and Experiences of Raising Concerns During Pre-Registration Training in England: A Systematic Review.Journal of advanced nursing · 2025Pooled it
- Pooled it
- Classification of influencing factors of speaking-up behaviour in hospitals: a systematic review.BMC health services research · 2024Pooled it
- Health workers' perspectives on the quality of maternal and newborn health care around the time of childbirth: Results of the Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) project in 12 countries of the World Health Organization European Region.Journal of global health · 2024Trial
- Workplace Violence in Indonesian Clinical Learning Environments: Cultural and Organisational Contexts Shaping Nursing Students' Experiences.Nursing inquiry · 2026Article
- Why Hide AI Use? Psychological Configurations and Explainable Machine Learning Evidence from Marketing Work.Behavioral sciences (Basel, Switzerland) · 2026Article
- Article
- Article
- The hidden cost of patient advocacy: moral courage mediating clinical advocacy behaviors and workplace ostracism among Chinese nurses.Frontiers in psychology · 2026Article
- From doubt to trust: how AI safety voice bridges the gap between employees and AI teammates through perceived capability and benevolence.Frontiers in psychology · 2026Article
- The mediating roles of self-efficacy and professional identity in the association between internship environment and voice behavior among nursing interns: a multicenter cross-sectional study.Frontiers in psychology · 2026Article
- Perceived organizational silence climate and turnover intention: indirect associations through learned helplessness, psychological withdrawal, and job burnout.Frontiers in psychology · 2026Article
- The Sounds of Silence: Problematizing Voicelessness in Nursing Practice.Nursing inquiry · 2026Article
- A 360-Degree View of Unprofessional Behaviours Between Nurses and Between Nurses and Medical Colleagues: A Secondary Analysis of a Mixed-Method Evaluation.Journal of nursing management · 2026Article
- The Code of Silence in Healthcare: Exploratory Cross-National Evidence and a Framework for Reporting and Responsibility.Health services insights · 2026Article
- Organizational inaction sustains destructive leadership in healthcare.Frontiers in psychology · 2026Article
- Safety Listening in High-Risk Situations: A Qualitative Analysis of Responses to Safety Voice in Aviation.Risk analysis : an official publication of the Society for Risk Analysis · 2025Article
- The relationship between professional moral courage and patient safety silence among nurses.BMC nursing · 2025Article
- Effect of Accreditation on Patient Safety Culture: Insights from a Brazilian Multicenter Cross-Sectional Study.Global journal on quality and safety in healthcare · 2025Article
- The relationship between compulsory citizenship behavior and nurses' silence: a cross-sectional study.BMC nursing · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The history of inquiries into the failings of medical care have highlighted the critical role of communication and information sharing, meaning that speaking up and employee silence have been extensively researched. However, the accumulated evidence concerning speaking-up interventions in healthcare indicates that they achieve disappointing outcomes because of a professional and organizational culture which is not supportive. Therefore, there is a gap with regard to our understanding of employee voice and silence in healthcare, and the relationship between withholding information and healthcare outcomes (e.g., patient safety, quality of care, worker wellbeing) is complex and differentiated. The following integrative review is aimed at addressing the following questions; (1) How is voice and silence conceptualized and measured in healthcare?; and (2) What is the theoretical background to employee voice and silence?. An integrative systematic literature review of quantitative studies measuring either employee voice or employee silence among healthcare staff published in peer-reviewed journals during 2016-2022 was conducted on the following databases: PubMed, PsycINFO, Scopus, Embase, Cochrane Library, Web of Science, CINAHL and Google Scholar. A narrative synthesis was performed. A review protocol was registered on the PROSPERO register (CRD42022367138). Of the 209 initially identified studies for full-text screening, 76 studies met the inclusion criteria and were selected for the final review (
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.