ArticleHuman resources for health2024
What inhibits "speaking up" for patient safety among healthcare workers? A cross-sectional study in Malaysia.
Article in Human resources for health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Classification of influencing factors of speaking-up behaviour in hospitals: a systematic review.BMC health services research · 2024Pooled it
- 'If You Don't Speak Up, It Will Eat You Up': A Critical Discourse Analysis of Voice and Silence in a Multicultural Clinical Healthcare System.Nursing inquiry · 2026Article
- Communication failure during operating room turnover: a HFACS-informed qualitative case study of system-level coordination.BMC health services research · 2026Article
- From blame to learning: implementing a just culture program for head nurses and its impact on silent behavior and error reporting among staff nurses.BMC nursing · 2026Article
- The relationship between nurses' speaking up about patient safety and nursing work environment in Saudi Arabia: A cross-sectional study.Belitung nursing journal · 2026Article
- Perception of patient safety culture among perioperative staff: exploring the roles of individual factors and organizational factors.BMC health services research · 2025Article
- Network analysis of the relationships between voice behavior and team psychological safety climate among Chinese nurses.BMC nursing · 2025Article
- Revised Hospital Survey on Patient Safety Culture (HSOPSC 2.0): cultural adaptation, validity and reliability of the Malay version.BMC health services research · 2024Article
- Assessment of patient safety culture among healthcare providers in tertiary hospitals in Malaysia-A cross-sectional study.Health science reports · 2024Article
- Cluster of Speaking-Up Behavior in Clinical Nurses and Its Association With Nursing Organizational Culture, Teamwork, and Working Condition: A Cross-Sectional Study.Journal of nursing management · 2024Article
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6 authors.
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Abstract
backgroundIn healthcare, "speaking up" refers to when healthcare workers raise concerns regarding patient safety through questions, sharing information, or expressing their opinion to prevent harmful incidents and ensure patient safety. Conversely, withholding voice is an act of not raising concerns, which could be beneficial in certain situations. Factors associated with speaking up and withholding voices are not fully understood, especially in strong authoritarian societies, such as Malaysia. This study aimed to examine the factors associated with speaking up and withholding the voices of healthcare workers in Malaysia, thus providing suggestions that can be used in other countries facing similar patient safety challenges.
methodsThis cross-sectional study was conducted in a tertiary hospital in Sarawak State, Malaysia. Data were collected from 474 healthcare workers from 43 departments using a self-administered questionnaire for speaking up and withholding voices measures in 4 weeks prior to data analysis as well as socio-demographic factors of healthcare workers (sex, age group, profession, department, weekly work hours for patient care, years of employment in the hospital, and the hierarchical level) and speaking up related climate of the working environment were recorded. Data were analyzed using descriptive statistics. Logistic regression was performed to find out (adjusted) odds ratio of frequent speaking up and withholding voices.
resultsNurse compared to doctors and healthcare workers with short weekly working hours were more likely to speak up. Healthcare workers in emergency and intensive care department, those with short years of employment, and those who worked at low hierarchical levels were less likely to speak up. Healthcare workers in discouraging environment towards speaking up were more likely to withhold their voices.
conclusionsThis study demonstrates the characteristics of healthcare workers who speak up and those who withhold their voices in Malaysia. To ensure patient safety and prevent harm, it is essential to establish an encouraging environment that promotes speaking up and prevents withholding voices among healthcare worker, especially in circumstances where multiple types of healthcare workers with different socio-demographic backgrounds work together.
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