ArticleJournal of nursing management2026
The Impact of Compulsory Citizenship Behavior on Organizational Silence in Nurses: The Roles of Presenteeism and Psychological Inflexibility.
Article in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Citizenship Fatigue as a Mediator Between Compulsory Citizenship Behavior and Work-Life Balance Among Nurses.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Article
- The Impact of Compulsory Citizenship Behavior on Organizational Silence in Nurses: The Roles of Presenteeism and Psychological Inflexibility.Journal of nursing management · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCompulsory citizenship behavior (CCB) and organizational silence are prevalent among nurses, undermining nursing care quality and potentially threatening patient safety. Prior studies have shown that CCB can lead to employee silence; however, this relationship has not been examined among nurses, and the underlying mechanisms and boundary conditions remain unclear.
aimThis study aimed to test whether presenteeism mediates the association between CCB and organizational silence, with psychological inflexibility serving as a moderator of this process.
methodsA cross-sectional study was conducted among nurses recruited via convenience sampling from three hospitals in Xi'an, Shaanxi Province, China. Four questionnaires were administered to assess CCB, presenteeism, organizational silence, and psychological inflexibility. A total of 400 valid responses were analyzed using Hayes' PROCESS macro in SPSS to test a moderated mediation model.
resultsPresenteeism mediated the relationship between CCB and organizational silence (β = 0.085, 95% CI: 0.039-0.131). Psychological inflexibility moderated the association between CCB and presenteeism: the positive effect of CCB on presenteeism was stronger among nurses high in psychological inflexibility (simple slope = 0.398, p < 0.001) than among those low in psychological inflexibility (simple slope = 0.217, p < 0.001).
conclusionPresenteeism helps explain how CCB relates to organizational silence among Chinese nurses, and psychological inflexibility strengthens the adverse effect of CCB on presenteeism. Reductions in CCB and presenteeism may be associated with lower levels of organizational silence. IMPLICATIONS FOR NURSING MANAGEMENT: To improve nursing care and public health, healthcare managers should consider interventions aimed at reducing nurses' experiences of CCB and presenteeism to help decrease organizational silence. In addition, strategies to reduce psychological inflexibility may help nurses better cope with demanding tasks and stressful work environments.
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