Nursing Professional Commitment as a Mediator of the Relationship Between Work Environment and Missed Nursing Care Among Nurses: A Cross-Sectional Analysis

Introduction: Nursing care plays a pivotal role in promoting patient well-being and optimizing health outcomes. The nursing
profession is characterized by its commitment to delivering high-quality care to patients.
Objective: The purpose of the study was to explore the role of nursing professional commitment as a mediator between the
work environment and missed nursing care.
Methods: A cross-sectional analysis study “STROBE guideline” used an online structured questionnaire to collect data. It was
conducted on a sample of 813 nurses who worked at seven governmental hospitals in Egypt, in the hospital wards, operating
rooms, intensive care unit (ICU) or outpatient clinics, during a 4-month period from April to August 2022. Researchers used
Characteristics of nurses, Nursing Work Index-Revised, Nursing Professional Commitment Scale, and MISSCARE
Questionnaire to collect the data. Structural equation modeling by AMOS was used for testing nursing professional commitment
as a mediator between the work environment and missed nursing care. Nurses’ professional commitment was used as a
mediator between work environment and missing nursing care.
Results: The working environment has a direct impact of −0.175, an indirect impact of −0.139, and a total impact of −0.314.
Furthermore, professional commitment has a direct impact of −0.421. Additionally, when the working environment increases by
1, professional commitment increases by 0.33. Similarly, when the working environment increases by 1, missed care decreases by
0.175. Moreover, when professional commitment, as a mediating factor, increases by 1, missed care decreases by 0.421.
Conclusion: In conclusion, the findings of this study highlight the significant role of professional commitment as an intermediary
factor between the working environment and missed nursing care. According to these results, it is necessary to formulate and
implement intervention strategies to improve nurses’ professional commitment and working environment, which is the key to
reducing their missed nursing care.