BMC Nursing (Apr 2025)
The mediating role of professional values and self-efficacy in the relationship between organizational justice and quality of working life among nurses in southwestern Iran
Abstract
Abstract Background An optimal quality of working life (QWL) is crucial for the preservation and maintenance of employees. Organizational justice, as a significant organizational factor, leads to the improvement and enhancement of QWL in organizations, promoting organizational commitment, job satisfaction, and ultimately increased productivity. A variable that can be influenced by organizational justice is self-efficacy, which strengthens the flexibility of nurses in challenging operating room environments. Professional values form the foundation of the nursing profession, enabling nurses to manage conflicts and prioritize actions. This study aimed to determine the relationship between organizational justice and QWL, emphasizing the mediating role of professional values and self-efficacy among operating room and anesthesia nurses. Methods This cross-sectional study was conducted in the operating rooms of hospitals affiliated with Shiraz University of Medical Sciences, Iran, including Namazi, Khalili, Shahid Faghihi, Shahid Rajaeii, Shahid Chamran, and Amir al-Momenin (AS) in 2023–2024. Through quota sampling, 376 operating room and anesthesia nurses participated in this study. Data were collected in person using five questionnaires: demographic characteristics, organizational justice (Niehoff & Moorman), QWL (Walton), professional values (Schank & Weis), and job self-efficacy (Riggs). To perform structural equation modeling (SEM) considering the sample size, we used Smart PLS version 4, and to determine the role and strength of the mediating effects of professional values and self-efficacy, we utilized Sobel tests and the Variance Accounted For (VAF) statistic. Results 376 operating room nursing and nurse anesthetists with a mean age of 33.92 ± 7.02 years and a mean work experience of 9.98 ± 7.76 years participated in this study; most of them were female, married, and held a bachelor’s degree. The mean overall score for organizational justice among participants in the study was 43.53 ± 4.91, indicating that 57.8% had a moderate level of organizational justice. The mean overall score of QWL was 79.90 ± 6.86, showing that the QWL of operating room personnel was at a moderate level. Furthermore, the results showed that the mean score of professional nursing values for the participants in the study was 112.21 ± 6.87, indicating that 98.7% of the operating room personnel had a high score in professional values. The mean self-efficacy score of the participants in the study was 103.51 ± 6.26), indicating that 96% of the operating room personnel had a high level of self-efficacy. The results of the Sobel test and VAF statistics also confirmed the mediating role of professional values and self-efficacy in the relationship between organizational justice and QWL. About 87.2% of the total effect of organizational justice on QWL was explained indirectly by the mediating variable of professional values. Also, the mediating effect of self-efficacy in the relationship between organizational justice and QWL was significant, and approximately 63.9% of the total effect of organizational justice on QWL was explained indirectly by the mediating role of professional values. Conclusion Organizational justice not only directly impacts QWL but also indirectly affects it through professional values and self-efficacy. Given that the scores for organizational justice and QWL among operating room nurses were at a moderate level, hospital managers need to implement strategies such as organizing periodic training classes and workshops on stress management, effective communication skills, and the development of professional ethics to improve the working conditions of personnel in these areas. Policymakers in the healthcare system and hospital managers can enhance QWL and promote a fairer work environment in operating rooms by increasing their self-efficacy levels and respecting nursing professional values.
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