Does experiencing patient incivility necessarily impair nurses' efforts to maintain patient dignity? The moderating effect of future time orientation

Objection: The purpose of this study was to systematically analyze the pathways of patient incivility on nurses' behaviors for maintaining patient dignity and to test the moderating mechanism of future time orientation in it. Background: Patient incivility in the healthcare arena has become a much-needed occupational stressor, and long-term occupational exposure may weaken nurses' behaviors for maintaining patient dignity, which in turn affects the overall quality of nursing care. Exploring the role boundaries and buffering mechanisms of this phenomenon has important practical value for optimizing the quality of nursing services and promoting a harmonious doctor-patient relationship. Methods: A cross-sectional survey of 593 clinical nurses from six tertiary hospitals in Anhui Province, Jiangsu Province, and Shanghai was conducted using convenience sampling method. The research instruments included the reliability-tested Patient Incivility Scale, the Nurses' Dignity in Nursing Scale, and the Future Time Consideration Scale. After controlling for common method bias by Harman's one-way method, hypothesis testing was conducted using partial least squares structural equation modeling. Results: Patient incivility significantly and negatively predicted nurses' behaviors for maintaining patient dignity ( β =-0.199, P <0.001), and the moderating effect of future time orientation was statistically significant ( β =0.106, P <0.001). A simple slope test showed that the negative effect of patient incivility was significant when the level of future time orientation was at -1 standard deviation from the mean ( β =-0.621, P <0.001), whereas the effect was no longer significant when it was at +1 standard deviation from the mean ( β =-0.153, P =0.108). Conclusion: This study extends the nursing occupational stress-performance theoretical framework and confirms that future time orientation, as an important personal resource, is effective in moderating the negative effects of patient incivility.