Academic Journal
View in EDS
Linked Full Text

Caring for Vulnerable Patients: Examining Job Satisfaction as a Mediator Between Perceived Stigma and Organizational Commitment.

Bibliographic Details
Title: Caring for Vulnerable Patients: Examining Job Satisfaction as a Mediator Between Perceived Stigma and Organizational Commitment.
Authors: Ali EA; Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt., El-Sayed MM; Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing, Qassim University, Buraydah, Saudi Arabia., Zoromba MA; College of Nursing, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia., Amin SM; Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing, Qassim University, Buraydah, Saudi Arabia., Dawood SS; Gerontological Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt., Ibrahim AMA; Gerontological Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt., Hamzaa HG; Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt.; Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, Saudi Arabia., Gabal SAA; Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt., Khedr MA; Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Source: International nursing review [Int Nurs Rev] 2026 Mar; Vol. 73 (1), pp. e70143.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Blackwell Science Ltd Country of Publication: England NLM ID: 7808754 Publication Model: Print Cited Medium: Internet ISSN: 1466-7657 (Electronic) Linking ISSN: 00208132 NLM ISO Abbreviation: Int Nurs Rev Subsets: MEDLINE
Imprint Name(s): Publication: Oxford, UK : Blackwell Science Ltd.
Original Publication: Geneva, International Council of Nurses.
MeSH Terms: Nursing Staff, Hospital*/psychology , Job Satisfaction* , Social Stigma* , Attitude of Health Personnel* , Personnel Loyalty*, Workplace/psychology ; Humans ; Cross-Sectional Studies ; Female ; Male ; Adult ; Middle Aged ; Egypt ; Surveys and Questionnaires ; Organizational Culture
Abstract: Aim: This study investigated the role of perceived stigma in predicting organizational commitment among nurses, examining job satisfaction as a potential mediating variable.
Background: Perceived stigma in the healthcare environment is increasingly recognized. However, the mechanisms linking stigma to organizational commitment, such as job satisfaction, remain underexplored.
Methods: A cross-sectional study was conducted from March to June 2025 among 313 nurses from various healthcare settings in Egypt. Data were collected using validated instruments measuring perceived stigma, job satisfaction, and organizational commitment. Pearson correlation analyses were used, and a mediation analysis was performed using the PROCESS macro to determine the significance of indirect effects.
Results: Perceived stigma was negatively correlated with job satisfaction (r = -0.140, p < 0.05) and its subscales and showed a weak correlation with the organizational commitment subdomains. Mediation analysis indicated that stigma significantly predicted lower job satisfaction (β = -0.312, p =  .013), which in turn was positively associated with organizational commitment (β = 0.227, p <  .001). The direct effect of stigma on commitment was positive and significant (β = 0.213, p =  .028). In contrast, the indirect effect through job satisfaction was negative and significant (β = -0.071, 95% CI [-0.141, -0.015]), supporting a partial mediation model.
Discussion: These findings underscore that while stigma may have a complex direct influence, its negative effect on commitment operates significantly through the reduction of job satisfaction.
Conclusion: Job satisfaction partially mediates the relationship between perceived stigma and organizational commitment.
Implications for Nursing and Health Policy: Healthcare policies and managerial interventions designed to reduce workplace stigma and proactively enhance job satisfaction are essential strategies for strengthening organizational commitment and improving nurse retention.
(© 2026 International Council of Nurses.)
References: AbdELhay, E. S., S. M. Taha, M. M. El‐Sayed, S. H. Helaly , and I. S. AbdELhay. 2025. “Nurses Retention: The Impact of Transformational Leadership, Career Growth, Work Well‐Being, and Work–Life Balance.” BMC Nursing 24, no. 1: 148. https://doi.org/10.1186/s12912‐025‐02762‐1.
Abo Shereda, H. M., S. S. Alqhtani, A. H. ALYami, et al. 2025. “Exploring the Relationship Between Compassion Fatigue, Stigma, and Moral Distress Among Psychiatric Nurses: A Structural Equation Modeling Study.” BMC Nursing 24, no. 1: 163. https://doi.org/10.1186/s12912‐025‐02802‐w.
Ahad, A. A., M. Sánchez‐González, and P. Junquera. 2023. “Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review.” Cureus 15, no. 5. https://doi.org/10.7759/cureus.39549.
Al‐Haroon, H. I., and M. F. Al‐Qahtani. 2020. “Assessment of Organizational Commitment Among Nurses in a Major Public Hospital in Saudi Arabia.” Journal of Multidisciplinary Healthcare 13: 519–526. https://doi.org/10.2147/JMDH.S256856.
Ali, E. A., M. A. Khedr, A. M. El‐Ashry, E. E. Elsayed, and J. Y. ELRazkey. 2025. “Perceived Stigma, Resilience, and Quality of Sleep Among Nurses Working in COVID‐19 Isolation Units.” Current Psychology 1–12. https://doi.org/10.1007/s12144‐025‐07835‐7.
Almansour, H., M. Gobbi, J. Prichard, and S. Ewings. 2020. “The Association Between Nationality and Nurse Job Satisfaction in Saudi Arabian Hospitals.” International Nursing Review 67, no. 3: 420–426. https://doi.org/10.1111/inr.12613.
Almuzini, T., G. Hamouda, and L. Sharif. 2020. “Assessment of Stigma‐by‐Association amongst Nurses Working in Mental Health Units.” Evidence‐Based Nursing Research 2, no. 3: 102–112. 10.47104/ebnrojs3.v2i3.140.
Alnajim, A. 2021. “Impact and Application of Social Exchange Theory in Employee Retention.” SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3884032.
Alshaibani, N. M., A. E. Aboshaiqah, and N. H. Alanazi. 2024. “Association of Job Satisfaction, Intention to Stay, Organizational Commitment, and General Self‐Efficacy Among Clinical Nurses in Riyadh, Saudi Arabia.” Behavioral Sciences 14, no. 12: 1140. https://doi.org/10.3390/bs14121140.
Alshammari, M. H., and A. Alenezi. 2023. “Nursing Workforce Competencies and Job Satisfaction: The Role of Technology Integration, Self‐Efficacy, Social Support, and Prior Experience.” BMC Nursing 22, no. 1: 308. https://doi.org/10.1186/s12912‐023‐01474‐8.
Alyousef, S. M., and S. A. Alhamidi. 2023. “Nurse Views of Obstacles Encountered by Nurses in Saudi Arabia During the Provision of Psychiatric Care.” Archives of Psychiatric Nursing 44: 8–17. https://doi.org/10.1016/j.apnu.2023.03.005.
Amaro, H., M. Sánchez, T. Bautista, and R. Cox. 2021. “Social Vulnerabilities for Substance Use: Stressors, Socially Toxic Environments, and Discrimination and Racism.” Neuropharmacology 188: 108518. https://doi.org/10.1016/j.neuropharm.2021.108518.
Bakker, A. B., and E. Demerouti. 2017. “Job Demands–Resources Theory: Taking Stock and Looking Forward.” Journal of Occupational Health Psychology 22, no. 3: 273. https://doi.org/10.1037/ocp0000056.
Bamforth, K., P. Rae, J. Maben, H. Lloyd, and S. Pearce. 2023. “Perceptions of Healthcare Professionals' Psychological Wellbeing at Work and the Link to Patients' experiences of Care: A Scoping Review.” International Journal of Nursing Studies Advances 5: 100148. https://doi.org/10.1016/j.ijnsa.2023.100148.
Bhatt, J., and P. Bathija. 2018. “Ensuring Access to Quality Health Care in Vulnerable Communities.” Academic Medicine 93, no. 9: 1271–1275. https://doi.org10.1097/ACM.0000000000002254.
Biggs, A., P. Brough, and S. Drummond. 2017. “Lazarus and Folkman's Psychological Stress and Coping Theory.” In The Handbook of Stress Health: A Guide to Research Practice, edited by C. L. Cooper and J. Campbell Quick, 349–364. John Wiley & Sons Ltd. doi: https://doi.org/10.1002/9781118993811.ch21.
Caricati, L., G. D'Agostino, A. Sollami, and C. Bonetti. 2022. “A Study on COVID‐19‐Related Stigmatization, Quality of Professional Life, and Professional Identity in a Sample of HCWs in Italy.” Acta Bio Medica: Atenei Parmensis 93, no. Suppl 2: e2022150. https://doi.org/10.23750/abm.v93iS2.12613.
El‐Ashry, A. M., Mohamed Elsayed Abdo, B. Khedr, et al. 2025a. “Mediating Effect of Psychological Safety on the Relationship Between Inclusive Leadership and Nurses' Absenteeism.” BMC Nursing 24, no. 1. https://doi.org/10.1186/s12912‐025‐03464‐4.
El‐Ashry, A. M., M. A. Khedr, M. M. El‐Sayed, I. S. Abdelhay, M. A. G. A. Zeid, and B. M. E. Abdo. 2025b. “Linking Psychological Capital to Job Embeddedness Among Nurses: Evidence From Egyptian Public Healthcare Setting.” BMC Nursing 24, no. 1: 917. https://doi.org/10.1186/s12912‐025‐03547‐2.
El‐Sayed, M. M., S. M. Taha, E. S. AbdElhay, et al. 2025. “Understanding the Connection: Attachment Patterns and Interpersonal Competence in Nursing Undergraduates.” BMC Nursing 24, no. 1: 847. https://doi.org/10.1186/s12912‐025‐03425‐x.
Fairbrother, G., A. Jones, and K. Rivas. 2010. “Development and Validation of the Nursing Workplace Satisfaction Questionnaire (NWSQ).” Contemporary Nurse 34, no. 1: 10–18. https://doi.org/10.5172/conu.2009.34.1.010.
Faul, F., E. Erdfelder, A. G. Lang, and A. Buchner. 2007. “G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences.” Behavior Research Methods 39, no. 2: 175–191. https://doi.org/10.3758/BF03193146.
Flaubert, J. L., S. Le Menestrel, D. R. Williams, and M. K. Wakefield, National Academies of Sciences, E., & Medicine. 2021. Supporting the Health and Professional Well‐Being of Nurses. The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity. National Academies Press. https://doi.org/10.17226/25982.
Hakami, A., H. Almutairi, R. Al Otaibi, T. Al Otaibi, and A. Al Battal. 2020. “The Relationship Between Nurses' Job Satisfaction and Organizational Commitment.” Health Science Journal 14, no. 1: 1–5. https://doi.org/10.36648/1791‐809X.14.1.692.
Karam, M., M.‐C. Chouinard, M.‐E. Poitras, et al. 2021. “Nursing Care Coordination for Patients With Complex Needs in Primary Healthcare: A Scoping Review.” International Journal of Integrated Care 21, no. 1: 16. https://doi.org/10.5334/ijic.5518.
Liao, G., J. Liu, Y. Li, H. Ye, and J. Liang. 2025. “Effect of Healthcare Professionals' perceived Occupational Stigma on Organizational Citizenship Behavior: A Moral Cleansing Perspective.” BMC Medical Ethics 26, no. 1: 28. https://doi.org/10.1186/s12910‐025‐01185‐6.
Meyer, J. P., N. J. Allen, and C. A. Smith. 1993. “Commitment to Organizations and Occupations: Extension and Test of a Three‐Component Conceptualization.” Journal of Applied Psychology 78: 538–551. https://psycnet.apa.org/doi/10.1037/0021‐9010.78.4.538.
Oruche, U. M., and T. C. Zapolski. 2020. “The Role of Nurses in Eliminating Health Disparities and Achieving Health Equity.” Journal of Psychosocial Nursing and Mental Health Services 58, no. 12: 2–4. https://doi.org/10.3928/02793695‐20201112‐01.
Rayan, A. 2024. “Stigma of Mental Illness: A Comparative Study of Demographic and Cultural Correlates Among Nursing Students and Registered Nurses in Jordan.” BMC Nursing 23, no. 1: 924. https://doi.org/10.1186/s12912‐024‐02616‐2.
Rushton, C. H., and K. Boston‐Leary. 2022. “Nurses Suffering in Silence: Addressing the Stigma of Mental Health in Nursing and Healthcare.” Nursing Management 53, no. 8: 7–11. https://doi.org/10.1097/01.NUMA.0000853148.17873.77.
Searby, A., D. Burr, and M. D. Abram. 2024. “Stigma Towards a Nursing Specialty: A Qualitative Analysis of the Perceptions of the Addiction Nursing Workforce.” International Journal of Mental Health Nursing 33, no. 5: 1460–1470. https://doi.org/10.1111/inm.13336.
Shnapper‐Cohen, M., N. Dolev, and Y. Itzkovich. 2023. “Social Identity in a Public Hospital: Sources, Outcomes, and Possible Resolutions.” Current Psychology 42, no. 16: 13975–13986. https://doi.org/10.1007/s12144‐022‐02729‐4.
Struening, E. L., D. A. Perlick, B. G. Link, F. Hellman, D. Herman, and J. A. Sirey. 2001. “The Extent to Which Caregivers Believe Most People Devalue Consumers and Their Families.” Psychiatric Services 52: 1633–1638. https://doi.org/10.1176/appi.ps.52.12.1633.
Subu, M. A., D. F. Wati, N. Netrida, et al. 2021. “Types of Stigma Experienced by Patients With Mental Illness and Mental Health Nurses in Indonesia: A Qualitative Content Analysis.” International Journal of Mental Health Systems 15: 1–12. https://doi.org/10.1186/s13033‐021‐00502‐x.
Trepte, S., and L. S. Loy. 2017. “Social Identity Theory and Self‐Categorization Theory.” The International Encyclopedia of Media Effects 63: 1–13. https://doi.org/10.1002/9781118783764.wbieme0088.
WHO, W. H. O. 2022. WHO Guideline on Self‐Care Interventions for Health and Well‐Being, 2022 Revision. World Health Organization. https://www.who.int/publications/i/item/9789240052192. Accessed on 2 April 2025.
WHO, W. H. O. 2024. Achieving Well‐Being: A Global Framework for Integrating Well‐Being Into Public Health Utilizing a Health Promotion Approach. World Health Organization. https://www.who.int/publications/i/item/9789240084858. Accessed on 3 April 2025.
Zoromba, M. A., H. E. El‐Gazar, M. G. N. Malek, M. M. El‐Sayed, M. H. R. Atta, and S. M. Amin. 2025. “Career Growth as a Mediator Between the Scope of Practice, the Importance of Practice, and Emergency Nursing Competency Among School Nurses.” Journal of Advanced Nursing 81, no. 10: 6406–6416. https://doi.org/10.1111/jan.16783.
Contributed Indexing: Keywords: Commitments; health care; job satisfaction; nursing staff; social stigma
Entry Date(s): Date Created: 20260105 Date Completed: 20260105 Latest Revision: 20260105
Update Code: 20260130
DOI: 10.1111/inr.70143
PMID: 41486689
Database: MEDLINE
Be the first to leave a comment!
You must be logged in first