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Exploring the nexus between organizational silence and hospital magnetism: A cross-sectional study on clinical nurses

Hui-Ying Chen1, Li-Hua Shen, Si-Jia Li

  • 1Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Medicine
|July 31, 2026
PubMed

Organizational silence, referring to employees' reluctance to voice their opinions and constructive suggestions, can have an adverse impact on hospitals, individuals, and patient safety. Magnet hospitals, which are renowned for attracting and retaining nursing talent, cultivate a more supportive work environment. However, there is a significant knowledge gap regarding the relationship between hospital magnetism levels and organizational silence among clinical nurses in China's Magnet hospitals. This study fills that gap. In March 2024, a cross-sectional survey at a Magnet-certified Grade A hospital in Zhejiang enrolled 390 clinical nurses via convenience sampling. Data were collected electronically using the Employee Silence Behavior Survey Scale and the Chinese Version of the Essentials of Magnetism Scale II. Overall and item - level mean scores for organizational silence and hospital magnetism were calculated. Pearson correlation coefficients were used to examine the relationship between organizational silence and hospital magnetism. Multiple linear regression analysis was performed, with organizational silence as the dependent variable and hospital magnetism as 1 independent variable, along with other significant demographic and occupational characteristics, to identify predictive factors. A total of 390 clinical nurses were included (89.7% under 40 years old, 98.5% female). The mean organizational silence score was 31.32 ± 11.02, and the mean hospital magnetism score was 152.88 ± 21.96. Hospital magnetism was negatively correlated with organizational silence (r = -0.488, P < .01). Multiple linear regression showed that unmarried status (β = 0.18, P < .01), lower professional title (β = -0.30, P < .01), poorer self-perceived health (β = 0.12, P = .01), and lower hospital magnetism (β = -0.44, P < .01) were significant predictors of higher organizational silence. The model explained 28% of the total variance in organizational silence, and hospital magnetism alone explained 17.7%. This is the 1st study to investigate the relationship between organizational silence and hospital magnetism levels among clinical nurses in China's Magnet hospitals. The findings confirm a significant negative correlation between the 2, with hospital magnetism emerging as a key influencing factor. We recommend that hospital managers focus on enhancing the magnetic work environment to reduce organizational silence.

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