title: Does job satisfaction mediate the relationship between healthy work environment and care quality?
abstract: BACKGROUND
  A healthy work environment can increase nurse-reported job satisfaction and patient care outcomes. Yet the associations between healthy work environment, nurse job satisfaction and QC have not been comprehensively examined in Chinese ICUs.
  
  
  OBJECTIVE
  To investigate the mediating effect of nurse job satisfaction on the relationship between healthy work environment and nurse-reported quality of care (QC) in Chinese intensive care units (ICUs).
  
  
  METHODS
  A total of 706 nurses were recruited from 28 ICUs of 14 tertiary hospitals. The nurses completed self-reported questionnaires to evaluate healthy work environment, job satisfaction and quality of patient care. Mediation analysis was conducted to explore the mediating effect between nurse-reported healthy work environment and QC.
  
  
  RESULTS
  Nurse work environment showed positive correlations with nurse-reported QC in the ICUs. Nurse-reported job satisfaction showed full mediating effects between healthy work environment and QC in the medical-surgical ICUs, surgical ICUs and neonatal/paediatric ICUs and indicated a partial mediating effect in the medical ICUs.
  
  
  CONCLUSIONS
  Significant mediating effects of nurse job satisfaction provide more support for thinking about how to use this mediator to increase nurse and patient care outcomes. Nurse administrators can design interventions to increase nurse work environment and patient care outcomes with this mediating factor addressed.
authors.affiliation: School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jinbing
authors.identifier: http://orcid.org/0000-0001-6726-5714
authors.initials: J
authors.lastname: Bai
mesh_terms: D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007588:Job Satisfaction; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D011787:Quality of Health Care; D057566:Self Report; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology
keywords: healthy work environment; intensive care unit; job satisfaction; mediating effect; quality of care