Association Between Effectiveness of Knowledge Management and Nurses' Intolerance of Ambiguity in Hospitals: A Cross-Sectional Study.

BACKGROUND: The effectiveness of knowledge management and staff's intolerance of ambiguity are two important topics that have not been addressed in previous studies regarding nurses. OBJECTIVE: The present research investigates the relationship between effectiveness of knowledge management and nurses' intolerance of ambiguity in public hospitals. DESIGN: A cross-sectional study conducted between September 2025 and March 2026. SETTING: Five public hospitals in southwest Iran. PARTICIPANTS: A total of 192 nurses participated in the study using a total population sampling approach. METHODS: Two questionnaires were used to measure the effectiveness of knowledge management and intolerance of ambiguity. The data were analyzed using SPSS Version 21.0. Data normality was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Multiple linear regression, regression assumptions, diagnostic analysis, and Spearman's correlation were used to examine associations between variables. Bonferroni correction was applied to account for multiple comparisons. RESULTS: Nurses perceived knowledge management capabilities and processes at moderate levels, with organizational structure and knowledge protection obtaining the highest scores in their respective domains. Sex, age, and professional experience did not significantly predict knowledge management capabilities, processes, or effectiveness. However, age was positively associated with novelty, complexity, and intolerance of ambiguity, whereas professional experience was negatively associated with novelty and intolerance of ambiguity. After Bonferroni correction, knowledge capabilities and effectiveness showed significant positive associations with novelty and insolubility and significant negative associations with complexity (all adjusted p < 0.001). No significant association was observed between knowledge capabilities, processes, and effectiveness and intolerance of ambiguity. CONCLUSION: Knowledge management capabilities were associated with specific dimensions of intolerance of ambiguity. These findings suggest that the association between the organizational knowledge environment and ambiguity-related perceptions is multidimensional. Knowledge management initiatives alone should not be assumed to modify nurses' intolerance of ambiguity. IMPLICATIONS FOR NURSE MANAGERS: Nurse managers should strengthen knowledge management infrastructure, knowledge sharing, and protection processes and access to relevant organizational knowledge, while also supporting nurses' ability to cope with ambiguity through continuing education, reflective learning, and organizational support. Because knowledge management capabilities were associated with specific intolerance of ambiguity dimensions, not with overall, knowledge management initiatives should be complemented by broader individual and organizational strategies rather than being expected to modify intolerance of ambiguity alone.