Green Voice Behavior in Nursing: The Roles of Organizational Support, Intrinsic Motivation, and Psychological Safety.

BACKGROUND: Coordinated action is needed to combat climate change and environmental damage, and it is important that healthcare be part of that response. Through proactive behaviors such as environmentally responsible communication or "green voice behavior," nurses can effectively support sustainability initiatives. However, empirical evidence on the factors that encourage such behavior remains limited. This study examined the relationship between perceived green organizational support and nurses' green voice behavior, while also testing the mediating role of green intrinsic motivation and the moderating effect of psychological safety. DESIGN: A descriptive correlational design with cross-sectional data was employed. METHODS: Data were collected from 649 nurses in South Korea. We tested a second-stage moderated mediation in which perceived green organizational support is associated with green voice behavior through green intrinsic motivation, while psychological safety moderates the association between green intrinsic motivation and green voice behavior. Analyses were conducted using the PROCESS macro in SPSS (Model 4 for simple mediation; Model 14 for moderated mediation). RESULTS: Perceived green organizational support was positively associated with green voice behavior, both directly (b = 0.40, 95% confidence interval [CI] [0.329, 0.479]) and via green intrinsic motivation (b = 0.05, 95% CI [0.023, 0.075]). In our model, psychological safety moderated the relationship between green intrinsic motivation and green voice behavior (interaction b = 0.19, p = 0.002). The conditional indirect effect of perceived green organizational support on green voice behavior via green intrinsic motivation increased as psychological safety rose (index of moderated mediation = 0.03, 95% CI [0.010, 0.053]). CONCLUSION: These findings highlight the importance of supportive organizational environments in encouraging nurses to engage in environmentally responsible communication. Recognizing nurses' environmental contributions, fostering intrinsic motivation, and ensuring psychological safety may promote green voice behavior in healthcare.