The impact of stretch service goals on unethical behaviors of nurses: A three-wave cross-sectional study.

ABSTRACT

BACKGROUND: Stretch service goals strive to motivate healthcare practitioners to maintain high quality in service provision. However, little is known about how stretch service goals trigger nurses' unethical behavior. RESEARCH AIM: This study aimed to investigate the influence of stretch service goals on nurses' unethical behavior, as well as the mediating effects of patient entitlement and nurses' emotional dissonance. RESEARCH DESIGN: A quantitative cross-sectional study is designed. PARTICIPANTS AND RESEARCH CONTEXT We sourced data by conducting a time-lagged three-wave survey study from March to September 2020. Random sampling was used, and data were collected from 422 nurse-patient pairs in Chinese hospitals. Bootstrapping method and structural equation modeling were employed to verify the conceptual model. ETHICAL CONSIDERATIONS The study was approved by the designated authority within hospitals and ethical committees. RESULTS: Stretch service goals are not directly related to nurses' unethical behavior. Stretch service goals can trigger nurses' unethical behavior via patient entitlement. Patient entitlement and nurses' emotional dissonance play a chain-mediating role between stretch service goals and nurses' unethical behavior. CONCLUSIONS: In the context of the healthcare industry, nurses may engage in unethical behavior due to the pressure of achieving stretch service goals. This study contributes to opening the "black box" of stretch service goals and nurses' unethical behavior by exploring the chain-mediating effect of patient entitlement and nurses' emotional dissonance.