AimTo investigate the effects of psychological contract breach and psychological safety on health and well‐being outcomes among nurses.DesignA cross‐sectional study.MethodsData were gathered from members of the Finnish social and healthcare workers' trade union (n = 4575) in February 2023. This study focused on data from 3260 nurses. Structural equation modelling was employed to firstly explain burnout and work engagement and subsequently health and well‐being outcomes in relation to perceived psychological contract breach and psychological safety.ResultsYounger male nurses, those with lower‐level university degrees, and nurses employed in public hospitals reported experiencing more psychological contract breaches. Conversely, older nurses and those working in private organizations perceived a higher level of psychological safety. Psychological contract breaches were associated with increased burnout and reduced work engagement, while psychological safety contributed to lower burnout and higher work engagement. Moreover, burnout was linked to health problems and diminished mental well‐being, whereas increased work engagement led to fewer health problems and improved mental well‐being. The final model demonstrated excellent fit.ConclusionBreaches in the psychological contract, followed by distrust, and anger significantly burden nurses, detrimentally affecting their well‐being at work. Psychologically safe working environments, consequently, improve nurses' well‐being at work and should be promoted within work teams.Implications for the ProfessionNursing managers could receive training to understand the consequences of, and practices for supporting, a beneficial psychological work climate.ImpactThe study examined psychological burden and resource factors at work, finding that psychological contract breaches increased burden and led to negative well‐being outcomes. In contrast, psychological safety emerged as a positive resource for health and well‐being. These results offer benefits for nurses, managers and organizations.Reporting MethodThe study was reported following the Strengthening of the reporting of observational studies in epidemiology guidelines.Patient or Public ContributionNo patient or public contribution.

中文翻译：

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护士心理安全与心理契约违背影响的结构方程模型


目的调查心理契约违背和心理安全对护士健康和福祉结果的影响。设计一项横断面研究。方法数据收集自芬兰社会和医护人员工会的成员（ n = 4575），2023 年 2 月。这项研究重点关注 3260 名护士的数据。采用结构方程模型首先解释职业倦怠和工作投入，以及随后与感知的心理契约违反和心理安全相关的健康和福祉结果。 结果年轻男护士、大学学历较低的护士和公立医院的护士报告经历更多的心理契约违背。相反，老年护士和在私营机构工作的护士则认为心理安全感较高。心理契约的违反与倦怠的增加和工作投入的减少有关，而心理安全则有助于降低倦怠和提高工作投入。此外，倦怠与健康问题和心理健康状况下降有关，而工作投入的增加则可以减少健康问题并改善心理健康状况。最终模型表现出极好的拟合度。 结论 心理契约的破坏，随之而来的不信任和愤怒给护士带来了很大的负担，对他们的工作幸福感产生了不利影响。因此，心理安全的工作环境可以改善护士在工作中的幸福感，应该在工作团队中予以推广。对专业的影响护理管理人员可以接受培训，以了解有益的心理工作氛围的后果和支持的实践。影响该研究检查了工作中的心理负担和资源因素，发现心理契约的违反会增加负担并导致负面的幸福结果。相比之下，心理安全成为健康和福祉的积极资源。这些结果为护士、管理人员和组织带来好处。报告方法该研究是根据流行病学指南中加强观察性研究的报告进行报告的。患者或公众贡献没有患者或公众贡献。