Abstract
BACKGROUND: Community hospital nurses worldwide operate as frontline responders in resource-constrained environments. In such settings, sustaining humanistic caring ability, a cornerstone of patient satisfaction and overall service quality, is increasingly challenged by both external organizational factors and the internal psychological resilience of the nursing staff. This study addresses that gap by examining how organizational climate mediates the relationship between nurses' psychological resilience and their caring behaviors, offering actionable insights for healthcare systems globally to safeguard the quality of nursing care in community hospitals. OBJECTIVES: The purpose of this study is to explore the factors influencing the caring behaviors of nurses in community hospitals, and to investigate the mediating influence of organizational climate on the correlation between caring behavior and psychological resilience among community hospital nurses. METHOD: This study utilized a cross-sectional design and recruited 231 nurses from 20 community hospitals in four main urban areas of Chongqing through convenience sampling. Nurses who met the inclusion criteria completed an online survey using self-report scales for caring behavior, psychological resilience, and organizational climate between November 2022 and March 2023. The potential mediating effect was examined using the Process Macro and bootstrap methods. RESULTS: Caring behavior was positively correlated with psychological resilience and organizational climate (r = 0.446, p < 0.001; r = 0.429, p < 0.001, respectively). Furthermore, the psychological resilience of nurses has a significant direct effect on their caring behavior (B = 0.34, p < 0.001). Organizational atmosphere could mediate the indirect path from psychological resilience to caring behavior (B = 0.22, p < 0.001). CONCLUSION: Organizational climate partially mediated the relationship between psychological resilience and caring behavior. Moreover, years of service and professional title emerged as key factors that can enhance caring behavior by fostering a supportive organizational climate and bolstering nurses' psychological resilience. Thus, targeted interventions aimed at optimizing the organizational environment and strengthening resilience may provide an effective strategy for improving caring behavior among community hospital nurses. CLINICAL TRAIL NUMBER: Not applicable.