# Identifying subgroups of nurses’ voice behavior in clinical settings: a latent profile analysis of work motivation and demographic predictors

## TL;DR

This study identifies four types of nurses based on their voice behavior and finds that intrinsic motivation is linked to more active behavior.

## Contribution

The study introduces a novel use of latent profile analysis to classify nurses' voice behavior and link it to work motivation dimensions.

## Key findings

- Four distinct voice behavior profiles were identified: Conservative, Balanced Risk-Taker, Transitional, and Challenging.
- Autonomous motivation strongly predicts active voice behavior, while amotivation is linked to conservative profiles.
- Nurses showed high work motivation and moderately high voice behavior levels.

## Abstract

Nurses’ voice behavior is critical for patient safety and organizational improvement. However, its manifestation is not uniform among nurses. This study aimed to identify latent profiles of nurses’ voice behavior using Latent Profile Analysis (LPA) to understand this heterogeneity and explore its influencing factors, with a specific focus on differences across work motivation dimensions (rooted in Self-Determination Theory, SDT).

A multicenter cross-sectional design was adopted. Data from 701 clinical nurses across six hospitals in Guangxi Province were analyzed: LPA identified four distinct profiles, and Multinomial Logistic Regression was used to examine predictors. Work motivation was measured by the Multidimensional Work Motivation Scale (MWMS), and voice behavior by the Voice Behavior Scale (VBS).

LPA identified four distinct profiles (Conservative, 5.42%; Balanced Risk-Taker, 26.39%; Transitional, 34.38%; Challenging, 33.8%), and Multinomial Logistic Regression was used to examine predictors. Work motivation was measured by the Multidimensional Work Motivation Scale (MWMS), and voice behavior by the Voice Behavior Scale (VBS). Results showed autonomous motivation (e.g., intrinsic drive) strongly predicted active voice behavior, while amotivation predicted conservative profiles. Nurses exhibited high work motivation (MWMS: 93.02 ± 21.09) and moderately high voice behavior (VBS: 39.27 ± 8.736).

The research found that nurses exhibited high work motivation and moderately high voice behavior, with autonomous motivation being a pivotal predictor. Differentiated strategies targeting intrinsic motivation enhancement are critical for fostering nursing innovation and improving care quality.