Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index The Influence of Organizational Commitment.
Effective Communication, and the Work Environment on the Caring Behavior of Inpatient Nurses at Annisa Hospital.
Cikarang Sashenna RahmadiyantoA.
Abdul AzizA.
Haidar IstiqlalA AAnnisa Hospital Cikarang APoltekkes Kemenkes Jakarta i ARespati University Indonesia ASasenarahma@gmail.
Aaz.
mandiri@yahoo.
ABSTRACT
NursesAo caring behavior in providing nursing care to patients plays a crucial role in enhancing the quality of nursing services and ensuring patient safety, which in turn contributes to patient recovery.
However, in practice, the delivery of highquality nursing services is still hindered by the prevalence of non-caring behaviors in patient care.
Therefore, concrete measures are required to reduce such behaviors by strengthening organizational commitment, effective communication, and the work environment, thereby fostering caring behavior among nurses.
This study aimed to examine the influence of organizational commitment, effective communication, and the work environment on nursesAo caring behavior.
A non-experimental, cross-sectional research design was The analysis focused on measuring the extent to which independent variables affect the dependent variable.
Data were analyzed using Multiple Linear Regression with the assistance of statistical software.
Data collection was conducted through questionnaires distributed to inpatient nurses at Annisa Hospital Cikarang.
The study population consisted of 95 nurses, with a final sample of 49 respondents.
The statistical analysis was carried out using SPSS Version 24.
The findings revealed that: .
organizational commitment significantly influenced caring behavior .
= -2.
751, p = 0.
009 < 0.
effective communication significantly influenced caring behavior .
= 2.
181, p = 034 < 0.
the work environment significantly influenced caring behavior .
= 3.
365, p = 0.
002 < 0.
organizational commitment, effective communication, and the work environment collectively had a significant effect on caring behavior (F = 91.
364, p = 0.
000 < 0.
In conclusion, organizational commitment, effective communication, and the work environment together account for 85.
9% of the variance in nursesAo caring behavior, while the remaining 1% is explained by other factors not examined in this study.
It is therefore recommended that reinforcement strategies be implemented to strengthen nursesAo caring behavior, particularly in inpatient care settings, by enhancing organizational commitment, improving communication effectiveness, and optimizing the work environment to foster positive caring practices.
Keywords:
caring behavior, work environment INTRODUCTION Caring is central to nursing practice, and its importance has become even more pronounced amidst the current turbulence within healthcare services.
Increasing demands, pressures, and strict time constraints within healthcare environments limit the space for caring practices, creating challenges not only for nurses but also for other healthcare professionals and patients themselves (Watson, as cited in Potter & Perry, 2.
According to Kozier .
, caring is often regarded by many nurses as a fundamental aspect of nursing.
Caring fosters self-actualization, supports individual growth, upholds dignity, and reduces distress.
Furthermore, caring creates meaningful bonds and positive relationships between nurses and patients.
Caring is not merely a means to an end, but rather a goal in itself.
Thus, caring represents a dynamic essence Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index in nursing practice, expressed through behaviors that help, support, and demonstrate concern for patients.
Caring constitutes the foundation of professional nursing practice, with the primary aim of improving the quality of nursing services and ensuring patient satisfaction.
Larson .
4, as cited in Watson, 2.
identified six dimensions of caring within the nursing practice environment, namely readiness and willingness, explanation and facilitation, comfort, anticipatory actions, building a trusting relationship, and patient guidance and supervision.
Readiness and willingness: The readiness and willingness of nurses are essential for fostering open relationships between nurses and patients, respecting emotions, and facilitating meaningful interactions among nurses, patients, and Manifestations of caring behavior include allowing patients to express their feelings, showing acceptance, expressing willingness to help patients address their problems, encouraging patients to share their expectations, and actively listening (Desianora et al.
, 2.
Explanation and facilitation: Problem-solving in nursing care can be achieved through an approach based on explanation and facilitation.
This refers to a nurseAos ability to provide clear explanations related to patient care, decision-making, and health education for patients and their families.
As noted by Desianora et al.
caring behavior is demonstrated when nurses create a supportive environment for health education tailored to patientsAo needs, provide reassurance of their willingness to share information, assist patients in decision-making through scientific approaches, safeguard patients from harmful practices, and act as mediators between patients and other healthcare professionals.
Comfort: Meeting patientsAo basic needs requires attention to comfort.
Nurses must be able to ensure physical, emotional, and psychological comfort.
According to Desianora et al.
, caring behavior in this dimension is manifested when nurses genuinely assist patients with their activities of daily living (ADL), respect patientsAo privacy, and demonstrate respect and appreciation for their dignity.
Anticipatory actions: Anticipation is a critical element of caring behavior.
involves preventive measures and proactive responses to undesirable changes in patientsAo conditions.
Desianora et al.
note that caring behaviors in this area include patience, calmness, empathy, accompanying patients, placing oneself in the patientAos position, sharing in patientsAo suffering, and interpreting patient behavior to identify psychological needs.
Building a trusting relationship: Caring requires the establishment of a trusting relationship, which reflects the nurseAos ability to build interpersonal connections, demonstrate responsibility, and interpret patientsAo conditions appropriately.
Manifestations of caring behavior include being physically present, showing honesty, being empathetic toward patientsAo feelings, and communicating in a calm tone and manner (Desianora et al.
, 2.
Patient guidance and supervision: Nurses also play a role in creating both physical and non-physical environments that provide support, prevention, and This requires recognizing internal and external environmental influences on patientsAo health.
Caring behaviors in this dimension include promoting togetherness and harmony by respecting patientsAo spiritual needs, providing a clean and orderly environment, and conducting home visits following discharge (Desianora et al.
, 2.
Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index Organizational commitment is defined as the bond between an individual and the organization in which they work, characterized by acceptance of and belief in organizational values and goals.
Individuals who are highly committed demonstrate a willingness to dedicate themselves, act earnestly in advancing organizational interests, align themselves with organizational objectives, and maintain their membership in the organization (Robbins & Judge, 2008.
Permatasari, 2.
According to Utaminingsih .
4, as cited in Desi, 2.
, organizational commitment is a key factor in the study of organizational behavior and management, particularly in relation to the interaction between individuals and organizations.
Organizational commitment refers to a strong acceptance by individuals, encompassing loyalty, job involvement, and identification with the organizationAos values and goals, as well as the willingness and determination to remain with the organization (Busro, 2.
Based on these definitions, organizational commitment can be understood as the belief in and acceptance of organizational values that motivates individuals to maintain membership and exert significant effort toward the achievement of organizational objectives.
Organizational commitment consists of several dimensions, each with distinct Meyer and Allen .
1, as cited in Desi, 2.
describe organizational commitment as multidimensional, comprising affective commitment, continuance commitment, and normative commitment.
Affective Commitment Affective commitment reflects the emotional attachment of individuals to identify with and become involved in their organizations (Shaleh, 2.
Individuals with strong affective commitment feel a close emotional bond with their organization, motivating them to make meaningful contributions (Busro, 2.
Such individuals continue working within the organization because of their emotional connection, characterized by a sense of love for the organization.
Affective commitment is considered a key determinant of dedication and loyalty (Yusuf & Syarif, 2.
Employees with high affective commitment typically exhibit high performance, positive attitudes at work, and a strong desire to remain with the organization (Starnes & Truhon, 2.
Thus, affective commitment can be summarized as the emotional attachment and involvement of individuals in sustaining their membership within the organization.
Indicators of affective commitment include satisfaction in career development within the organization, feeling like a part of the organization, sharing in the organizationAos problems, and pride in discussing the organization with others (Allen & Meyer, as cited in Desi, 2.
Continuance Commitment Continuance commitment is based on the perceived costs and benefits of remaining in the organization (Shaleh, 2.
Individuals make their best efforts when appropriately rewarded (Starnes & Truhon, 2.
According to Robbins and Timothy .
, the perceived economic value of staying in an organization is often greater than that of leaving it.
Employees may remain committed because of financial incentives, fear of economic loss, or the negative impact that resignation may have on their families.
In essence, individuals with strong continuance commitment stay within the organization for personal benefit.
Indicators of continuance commitment include feeling reluctant to leave the organization, perceiving no alternatives, experiencing loss if they resign, and believing the organization aligns with their expectations and desires (Allen & Meyer, as cited in Desi, 2.
Normative Commitment Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index Normative commitment is characterized by a sense of obligation to remain in the organization, often arising from a belief that leaving would be morally or socially inappropriate (Permatasari, 2018.
Shaleh, 2.
This dimension generates feelings of responsibility and duty to reciprocate the benefits received from the organization.
Employees with high normative commitment remain because they perceive it as the right thing to do (Busro, 2.
Normative commitment can be measured through indicators such as reluctance to transfer to another organization, loyalty, a sense of compatibility with the organization, and awareness that many outside the organization remain unemployed (Allen & Meyer, as cited in Desi, 2.
Communication is a multidimensional, multifactorial, dynamic, and complex process that is closely linked to the environment and individual experiences (Fleischer et al.
, 2.
Effective communication is a key element in delivering high-quality nursing care, leading to improved patient satisfaction and outcomes (Ratna Sari et al.
Communication between nurses and patientsAo families is an essential component of nursing practice.
The ability of healthcare professionals to communicate effectively reduces anxiety, guilt, pain, and symptoms, while enhancing caring behavior, patient acceptance, compliance, and cooperation.
Furthermore, it improves patientsAo physiological and functional status and supports health education (Moslehpour et al.
, 2.
Hospital services, being multidisciplinary, often risk overlapping interventions, interprofessional conflicts, and delays in care delivery.
Previous studies have shown that while nurses are trained to build effective communication, not all of them implement these strategies consistently in clinical settings, leading to misunderstandings among healthcare teams, particularly in hospital contexts.
Patients of various ages frequently require complex health services that demand effective communication, especially regarding mobility, sensory, cognitive needs, and language barriers during hospitalization (Prasanti et al.
, 2.
Hospitalization can be stressful and unpleasant for patients and their families.
Effective communication is therefore vital, as patients often perceive their interactions with nurses as the key to their overall care experience (Fleischer et al.
, 2.
Through communication, nurses become familiar with patient needs, thereby enabling the provision of high-quality healthcare.
Patients with communication disabilities are three times more likely to experience medical or clinical complications compared to others (Burgess et al.
, 2.
The first step in addressing communication issues between healthcare professionals .
hysicians, nurses, etc.
) and patients is mutual awareness of communication barriers.
Establishing effective relationships requires a shared understanding between both parties (Maame Kissiwaa Amoah et al.
, 2.
One structured tool for improving communication is the Situation-BackgroundAssessment-Recommendation (SBAR) communication-related errors and enhance caring behavior.
SBAR improves clarity in nurse communication, thereby strengthening caring practices, service quality, and patient safety.
In Korea.
SBAR has gained significant attention, prompting regulatory calls to ensure accurate communication among healthcare professionals.
Several studies have highlighted SBAR as an essential competency for patient safety in healthcare systems (Andreasen et al.
, 2.
According to Mardiana .
, the work environment refers to the setting in which employees perform their daily tasks.
It is crucial for managers and organizations to ensure that employees feel comfortable, safe, and focused while carrying out their Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index Nitisemito .
describes the work environment as everything surrounding employees that may affect their ability to perform their tasks, such as cleanliness, ambiance, or background music.
Both internal and external factors within an organization can influence its progress.
Therefore, organizations must anticipate and manage these factors, as the work environment plays a decisive role in determining employee performance and quality of work.
Sedarmayanti .
defines the work environment as the totality of tools, equipment, surroundings, work methods, and organizational arrangements that shape individual and group performance.
METHOD
This study employed a quantitative research design using logistic regression analysis with a descriptive-analytic approach through a cross-sectional design.
The cross-sectional method was chosen because no intervention was conducted, and data collection was carried out only once.
In this design, cross-tabulation was performed between the dependent variable .
aring behavio.
and the independent variables .
rganizational commitment, effective communication, and work environmen.
Measurements of all variables were conducted simultaneously, and the correlations between them were then analyzed.
The target population of this study consisted of all nurses working in the inpatient care unit of Annisa Hospital Cikarang, totaling 95 nurses.
Based on sampling calculations, the study sample comprised 49 nurses employed in the inpatient care unit of Annisa Hospital.
These participants were selected because their daily responsibilities involve providing direct health care services to patients utilizing the hospitalAos health facilities.
RESULTS AND DISCUSSION
Results of t-Test in Multiple Linear Regression The t-test was conducted to determine whether each independent variable individually .
affects the dependent variable.
The results of the t-test are presented in Table 1.
Table 1.
Results of t-Test in Multiple Linear Regression Model Sig.
(Constan.
Organizational Commitment 2.
Effective Communication 2.
Work Environment Source: SPSS Data Processing, 2025 The findings indicate that:
Organizational Commitment has a positive and significant effect on Caring Behavior .
= 2.
751, p = 0.
009 < 0.
Effective Communication has a positive and significant effect on Caring Behavior .
= 2.
181, p = 0.
034 < 0.
Work Environment has a positive and significant effect on Caring Behavior .
= 365, p = 0.
002 < 0.
Results of F-Test in Multiple Linear Regression The F-test was conducted to examine whether all independent variables jointly .
influence the dependent variable.
The results are presented in Table Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index Table 2.
Results of F-Test in Multiple Linear Regression Model Sum of Squares df Mean Square Sig.
Regression Residual Total Source: SPSS Data Processing, 2025 The F-test results show that the calculated F-value is 91.
364 with a p-value of 000 (< 0.
This indicates that Organizational Commitment.
Effective Communication, and Work Environment simultaneously exert a significant influence on Caring Behavior.
Standardized Coefficients Beta Analysis The magnitude of each independent variableAos influence is shown in Table 3.
Table 3.
Standardized Coefficients Beta of Each Variable Variable Standardized Coefficients Beta Organizational Commitment Effective Communication Work Environment Source: SPSS Data Processing, 2025 The results indicate that the Work Environment variable has the strongest effect ( = 0.
compared to the other independent variables.
Therefore, the Work Environment is the most dominant factor influencing Caring Behavior.
Effect of Organizational Commitment on Caring Behavior The results reveal that Organizational Commitment has a significant positive effect on Caring Behavior .
= 2.
751, p = 0.
009 < 0.
This finding is consistent with Desi .
, who reported a significant effect of organizational commitment on nursesAo caring behavior .
= 0.
Similarly.
Evi .
found that organizational commitment significantly influenced the implementation of caring behavior among inpatient nurses at Rumah Sakit Tingkat i Baladhika Husada Jember .
= 0.
According to Arbabisarjou et al.
, organizations require employees who perform their duties with love, enthusiasm, and strong organizational commitment to achieve their objectives.
Therefore, hospitals should strengthen nursesAo organizational commitment to enhance caring behavior.
This study suggests that nurses with high organizational commitment are three times more likely to demonstrate caring behavior compared to those with low Conversely, neglecting employee commitment may increase resource costs and result in instability within the workforce, negatively impacting organizational performance and caring behavior.
Effect of Effective Communication on Caring Behavior The findings demonstrate that Effective Communication has a significant positive effect on Caring Behavior .
= 2.
181, p = 0.
034 < 0.
This result aligns with Hany .
, who found a significant relationship .
= 0.
, with 71% of nurses practicing effective communication.
Anillis .
also confirmed this relationship .
= According to Carl Rogers, as cited in Musliha & Fatmawati .
, effective communication must be based on trust and respect.
Nurses should understand patientsAo values, recognize both physical and psychological needs, and build Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index therapeutic relationships.
Effective communication not only enhances cooperation but also improves patientsAo ability to cope with health challenges.
The researcher assumes that strengthening effective communication is crucial to improving caring behavior.
Hospitals must foster communication grounded in trust, respect, and empathy to enhance patient-centered care.
Effect of Work Environment on Caring Behavior The results show that the Work Environment significantly influences Caring Behavior .
= 3.
365, p = 0.
002 < 0.
This finding is consistent with Anillis .
, who reported a significant effect of work environment on caring behavior .
= 0.
and Wahyuni .
, who demonstrated that dimensions of the work environment were strongly correlated with nursesAo caring behavior.
According to Sihombing .
, the work environment encompasses both physical .
, equipment, temperature, noise, cleanliness, safet.
and non-physical factors .
, relationships between superiors and subordinate.
A supportive environment creates comfort and focus, while poor conditions reduce performance and caring behavior.
The researcher concludes that a positive work environment fosters discipline, creativity, collaboration, and higher productivity, which in turn enhances caring behavior among nurses.
Simultaneous Effect Organizational Commitment.
Effective Communication, and Work Environment The simultaneous regression analysis indicates that Organizational Commitment.
Effective Communication, and Work Environment collectively exert a significant influence on Caring Behavior (F = 91.
364, p = 0.
000 < 0.
, with an RA value of 0.
This means that 85.
9% of Caring Behavior is explained by the three independent variables, while the remaining 14.
1% is influenced by other factors not examined in this study.
The most dominant predictor of Caring Behavior is the Work Environment ( = Other factors beyond the model, such as knowledge, motivation, job satisfaction, organizational culture, work experience, and education, may also influence nursesAo caring behavior, as supported by various studies (Watson, 2008.
et al.
, 2012.
Cummings et al.
, 2010.
Scott-Findlay & Estabrooks, 2006.
Ericsson, 2006.
McCance et al.
, 2.
In summary, enhancing organizational commitment, effective communication, and work environment are essential strategies for hospitals to promote caring behavior among nurses.
CONCLUSION
The hypothesis testing in this study provides valuable insights into the factors influencing nursesAo caring behavior in the inpatient ward of RS.
Annisa Cikarang.
The analysis emphasizes the role of organizational commitment, effective communication, and work environment as key determinants in shaping and strengthening caring practices in nursing services.
The following points outline the main findings:
Organizational Commitment and Caring Behavior: The study identified a significant influence of organizational commitment on nursesAo caring behavior.
This aligns with organizational commitment theory, which suggests that strong commitment fosters attachment and motivation among individuals.
In nursing practice, organizational commitment motivates nurses to consistently provide Volume 6.
Number 2, 2025 https://ijble.
com/index.
php/journal/index quality care.
Strengthening organizational commitment is therefore essential to enhance caring behavior.
Effective Communication and Caring Behavior: The findings indicate a significant impact of effective communication on nursesAo caring behavior.
Supported by communication theory, effective communication improves understanding of patient needs and enables delivery of high-quality care.
Nurses must therefore foster effective communication with patients and colleagues to strengthen caring practices.
Work Environment and Caring Behavior: The results also demonstrate that the work environment significantly affects nursesAo caring behavior.
In line with work environment theory, a supportive and positive atmosphere motivates nurses and enhances their willingness to provide optimal care.
Hospitals should thus create conducive working conditions to promote caring behavior.
Simultaneous Influence of Organizational Commitment.
Effective Communication, and Work Environment: Collectively, these three variables 9% of the variance in nursesAo caring behavior, highlighting their critical role in shaping professional nursing practices.
This finding confirms that both internal and external organizational factors jointly influence behavioral outcomes.
This study concludes that nursesAo caring behavior is significantly shaped by organizational commitment, effective communication, and work environment.
Both individually and collectively, these factors demonstrate a powerful impact on the quality of patient care.
Hospitals seeking to improve nursing services must pay careful attention to these elements as strategic levers for strengthening caring behavior among their staff.
Recommendations Strengthen Organizational Commitment: Hospitals should design programs and policies that foster loyalty, motivation, and a sense of belonging among nurses, including recognition systems, career development, and fair reward mechanisms.
Promote Effective Communication: Continuous training in communication skills should be provided to enhance nurseAepatient and inter-professional communication, ensuring that patient needs are well-understood and met with Enhance the Work Environment: Hospital management should build a supportive, safe, and collaborative work environment that encourages teamwork, reduces stress, and motivates nurses to perform at their best.
Integrative Strategy: A comprehensive approach that simultaneously addresses organizational commitment, communication effectiveness, and work environment should be implemented to maximize the impact on caring behavior and improve patient outcomes.
Reference