Presenting the Cognitive-Behavioral Exclusion Experience Model in the Field of Nursing

Background: Workplace ostracism refers to the experience of being excluded or ignored by colleagues or the organization, often leading to a range of negative consequences. This experience can have long-lasting psychological, behavioral, and organizational impacts. Accordingly, this study aimed to design and validate a strategic causal model of workplace ostracism experience among nurses. Methods: A mixed-methods approach was employed to investigate the antecedents and consequences of workplace ostracism among nurses from 2023 to 2024. The population of the qualitative phase consisted of 12 academic experts and experienced nurses selected through purposive sampling. Data collection involved in-depth interviews and empirical experience analysis to identify the mechanisms and processes underlying nurses’ experience of ostracism. Thematic analysis was conducted using ATLAS.TI 8. Based on qualitative findings, a proposed model was developed and assessed in the quantitative phase. The quantitative sample included 400 nurses working in public hospitals in Qazvin, selected via random sampling and based on Morgan’s table. A validated researcher-made questionnaire was used for data collection. Eventually, confirmatory factor analysis (CFA) and path analysis were performed using AMOS 24. Results: Qualitative findings indicated that workplace ostracism among nurses is influenced by high workload, lack of social support, non-transparent managerial decision-making, psychosocial stressors, and lack of professional advancement. In addition, the experience of ostracism was found to result in organizational silence, decreased motivation, social isolation, and decreased quality of patient care. Quantitative results revealed that path coefficients exceeded 0.7, and t-values were higher than 1.96, thus confirming the validity of the qualitative model and its overall reliability. Conclusion: Overall, managing workplace ostracism experiences through fostering a supportive organizational culture, enhancing communication and conflict resolution skills, and improving work conditions can mitigate their negative effects among nurses. The proposed model provides a comprehensive framework for understanding the cognitive-behavioral dimensions of workplace ostracism and offers practical strategies for improving nurses’ work environments and enhancing human resource productivity in healthcare systems.