Effects of the Nursing Work Environment, Patient-Centered Communication, Occupational Coping Self-Efficacy, and Professional Identity on Missed Nursing Care among General Hospital Nurses

Purpose: This study examined the associations between the nursing work environment, patient-centered communication, occupational coping self-efficacy, professional identity, and missed nursing care among nurses working in general hospitals. Methods: A descriptive cross-sectional design was adopted, using data collected in 2025 from 177 nurses working in a general hospital. The following questionnaires were used: the Practice Environment Scale of the Nursing Work Index-5, Patient-Centered Communication Scale for Nurses, Korean Version of the Occupational Coping Self-efficacy for Nurses Scale, Professional Identity in Nursing Scale 2.0, and MISSCARE Scale. Descriptive statistics, t-tests, Pearson’s correlation coefficients, and multiple regression analyses were performed. Results: Total clinical experience and overtime were negatively and positively correlated with missed nursing care, respectively. The nursing work environment, patient-centered communication, occupational coping self-efficacy, and professional identity were negatively associated with missed nursing care. Multiple regression analysis revealed that increased overtime hours (β=.24, <i>p</i><.001) were associated with higher levels of missed nursing care, whereas a favorable nursing work environment (β=-.34, <i>p</i><.001), effective patient-centered communication (β=-.21, <i>p</i><.001), and strong professional identity (β=-.27, <i>p</i><.001) were associated with lower levels of missed nursing care. Furthermore, these factors explained 47.4% of the variance in missed nursing care (F=32.74, <i>p</i><.001). Conclusion: Professional identity and patient-centered communication were identified as new factors associated with missed nursing care among nurses in general hospitals. To potentially address missed nursing care and enhance patient safety, efforts to reinforce nurses’ professional identities and patient-centered communication should be considered.