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Life sciences · Journal article
International Journal of Nursing Studies Advances · June 30, 2026
Points the other way from the current standard, or from comparable studies.
This cluster-randomised trial of a participative organisational intervention targeting psychosocial workload in 10 German hospitals found no evidence that improving the nursing work environment improved any of four patient satisfaction dimensions. All point estimates and 95% confidence intervals were consistent with null effects, and patient education and self-rated health explained more variance than work environment factors.
Cluster-randomised controlled trial. Patients from several wards in 10 German participating hospitals. Intervention: Participative organisational intervention aimed to reduce psychosocial workload and improve work environment and job performance of health care workers. Compared with: Control arm (standard care, no intervention). n = 1,664. 10 hospitals in Germany.
Intervention did not improve patient trust in health care workers (OR 1.21, 95% CI [0.79–1.85]) Intervention did not improve received support (OR 1.28, 95% CI [0.82–1.99]) Intervention did not improve availability of health workers (OR 1.13, 95% CI [0.75–1.69])
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should not assume that interventions targeting nursing work environment psychosocial factors will necessarily improve patient-reported satisfaction with care. This finding contradicts prior observational data and suggests patient satisfaction is driven primarily by individual characteristics rather than workplace organisational changes, warranting reconsideration of which organisational targets may actually improve patient outcomes.
A cluster-randomised trial with adequate sample size found null results across all four primary endpoints (all 95% CIs crossing unity), contradicting the hypothesis and prior observational evidence that nursing work environment improvements enhance patient satisfaction.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should not assume that interventions targeting nursing work environment psychosocial factors will necessarily improve patient-reported satisfaction with care. This finding contradicts prior observational data and suggests patient satisfaction is driven primarily by individual characteristics rather than workplace organisational changes, warranting reconsideration of which organisational targets may actually improve patient outcomes.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Objective. To investigate the hypothesis that an organisational intervention with health care workers would help improve patient satisfaction with care.Methods. An organisational intervention with health care workers was implemented in 10 German hospitals. Wards were randomised either to the intervention or control arm. The intervention was participative and aimed to reduce the psychosocial workload, and improve the work environment and job performance of health care workers. It was hypothesised that patient satisfaction with care would also improve as a result of the intervention. A total of 1,664 patients from several wards in the participating hospitals were interviewed before and after the intervention. The research hypotheses were investigated with cumulative logit regression models on four dimensions of patient satisfaction, namely, trust in health care workers, received support, availability of health care workers and patient decisional control.Results. The analyses did not provide evidence that the intervention had a positive impact on patient trust (OR 1.21, 95% CI [0.79-1.85]), support (OR 1.28, 95% CI [0.82-1.99]), availability of health workers (OR 1.13, 95% CI [0.75-1.69]) and patient decisional control (OR 1.01, 95% CI [0.68-1.48]). On the contrary, the largest proportion of explained variance of the scales was related to education and self-rated health.Conclusions. Individual patient characteristics were found to be the most influential factors of patient satisfaction appraisals. More work seems to be required to understand the mechanisms linking the nursing work environment and patient outcomes in order to inform effective organisational interventions.Registration number DRKS00021138, German Registry of Clinical Studies.
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