The effect of nurses' attitudes toward specialization on the quality of care they provide

This study aimed to examine the relationship between nurses' attitudes toward specialization and the quality of care they provide, as well as to identify the individual and professional factors affecting this relationship. The research, designed as a descriptive and correlational study, was conducted with 273 nurses working in various hospitals across Turkey. Data were collected using the "Nurse Descriptive Information Form," the "Attitude Toward Specialization in Nursing Scale," and the "Quality Nursing Care Scale." Descriptive statistics, correlation analysis, robust regression, and path analysis (AMOS) were used in the data analysis. According to the findings, the mean score of the Attitude Toward Specialization in Nursing Scale was 74.65 ± 13.87, and the mean score of the Quality Nursing Care Scale was 167.82 ± 23.04, indicating a moderate to high level for both scales. A positive and significant correlation was found between attitudes toward specialization and overall quality of care (r = 0.525; p < 0.001). Robust regression analysis revealed that individual and professional characteristics explained 16.6% of the variance in nurses' attitudes toward specialization (R² = 0.166; F = 2.159; p = 0.002). In addition, the model predicting Quality Nursing Care explained 18.7% of the variance (R² = 0.187; F = 2.493; p < 0.001), and nurses who reported that the care provided in their units was adequate had significantly higher scores (β = 7.084; p = 0.025). Path analysis results demonstrated that attitudes toward specialization had a significant and positive direct effect on the overall Quality Nursing Care score (β = 0.886; p < 0.001; R² = 0.285). Furthermore, attitudes toward specialization significantly affected all sub-dimensions of quality care: Physical Environment (β = 0.484; p < 0.001; R² = 0.234), Nursing Care Activities (β = 0.515; p < 0.001; R² = 0.265), Patient Outcomes (β = 0.397; p < 0.001; R² = 0.158). The model demonstrated excellent fit indices (GFI = 1.00; CFI = 1.00; SRMR = 0.00). In conclusion, nurses' attitudes toward specialization are a strong predictor of quality nursing care. Therefore, strengthening policies that support specialization within nursing education and in-service training programs may play a critical role in improving the quality of care.