{"id":"https://openalex.org/W4406089707","doi":"https://doi.org/10.1186/s12913-024-11782-7","title":"Exploring voice barriers and subsequent practices among frontline healthcare workers in Pakistan: a comprehensive mixed-methods analysis","display_name":"Exploring voice barriers and subsequent practices among frontline healthcare workers in Pakistan: a comprehensive mixed-methods analysis","publication_year":2025,"publication_date":"2025-01-06","ids":{"openalex":"https://openalex.org/W4406089707","doi":"https://doi.org/10.1186/s12913-024-11782-7","pmid":"https://pubmed.ncbi.nlm.nih.gov/39762886","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/11705984"},"language":"en","primary_location":{"id":"doi:10.1186/s12913-024-11782-7","doi":"https://doi.org/10.1186/s12913-024-11782-7","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12913-024-11782-7","pdf_url":"https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-024-11782-7","source":{"id":"https://openalex.org/S12898181","display_name":"BMC Health Services Research","issn_l":"1472-6963","issn":["1472-6963"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Health Services Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-024-11782-7","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5027126686","display_name":"Noreen Kanwal","orcid":"https://orcid.org/0000-0001-8197-4242","observed_orcids":["https://orcid.org/0000-0001-8197-4242"]},"institutions":[{"id":"https://openalex.org/I84339108","display_name":"Sunway University","ror":"https://ror.org/04mjt7f73","country_code":"MY","type":"education","lineage":["https://openalex.org/I84339108"]}],"countries":["MY"],"is_corresponding":true,"raw_author_name":"Noreen Kanwal","raw_affiliation_strings":["Department of Management, Sunway Business School, Sunway University, Subang Jaya, Selangor, 47500, Malaysia. Kanwalnoreen72@yahoo.com","Department of Management, Sunway Business School, Sunway University, Subang Jaya, Selangor, 47500, Malaysia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Management, Sunway Business School, Sunway University, Subang Jaya, Selangor, 47500, Malaysia. Kanwalnoreen72@yahoo.com","institution_ids":["https://openalex.org/I84339108"]},{"raw_affiliation_string":"Department of Management, Sunway Business School, Sunway University, Subang Jaya, Selangor, 47500, Malaysia","institution_ids":["https://openalex.org/I84339108"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5035598386","display_name":"Ahmad Shahrul Nizam Isha","orcid":"https://orcid.org/0000-0003-0553-4346","observed_orcids":["https://orcid.org/0000-0003-0553-4346"]},"institutions":[{"id":"https://openalex.org/I203899302","display_name":"Universiti Teknologi Petronas","ror":"https://ror.org/048g2sh07","country_code":"MY","type":"education","lineage":["https://openalex.org/I203899302"]}],"countries":["MY"],"is_corresponding":false,"raw_author_name":"Ahmad Shahrul Nizam Isha","raw_affiliation_strings":["Department of Management and Humanities, University Technology PETRONAS, Persiaran UTP, 32610, Seri Iskandar, Perak, Malaysia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Management and Humanities, University Technology PETRONAS, Persiaran UTP, 32610, Seri Iskandar, Perak, Malaysia","institution_ids":["https://openalex.org/I203899302"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5073987350","display_name":"Al\u2010Baraa Abdulrahman Al\u2010Mekhlafi","orcid":"https://orcid.org/0000-0003-0341-122X","observed_orcids":["https://orcid.org/0000-0003-0341-122X"]},"institutions":[{"id":"https://openalex.org/I112982808","display_name":"Universiti Sains Islam Malaysia","ror":"https://ror.org/020ast312","country_code":"MY","type":"education","lineage":["https://openalex.org/I112982808"]}],"countries":["MY"],"is_corresponding":false,"raw_author_name":"Al-baraa Abdulrahman Al-Mekhlafi","raw_affiliation_strings":["Faculty of Leadership and Management, Universiti Sains Islam Malaysia (USIM), Bandar Baru Nilai, Nilai, Negeri Sembilan, 71800, Malaysia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Faculty of Leadership and Management, Universiti Sains Islam Malaysia (USIM), Bandar Baru Nilai, Nilai, Negeri Sembilan, 71800, Malaysia","institution_ids":["https://openalex.org/I112982808"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5048379343","display_name":"Rabia Haider","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I195024194","display_name":"Riphah International University","ror":"https://ror.org/02kdm5630","country_code":"PK","type":"education","lineage":["https://openalex.org/I195024194"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Rao Irfan Ali Haider","raw_affiliation_strings":["Department of Doctor of Physiotherapy, Riphah International University, Islamabad, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Doctor of Physiotherapy, Riphah International University, Islamabad, Pakistan","institution_ids":["https://openalex.org/I195024194"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5027126686"],"corresponding_institution_ids":["https://openalex.org/I84339108"],"apc_list":{"value":3290,"currency":"USD","value_usd":3290},"apc_paid":{"value":3290,"currency":"USD","value_usd":3290},"fwci":7.2928,"has_fulltext":true,"cited_by_count":9,"citation_normalized_percentile":{"value":0.96925087,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":95,"max":99},"biblio":{"volume":"25","issue":"1","first_page":"32","last_page":"32"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11647","display_name":"Workplace Violence and Bullying","score":0.5673999786376953,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T11647","display_name":"Workplace Violence and Bullying","score":0.5673999786376953,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.40700000524520874,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11537","display_name":"Ethics in medical practice","score":0.004800000227987766,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/voice-behavior","display_name":"voice behavior","score":0.7730000019073486},{"id":"https://openalex.org/keywords/frontline-health-workers","display_name":"frontline health workers","score":0.9380000233650208},{"id":"https://openalex.org/keywords/patient-safety","display_name":"patient safety","score":0.777999997138977},{"id":"https://openalex.org/keywords/occupational-safety","display_name":"occupational safety","score":0.8029999732971191},{"id":"https://openalex.org/keywords/safety-culture","display_name":"safety culture","score":0.5879999995231628},{"id":"https://openalex.org/keywords/fear-of-retaliation","display_name":"fear of retaliation","score":0.7179999947547913},{"id":"https://openalex.org/keywords/job-insecurity","display_name":"job insecurity","score":0.7170000076293945},{"id":"https://openalex.org/keywords/workplace-bullying","display_name":"workplace harassment","score":0.4440000057220459},{"id":"https://openalex.org/keywords/pakistan","display_name":"Pakistan","score":0.6679999828338623}],"concepts":[{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6329519748687744},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5819296836853027},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.5180278420448303},{"id":"https://openalex.org/C137992405","wikidata":"https://www.wikidata.org/wiki/Q1137608","display_name":"Health administration","level":3,"score":0.4974360764026642},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.48394444584846497},{"id":"https://openalex.org/C2778476105","wikidata":"https://www.wikidata.org/wiki/Q628539","display_name":"Workload","level":2,"score":0.45770028233528137},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.33313554525375366},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.29360461235046387},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C111919701","wikidata":"https://www.wikidata.org/wiki/Q9135","display_name":"Operating system","level":1,"score":0.0},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001291","descriptor_name":"Attitude of Health Personnel","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006282","descriptor_name":"Health Personnel","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D006282","descriptor_name":"Health Personnel","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007407","descriptor_name":"Interviews as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010154","descriptor_name":"Pakistan","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011795","descriptor_name":"Surveys and Questionnaires","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D036301","descriptor_name":"Qualitative Research","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D061214","descriptor_name":"Patient Safety","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.1186/s12913-024-11782-7","doi":"https://doi.org/10.1186/s12913-024-11782-7","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12913-024-11782-7","pdf_url":"https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-024-11782-7","source":{"id":"https://openalex.org/S12898181","display_name":"BMC Health Services Research","issn_l":"1472-6963","issn":["1472-6963"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Health Services Research","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:11705984","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11705984","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11705984/pdf/12913_2024_Article_11782.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Health Serv Res","raw_type":"Text"},{"id":"pmid:39762886","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/39762886","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC health services research","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:31a0aab7500542ccb1888c7a623fd57d","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/31a0aab7500542ccb1888c7a623fd57d","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Health Services Research, Vol 25, Iss 1, Pp 1-15 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s12913-024-11782-7","doi":"https://doi.org/10.1186/s12913-024-11782-7","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12913-024-11782-7","pdf_url":"https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-024-11782-7","source":{"id":"https://openalex.org/S12898181","display_name":"BMC Health Services Research","issn_l":"1472-6963","issn":["1472-6963"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Health Services Research","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0},{"display_name":"Decent work and economic growth","id":"https://metadata.un.org/sdg/8","score":0.7257999777793884},{"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10","score":0.4000000059604645}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320323380","display_name":"Universiti Teknologi Petronas","ror":"https://ror.org/048g2sh07"},{"id":"https://openalex.org/F4320329394","display_name":"Yayasan UTP","ror":"https://ror.org/00mj5vx34"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4406089707.pdf","grobid_xml":"https://content.openalex.org/works/W4406089707.grobid-xml"},"referenced_works_count":61,"referenced_works":["https://openalex.org/W785388884","https://openalex.org/W1974043834","https://openalex.org/W2003015733","https://openalex.org/W2022594846","https://openalex.org/W2027105085","https://openalex.org/W2028351868","https://openalex.org/W2062121040","https://openalex.org/W2077545220","https://openalex.org/W2085641295","https://openalex.org/W2089601249","https://openalex.org/W2106398471","https://openalex.org/W2124020615","https://openalex.org/W2148874850","https://openalex.org/W2151147343","https://openalex.org/W2162503628","https://openalex.org/W2339426741","https://openalex.org/W2339808869","https://openalex.org/W2371547131","https://openalex.org/W2522341739","https://openalex.org/W2590791531","https://openalex.org/W2606588823","https://openalex.org/W2762156019","https://openalex.org/W2782838015","https://openalex.org/W2791370670","https://openalex.org/W2800444048","https://openalex.org/W2811320942","https://openalex.org/W2895214953","https://openalex.org/W2897189343","https://openalex.org/W2912584735","https://openalex.org/W2912604358","https://openalex.org/W2916887092","https://openalex.org/W2941928670","https://openalex.org/W2943005096","https://openalex.org/W2946129859","https://openalex.org/W2999146724","https://openalex.org/W3007534392","https://openalex.org/W3012178317","https://openalex.org/W3016682800","https://openalex.org/W3096028464","https://openalex.org/W3110670325","https://openalex.org/W3111044931","https://openalex.org/W3147543999","https://openalex.org/W3164555539","https://openalex.org/W3184458750","https://openalex.org/W3197660118","https://openalex.org/W3209159797","https://openalex.org/W4210657999","https://openalex.org/W4213233868","https://openalex.org/W4229334619","https://openalex.org/W4229560905","https://openalex.org/W4238938912","https://openalex.org/W4248161867","https://openalex.org/W4281383088","https://openalex.org/W4296381463","https://openalex.org/W4306938133","https://openalex.org/W4312065227","https://openalex.org/W4313230526","https://openalex.org/W4313648365","https://openalex.org/W4365141907","https://openalex.org/W4366729877","https://openalex.org/W4391487280"],"related_works":["https://openalex.org/W4399070707","https://openalex.org/W4387531935","https://openalex.org/W2791370670","https://openalex.org/W2073266565","https://openalex.org/W2522341739","https://openalex.org/W6959376276","https://openalex.org/W4312170089","https://openalex.org/W7163541273","https://openalex.org/W2046354675","https://openalex.org/W4396676948"],"abstract_inverted_index":{"BACKGROUND:":[0],"Voice":[1],"barriers":[2,16,36,78,102],"among":[3,39],"frontline":[4,59,117],"healthcare":[5,26,40,60,118,126,176,259,293],"workers":[6,41,61,119,177,260,294],"hinder":[7],"safety":[8,158,163,228,299,331],"related":[9],"to":[10,21,32,65,75,82,93,226,250,263,286,302,329],"work":[11,188,193],"and":[12,17,37,70,79,103,124,160,210,246,307,333,345],"patients.":[13],"Understanding":[14],"these":[15,257,337],"practices":[18,38,81],"is":[19,339],"crucial":[20,340],"improve":[22,330],"voice":[23,35,77,101],"behavior":[24],"in":[25,42,120,280,295],"settings.":[27],"Therefore,":[28],"this":[29,110],"study":[30,47,67,90,167],"aims":[31],"identify":[33],"the":[34,95,99,104,121,150,166,173,251,324],"Pakistan.":[43],"RESEARCH":[44],"METHOD:":[45],"The":[46],"has":[48],"adopted":[49],"a":[50,88,219],"mixed-method":[51],"research":[52],"design.":[53],"Data":[54],"was":[55,91,113,131,141],"collected":[56,114],"from":[57,115],"15":[58],"through":[62],"semi-structured":[63],"interviews":[64],"achieve":[66],"objectives.":[68],"Descriptives":[69],"content":[71],"analysis":[72,140],"were":[73],"conducted":[74,92],"explore":[76],"alternative":[80],"solve":[83],"their":[84,107],"concerns.":[85,164,254],"After":[86],"that,":[87],"quantitative":[89],"determine":[94],"statistical":[96],"significance":[97],"of":[98,106,152,175,196,202,214,236,239,253,309],"identified":[100],"magnitude":[105],"effect.":[108],"For":[109],"purpose,":[111],"data":[112,134,144],"480":[116],"primary,":[122],"secondary,":[123],"territory":[125],"units.":[127],"A":[128],"questionnaire":[129],"survey":[130],"used":[132],"for":[133,143,326,341],"collection.":[135],"Then,":[136],"multistage":[137],"hierarchical":[138,303],"regression":[139],"employed":[142],"analysis.":[145],"RESULTS:":[146],"Study":[147],"findings":[148],"highlight":[149],"determinants":[151],"two":[153],"key":[154],"factors:":[155],"withholding":[156,161,178,252],"patient":[157,181,203,344],"concerns":[159,179,300],"worker":[162,346],"First,":[165],"identifies":[168],"several":[169],"factors":[170,184,230],"that":[171,292],"increase":[172],"likelihood":[174],"about":[180],"safety.":[182,347],"These":[183],"include":[185],"professional":[186],"designation,":[187],"experience,":[189],"blackmailing,":[190],"overconfidence,":[191],"longer":[192],"tenure,":[194],"feelings":[195],"insult,":[197],"early":[198],"career":[199],"stage,":[200],"fear":[201,238,308],"reactions,":[204],"bad":[205],"past":[206],"experiences,":[207],"job":[208],"insecurity,":[209],"uncooperative":[211],"management.":[212],"Fear":[213],"increased":[215],"workload":[216],"also":[217],"plays":[218],"significant":[220,327],"role.":[221],"Second,":[222],"when":[223],"it":[224],"comes":[225],"work-related":[227],"concerns,":[229],"such":[231,265,316],"as":[232,266,317],"gender,":[233],"shyness,":[234],"lack":[235],"confidence,":[237],"duty":[240],"changes,":[241],"management":[242,334],"issues,":[243],"interpersonal":[244],"conflicts,":[245],"resource":[247],"shortages":[248],"contribute":[249],"To":[255],"navigate":[256],"challenges,":[258],"often":[261,297],"resort":[262],"strategies":[264],"seeking":[267],"political":[268,318],"connections,":[269],"personal":[270,305],"settlements,":[271],"transfers,":[272],"union":[273],"protests,":[274],"quitting,":[275],"using":[276],"social":[277,321],"media,":[278,322],"engaging":[279],"private":[281],"practice,":[282],"or":[283,320],"referring":[284],"patients":[285],"other":[287],"hospitals.":[288],"CONCLUSION:":[289],"Findings":[290],"demonstrates":[291],"Pakistan":[296],"withhold":[298],"due":[301],"pressures,":[304],"insecurities,":[306],"repercussions.":[310],"Their":[311],"reliance":[312],"on":[313],"external":[314],"mechanisms,":[315],"influence":[319],"underscores":[323],"need":[325],"reforms":[328],"culture":[332],"support.":[335],"Addressing":[336],"issues":[338],"ensuring":[342],"both":[343]},"counts_by_year":[{"year":2026,"cited_by_count":6},{"year":2025,"cited_by_count":3}],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2025-01-06T00:00:00"}