Depiction of Health. 2024;15(2): 134-148.
doi: 10.34172/doh.2024.11
  Abstract View: 176
  PDF Download: 57

Health Information/Library

Original Article

Identifying the Effective Components on Nurses' Knowledge Sharing Behavior with Mixed Method Research

Seifollah Khosravi 1, Atefeh Zarei 2* ORCID logo, Behrooz Bayat 3 ORCID logo, Zarrin Zarrinabadi 4 ORCID logo

1 PhD Student, Department of Knowledge and Information Science, Hamedan Branch, Islamic Azad University, Hamedan, Iran
2 Associate Professor, Department of Knowledge and Information Science, Hamedan Branch, Islamic Azad University, Hamedan, Iran
3 Assistant Professor, Department of Knowledge and Information Science, Hamedan Branch, Islamic Azad University, Hamedan, Iran
4 Assistant Professor, Department of Medical Library and Information Sciences, Abadan University of Medical Sciences, Abadan, Iran
*Corresponding Author: Email: Atefehzarei@gmail.com


Background. Knowledge-sharing is a process in which people mutually exchange tacit and objective knowledge and create new knowledge. This study aimed to identify the main themes and organize the components of nurses' knowledge sharing.

Methods. A mixed research method was adopted to conduct the present study. To this end, a qualitative method with a thematic analysis approach was first implemented to investigate the statistical population. The required data were collected by reviewing the published national and international articles using the keyword "knowledge sharing" in search engines. In total, 387 scientific research articles were retrieved from searching the literature. Then, the inclusion criteria were used to filter the information and reduce the number of articles to 48 containing the related codes specific to the themes. The quantitative part was an analytical survey. The statistical population included the nurses of Kermanshah University of Medical Sciences. The structural equation modeling methodology was adopted to determine a sample size of 284 individuals.

Results. In the qualitative part, there were 27 main themes, 11 sub-core themes, and nine knowledge-sharing organizing themes, including attitude, mental norms, rewards, costs, perceived behavioral control, mutual benefits, knowledge-sharing tools, and perception of gaining reputation. The components of knowledge-sharing intention were identified in the quantitative part based on the nurses' points of view, and gaining reputation, mutual benefits, and mental norms were found the most important components in order of priority.

Conclusion. Based on the findings of this study, the components of attitude, perceived behavioral control, reward, mutual benefits, reputation and subjective norms are effective in the knowledge sharing behavior pattern of nurses and can cause the actual behavior of the individual.

Extended Abstract


Knowledge-sharing behavior of nurses has recently gained urgent attention in Iran as it is particularly emphasized in the Fifth Five-year Development Plan of the Islamic Republic of Iran (2011-2015, articles of Chapter 2: Science and Technology, Article 20). Devoting enough attention to the sharing and storage of tacit knowledge among expert forces in health centers and its efficient transfer to the staff working for health and treatment centers can improve the employees' knowledge, reduce the medical errors caused by incorrect diagnoses of diseases, and facilitate the prescription of appropriate medicines. As a result, this increases the quality and efficiency of treatment, speeds up the decision-making processes, and improves the patients' outcomes. Therefore, improving the knowledge and performance of nurses in hospitals and medical education centers is critical to measuring their knowledge-sharing intention. Accordingly, the present study aimed to identify factors affecting the knowledge-sharing behavior of nurses.


A mixed research method was adopted in this study to determine factors affecting the knowledge-sharing behavior of nurses. To this end, a qualitative method with a theme analysis approach was first implemented, followed by a quantitative approach, to describe the data. Data was collected from research articles in the field of knowledge-sharing published in 2000-2022 indexed in national and international databases. The published literature, the internet, and library methods were used to collect the required data.

The inclusion criterion for the publications was having at least one of the two constructs of Eisen's theory of planned behavior and Homans' social exchange (i.e., attitude, mental norms, perceived behavioral control, intention to share knowledge, reward, expected mutual benefits, costs, perception of gain reputation, and knowledge-sharing tools).

Qualitative data of the articles are usually sampled in a targeted manner using non-probability methods and is continued until theoretical saturation.

The reliability of qualitative data was calculated with the one-step Delphi method, an evaluation checklist, and the Holstein reliability coefficient formula (PAO = 2*NA/NC1 + NC2). Then, the opinions of 34 professors of knowledge and information science were recorded regarding the coding of the themes extracted from the literature. In this method, the texts are coded in two steps. In the Holstein formula, NA is the number of common primary codes between two encoders extracted from the texts, and NC1 and NC2 represent the numbers of coded units in the first and second stages, respectively. PAO indicates the percentage of observed agreement between variables zero and one. According to the output result of the formula, the reliability coefficient of this study (86%) demonstrates high reliability.

To implement the quantitative method, 1100 nurses from teaching hospitals affiliated with Kermanshah University of Medical Sciences and the Ministry of Health were included as the statistical population of the study. The sample size (n = 284 people) was determined based on the structural equation modeling and according to the rules of structural equations 5Q < n < 15Q (Q is the number of questions and N is the sample change range). The reliability and validity of the questionnaire were determined using Cronbach's alpha and SPSS software (version 22).


This study aimed to identify the factors affecting the knowledge-sharing behavior of nurses working in Kermanshah University of Medical Sciences, Iran. To this end, the qualitative part was analyzed using a thematic analysis approach. In total, 27 main themes of knowledge-sharing components, 11 central-sub themes, and nine organizing themes (i.e., attitude, mental norms, perceived behavioral control, intention to share knowledge, rewards, expected mutual benefits, costs, perception of gaining reputation, and knowledge-sharing tools) were identified and categorized under the comprehensive theme of knowledge-sharing.

As for the quantitative part, Friedman's test was first performed to determine the prioritization of the knowledge-sharing components of in relation to the knowledge-sharing intention based on the nurses' points of view. The results from the test showed that the most important components, in order of priority, were attitude, perception of gaining reputation, mutual benefits, mental norms, rewards, knowledge-sharing tools, perceived behavioral control, and knowledge-sharing risk. This prioritization of variables was statistically significant at a significance level of < 0.05.


The identified components of knowledge-sharing affected the nurses' knowledge-sharing behavioral intention. It is recommended to conduct further applied research to investigate the effects of the identified components on knowledge-sharing in organizations.

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Submitted: 08 Sep 2023
Revision: 13 Feb 2024
Accepted: 19 Feb 2024
ePublished: 29 May 2024
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