A Systematic Review of Psychological Contracts Research of Nurses

Nurses who are at the forefront of the health system and have one of the most challenging jobs, experience high levels of risk and emotional conflict due to the fact that they often face stressful situations, which more likely reduce their job satisfaction and organizational commitment that eventually leads to quit their jobs. The purpose of the current research was to provide a comprehensive and clear overview of psychological contract research and finally recommended research directions for future researchers to fill research gaps. Psychological contract is defined as the employees' beliefs and perceptions about the terms and conditions of a reciprocal exchange agreement between them and the organization. Psychological contract is important in labor relations and is shaped based on the attitudes and behaviors of the various parties to the contract.

A systematic search was conducted in international and domestic databases in Azar 1400. Following the protocols of the proposed tools for systematic review and inclusion and exclusion criteria, finally 22 articles were selected for analysis.

Total of 22 articles were identified from 1999 to 2021, of which 14 were conducted in the last seven years. The number of samples varied from 10 nurses for interviews to 1039 nurses through online questionnaires. All records were cross-sectional of which 16 were quantitative, 5 were qualitative and one used combined method. Nurses' psychological contracts were divided into three general themes. The first theme focused on the process of formation and development of psychological contract. The second theme focused on identifying the content and nature of these contracts. The third theme focused on the process of fulfilling and breach of the psychological contract. The results showed that despite the growing interest and effort of published research on nurses and psychological contracts, and despite recognizing that the concept of psychological contracts is a valuable theoretical framework to understand nurses' experiences and how to better manage hospitals, yet there is a lot of information about nurses' psychological contracts that future papers should study.

Moreover, as cross-sectional approach was the only used method so far, it is suggested to do longitudinal designs in future studies. In a cross-sectional study, it cannot be said with certainty that the effective factors unilaterally affect the fulfillment or breach and there is no inverse relationship. In addition, the impact of the COVID-19 epidemic on the process of formation, development, content, fulfillment and breach of nurses' psychological contracts can be noted in future studies.