The relationship and predictive role of reflective capacity with respect to the work environment and patient-centered care in ICU nurses

Abstract Background ICU nurses play a vital role in providing safe, quality, and patient-centered care. Reflection helps nurses learn from experiences, improve their practice, and make better decisions in complex situations. However, factors such as inappropriate work environment, lack of training, and systemic pressures are barriers to reflection and patient-centered care. Therefore, this study investigated the relationship of reflective capacity with the work environment and patient-centered care among ICU nurses. Methods This descriptive-correlational study involved 303 nurses working in intensive care units affiliated with Kerman University of Medical Sciences in 2026, who were included in the study through census. Participants completed a demographic characteristics questionnaire, the Reflective Practice Questionnaire (RPQ), the Practice Environment Scale of the Nursing Work Index (PES-NWI), and the Patient-Centered Care (PCC) measure. Results The mean scores of reflective capacity and patient-centered care were favorable (5.58 ± 59.19 and 4.61 ± 61.58, respectively), while the mean score of nursing work environment was unfavorable (2.29 ± 0.18). Positive and significant relationships were observed between reflective capacity and the nursing work environment (p = 0.050, r = 0.39), between reflective capacity and patient-centered care (p = 0.025, r = 0.61), and between the nursing work environment and patient-centered care (p = 0.046, r = 0.44). Conclusion The study results showed that while reflective capacity and patient-centered care were favorable in ICU nurses, their work environment was unfavorable. Therefore, policymakers and nurse managers should improve the work environment for ICU nurses to provide safe and patient-centered care.