From wage dissatisfaction to union expectations: The mediating role of union perception among nurses

Abstract

Aim: This study examines the relationships between wage satisfaction, union perceptions, expectations, and union membership among Turkish nurses, identifying factors associated with union participation. Design: Sequential explanatory mixed-methods design. Methods: This two-phase study (January–July 2023) included: (1) a quantitative survey of 210 nurses assessing wage satisfaction, union perceptions, and expectations, analysed using regression and PROCESS Macro (Model 4); and (2) qualitative interviews with 22 nurses, including 15 with union leadership experience, analysed through thematic analysis using MAXQDA. Results: Quantitative findings indicated that wage satisfaction was associated with nurses' perceptions of unions but did not independently predict union expectations. The study hypothesises that union perception functions as a key mediating mechanism, translating wage dissatisfaction into expectations for union action. Qualitative findings supported this pattern, showing that although wage dissatisfaction was widespread, nurses' expectations were primarily shaped by perceptions of unions' transparency, political independence, democratic participation, and representational capacity rather than by wages alone. Conclusions: Union participation among nurses is influenced by both economic conditions and normative evaluations of unions. While wage dissatisfaction provides an important contextual background, expectations and engagement are mainly driven by perceptions of union credibility, fairness, and representational effectiveness. Implications for Profession and/or Patient Care: Nursing unions should prioritise transparent governance, democratic participation, and political independence to enhance trust, member engagement, workforce stability, and quality of care. Impact: This study addresses persistent wage dissatisfaction alongside declining union membership and trust. The findings demonstrate that union engagement depends not only on economic dissatisfaction but also on perceived representational fairness. The results are particularly relevant for nursing unions, professional organisations, and policymakers aiming to strengthen union legitimacy and workforce engagement in healthcare systems. Reporting Method: Compliant with COREQ guidelines and mixed-methods reporting standards. Patient or Public Contribution: No patient or public contribution.