Association Between Workplace Gaslighting and Perceived Quality of Care, Patient Safety and Quiet Quitting: A Cross-Sectional Study Among Nurses in Greece

Background: Patient safety is a top priority for healthcare organization leadership worldwide, as approximately one in ten patients experiences an adverse event, and nurses often report that the quality of the care they deliver is poor. Objectives: The present study aim was to examine the impact of work gaslighting on perceived quality of care, patient safety and quiet quitting on nursing staff. Methods: A cross-sectional study was conducted in Greece and data were collected using an online survey during October to November 2025, with 492 nurses. We used the Gaslighting at Work Scale (GWS) and the Quiet Quitting Scale to measure workplace gaslighting and quiet quitting. Perceived quality of care and perceived patient safety were measured with single items, representing the overall assessments in nurses’ unit. Results: Nurses reported low to moderate levels of workplace gaslighting and quiet quitting, as well as almost half of the participants (52.0%, n=256) evaluated the quality of care in their unit as good, and 33.1% (n=163) of nurses perceived patient safety as good. In the univariate comparisons, greater workplace gaslighting was significantly associated with lower odds of reporting perceived quality of care to be good or excellent (OR = 0.650, 95% CI: 0.527–0.803; p < 0.001). This association was still statistically significant in the multivariable model after gender, years of work experience, working in shifts and working in an understaffed department were included (adjusted OR = 0.655; 95% CI: 0.529–0.810; p < 0.001). Workplace gaslighting was also strongly related to perceived patient safety. In the univariate analysis increased workplace gaslighting was associated with decreased odds of good-to-excellent patient safety (OR = 0.553, 95% CI: 0.445–0.686, p < 0.001). This association remained after controlling for the potential confounders (adjusted OR = 0.561, 95% CI: 0.450–0.700, p < 0.001). In the multivariable model, workplace gaslighting was significantly and positively associated with quiet quitting (adjusted beta = 0.224, 95% CI = 0.163 to 0.285, p < 0.001) after adjusted for demographic and work-related characteristics. Conclusions: The present study is the first that highlighted the significant association between workplace gaslighting and the quality and safety of care, as well as nurses’ quiet quitting. A zero-tolerance stance by senior leadership, coupled with the establishment of clear policies and procedures that encourage staff to report such behaviors, is essential to dismantle the barriers created by psychological manipulation.