Investigating the Antecedents of Knowledge Hiding Behavior in Therapeutic Environments

Sharei, Zohre; Heidari Nezhad, Hanie

doi:10.22034/jmep.2026.557312.1595

Investigating the Antecedents of Knowledge Hiding Behavior in Therapeutic Environments

Document Type : Original Article (Quantified)

Authors

zohre sharei ¹

Hanie Heidari Nezhad ²

¹ Department of Public Administration, Faculty of Management, Payame Noor University, Tehran, Iran

² Faculty of Management, Payame Noor University, Tehran, Iran

https://doi.org/10.22034/jmep.2026.557312.1595

Abstract

This study investigated the effect of colleagues' rudeness on knowledge concealment through the mediation of work involvement and intention to leave, and the moderating role of staff pessimism in Valiasr Hospital in Bafgh. This is a causal-effectual, descriptive-survey and applicable research conducted with a field method and by a standard questionnaire. Data were collected from employees of Valiasr Hospital in Bafgh and analyzed by descriptive and inferential statistical methods (including structural equation modeling based on the partial least squares method). Analyses were performed by SPSS27 software for preliminary calculations and SmartPLS4 for structural modeling. The results showed that in Valiasr Hospital in Bafgh, rudeness of colleagues significantly reduces job involvement, increases intention to leave the service, and ultimately strengthens knowledge concealment; so that job involvement and intention to leave the service play a significant sequential mediating role. The moderating role of employee cynicism was not confirmed. These findings indicate that in the small environment and close relationships of this city government hospital, rudeness of colleagues has a significant effect on reducing the motivation to share knowledge. Therefore, strengthening job involvement and improving interpersonal relationships in Valiasr Hospital in Bafgh can reduce knowledge concealment and improve the organizational performance.
Introduction
Knowledge concealment, as an intentional attempt by employees to hide all or part of their required knowledge from others, is considered one of the key challenges in organizations (Valikhani Dehaghani & Mohammadi, 2022). This behavior not only hinders knowledge sharing and undermines teamwork and organizational productivity, but in healthcare settings it can also negatively impact patient safety and lead to medical errors, treatment delays, and reduced patient satisfaction. In small and medium-sized hospitals such as Valiasr Hospital in Bafgh, which face human resource constraints and challenges in retaining expert staff, knowledge hiding is a serious issue because the clinical and empirical knowledge of employees directly affects the quality of patient care. One of the main factors associated with knowledge hiding is coworker rudeness (Mahdikhani & Elhami, 2025). Meanwhile, work engagement and turnover intention can play a mediating role, and employee cynicism can play a moderating role. The main objective of this study is to investigate the effect of coworker rudeness on knowledge concealment through the mediation of work engagement and turnover intention and the moderating role of employee cynicism in Valiasr Hospital in Bafgh.
Theoretical Framework
Knowledge Concealment:
Knowledge is divided into two types: tacit (based on individual skills) and explicit (descriptible and transferable) (Yazdipour & Sabouni, 2022). Knowledge concealment refers to a deliberate attempt to conceal requested knowledge, and its forms include fooling around, avoidance, and rational concealment (Imani et al., 2022).
Coworker incivility:
Coworker incivility refers to low-intensity disrespectful behaviors with vague intent to harm that violate norms of mutual respect. (Rahimi Koloor et al., 2023) This behavior can be verbal or nonverbal and carries high psychological costs. (Mahdikhani & Elhami, 2025).
Work engagement:
Work engagement is a positive psycho-behavioral state including high energy, focus, and a sense of belonging. (Sharei & Abbasi Darreh Bidi, 2025). This concept has cognitive, emotional, physical-psychological, social, and moral-value dimensions. (Karami et al., 2025)
Turnover intention:
Turnover intention is an individual’s subjective desire to leave the organization within a given period of time, influenced by factors such as job security and organizational justice (Sadeghi, 2023; Zamanipour et al., 2025).
Employee cynicism:
Employee cynicism is a negative attitude toward the organization, including a belief in a lack of integrity, negative emotions, and critical behaviors (Zamanipour et al., 2025).
According to the Conservation of Resources (COR) theory, coworker rudeness, as a stressor, drains employees' psychological resources and leads to reduced work engagement and increased turnover intention, and ultimately knowledge concealment. The research background shows that Agarwal et al. (2024) concluded that rudeness increases knowledge concealment by reducing work engagement and increasing turnover intention. Also, Jabbari et al. (2023) showed that organizational cynicism mediates the relationship between rudeness and organizational silence.
Research Methodology
This study is applicable in terms of purpose; quantitative in terms of data nature; and descriptive-survey of causal-effectual type in terms of implementation method. The statistical population consisted of 450 official and contractual employees of Valiasr Hospital in Bafgh. The sample size was calculated based on the Cochran formula for the limited population as 210 people (with a confidence level of 95% and an error of 5%). Sampling was done by simple random sampling. The data collection tool was a standard five-point Likert questionnaire including: the Coworker Incivility Questionnaire (Cortina et al., 2001) with 7 questions, the Knowledge Concealment Questionnaire (Badar et al., 2023) with 3 questions, the Work Involvement Questionnaire (Islam & Chaudhary, 2024) with 7 questions, the Intention to Leave Questionnaire (Badar et al., 2023) with 3 questions, and the Employee Pessimism Questionnaire (Durrah et al., 2019) with 7 questions. Content validity was confirmed by experts and the supervisor. The reliability of the tool was reported to be higher than 0.70 by calculating the Cronbach's alpha coefficient in an initial sample of 30 people for all variables (Incivility: 0.845, Concealment: 0.708, Involvement: 0.092, Intention to Leave: 0.866, Pessimism: 0.899). Data were analyzed by SPSS version 27 for descriptive analysis (mean, standard deviation, skewness, and kurtosis) and SmartPLS version 4 for structural equation modeling based on the partial least squares method (PLS-SEM). In the inferential section, the measurement model (factor loadings, composite reliability, convergent validity with AVE, and divergent validity with the Fornell and Larker matrix), the structural model (β path coefficients, R² coefficients, redundancy criterion, and t-statistics), and overall model fit (GOF) were evaluated.
Research findings
Out of 210 respondents, 133 (63.3%) were male and 77 (36.7%) were female. The modeling results showed: (1) Rudeness has a negative effect on engagement (β = -0.585, t = 7.238). (2) Involvement has a negative effect on intention to quit (β = -0.484, t = 7.058). (3) Intention to quit has a positive effect on concealment (β = 0.622, t = 13.271). (4) Pessimism did not have a moderating role (β = 0.063, t = 1.206). (5) The chain mediation of involvement and intention to quit was confirmed (β = 0.176, t = 5.011). R² for concealment (0.387), involvement (0.349) and intention to quit (0.234) was at a strong level.
Conclusion
The findings of this study showed that rudeness of colleagues reduces work engagement by draining employees' psychological resources (based on the conservation of resources theory). This decrease in engagement, in turn, increases the intention to leave the service and, ultimately, employees resort to knowledge concealment to preserve their knowledge capital. This causal chain shows that abnormal interpersonal behaviors in the healthcare environment not only drain employees' psychological resources, but also lead to defensive behaviors such as knowledge concealment by weakening job enthusiasm and creating a desire to leave. The findings of this study are consistent with the studies of Agarwal et al. (2024), Anand et al. (2023), Mahdikhani & Elhami (2025), and Jabbari et al. (2023), that have confirmed the role of rudeness, work engagement and pessimism in knowledge concealment. In this study, the moderating role of employees' pessimism was not confirmed; this finding is in contrast to the results of Agarwal et al. (2024) and Anand et al. (2023) who reported pessimism as an aggravating or mediating factor. However, it is consistent with the findings of Akhlaghimofrad & Farmanesh (2021) and Sadeghi (2023) who reported pessimism as having no moderating or mediating role. Contrary to the conservation of resources (COR) theory, pessimism did not have a moderating effect in this study. This is likely due to the low level of pessimism in the sample (mean 2.1 out of 5) and the prevalence of the medical professional culture (moral commitment to patients) that neutralizes the negative effects of rudeness.
Based on the results, practical suggestions include: holding communication skills workshops (active listening and conflict management) several times a year, developing a code of ethics and organizational behavior, creating a confidential reporting system, monthly recognition of exemplary employees with a plaque and cash bonus, developing a clear career path map, holding weekly meetings to share clinical experiences, and holding responsibility transfer meetings for knowledge transfer in the final months of employees' service. For future research, it is recommended to examine different dimensions of knowledge concealment (foolish play, avoidance, and rational concealment), consider other mediators such as emotional exhaustion and interpersonal distrust, conduct longitudinal studies in larger hospitals, and examine the role of cultural variables such as ethical leadership or organizational support as moderators.

Acknowledgments
The authors gratefully acknowledge all individuals, institutions, and organizations that provided scientific, technical, administrative, or advisory support throughout this research and the preparation of this manuscript.
Conflicts of Interest
The authors declare that they have no financial or non-financial, personal, professional, or institutional conflicts of interest relevant to this work.
Data Availability Statement
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
AI Use Statement
The authors declare that no generative artificial intelligence (AI) or AI-assisted technologies were used in the preparation, writing, or editing of this manuscript.
Funding
The authors declare that no funds, grants, or other financial support were received during the conduct of this research or the preparation of this manuscript.
Ethics Approval
All procedures performed in this study were conducted in accordance with the ethical standards of the responsible institutional and national research committee.

Keywords

Knowledge concealment

Coworker rudeness

Work engagement

Intention to leave

Organizational cynicism

Subjects

Human Resource Management

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