Psychological Drivers Of Pro-Environmental Behaviour In Healthcare Organizations: Implications For Sustainable Renal Care
DOI:
https://doi.org/10.65327/kidneys.v15i1.597Keywords:
Environmental psychology; Kidney health; Pro-environmental behaviour; Renal care sustainability; Sustainable healthcareAbstract
Healthcare organisations play a critical role in protecting human health, yet contribute substantially to environmental degradation through intensive energy use, water consumption, and waste generation. Renal care—particularly dialysis—is among the most resource-intensive domains within healthcare, making sustainability in kidney care both urgent and complex. Although healthcare systems increasingly adopt environmental policies and technological innovations, these initiatives often underperform because they insufficiently address the psychological and behavioural factors shaping everyday clinical practice. This narrative review synthesises evidence on the psychological drivers of pro-environmental behaviour (PEB) in healthcare organisations and examines their implications for kidney health and sustainable renal care. Drawing on established psychological frameworks, including the Norm Activation Model, the Theory of Planned Behaviour, and value-based theories, the review highlights the roles of personal values, lifestyle orientation, perceived behavioural capability, and organisational climate in shaping discretionary sustainability behaviours. The evidence consistently indicates that green lifestyle orientation and value congruence are stronger predictors of workplace pro-environmental behaviour than environmental commitment, awareness, or green human resource management alone. In renal care settings—where clinical protocols, workload pressures, and patient safety concerns constrain action—effective sustainability depends on behaviourally informed strategies that align environmental responsibility with professional ethics and routine practice. The review concludes that sustainable renal care is not solely a technological challenge but a behavioural one, underscoring the need to embed psychological insights into healthcare sustainability efforts to advance both planetary health and long-term kidney care resilience.
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Hasan A, Zhang X, Mao D, Kashif M, Mirza F, Shabbir R. Unravelling the impact of eco-centric leadership and pro-environment behaviours in healthcare organisations: role of green consciousness. J Clean Prod. 2024;434:139704. DOI: https://doi.org/10.1016/j.jclepro.2023.139704
ul Mateen A, Nisar QA, Nasir N. Fostering pro-environmental behaviours in healthcare organisations: an empirical analysis of psychological and strategic factors. Asia Pac Manag Rev. 2023;28(1):13–23. DOI: https://doi.org/10.1016/j.apmrv.2022.01.004
Xu L, Cherian J, Zaheer M, Sial MS, Comite U, Cismas LM, et al. The role of healthcare employees’ pro-environmental behaviour for de-carbonization: an energy conservation approach from a CSR perspective. Energies. 2022;15(9):3429. DOI: https://doi.org/10.3390/en15093429
Owusu EA, Zhou L, Sarpong FA, Sampene AK, Antwi HA, Arboh F, et al. Exploring the impact of green performance on employees' pro-environmental behaviors: a multi-group analysis from developed and emerging economies healthcare industries. Bus Strategy Environ. 2025;34(4):4717–4746. DOI: https://doi.org/10.1002/bse.4228
Tessema DH, Yesilada F, Aghaei I. Enhancing pro-environmental behavior through green human resource management practices: evidence from Ethiopian private hospitals. J Health Organ Manag. 2025. DOI: https://doi.org/10.1108/JHOM-12-2024-0519
Fitri DE, Nastiti A. The effect of information, fear, and risk perceptions on pro-environmental behaviour among university students in Indonesia. J Pengelolaan Sumberdaya Alam dan Lingkungan. 2025;15(2):206. DOI: https://doi.org/10.29244/jpsl.15.2.206
Figueiredo T, Midão L, Rocha P, Cruz S, Lameira G, Conceição P, et al. The interplay between climate change and ageing: a systematic review of health indicators. PLoS One. 2024;19(4):e0297116. DOI: https://doi.org/10.1371/journal.pone.0297116
Okoye OC. Ambient air pollution near petrochemical industries and chronic kidney disease risk: integrating citizen science within an exploratory mixed methods study [dissertation]. Edinburgh: Edinburgh Napier University; 2024. DOI: https://doi.org/10.1016/j.ekir.2024.02.480
Verbruggen SC, den Otter SC, Bakker J, Briassoulis G, Ilia S, Latten L, et al. Call for sustainable food systems including (medical) nutrition for hospitalised children and their families. Frontline Gastroenterol. 2024;15(e1):e73–e87. DOI: https://doi.org/10.1136/flgastro-2023-102478
Hassen TE, Cabases MV, Zine Eddine El Idrissi JM, Mills MD. Changes in inequality in use of maternal health care services: evidence from skilled birth attendance in Mauritania for the period 2007–2015. Int J Environ Res Public Health. 2022;19:3566. DOI: https://doi.org/10.3390/ijerph19063566
Güntürkün P, Studte S, Winkler D, Clement M, Tan JH, Merz EM, et al. Crowding-out effects of opt-out defaults: evidence from organ donation policies. PNAS Nexus. 2025;4(10):pgaf311. DOI: https://doi.org/10.1093/pnasnexus/pgaf311
Adriana L, Bobbio A, Filippo A, Daniela T. Attitude toward online administration of tests in Italian psychologists. Eur J Psychol Open. 2023;82:285.
Oh YJ, Park S, Ryu JY. Boosting organ donation self-efficacy through AI-generated health messaging: the differential impacts of “why” vs. “how” messaging and media modality. Health Commun. 2025:1–10. DOI: https://doi.org/10.1080/10410236.2025.2580327
Prabowo H, Prasetyo A. Forest therapy, stress, and immune system: a health triangle. In: Alternative Medicine – New Insights. 2025. p. 51. DOI: https://doi.org/10.5772/intechopen.1006500
Pellizzari C, Marco Z. Relationship between emotional regulation, emotional intelligence and emotional response: emotional intelligence as mediator. Eur J Psychol Open. 2023;82(Suppl 1):539–540.
Shim S, Sorgente A, Lanz M, Serido J. Examining the effects of personal and sociodemographic factors on the family financial socialization process. Eur J Psychol Open. 2023;82:434. DOI: https://doi.org/10.1037/t89920-000
Zairbani A, Doddaullarthi Basavaraj C, SriSai V, Manikrishna V, Jaya Prakash SK. Does waste management matter in the medical materials business performance? Int J Prod Perform Manag. 2025:1–20. DOI: https://doi.org/10.1108/IJPPM-10-2024-0746
Singh A, Joshi R, Patel A, Maurya S, Shehu SA. Socio-environmental impacts of sustainable waste management. In: Sustainable Waste Management: Challenges and Visions. Cham: Springer Nature Switzerland; 2025. p. 275–299. DOI: https://doi.org/10.1007/978-3-031-85685-3_18
Dadvand P, de Vries S, Bauer N, Dayamba DS, Feng X, Morand S, et al. The health and wellbeing effects of forests, trees and green space. In: Forests and Trees for Human Health. p. 77.
Pinson M. Development of an educational toolkit for Washington State nursing professionals regarding climate-related impacts on health. 2025.
Sehajpal S, Rao K, Kumar S, Dahiya K. Transforming business management with AI and data-driven decision-making: insights from FemTech tools for pelvic floor muscle training among women. In: Transforming Business Management with AI, BI, and Data-Driven Decision-Making. Boca Raton: CRC Press; 2025. p. 161–188. DOI: https://doi.org/10.1201/9781003564621-11
Grobelna A, Bogalecka M. Tourism and career development in the face of seawater threats: perspectives of tourism and hospitality students from coastal areas. Sustainability. 2024;16(23). DOI: https://doi.org/10.3390/su162310351
Zucchelli MM, Gambetti E, Giusberti F, Nori R. Use of default option nudge and individual differences in everyday life decisions. Cogn Process. 2024;25(1):75–88. DOI: https://doi.org/10.1007/s10339-023-01161-1
Ferrari E, Vecchi E, Mattei G, Belloli G, Diegoli G, Monte P, et al. The shape of water: preliminary data from a cluster of patients infected by Mycobacterium saskatchewanense in a haemodialysis setting. Popul Med. 2023;5(Suppl). DOI: https://doi.org/10.18332/popmed/165460
Thakur SJ, Roy H. Job embeddedness and workplace well-being: moderating role of remoteness. Int J Organ Anal. 2025:1–26. DOI: https://doi.org/10.1108/IJOA-06-2024-4561
Khurshid M, Abdullah M, Azeem M. Making the world a better place by creating eco-friendly products and customers’ adoption intentions. Pak J Human Soc Sci. 2023;11(2):2338–2346. DOI: https://doi.org/10.52131/pjhss.2023.1102.0532
Gea M, Previti C, Bert F, Massocco G, Moro G, Scaioli G, et al. Environmental health literacy of the Italian general population: the SPeRA study. Popul Med. 2023;5(Suppl):91. DOI: https://doi.org/10.18332/popmed/165693
Ferraguzzi G, Zanetti M, Mazzola P, Sandrini M, Sanvito F, Gagliardo R, et al. The role of the built environment in dementia. Popul Med. 2023;5(Suppl):55. DOI: https://doi.org/10.18332/popmed/164033
Christie M, Elliott D, Wilbraham S. Freedom, fun, friendship and freezing: women’s perspectives of participation in open water swimming. Sport Soc. 2025:1–25. DOI: https://doi.org/10.1080/17430437.2025.2470158
Tawil S, Haque S, Salameh P. Mental health during COVID-19: an evaluation of academic universities’ contribution. J Multidiscip Healthc. 2024:2053–2068. DOI: https://doi.org/10.2147/JMDH.S439983
Garlasco J, Koripalli M, Bridge G. Public health interventions to promote oral health in patients with type 2 diabetes: a systematic review. Popul Med. 2023;5(Suppl). DOI: https://doi.org/10.18332/popmed/164728
Choi J. The promotion of human rights and climate norms in the DPRK. In: Advances in Sociology Research. 2022. p. 183.
Wang Q, Farhadipour M, Leng H, Thijs T, Nys L, Ceulemans LJ, et al. Activation of bitter taste receptors regulates expression of growth differentiation factor 15 in the small intestine of patients with obesity. Chem Senses. 2023;48.
Karam S, Wong MM, Jha V. Sustainable development goals and global kidney health. Kidney360. 2023;4(10):1494–1502. DOI: https://doi.org/10.34067/KID.0000000000000237
Duane B, Steinbach I, Stancliffe R, Barna S, Cameron D, de Barbieri I, et al. Improving sustainability and quality of kidney health care: the KitNewCare approach. J Nephrol. 2025;38(1):87–99. DOI: https://doi.org/10.1007/s40620-024-02114-3
Stigant CE, Rajan T, Barraclough KA, Miller FA. The necessity of environmentally sustainable kidney care. Can J Kidney Health Dis. 2023;10:20543581231166484. DOI: https://doi.org/10.1177/20543581231166484
Stigant CE, Barraclough KA, Harber M, Kanagasundaram NS, Malik C, Jha V, et al. Our shared responsibility: sustainable kidney care. Kidney Int. 2023;104(1):12–15. DOI: https://doi.org/10.1016/j.kint.2022.12.015
Francis A, Harhay MN, Ong AC, Tummalapalli SL, Ortiz A, Fogo AB, et al. Chronic kidney disease and the global public health agenda. Nat Rev Nephrol. 2024;20(7):473–485. DOI: https://doi.org/10.1038/s41581-024-00820-6
Smyth B, Pippias M, Sandal S, Fung WW, Ethier I, Kelly D, et al. Green nephrology: minimizing environmental impact. Kidney Int. 2023;104(1):7–11. DOI: https://doi.org/10.1016/j.kint.2023.03.038
Davison SN, Pommer W, Brown MA, Douglas CA, Gelfand SL, Gueco IP, et al. Conservative kidney management and supportive care. Kidney Int. 2024;105(1):35–45. DOI: https://doi.org/10.1016/j.kint.2023.10.001
Johnston-Webber C, Bencomo-Bermudez I, Wharton G, van Kessel R, Barone S, Muntó FB, et al. A framework to assess the burden of chronic kidney disease. Health Policy. 2025;152:105244. DOI: https://doi.org/10.1016/j.healthpol.2024.105244
Hmida MB, Mechichi T, Piccoli GB, Ksibi M. Water implications in dialysis therapy. Kidney Int. 2023;104(1):46–52. DOI: https://doi.org/10.1016/j.kint.2023.04.008
Langham RG, Kalantar-Zadeh K, Bonner A, Balducci A, Hsiao LL, Kumaraswami LA, et al. Kidney health education and literacy. J Nephrol. 2022;35(6):1555–1563. DOI: https://doi.org/10.1007/s40620-022-01290-4
Vanholder R, Agar J, Braks M, Gallego D, Gerritsen KG, Harber M, et al. The European Green Deal and nephrology. Nephrol Dial Transplant. 2023;38(5):1080–1088. DOI: https://doi.org/10.1093/ndt/gfac160
Judge PK, Staplin N, Mayne KJ, Wanner C, Green JB, Hauske SJ, et al. Impact of primary kidney disease in the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol. 2024;12(1):51–60. DOI: https://doi.org/10.1016/S2213-8587(23)00322-4
Law JP, Pickup L, Pavlovic D, Townend JN, Ferro CJ. Hypertension and cardiomyopathy in chronic kidney disease. J Hum Hypertens. 2023;37(1):1–9. DOI: https://doi.org/10.1038/s41371-022-00751-4
Hsu CM, Gupta S, Tighiouart H, Goyal N, Faugno AJ, Tariq A, et al. Kidney recovery and death in COVID-19–associated AKI. Am J Kidney Dis. 2022;79(3):404–416. DOI: https://doi.org/10.1053/j.ajkd.2021.11.004
Schmieder RE. Renal denervation in chronic kidney disease. Nephrol Dial Transplant. 2023;38(5):1089–1096. DOI: https://doi.org/10.1093/ndt/gfac189
García GG, Iyengar A, Kaze F, Kierans C, Padilla-Altamira C, Luyckx VA. Sex and gender differences in chronic kidney disease. Semin Nephrol. 2022;42(2):101–113. DOI: https://doi.org/10.1016/j.semnephrol.2022.04.001
Green JB, Mottl AK, Bakris G, Heerspink HJL, Mann JF, McGill JB, et al. Design of the CONFIDENCE study. Nephrol Dial Transplant. 2023;38(4):894–903. DOI: https://doi.org/10.1093/ndt/gfac198
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