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Purpose

While job demands are commonly linked to burnout and disengagement, their influence on knowledge withholding remains underexplored, particularly in high-stakes healthcare settings where knowledge sharing is critical. Specifically, existing frameworks explain general stress responses but do not account for knowledge-specific and strategic decisions, nor the cognitive mechanisms underlying such behaviour. This study investigates the psychological mechanisms and boundary conditions through which job demands lead to knowledge withholding.

Design/methodology/approach

Drawing on conservation of resources (COR) theory, this study examines the mediating role of perceived reward–effort unfairness and the moderating role of knowledge power threat (KPT). Data were collected using a time-lagged design from 316 healthcare professionals across multiple organisations in the UAE. Structural equation modelling (SEM) was used to test the hypothesised relationships.

Findings

The results indicate that job demands positively influence knowledge withholding through perceived unfairness in reward–effort balance. This suggests that employees cognitively interpret resource imbalances as unfair, which in turn shapes knowledge-related decisions. Moreover, the relationship is intensified by KPT, reflecting employees' anticipatory concerns about losing knowledge-based influence and professional value, leading to stronger knowledge withholding behaviour.

Practical implications

The findings highlight the importance of managing workload, ensuring fair reward systems and fostering trust-based leadership to reduce knowledge withholding and promote knowledge-sharing behaviours in healthcare organisations.

Originality/value

This study provides a more precise explanation of knowledge withholding by integrating resource-based, cognitive and power-related perspectives, with KPT introduced as a novel boundary condition.

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