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Drawing on social exchange theory, this study has two objectives. First, it sought to explore the mediating role of social exchange reciprocating responses, specifically citizenship behavior toward the organization (OCB-O) and organizational deviance, in the relationship between perceived organizational support (POS) and quality of care. Second, it aimed to develop a better understanding of the moderating effect of the educational level in the relationships proposed.

A cross-sectional survey design was implemented. The study involved 228 nurses from Argentina and data were collected between May and November 2019. A cross-sectional survey design was implemented. This study employs partial least squares structural equation modeling (PLS-SEM) and multi-group analysis (MGA) to examine hypotheses.

The findings indicate that both social exchange reciprocating responses (i.e. OCB-O and organizational deviance) play a mediating role in the relationship between POS and quality of care. Moreover, the mediating role of OCB-O between POS and quality of care is moderated by the educational level of nursing professionals.

Nurse managers should acknowledge and promote nurses' reciprocating responses such as citizenship or deviant behaviors that enhance the quality of care. Furthermore, senior managers and HR departments should design strategies to support nurses in obtaining further education.

This study identifies the mediating role of social exchange reciprocating responses such as OCB-O and organizational deviance in the relationship between POS and quality of care. Furthermore, our research shows that educational level moderates the mediating effect of OCB-O in the relationship between POS and quality of care.