Authentic leadership and psychological well-being at work of nurses: The mediating role of work climate at the individual level of analysis

Healthy work environment: A systematic review informing a nursing professional practice model in the US Military Health System

AIM

The aim of the study was to develop recommendations for creating a healthy work environment based on current literature for nurses working within the US Military Health System (MHS). However, our findings would likely benefit other nursing populations and environments as well.

DESIGN

Systematic literature review.

DATA SOURCES

We conducted a systematic literature search for articles published between January 2010 until January 2024 from five databases: PubMed, Joanna Briggs, Embase, CINAHL and Scopus.

METHODS

Articles were screened, selected and extracted using Covidence software. Article findings were synthesized to create recommendations for the development, implementation and measurement of healthy work environments.

RESULTS

Ultimately, a total of 110 articles met the criteria for inclusion in this review. The articles informed 13 recommendations for creating a healthy work environment. The recommendations included ensuring teamwork, mentorship, job satisfaction, supportive leadership, nurse recognition and adequate staffing and resources. Additionally, we identified strategies for implementing and measuring these recommendations.

CONCLUSIONS

This thorough systematic review created actionable recommendations for the creation of a healthy work environment. Based on available evidence, implementation of these recommendations could improve nursing work environments.

IMPACT

This study identifies methods for implementing and measuring aspects of a healthy work environment. Nurse leaders or others can implement the recommendations provided here to develop healthy work environments in their hospitals, clinics or other facilities where nurses practice.

REPORTING METHOD

PRISMA 2020 guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Key elements to support primary healthcare nurses to thrive at work: A mixed-methods sequential explanatory study

AIM

Develop evidence-based recommendations for managers to support primary healthcare nurses to thrive at work.

DESIGN

A mixed-methods sequential explanatory design.

METHODS

National data were collected in 2020 via an e-survey based on a meta-analysis of antecedents of thriving from 213 primary healthcare nurses across New Zealand. Structural equation modelling analysis identified the key factors supporting primary healthcare nurses to thrive. This informed a second open-ended e-survey in 2022 of 19 nurses from one primary healthcare organization. The thematic analysis provided recommendations for improving management strategies to support thriving primary healthcare nurses.

RESULTS

The vitality component of thriving significantly reduced burnout and intention to leave organization and profession. In contrast, the learning component of thriving had a significant positive effect on burnout. The key factors that support thriving at work are empowering leadership and perceived organizational supports (decreases burnout and intention to leave organization and profession through enhanced vitality). Recommendations for improving thriving were made in eight key areas: communication, effective management, professional development, scope of practice, autonomy, effective orientation, reward and work-life balance.

CONCLUSIONS

Vitality is important in reducing burnout and turnover intentions. While learning was identified as increasing burnout, professional development and training for managers were identified as essential. Hence, the vitality dimension of the thriving at work construct should be studied at the dimension level, but more research is needed into the impact of learning on thriving over time. Primary healthcare nurses have identified that empowering leadership and perceived organizational support are critical factors in supporting them to thrive, and they provide specific recommendations for managers to improve these factors in the clinical setting.

NO PATIENT OR PUBLIC CONTRIBUTION

This study collected data from Registered Nurses only.

WHAT IS ALREADY KNOWN

A plethora of existing research focuses on resilience in nurses rather than thriving at work. Enabling employees to thrive at work contributes to improved well-being and sustainable organizational performance.

WHAT THIS PAPER ADDS

Empowering leadership and perceived organizational support are the key factors that support primary healthcare nurses to thrive at work. The vitality dimension of the thriving at work construct should be studied at the dimension level, and further research is needed into the impact of learning on thriving over time. Primary healthcare nurses recommend that managers focus on improving communication, management efficiency, professional development, scope of practice, autonomy, orientation, reward and work-life balance.

Authentic Leadership Behaviors and Thriving at Work: Empirical Evidence From The Information Technology Industry in Australia

Authentic leaders display an exceptional level of integrity and honesty, a high level of awareness and responsibility as well as a commitment to achieving their goals; as a result, they develop more trusting relationships with their employees, which could be translated into many positive outcomes, such as enhancing the ability to thrive at work. The present study aims to determine the role of authentic leadership´s (AL's) four dimensions (self-awareness, relational transparency, balanced processing, and internalized moral perspective) in fostering an environment that offers workers the opportunity to do well, including in terms of two related elements (vitality and learning). An online questionnaire was conducted to collect data from a sample of 402 participants from the information technology (IT) industry in Australia. The study used WarpPLS software to analyze the collected data by the structural equation model. According to the results, balanced processing of AL has a positive and significant effect on two aspects of thriving at work, namely vitality and learning, Moreover, the internalized moral perspective inherent in the aforementioned phenomenon affects learning. The current study is novel as it is among examples of pioneering research that employ the path model, and it uses multi-dimensional structures to examine authentic leadership and thriving at work in the workplace. The research also discusses theoretical contributions, managerial implications, and limitations along with future study directions.

Mental health in athletes: Does authentic leadership matter?

Recent research has attested to the prevalence of mental health issues in sport, and the need to identify factors that could promote athletes' mental health. In this study, we investigated: (a) whether authentic leadership is associated with athletes' mental health directly and indirectly via psychological capital and prosocial and antisocial behaviour experienced from one's teammates; and (b) whether the hypothesized model testing these relationships is the same in higher versus lower competitive level athletes. We examined two dimensions of mental health, namely positive mental health and mental illness. A total of 751 athletes (Mage = 22.92, SD = 8.53; 294 female) from a range of sports completed a multi-section questionnaire administered via an online survey. Path analysis showed that authentic leadership was positively related to positive mental health via psychological capital and prosocial behaviour and negatively linked to mental illness via psychological capital and antisocial behaviour. The effects of authentic leadership on positive mental health via prosocial teammate behaviour and subsequently psychological capital, and on mental illness via prosocial teammate behaviour, were stronger in higher compared to lower competitive level athletes. The findings suggest that by adopting an authentic leadership style coaches could strengthen athletes' positive mental health and protect them from mental illness. This may happen by increasing athletes' psychological capital and prosocial behaviour within the team and decreasing antisocial behaviour within the team.

Impact of authentic leadership on nurses' well-being and quality of care in the acute care settings

INTRODUCTION

Both nurses' well-being and quality of care are top priorities of the healthcare system. Yet, there is still a gap in understanding the extent and how authentic leadership influences them. This information is needed to inform the development of effective interventions, organizational practices, and policies. Thus, this study aimed to test the mechanism by which nurses' perception of their managers' authentic leadership impacts nurses' well-being and perception of quality of care, given the role of the nursing practice environment and nurses' psychological capital.

DESIGN

A cross-sectional design was used.

METHODS

This study recruited a random sample of 680 nurses from six hospitals in Saudi Arabia. A final sample of 415 completed the surveys, with a response rate of 61%. Structural equation modeling was performed to test the hypothesized model.

RESULTS

The study showed that nurses' perceptions of authentic leadership in their managers positively and directly affect their perceptions of quality of care but do not directly affect nurses' well-being. Both the nursing practice environment and psychological capital fully mediated the relationship between authentic leadership and nurses' well-being. However, the nursing practice environment partially mediated the relationship between authentic leadership and perceptions of quality of care.

CONCLUSION

The findings contribute to understanding the crucial role of authentic leaders' style in nurses' well-being and quality of care through its positive impact on the nursing practice environment and psychological capital.

CLINICAL RELEVANCE

Designing interventions and policies that specifically target nursing managers' authentic leadership style has implications for enhancing nurses' well-being and the quality of patient care. Institutional measures are needed to help leaders practice an authentic leadership style to create a positive nursing practice environment and cultivate nurses' psychological capital, both of which contribute to nurses' well-being and attaining a better quality of care. Further work is required to highlight the outcomes of implementing an authentic leadership style relevant to other leadership styles.

Impact of confrontation to patient suffering and death on wellbeing and burnout in professionals: a cross-sectional study

BACKGROUND

Palliative care and oncology generate a risk of burnout and psychological distress in professionals. The purpose of this study is to identify both psychopathological and positive factors related to mental health at work. It aims (i) to explore the extent to which these professionals are confronted with suffering, illness, and death; and to explore the prevalence of psychological distress and/or burnout, (ii) to identify potential determinants of burnout and psychological wellbeing at work, (iii) to develop an integrative model of mental health; and to identify frequency and impact of confrontations with death, and (iv) to identify profiles of professionals are at risk of developing a mental health disorder or, conversely, characterized by wellbeing.

METHODS

A cross-sectional questionnaire study was conducted in palliative care and oncology evaluating confrontations with death, coping, burnout, psychological distress, personality, self-esteem, well-being and meaning at work. Regressions, clustering, and structural equation modeling analyses were performed.

RESULTS

109 professionals participated (58% from oncology and 42% from palliative care), of which 79% were female, and 65% were between 30 and 49 years old. Aim i: 30% witnessed an intolerable suffering at least 9 times a month, 45% reported moderate to high levels of burnout, 39% suffered from anxiety and 11% from depression. Aim ii: the determinants of burnout were the personality traits conscientiousness and neuroticism, low meaning of work, and low wellbeing (R2 = 0.44). The determinants of wellbeing were work meaning, depersonalization, self-esteem, fulfillment and low emotional exhaustion (R2 = 0.71). Aim iii: the integrative model included both well-being (self-esteem, conscientiousness) and psychopathology (neuroticism, anxiety) parameters, and strongly satisfied the standard SEM goodness of fit indices (e.g., CFI, IFI, and TLI ≥ 0.95). Aim iv: three profiles were identified: (a) a "distressed profile" with a majority of professionals at the patient's bedside, (b) a "disengaged profile" with professionals working as second-line consultants, (c) a "wellbeing profile" contains profiles of caregivers insensitive to psychological distress and with a high level of positive Impact of confrontation on different areas of their lives.

CONCLUSIONS

An integrative approach is essential to understand the full range of mental health issues for professionals. Meaning of work is a key factor in professional interventions that should primarily affect front-line professionals with limited experience.

Organizational factors to optimize mental health nurses' wellbeing in the workplace: An integrative literature review

Mental health nursing is a privilege and a rewarding profession. There has been a call for transformational change in mental health services to improve outcomes for the people of New Zealand, with mental health nurses integral to this. However, with predicted nursing shortages, high levels of burnout, and increasing demands in the workplace, an organizational focus on wellbeing for mental health nurses is needed to sustain the workforce, implement change and improve outcomes for people using mental health services. An integrative review of the literature was undertaken to explore how organizations can optimize mental health nurses' wellbeing in the workplace and to identify measures for organizations to support mental health nurses' wellbeing with a focus on New Zealand. Seven articles were included in this review after a search, data extraction and evaluation. Data were synthesized and categorized using thematic analysis. The findings indicate organizations can invest in several initiatives to enhance mental health nurses' wellbeing in the workplace. These include professional development, skills to build resilience, enabling time to reflect on practice, enhancing professional supervision, having the right managerial support and focusing on individual's strengths. Organizations need to prioritize mental health nurses' wellbeing by embedding the practical strategies this review identified and by addressing organizational barriers to wellbeing. Organizations should consider implementing multileveled organizational wellbeing initiatives to nurture and grow the New Zealand mental health nursing workforce which in turn will contribute to quality care and enable mental health nurses to have long meaningful careers. Time, investment and resources are essential for these initiatives to be effective.

Toxic leadership, mental well-being and work engagement among nurses: a scale adaptation study and structural equation model approach

PURPOSE

Although the background on positive and supportive leadership styles and their positive effects is constantly increasing, it is known that negative and destructive leadership styles are less researched. Thus, examining the toxic leadership behaviors of nurse managers and the effects of these on nurses has a critical significance. When the measurement tools evaluating toxic leadership are examined, it is seen that there is a need for measurement tools that evaluate the toxic leadership behaviors of nurse managers. This study's purpose is to psychometrically examine the Turkish version of the Toxic Leadership Behaviors of Nurse Managers (ToxBH-NM-TR) Scale and test the hypothesized conceptual model that includes the relationships between toxic leadership, mental well-being and work engagement.

DESIGN/METHODOLOGY/APPROACH

This quantitative research was carried out in psychometric, correlational and cross-sectional design. A total of 559 nurses were included in the study by using the convenience sample method. The ToxBH-NM-TR Scale, Warwick-Edinburg Mental Well-Being Scale and Utrecht Work Engagement Scale (UWES) were used to measure the latent variables of the study. The data were collected between June and October 2020 with the online survey method. IBM SPSS Statistics 24 and Amos 21 statistical programs were used to analyze the data.

FINDINGS

The scale-content validity index of the ToxBH-NM-TR was 0.88. Confirmatory factor analysis results showed that the fit indices were acceptable. The ToxBH-NM-TR had high internal consistency and temporal stability. In addition, the relationships between the latent variables of the study were in the expected direction and statistically significant (p < 0.001). The hypothesized conceptual model showed an acceptable or good fit to the data. Mental well-being partially mediated the relationship between toxic leadership and work engagement. The study showed that the ToxBH-NM-TR is a valid and reliable instrument and provided evidence that confirmed the hypothesized conceptual model.

RESEARCH LIMITATIONS/IMPLICATIONS

The first of these is the fact that managers' toxic leadership behaviors were determined based on nurses' self-report. For this reason, participants' potential prejudices may have affected the results of the study. The second limitation concerns the data collection technique. Using face-to-face data collection techniques during the COVID-19 pandemic could create a danger/risk for the health of nurses, researchers and patients. Therefore, the nurses in this research were reached through an online survey on social media platforms. The participants of the study were limited to those who had access to social media. Finally, some socio-demographic and professional characteristics of the participants may be a confounding variable for the model. For this reason, this conceptual model needs to be validated on other samples in different countries to increase the generalizability of the research results.

PRACTICAL IMPLICATIONS

The characteristics of this leadership style should be understood, and its effects on employees and organizations should be evaluated by screening regularly to prevent the development of toxic leaders and to eliminate the harmful effects of their behavior. The nurses should respond decisively to the forces that cause them to submit in order not to encourage a toxic leadership style. Healthcare institutions should develop procedures and take a proactive approach to destructive and negative leadership behaviors and practices. In addition, nurse managers should get feedback by using informal networks and 360-degree assessment tools and evaluate whether their leadership has a toxic function by regularly screening the effects of their leadership.

ORIGINALITY/VALUE

The results of this study offer important implications for nurses, managers and healthcare institutions and can be useful in gaining awareness about the negative effects of a toxic leadership style. In addition, the study provides a valid and reliable scale that will enable the identification of managers with this leadership style to prevent the development of toxic leaders and eliminate the harmful effects of their behavior.

The mediating roles of workplace support and ethical work environment in associations between leadership and moral distress: a longitudinal study of Canadian health care workers during the COVID-19 pandemic

Introduction

The COVID-19 pandemic has resulted in heightened moral distress among health care workers (HCWs) worldwide. Past research has shown that effective leadership may mitigate potential for the development of moral distress. However, no research to date has considered the mechanisms by which leadership might have an influence on moral distress. We sought to evaluate longitudinally whether Canadian HCWs' perceptions of workplace support and ethical work environment would mediate associations between leadership and moral distress.

Methods

A total of 239 French- and English-speaking Canadian HCWs employed during the COVID-19 pandemic were recruited to participate in a longitudinal online survey. Participants completed measures of organizational and supervisory leadership at baseline and follow-up assessments of workplace support, perceptions of an ethical work environment, and moral distress.

Results

Associations between both organizational and supervisory leadership and moral distress were fully mediated by workplace supports and perceptions of an ethical work environment.

Discussion

To ensure HCW well-being and quality of care, it is important to ensure that HCWs are provided with adequate workplace supports, including manageable work hours, social support, and recognition for efforts, as well as an ethical workplace environment.

Authentic Leadership and Psychological Well-Being of Nurses: A Mediated Moderation Model

Aims. This study investigates how authentic leadership influences the psychological well-being of Australian nurses. We examined whether authentic leadership could reduce the prevalence of workplace incivility and tested whether shared values and person-organization (P-O) fit could moderate the relationship between workplace incivility and psychological well-being (PWB). A mediated moderation model underpinned by social learning theory was developed to test the influence of authentic leadership on PWB. Design. We adopted a descriptive correlational research design to test the hypothesized model with a cross-sectional sample of Australian nurses using an online survey. Data were collected across two-waves separated by a six-month interval (N = 230, response rate = 38.3%) to minimize the potential effects of common source bias. The hypotheses were tested using Hayes Process Macro (Model 14) on IBM SPSS. Results. The hypothesized model had good fit indices and supported the mediated moderation model. There was no support for the direct association between authentic leadership and PWB. The supervisor authentic leadership behavior was negatively associated with workplace incivility and PWB. The association between incivility and PWB was positively associated with P-O fit. Nurses with high P-O fit reacted strongly to the positive effect of authentic leadership in reducing workplace incivility, such that they experienced higher levels of PWB. Conclusion. Authentic leadership behavior is important in the healthcare workplace. It reduces workplace incivility and improves PWB for nurses with high levels of congruence. Implications: our study suggests that senior management should deploy strategies through which frontline supervisors can learn and enact authentic leadership behaviors. They will then be better equipped to improve the PWB of their followers by minimizing the prevalence of workplace incivility. Impact: the study found a significant indirect relationship between authentic leadership behavior and psychological well-being, as mediated by workplace incivility and moderated by person-organization fit. The findings highlight the importance of positive leadership behaviors on the well-being outcomes of nurses in Australia.

Authentic Leadership and Its Role in Registered Nurses' Mental Health and Experiences of Workplace Bullying

Introduction

Bullying is a widespread problem in healthcare organizations, resulting in nurses' poor mental health. Effective leadership, such as authentic leadership, may help to overcome this problem.

Objective

To examine the relationship between authentic leadership, workplace bullying, and nurses' mental health, controlling for demographic characteristics.

Methods

A descriptive correlational design was utilized with a sample of 170 nurses. Nurses were recruited from four private hospitals in Jordan and completed a survey about their perception of managers' authentic leadership, their experience of workplace bullying, and their mental health.

Results

About 48.8%, 25.9%, and 25.3% were categorized as "not bullied," "occasionally bullied," and "severely bullied," respectively. Participant nurses had mild depression (m = 12.11) and moderate anxiety (m = 10.92). Workplace bullying was higher among nurses who earn less than 600 Jordanian dinars and nurses working in the smallest hospital, with 130 beds. Authentic leadership explains 6% of the variance of workplace bullying, 3% of anxiety, 7% of stress, and 7% of depression above and beyond the variance explained by other variables.

Conclusions

Healthcare organizations are facing a challenge in providing a healthy work environment. Employing authentic leadership in the workplace could be one of the factors that could help in addressing this issue.

Authentic Leadership, Employee Work Engagement, Trust in the Leader, and Workplace Well-Being: A Moderated Mediation Model

Purpose

This study proposes a model based on social contagion theory to evaluate the impacts of authentic leadership on employee work engagement (WE) and trust in the leader (TL), integrating the mediating effect of TL and the moderating effect of workplace well-being (WW). Authentic leadership is disaggregated into its subscales: relational transparency (RT), internalized moral perspective (IMP), balanced processing (BP), and self-awareness (SA).

Methods

Dubai hotel employees completed 476 surveys. Applying the bootstrapping technique, SmartPLS 4 software was utilized to test the hypotheses in a mediation model.

Results

The findings indicate (1) that three subscales of authentic leadership (RT, IMP, and BP) positively impact WE; (2) that RT, IMP, and SA positively impact TL; (3) that TL positively impacts WE; (4) that TL mediates the relationship between RT, IMP, SA, and WE; (5) and that WW moderates the relationship between RT, BP, and WE.

Conclusion

Authentic leadership and its subscales are proven to be an excellent tool for achieving employee WE and TL. TL is crucial for effective hotel operation, as it impacts employee WE and acts as a mediator between three subscales of authentic leadership and WE. WW moderates the relationship between two authentic leadership subscales and WE but does not interact in the relationship between TL and WE. Both researchers and hotel managers can benefit from these new findings, which also provide a foundation on which to build future investigations.

A systematic review of the relationships between nurse leaders' leadership styles and nurses' work-related well-being

AIM

This systematic review aimed to summarize current research knowledge about the relationships between nurse leaders' leadership styles and nurses' work-related well-being.

BACKGROUND

Due to the global shortage of nurses, it is essential for nurse leaders to maximize staff retention and work-related well-being.

METHODS

Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published between 1 January 2012 and 31 December 2020 were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. Seventeen cross-sectional and follow-up studies with surveys were retained for inclusion and evaluated with the Critical Appraisal of a Survey instrument. The data were summarized narratively.

RESULTS

Three core themes of leadership styles: destructive, supportive and relationally focused, were identified, with statistically significant direct and indirect connections between nurses' work-related well-being. Well-being was mainly assessed in terms of burnout. Effects of leadership styles on work-related well-being were reportedly mediated by trust in leader, trust in organization, empowerment, work-life conflict, relational social capital, emotional exhaustion, affectivity, job satisfaction and motivation.

CONCLUSION

Nurse leaders' leadership styles affect nurses' work-related well-being. In developing intervention studies and providing training on work-related well-being, the impact of the indirect effects and the mediating factors of the leadership styles should be acknowledged.

Authentic leadership and flourishing: Do trust in the organization and organizational support matter during times of uncertainty?

Orientation: This study investigated the influence of authentic leadership on employee flourishing while considering the potential mediating effect of trust in the organization and organizational support as underlying mechanisms in an uncertain setting. Research purpose: To examine the relationship between authentic leadership and employee flourishing by evaluating the indirect effect of organizational support and trust in the organization as potential mediators. Motivation for the study: An authentic leadership approach, organizational support, and trust in the organization may influence the flourishing of employees in uncertain times. Increasing the comprehension of the possible interaction effect of organizational support and trust in the organization in the relationship between authentic leadership and employee flourishing may improve individual and organizational efficiency. Research approach/design and method: A quantitative, cross-sectional survey design was applied in this study. The sample comprised 314 employees in a noteworthy South African steel manufacturing entity. The Authentic Leadership Inventory, Workplace Trust Survey, Flourishing-at-Work Scale, and the Job Demands-Resources Scale were administered. Main findings: The findings of this study suggest that authentic leadership was a significant predictor of employee flourishing through organizational support and trust in the organization. Practical/managerial implications: This research illuminates the potential value-adding contribution of an authentic leadership style in promoting a trust-filled relationship between team members and their organization and the support they experience from their employer. Despite the prevailing precarious context, working under the mentioned conditions might result in the increased flourishing of employees. Contribution/value-add: The analyses of the mentioned relationships might assist businesses in optimizing the resources required to improve employee and organizational performance. Additionally, the exploration of organizational support in conjunction with organizational trust raises our understanding of the possible influence these elements can have in enhancing employee flourishing in the workplace.

Relationship Between Authentic Leadership, Transformational Leadership and Innovative Work Behaviour: Mediating Role of Innovation Climate

Purpose. This study aimed to demonstrate the effect of transformational and authentic leaderships characteristics of healthcare managers on employees' innovative work behavior and the mediating role of innovation climate. Methods. The study was conducted in 19 hospitals in Turkey and 263 managers participated in the study. The data were collected using the Transformational Leadership Questionnaire, the Authentic Leadership Questionnaire, Innovative Climate Assessment Tool, and Innovative Work Behavior Scale. Path analysis was performed to demonstrate the relationship between the variables. Results. When transformational and authentic leadership were put into the model separately through the innovation climate, transformational leadership had an effect of 0.39 units (0.22 units direct, 0.17 units indirect) and a uthentic leadership had a 0.44 unit (0.29 unit direct, 0.15 unit indirect) effect on innovative work behavior. When transformational and authentic leadership were put together in the model, the total (direct and indirect) effect of them increased to 0.52 units. In this case, the effect of authentic leadership characteristics of health managers on innovative work behavior of their followers (0.42 units) was greater than the effect of transformational leadership characteristics (0.10 units). Conclusions. Although both types of leadership affect innovative work behavior, authentic leadership was more effective than transformational leadership.

Authentic Leadership Questionnaire applied to Brazilian nurses: evidence of validity

OBJECTIVE

to establish the psychometric properties of the Authentic Leadership Questionnaire (ALQ) applied to Brazilian nurses.

METHOD

cross-sectional observational study with a non-probabilistic sample. The psychometric properties of the RATER and SELF versions of the ALQ were calculated using confirmatory factor analysis with the WLSMV robust estimation method. The following indices were used to assess the goodness-of-fit of the model: chi-square by degrees of freedom (χ2/df), Tucker-Lewis Index (TLI), Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Squared Residual (SRMR). Data reliability was analyzed using the ordinal coefficient alpha and composite reliability.

RESULTS

181 nurses participated of the study (female gender: 80.1%; mean age of 34.6 years; working time of less than five years: 76.3%). The complete ALQ RATER and ALQ SELF models did not present an adequate fit. Therefore, the refined models presented a better fit to the sample data (ALQ RATER: χ2/df=2.77; CFI=0.97; TLI=0.97; RMSEA=0.10; SRMR=0.05; ALQ SELF: χ2/df=2.74; CFI=0.94; TLI=0.92; RMSEA=0.10; SRMR=0.08). In the ALQ RATER model, items 1, 7 and 13 were excluded. Due to the high correlation between the factors Relational Transparency and Moral Perspective, a three-factor model based on the combination of the factors mentioned above was proposed. In the ALQ SELF model, items 2, 5, 9 and 10 were excluded. Likewise, a three-factor model based on the combination of two factors, now called Self-Awareness Balance, was proposed.

CONCLUSION

the data obtained with the Authentic Leadership Questionnaire with Brazilian nurses were valid and reliable.

The Real Deal: A Qualitative Investigation of Authentic Leadership in Irish Primary School Leaders

Recognition of the importance of authentic leadership is growing in popularity amonleadership scholars. However, little remains known about how it is valued or received among practicing school leaders. The purpose of this research was to explore the perspectives and experiences of school leaders with reference to authentic leadership in Irish primary school leaders. As this is a scoping study, a qualitative research design was adopted, using semi-structured interviews with school leaders. Core traits of self-awareness, balanced processing, relational transparency and internalized perspectives, that are associated with authentic leadership emerged as important for those interviewed. Barriers and facilitators of authentic leadership were also identified including educational policy, procedures and school culture.

Authentic Leadership Questionnaire aplicado a enfermeros brasileños: evidencias de validez

Resumen Objetivo: estimar las propiedades psicométricas del Authentic Leadership Questionnaire (ALQ) aplicado a enfermeros brasileños. Método: estudio observacional transversal con muestreo no probabilístico. Las propiedades psicométricas de las versiones RATER y SELF del ALQ se estimaron mediante análisis factorial confirmatorio con el método de estimación robusta WLSMV. Como índices de calidad de ajuste de los modelos se utilizó: razón de chi-cuadrado por grados de libertad (χ2/gl), Tucker-Lewis Index (TLI), Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA) y Standardized Root Mean Squared Residual (SRMR). La confiabilidad de los datos se analizó mediante el coeficiente alfa ordinal y la confiabilidad compuesta. Resultados: participaron 181 enfermeros (sexo femenino: 80,1%; edad media de 34,6 años; tiempo de trabajo inferior a cinco años: 76,3%). Los modelos completos ALQ RATER y ALQ SELF no mostraron un ajuste adecuado. Por lo tanto, el modelo refinado presentó un mejor ajuste para la muestra (ALQ RATER: χ2/gl=2,77; CFI=0,97; TLI=0,97; RMSEA=0,10; SRMR=0,05; ALQ SELF: χ2/gl=2,74; CFI=0,94, TLI=0,92, RMSEA=0,10, SRMR=0,08). En el modelo ALQ RATER se eliminaron los ítems 1, 7 y 13. Debido a la alta correlación entre los factores Transparencia Relacional y Perspectiva Moral, se propuso un modelo de tres factores basado en la unión de los factores mencionados anteriormente. En el modelo ALQ SELF se eliminaron los ítems 2, 5, 9 y 10. Asimismo, se propuso un modelo trifactorial basado en la unión de dos factores, ahora denominado Equilibrio de Autoconciencia. Conclusión: los datos obtenidos con el Authentic Leadership Questionnaire con enfermeros brasileños fueron válidos y confiables.

Authentic Leadership Questionnaire applied to Brazilian nurses: evidence of validity

Objective:

to establish the psychometric properties of the Authentic Leadership Questionnaire (ALQ) applied to Brazilian nurses.

Method:

cross-sectional observational study with a non-probabilistic sample. The psychometric properties of the RATER and SELF versions of the ALQ were calculated using confirmatory factor analysis with the WLSMV robust estimation method. The following indices were used to assess the goodness-of-fit of the model: chi-square by degrees of freedom (χ²/df), Tucker-Lewis Index (TLI), Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Squared Residual (SRMR). Data reliability was analyzed using the ordinal coefficient alpha and composite reliability.

Results:

181 nurses participated of the study (female gender: 80.1%; mean age of 34.6 years; working time of less than five years: 76.3%). The complete ALQ RATER and ALQ SELF models did not present an adequate fit. Therefore, the refined models presented a better fit to the sample data (ALQ RATER: χ²/df=2.77; CFI=0.97; TLI=0.97; RMSEA=0.10; SRMR=0.05; ALQ SELF: χ²/df=2.74; CFI=0.94; TLI=0.92; RMSEA=0.10; SRMR=0.08). In the ALQ RATER model, items 1, 7 and 13 were excluded. Due to the high correlation between the factors Relational Transparency and Moral Perspective, a three-factor model based on the combination of the factors mentioned above was proposed. In the ALQ SELF model, items 2, 5, 9 and 10 were excluded. Likewise, a three-factor model based on the combination of two factors, now called Self-Awareness Balance, was proposed.

Conclusion:

the data obtained with the Authentic Leadership Questionnaire with Brazilian nurses were valid and reliable.

Effect of Chief Executive Officer’s Sustainable Leadership Styles on Organization Members’ Psychological Well-Being and Organizational Citizenship Behavior

Situational leadership theory and the contingency approach of leadership were utilized and applied based on situational theory. Based on a total of four foundational theories, that is, bottom-up spillover theory, theories of prosocial behavior, and so on, this study empirically analyzed what influence a chief executive officer’s (CEO’s) sustainable leadership styles (servant, ethical, and authentic leadership) have on the psychological well-being and organizational citizenship behaviors of organization members. The study was conducted on adult employees of midsized or larger companies (including subsidiaries) across four countries: South Korea, the United Kingdom, the United States, and South Africa. Data were obtained from 649 adult employees. SmartPLS was used to conduct structural equation modeling analysis of the data. The results were as follows: (1) CEOs’ servant and authentic leadership styles had statistically significant positive (+) effects on employees’ psychological well-being; however, ethical leadership did not. (2) CEOs’ ethical leadership had a statistically significant (+) effect on employees’ organizational citizenship behavior; however, servant and authentic leadership did not. (3) Employees’ psychological well-being had a statistically significant (+) effect on organizational citizenship behavior. CEOs are attracting more attention than ever, leading companies in today’s rapidly changing times. This suggests that it is necessary to comprehend principles that show when, where, and how important leaders are and sustainable leadership styles that can increase their chances of success. Moreover, this study derived constructive implications that a leader can overcome today’s challenges through sustainable leadership styles.

Work community factors, occupational well-being and work ability in home care: A structural equation modelling

Aim

To examine how work community factors are related to occupational well‐being and work ability, and how occupational well‐being is related to work ability.

Design

A cross‐sectional study was conducted among home care workers in one municipality in Finland.

Methods

A self‐administered survey on work and well‐being was filled out by 167 employees working two shifts in 2019. Structural equation modelling was used to analyse the association between work community factors, occupational well‐being and work ability.

Results

The only work community factor directly affecting Occupational well‐being was Information and work organization; the effect of the other two factors, Social support and Influence on work shifts, was indirect. All work community factors indirectly affected Work ability. Home care should emphasize information provision and work organization with optimal time use. This requires social support, a well‐functioning work atmosphere and providing employees with opportunities for influence and participation.

The relationship of nurses' psychological well-being with their coronaphobia and work-life balance during the COVID-19 pandemic: A cross-sectional study

AIMS AND OBJECTIVES

This study aimed to determine the relationship of nurses' psychological well-being with their coronaphobia and work-life balance during the COVID-19 pandemic.

BACKGROUND

COVID-19 is a global life-threatening disease. The COVID-19 pandemic negatively affects nurses' mental health. No studies have been conducted to determine the factors that affect nurses' psychological well-being during the COVID-19 pandemic in Turkey. If nurses' psychological well-being is impaired during the COVID-19 pandemic, the quality of nursing care and the nurses' performance may be negatively affected.

DESIGN

This is a descriptive, correlational and cross-sectional study. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) reporting guideline checklist for cross-sectional studies was used for reporting in this study.

METHODS

The study population consisted of the nurses working in a Health Application and Research Center in Turkey. Data were collected using Google forms between June-August 2020. The study sample consisted of 295 nurses who voluntarily agreed to participate in the study and used social media tools. The data were collected using a Sociodemographic Characteristics Form, the COVID-19 Phobia Scale (C19P-S), the Work-Life Balance (WLB) Scale and the Psychological Well-Being (PWB) Scale. The factors that affect psychological well-being were determined using the stepwise multiple linear regression analysis.

RESULTS

The nurses' work-life balance and psychological well-being were negatively affected during the COVID-19 pandemic. Their COVID-19 phobia was mild-to-moderate level. The nurses' psychological well-being was significantly affected by the variable of neglecting life the most, followed by coronaphobia and work-life balance, which explain 75% of the variance.

CONCLUSIONS

This study shows that coronaphobia experienced by nurses and work-life balance was related to their psychological well-being during the COVID-19 pandemic. Managers should take measures (regulating the working hours) to decrease nurses' COVID-19 phobia (education, counselling or psychotherapy) and work-life imbalance.

RELEVANCE TO CLINICAL PRACTICE

Nurses' peers, managers and organisations need to take into account nurses' negative emotions and behaviours and organise training programmes to help them overcome their fears, communicate clearly and provide for their basic needs. Organisations, including managers and nurses, must recognise the distress being experienced by their nurses and create safe environments in which to have significant conversations. Nurses' mental health can be screened regularly by multidisciplinary teams, psychological support can be provided when required, and working hours can be regulated through appropriate shifts and breaks that will ensure work-life balance during and after the COVID-19 pandemic. Nurses receiving emotional support from their families and friends (via chatting and sharing troubles) can also contribute positively. These measures and regulations will positively affect nurses' psychological well-being and contribute to an increase in the quality of care and nurses' performance.

Creating Empowering Conditions for Nurses with Workplace Autonomy and Agency: How Healthcare Leaders Could Be Guided by Strengths-Based Nursing and Healthcare Leadership (SBNH-L)

The COVID-19 pandemic had the unintended consequence of placing nurses in the spotlight because their knowledge and skills were in desperate need. While it will be years until we fully understand the impact that this pandemic has exacted on the nursing workforce, early studies have found that nurses have been traumatized by this event and many intend to leave the profession This seismic event only further exacerbated an already vulnerable and strained nursing workforce that pre-existed worldwide prior to COVID-19. The pandemic also highlighted the many challenges facing nursing leadership, in particular, how to create conditions to maintain and sustain a healthy nursing workforce. Nurses’ job satisfaction has emerged as an important predictor of whether nurses remain in an organization and stay in the profession. When examined more closely, job satisfaction has been related to nurses feeling empowered to exercise autonomy over their own practice and having agency. Autonomy and agency, in turn, are affected by their managers' leadership styles. Leaders are instrumental in setting the tone and creating the climate and culture that either values or devalues autonomy and agency. To help leaders create empowering conditions, we have developed a guide for leaders. This guide, based on the value-driven philosophy of leadership called Strengths-Based Nursing and Healthcare Leadership (SBNH-L), is founded on principles of person-centered, empowerment, relationship-focused, and innate capacities (ie, strengths) that are operationalized in eight core values. This guide can be used by leaders as their roadmap to create empowering workplace conditions that value and facilitate nurses’ autonomy and agency.

Leader–member exchange as a mediator of the relationship between authentic leadership and employee creativity

The purpose of this study was to acquire meaningful insights on the determinants of creativity with a meticulous examination, and by dint of that, expand the concerned literature. To accomplish the same, a conceptual model that includes authentic leadership, employee creativity, and leader–member exchange (LMX) was methodically developed and evaluated. This research is a quantitative study incorporating a self-report survey. The data were amassed from hotel employees in Northern Cyprus. Data from 314 applicable surveys were analyzed using Statistical Package for the Social Sciences (SPSS)-22 and analysis of a moment structures (AMOS)-18 programs. Based on the findings, it can be deduced that authentic leadership has a considerable impact on employee creativity, while LMX plays an intermediary role in this relationship. The results of this study are useful and relevant for both researchers and policymakers.

An explanatory model of authentic leadership, flourishing and work-family balance of nurses in French hospitals

PURPOSE

This study aims to investigate the relationship between a positive leadership style [i.e. authentic leadership (AL)] and nurses' psychological health (i.e. nurses' flourishing and satisfaction with work-family balance), including psychological capital (PsyCap) as a mediational variable.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional study was conducted with a self-report questionnaire including 1,076 nurses from public and private hospitals in France.

FINDINGS

Structural equation modeling results revealed that AL is related to nurses' flourishing and satisfaction with work-family balance and that PsyCap acted as a partial mediator between this leadership style and positive outcomes.

PRACTICAL IMPLICATIONS

This research indicated that hospitals can enhance nurses' psychological health not only in their work but also in their lives in general by improving leaders' authentic management style and developing PsyCap (e.g. staffing, training and development).

ORIGINALITY/VALUE

An original feature of this paper concerns its focus on the mediating role of PsyCap in the relationship between AL and these positive outcomes. Moreover, this study underlined the influence of leadership style on nurses' psychological health beyond occupational health. The research makes a valuable contribution to the existing AL literature by establishing a new explanatory model of AL and nurses' psychological health in the French context. It also highlights the interest in developing this leadership style in health-care settings.

Role of leader and followers' well-being, engagement and the moderating role of psychological capital

Purpose

The present study had two objectives, first objective was to examine the impact of authentic leadership on followers' well-being and work engagement. The second objective was to examine the moderating role of authentic leadership and followers' outcomes. Despite an immense amount of research on authentic leadership, how and when authentic leadership is more or less effective in promoting the well-being and work engagement of followers is little known. Drawing from the conservation of resource theory, the authors draw upon the interactionist perspective and suggest psychological capital is a dispositional boundary condition that influences the effectiveness of authentic leadership in promoting well-being and work engagement of followers.

Design/methodology/approach

Using cross-sectional research design data were collected from 547 team members nested under 118 team leaders from the financial sector in India. The study used structural equation modelling and hierarchical regression analysis to examine the hypothesised relationships.

Findings

The findings from the study revealed that authentic leadership predicts followers' psychological well-being and work engagement. Also as proposed, the study found psychological capital moderates the relationship between authentic leadership and the well-being of followers. However, the study found psychological capital does not moderate the relationship between authentic leadership and followers' work engagement.

Research limitations/implications

The study has helped expand the nomological network of authentic leadership by examining the authentic leadership model with followers' psychological well-being and work engagement. Further, the findings suggest that psychological capital being a dispositional boundary condition, it plays a contingent role in explaining the role of authentic leadership in promoting the well-being of followers.

Practical implications

The results offer strong practical implications that can be considered as the basis for actionable strategies by the human resource management system of the organisation to enhance authentic leadership and psychological capital.

Originality/value

The study is unique in its scope and contribution, as it tries to develop an understanding of how and when authentic leadership promotes psychological well-being and work engagement by considering an interactionist approach in the Indian context.

Authentic leadership and employee engagement: The role of employee well-being

BACKGROUND/OBJECTIVE: To understand how perceived authentic leadership translates into work engagement, this study hypothesize that perceived authentic leadership facilitates positive conditions of well-being, which in turn predict employee work engagement. This study asserts that each of the three mediating paths comprising life, workplace, and psychological well-being, is expected to mediate the relationship based on the conservation of resources (COR) theory and relational perspective. METHODOLOGY: Data were collected from the two-wave survey of 150 full-time employees and analyzed using the PROCESS macro in SPSS. An additional analysis to identify well-being sentiment was conducted using NodeXL with Twitter data. RESULTS: The results indicated only workplace well-being has a mediational effect between perceived authentic leadership and work engagement. The additional analysis found that workplace well-being is the central tenet of interaction between people in social media. CONCLUSIONS: These findings demonstrate the importance of workplace well-being in promoting work engagement.

Authentic leadership and organizational citizenship behaviour: the role of psychological capital

Purpose

The purpose of this paper is to examine the direct and indirect effects of authentic leadership on organizational citizenship behaviour (OCB) with the presence of psychological capital as a mediating factor.

Design/methodology/approach

This quantitative research was conducted among 396 front-line employees in six public sector organizations in Sri Lanka. A survey method was employed to collect the data.

Findings

It was found that psychological capital partially mediates the relationship between authentic leadership and OCB. In other words, the relationship between authentic leadership and OCB is both direct and indirect, mediated though psychological capital.

Research limitations/implications

The authenticity of leaders' conduct, psychological capabilities and the outcomes of the performance, are rooted in and reinforced by the culture of the particular organization; hence, the findings should be interpreted cautiously.

Practical implications

The framework of the present study provides a guideline to the top management of the public sector in Sri Lanka to design leadership programs that can develop authentic leaders.

Originality/value

The direct and indirect relationships established between authentic leadership and psychological capital and OCB signifies the critical importance of authentic leadership in the development of psychological capital and OCB among employees.

An Integrative Review of How Healthcare Organizations Can Support Hospital Nurses to Thrive at Work

Background: Solutions that address the anticipated nursing shortage should focus on thriving at work: a positive psychological state characterized by a sense of vitality and learning, resulting in higher levels of work engagement, commitment, and wellbeing. Purpose: To synthesize international evidence on organizational factors that support hospital nurse wellbeing and to identify how the Social Embeddedness of Thriving at Work Model can support health managers to develop management approaches that enable nurses to thrive. Method: Conduct an integrative review of literature published between 2005–2019. Results: Thematic analysis identified five key themes: (1) Empowerment; (2) Mood of the organization; (3) An enabling environment; (4) Togetherness with colleagues; and (5) Leaders’ connectivity. Conclusions: The Social Embeddedness of Thriving at Work Model supports managers to develop management approaches that enable their nurses to thrive. Health managers should consider strategies to support nurses to thrive at work to improve nurse work engagement and wellbeing.

Empirical Research in Colombian Services Sector: Relation between Transformational Leadership, Climate and Commitment

The objective of this study is to analyze the relationship between the variables of transformational leadership, climate and commitment in a sample of 319 workers of a multinational organization in the Colombian Services Sector. For data collection, we used the Multifactor Leadership Questionnaire (MLQ), the climate/culture questionnaire FOCUS-93 and the Intellectual, Social and Affective Commitment Scale (ISA). Data were processed with SPSS 23 and AMOS 22 for modeling with structural equations. In the path diagram, calculated according to the indicators of structural adjustments, variances were obtained for the dimensions of organizational commitment. The resulting model presented favorable adjustment indicators as evidenced in the results, and the relationship between commitment and climate was significant (β = 4.61; p = 0.001), as well as between climate and commitment (β = 0.018; p = 0.001). However, the relationship between transformational leadership and commitment was not direct but mediated through organizational climate.

Coach Mindset: Preparing Leaders to Create a Climate of Trust and Value

Health care, like other industries, is faced with increased competition from both traditional and nontraditional players. A top challenge facing organizations is the ability to effectively develop leaders to lead in an increasingly volatile, uncertain, complex, and ambiguous environment. Organizations with effective leaders have been shown to outperform their peers. Transforming leadership to include the adoption of a coach mindset that creates a climate of trust, enables improved engagement and performance of nurses (employees) and teams, while also accelerating the creation of value and outcome improvements for patients, is a pursuit worthy of leadership attention. The purpose of this article is to describe a conceptual framework, define a coach mindset, and describe the mediating antecedents and consequences that result when leaders adopt a coach mindset as a leadership competency. This work can be applied as a part of leadership development implementation and adoption-related activities and used in future research.

Effect of authentic leadership on newly qualified nurses: a scoping review

Authentic leadership is a relatively new concept in nursing in which authentic leaders are anchored by their deep sense of self, and know where they stand on important issues, values and beliefs. While there is considerable literature available on authentic nurse leadership, little has been written regarding its effect on newly qualified nurses. Therefore, the author undertook a scoping review of the literature on authentic leadership and newly qualified nurses. A total of 12 articles were found through database searches and included in the review. Thematic analysis of the articles identified two primary themes of 'well-being at work' and 'work environment', and two lesser themes of 'transition from student to nurse' and 'retention'. The scoping review found that authentic leadership has a positive effect on newly qualified nurses and that authentic leaders can develop genuine and trusted relationships, thereby promoting a supportive work environment for newly qualified nurses.

Drivers and barriers in the practice of health-specific leadership: A qualitative study in healthcare

BACKGROUND

Managers have a significant impact on the health and well-being of employees, particularly when the managers lead in a health-specific way and intentionally foster their employees' health. However, the data on contextual and individual factors influencing the practice of health-specific leadership is at present limited.

OBJECTIVE

To survey the experiences of healthcare managers with health-specific leadership skills and identify the drivers and barriers in the practice of health-specific leadership.

METHODS

Semi-structured interviews were conducted with 51 managers from 18 geriatric-care facilities in Germany, between November 2014 and February 2015. The interviews were analysed through qualitative content analysis.

RESULTS

In their reports, managers mentioned several drivers and barriers in the practice of health-specific leadership. These drivers and barriers were found at the leader level, the employee level, and the organizational level. The factors identified relate to the theoretical aspects of health-specific leadership: health value, health awareness, health behaviour, and role modelling.

CONCLUSION

For successful practice of health-specific leadership, the findings suggest a more holistic approach for worksite health promotion. Managers should promote personal initiative that benefit employee health, encourage their employees to exhibit healthy behaviour themselves, address organizational resources and restrictions, and gain competencies in change management.

Authentic Leadership and Creativity: Moderated Meditation Model of Resilience and Hope in the Health Sector

Authentic leaders are recognized as self-aware individuals who act according to their values and beliefs in the organization. Most of the studies have acknowledged the positive impact of authentic leaders on followers. However, the characteristics of an authentic leader, such as making decisions according to his/her own belief system, might negatively affect the followers. The current study aims to investigate the relationship of authenthic leadership/leaders (AL) and creativity through the mediating role of resilience. In this study, data were collected from 172 nurses working at public hospitals using a three-wave, time-lagged study design. The findings show that authentic leadership significantly predicts hope among employees. A hopeful individual positively reflects creativity in the workplace and also mediates the relationship between authentic leadership and creativity at workplace. These results report that authentic leadership impacts hope in a positive manner; thereby, increasing the level of creativity of nurses at the workplace. The study also highlights that if a resilient nurse is supervised by an authentic leader, it decreases hope and eventually creativity at work. The paper elaborates theoretical and practical implications for the health care sector along with limitations and direction for future research.

Positivity at the workplace

Purpose

Recognising the value of positive organisational behaviour at the workplace, this paper aims to provide a major review of the current state of research on positivity, and subsequently proposes new pathways for more theory building relating to important constructs conceptually related to positivity. Following the integration of emerging but disparate research on workplace positivity and related concepts, the paper develops a conceptual framework depicting the relationships amongst authentic leader behaviours, organisational virtuousness, psychological capital, thriving and job performance.

Design/methodology/approach

The paper offers a systematic critical review of published studies representing the literature addressing authentic leadership, organisational virtuousness, thriving, psychological capital and job performance. The paper relied on computerised keyword searches in the main business source databases of Emerald, ProQuest, ScienceDirect, EBSCOhost and SpringerLink.

Findings

This paper leads to a conceptual framework proposing direct relationships between authentic leadership, psychological capital, organisational virtuousness and job performance. Further, authentic leadership is proposed to potentially nurture organisational virtuousness, psychological capital, employee thriving and job performance, given the theoretical linkages between these conceptually relevant variables related to positivity. Additionally, organisational virtuousness and psychological capital are projected to mediate the relationship between authentic leadership and employee thriving. Finally, organisational virtuousness, psychological capital and employee thriving are designated as mediators of the relationship between authentic leadership and job performance.

Research limitations/implications

This paper proposes a conceptual framework focusing on one form of positive leader behaviour and also assumes specific causal pathways using a positivistic research approach to understanding the leadership–performance relationship. The paper did not examine all possible antecedents of positivity at the workplace.

Practical implications

The proposed conceptual framework should form the basis of many organisational interventions, especially in relation to boosting authentic leadership, organisational virtuousness, psychological capital, employee thriving and job performance. By suggesting the association between authentic leadership, psychological capital and organisational virtuousness, this paper highlights potential benefits from effective leaders’ commitment to enhancing psychological capital and organisational virtuousness and engendering thriving behaviour and job performance.

Originality/value

This novel paper has the potential to stimulate the empirical studies on workplace positivity through the association of authentic leadership, psychological capital, organisational virtuousness and thriving.

Relationship between authentic leadership and nurses' intent to leave: The mediating role of work environment and burnout

AIM

The aim of this study was to explore the mediating effects of work environment and burnout on the relationship between authentic leadership and the intention of nurses to leave their job.

BACKGROUND

Authentic leadership can contribute to a good work environment. Burnout is a critical factor that affects nurses‧ intent to leave. The mediating roles of work environment and burnout on the relationship between authentic leadership and intent to leave is unclear.

METHODS

A cross-sectional design was used, and 946 nurses from three different levels of hospital (medical center, regional, and district), defined in terms of the number of beds and type of medical care provided, responded to four self-report questionnaires.

RESULTS

Work environment and burnout mediated the effect of authentic leadership on intent to leave among nurses. The mediating effects of burnout on authentic leadership was present both for junior (β = 0.073) and senior (β = 0.081) nurses.

CONCLUSION

Authentic leadership can affect nurses‧ intent to leave but the work environment and burnout are important mediators of this influence.

IMPLICATIONS FOR NURSING MANAGEMENT

Administrators should adopt authentic leadership practices and make efforts to improve the work environment and decrease burnout in order to decrease nurses‧ intent to leave.

The perceived and experienced role of the nurse unit manager in supporting the wellbeing of intensive care unit nurses: An integrative literature review

INTRODUCTION

The number of patients requiring admission into intensive care units (ICUs) is increasing worldwide. Concurrently, recruitment and retention of the ICU nursing workforce is becoming a major challenge due to the high intensity environment, heavy workloads, and decreasing nurse wellbeing. Nurse unit managers play a vital role in promoting and supporting ICU nurse wellbeing, yet little is known about perceptions and experiences of this role.

OBJECTIVES

To examine the perceived and experienced role of the nurse unit manager in supporting the wellbeing of ICU nurses.

REVIEW METHODS

A comprehensive review of the literature was undertaken using Whittemore and Knafl's five stage approach: (i) problem identification, (ii) literature search, (iii) quality appraisal, (iv) data analysis, and (v) presentation of findings.

DATA SOURCES

The following databases were searched for literature published between January 2007 and December 2017: Cumulative Index to Nursing and Allied Health Literature, Cochrane, Informit, Joanna Briggs Institute Library of Systematic Review, ProQuest, PubMed, Scopus, and Wiley online library digital databases. Variations and synonyms of key words included: nurse unit manager, ICU, compassion fatigue, burnout, stress, job satisfaction, bullying, wellbeing, and work environment.

RESULTS

Rigour and trustworthiness of the included studies were assessed using the Critical Appraisal Skills Program qualitative research checklist,⁷¹ a modified Critical Appraisal Skills Program Cohort study checklist for quantitative research,⁷² and the Mixed Methods Appraisal Tool for mixed-method studies.⁷³ The critical review guidelines by Shenton⁷⁴ and Polit and Beck⁷⁵ were also used to make judgements about the worth of the evidence. All of the 11 qualitative studies provided moderate to strong evidence. The overall quality of the quantitative studies was lower, with three of seven studies providing only adequate evidence. The majority of the 19 included studies represented the voices of ICU nurses. Three major themes emerged from the analysis; '1) building professional relationships', '2) leading the way' and '3) satisfying the needs of ICU nurses'.

CONCLUSION

Nurse unit manager behaviours clearly affect the wellbeing of ICU nurses. However, the role of supporting ICU nurses is complex and challenging. More research is needed to investigate the needs of ICU nurses and the facilitators and barriers nurse unit managers face when supporting the wellbeing of nurses in their unit.

Organizational Factors and Burnout of Perioperative Nurses

BACKGROUND

Knowing the organizational factors that predict burnout in perioperative nurses is paramount for improving the care of patients and promoting nurses' psychosocial well-being and health.

OBJECTIVE

To determine the influence of organizational factors of the perioperative nurse's work environment on the three burnout dimensions: emotional exhaustion, despersonalization, and personal accomplishment.

METHOD

A cross-sectional study was conducted among 136 nurses in a perioperative care unit at a university hospital in Barcelona, Spain. Data were collected using a demographic data form, and the Spanish versions of the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory.

RESULTS

Findings showed emotional exhaustion in 43% (56) of nurses, depersonalization in 21% (28), and reduced personal accomplisment in 53% (69). The degree of general burnout was moderate.The work environment was considered unfavourable as only one factor of five was favourable (Nursing foundations of quality care). Multiple regression analyses showed three organizational factors were associated with all three dimensions of burnout: "Nurse manager ability, leadership, and support of nurses"; "Staffing and resources adequacy"; and "Nursing foundations of quality care".

CONCLUSIONS

In this study three organizational factors played a significant role in predicting burnout among perioperative nurses. We recommend hospital management implement policies to improve these organizational factors. Promoting positive leadership styles, providing necessary resources, and creating a positive climate in the work environment could increase psychosocial wellbeing and decrease burnout among perioperative nurses.

Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review

BACKGROUND

Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments.

METHODS

The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers.

RESULTS

A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes.

CONCLUSIONS

The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to enhance nursing job satisfaction, retention, work environment factors and individual productivity within healthcare settings.

Use of instruments to evaluate leadership in nursing and health services

OBJECTIVE

To identify the available scientific evidence about the use of instruments for the evaluation of leadership in health and nursing services and verify the use of leadership styles/models/theories in the construction of these tools.

METHOD

Integrative literature review of indexed studies in the LILACS, PUBMED, CINAHL and EMBASE databases from 2006 to 2016.

RESULTS

Thirty-eight articles were analyzed, exhibiting 19 leadership evaluation tools; the most used were the Multifactor Leadership Questionnaire, the Global Transformational Leadership Scale, the Leadership Practices Inventory, the Servant Leadership Questionnaire, the Servant Leadership Survey and the Authentic Leadership Questionnaire.

CONCLUSIONS

The literature search allowed to identify the main theories/styles/models of contemporary leadership and analyze their use in the design of leadership evaluation tools, with the transformational, situational, servant and authentic leadership categories standing out as the most prominent. To a lesser extent, the quantum, charismatic and clinical leadership types were evidenced.

Authentic leadership in healthcare: a scoping review

Purpose

The purpose of this paper is to review peer-reviewed original research articles on authentic leadership (AL) in health care to identify potential research gaps and present recommendations for future research. The objectives are to examine and map evidence of the main characteristics, research themes and methodologies in the studies. AL is a leader’s non-authoritarian, ethical and transparent behaviour pattern.

Design/methodology/approach

A scoping review with thematic analysis was conducted. A three-step search strategy was used with database and manual searches. The included studies were composed of English language peer-reviewed original research articles referring to both AL and health care.

Findings

In total, 29 studies were included. The studies favoured Canadian nurses in acute care hospitals. AL was understood as its original definition. The review identified four research themes: well-being at work, patient care quality, work environment and AL promotion. Quantitative research methodology with the authentic leadership questionnaire and cross-sectional design were prevalent.

Research limitations/implications

Future research needs more variation in research themes, study populations, settings, organisations, work sectors, geographical origins and theory perspectives. Different research methodologies, such as qualitative and mixed methods research and longitudinal designs, should be used more.

Originality/value

This is presumably the first literature review to map the research on AL in health care.

Supervisors’ Ability to Manage Their Own Emotions Influences the Effectiveness of Their Support-Giving

Abstract. Although supervisor support is generally considered a job resource that buffers the negative consequences of job demands, reverse-buffering effects have been found. It was proposed that supervisor support would be stress buffering when supervisors were skilled in emotion management and stress exacerbating when supervisors were low in emotion management. A sample of 210 US employees found three-way interactions on psychological strain, job burnout, and two stress-related intentions. Supportive supervisors high in emotion management buffered high emotional demands on psychological strain and medical advice intentions, but not burnout or turnover intentions. The stress-exacerbating hypothesis was not supported. Instead, employees with highly supportive supervisors low in emotion management reported low strain at low emotional demands. However, this benefit was diminished at high emotional demands.

Subjective well-being of mental health nurses in the United Kingdom: Results of an online survey

The aim of the present study was to measure the subjective well-being of a group of 225 UK registered mental health nurses (MHN) using three survey measures, and to identify whether certain demographic and workplace factors correlated with subjective well-being measure scores. An online survey incorporating the subjective well-being questions used by the Office for National Statistics, the Satisfaction with Life Scale, and the Warwick Edinburgh Mental Well-Being Scale was administered to members of two professional bodies for MHN. There was good consistency between the three subjective well-being measures, each demonstrating that UK MHN had a relatively low subjective well-being. Apart from the Office for National Statistics question, 'Overall, to what extent do you feel the things you do in your life are worthwhile?', demographic and workplace factors did not correlate with subjective well-being measure scores, although the characteristics of being male, living alone, and being aged 40-49 years were associated with lower mean scores on all three measures. The findings of the exploratory study suggest that a similar study should be undertaken with a larger representative population of MHN, and that qualitative research should explore why and how UK MHN have relatively low subjective well-being. The limitations of this study, namely the response rate and sample representativeness, mean that the results of the present study must be tested in further research on the MHN population.

Toward a mediation model for nurses' well-being and psychological distress effects of quality of leadership and social support at work

Given the lack of active nurses in industrialized countries throughout the world, in combination with demographic changes, it is of utmost importance to protect nurses' well-being and to prevent psychological distress, because of their strong association with premature occupational leave. The aim of this study was to investigate the effects of quality of leadership and social support at work on well-being and psychological distress of nurses and to determine whether nurses' overcommitment mediates the relationship between the abovementioned determinants and the outcomes. A cross-sectional survey design was used to gather our data. This study utilized part of the database of the Nurses' Early Exit Study. A total of 34,771 nurses (covering all nurse qualifications) working in hospitals, nursing homes, and home-care institutions in 8 European countries filled out a questionnaire (response rate = 51.4%). For all model variables (job satisfaction, satisfaction with salary, positive affectivity, personal burnout, negative affectivity, quality of leadership, social support from immediate supervisor, social support from near colleagues, and overcommitment), psychometrically sound, that is, valid and reliable measures were used. Outcomes from testing a structural equation mediation model indicated that, respectively, positive and negative influences of leadership quality and social support from supervisor and colleagues on nurses' well-being and psychological distress are partially mediated, that is, reduced, by nurses' overcommitment. Social work environment is highly important in relation to nurses' well-being and psychological distress.