Antecedents, mediators, and outcomes of authentic leadership in healthcare: A systematic review

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.

Leadership styles and personal values of professors at a school of nursing

OBJECTIVES

to identify professors' leadership styles and personal values.

METHODS

a quantitative, descriptive-exploratory study. Population was made up of professors in doctoral category 1 at a public university in the state of São Paulo. Data collection took place from June to August 2021. Sociodemographic characterization was extracted, and the Leadership Team Values Assessment was applied. Data were analyzed using measures of central tendency.

RESULTS

population included 13 professors. The level that represents authentic leadership was the most prevalent. The commitment, positive attitude and trust values stood out. The level portrayed by visionary leadership was the least identified.

CONCLUSIONS

professors' personal values provide a theoretical basis for guiding and analyzing professors' leadership styles. Leadership in the educational context must be recognized and studied to promote a more comprehensive and effective approach to developing and improving educational leaders.

A systematic review of leadership styles in healthcare sector: Insights and future directions

In light of the ongoing global health crisis, the significance of leadership within the healthcare sector has intensified. Given this consideration, the significance of appropriate leadership styles cannot be overstated. The objective of this paper is to critically review published studies on leadership elements in the healthcare sector. Using Bibliometrix R package and VOS viewer, we conducted bibliometric and network analyses on publications retrieved from the Web of Science (WOS) database, with content analysis integrated throughout the paper to deepen understanding. Ultimately, 243 articles were identified as relevant. The findings revealed transformational leadership emerges as the most extensively discussed leadership style. 91% of the articles' theme focus on quantitative research methods. This study synthesizes the influencing factors of the three most frequently discussed leadership styles-transformational, authentic, and ethical leadership-emphasizing the importance of job satisfaction and organizational citizenship behavior. And provides direction for future research through thematic analysis.

Leadership and physiotherapy: A scoping review

Questions

The challenges faced by healthcare organizations require effective leaders. Leadership has been extensively studied in medicine and nursing, but it is limited in physiotherapy. The objective of this study is to know and analyze the published research on the characteristics of leadership in physiotherapy.

Design

A scoping review was conducted following the PRISMA extension guidelines. MEDLINE, The Cochrane Library, PEDro, Embase, CINAHL, Web Of Science and Scopus databases were reviewed between 01/01/2000 and 30/06/2022.All quantitative studies addressing the characteristics of leadership in physiotherapy were selected. Data extraction was performed using a table including author, year of publication, country of origin, title, objective, measurement instrument, sample and main findings.

Data synthesis

The results obtained were framed within the framework for the study of leadership designed by Bolman and Deal.

Results

Eight studies were selected. The characteristics most valued or used by physiotherapists are communication, desire for continuous learning and improvement, credibility and professionalism.

Conclusion

Leadership is very important for physiotherapists, and for physiotherapy, as profession they consider it very important to have vision and to lead change. Communication skills are the most highly regarded characteristic.

Trust in the Leader, Organizational Commitment, and Nurses' Intention to Leave-Insights from a Nationwide Study Using Structural Equation Modeling

Nursing retention is a major challenge globally. Ongoing workforce instability across countries underscores the need to understand the factors influencing turnover and nursing retention. Trust is a crucial element in managing workplace relationships between nurse managers and nurses. Existing studies have shown the direct impact of trust on employees' intention to leave their job but have not explored the effects of potential mediators such as organizational commitment. The aim of this study was to examine the impact of trust in the leader on nurses' intention to leave their job through the mediation of organizational commitment. A cross-sectional study was conducted in Italy. A convenience sample of 1853 nurses completed a self-report survey. The study tested a hypothesis-based mediation model using structural equation modeling, which showed good fit indices. The results indicated that trust in the leader had a significant impact on nurses' intention to leave, and this relationship was partially mediated by organizational commitment. Nurses who trust their leader are more likely to demonstrate higher levels of organizational commitment, resulting in a lower intention to leave their job. Furthermore, organizational commitment and trust emerge as critical factors in reducing nurses' intention to leave their current positions. Therefore, managers can reduce nurses' intention to leave by building trustful relationships that enhance organizational commitment.This study was not registered.

Co-creating a continuous leadership development program in rural municipal healthcare - an action research study

BACKGROUND

An increasingly complex healthcare system entails an urgent need for competent and resilient leadership. However, there is a lack of extensive research on leadership development within healthcare. The knowledge gaps extend to various frameworks and contexts, particularly concerning municipal healthcare, knowledge leadership, and the application of knowledge in the field of practice. This study is the first in a larger action research project that aims to co-create a knowledge-based continuous leadership development program for healthcare in a rural Arctic municipality. This present study aims to explore the knowledge and experiences of the participating healthcare leaders to develop a common basis for co-creating the program.

METHODS

This hermeneutical study presents the first cycle of the larger action research project. An appreciative approach facilitated the project. Twenty-three healthcare leaders from three different leadership levels attended and evaluated two leadership development workshops and participated in four focus groups. The data were analyzed using Braun and Clarke's reflexive thematic analysis.

RESULTS

Two main themes were identified: (1) changing from striving solo players to team players, and (2) learning to handle a conflicting and complex context. These results influenced how the leadership development program based on the participants' co-creation was organized as a collective and relational process rather than an individual competence replenishment.

CONCLUSIONS

The knowledge and experiences of healthcare leaders led to the co-creation of a knowledge-based continuous leadership development program based on the facilitated interaction of four essential elements: (1) competence development, (2) structures for interaction, (3) interpersonal safety, and (4) collective values and goals. The interaction was generated through trusted reflection facilitated by appreciative inquiry. The four elements and core played a crucial role in fostering relationships and facilitating learning, driving transformative change in this leadership development program. The study's results provide a solid foundation for further co-creating the program. However, more research is needed to fully explore the practical application and overall significance.

Effect of authentic leadership on nurses' stress, burnout, presenteeism during COVID-19

PURPOSE

The COVID-19 pandemic has burdened the health-care system and exposed nurses to immense stress. This study therefore aims to investigate nurses' mental well-being who are working with COVID-19-positive patients. Burnout leads to decreased productivity and manifests as emotional exhaustion, depersonalisation (cynicism) and low personal accomplishment (professional efficacy). Authentic leadership is built on a humanistic value system, which is the core value of nurses and other health-care professionals. This study therefore used authentic leadership as the independent variable.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional quantitative research method was adopted by distributing validated online questionnaires to 1,334 nurses in a private pathology laboratory and 241 questionnaires were analysed with 93.4% female respondents. Multiple linear regression model testing was conducted.

FINDINGS

Multiple regression analyses showed statistically significant negative correlations between authentic leadership and emotional exhaustion, cynicism, job stress and job-stress-related presenteeism, and a positive correlation between authentic leadership and professional efficacy.

PRACTICAL IMPLICATIONS

This study provides empirical data to encourage organisations to focus on developing authentic leaders to decrease nurses' burnout, job stress and presenteeism. The health-care sector should strive to create an environment where nurses are valued and their talent is recognised to increase employee engagement and commitment.

ORIGINALITY/VALUE

There were two contributions in this study: first, to determine whether there is a relationship between authentic leadership job stress and job-stress-related presenteeism. Second, to determine whether there is a relationship between authentic leadership and the three sub-constructs of burnout.

How relational leadership can enhance nurses' well-being and productivity

Leadership is an essential skill in nursing and has a fundamental role in ensuring high-quality patient care and the effective functioning of healthcare systems. Effective nursing leadership is vital to support nursing teams as they negotiate the challenges confronting the profession, such as ageing populations and the increased use of healthcare technology. This article discusses various relational leadership styles that can be used to promote nurses' health and well-being and enhance productivity. The author also explores the benefits and challenges of implementing relational leadership in nursing.

Systematic Review on Characteristics and Effects of Leadership Development Interventions for Nursing Students

BACKGROUND

Effective nursing leadership improves health care quality, patient well-being, and nursing staff outcomes. Newly graduated nurses face challenges in transitioning into leadership roles. Thus, examining the leadership development interventions for nursing students is critical.

PURPOSE

This systematic review examined the characteristics and effectiveness of leadership development interventions designed for and implemented with undergraduate nursing students.

METHODS

A comprehensive search covered Scopus, CINAHL Ultimate, ScienceDirect, MEDLINE, WOS Core Collection, Journals@Ovid, JSTOR Journals, and ERIC databases. Included studies were assessed using the Mixed Methods Appraisal Tool.

RESULTS

The final review comprised 19 studies showcasing positive impacts on leadership development. The interventions varied in leadership approach, design and content, structure, qualifications, student involvement, and outcomes.

CONCLUSIONS

Leadership development interventions are effective in enhancing nursing students' leadership. Nevertheless, future interventions should prioritize well-structured content, and studies must incorporate robust methodologies.

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.

The positive role of authentic leadership in organizations negatively affected by cognitive diversity

Workplace diversity has recently gained increasing significance and urgency in business organizations. This promotion may stem from information processing, and specifically from information elaboration. Information elaboration leverages diverse task-related information and skills possessed by members, fostering the exchange of diverse perspectives, elaborate discussions, and achieving high team performance. In this context, cognitive diversity, encompassing members' knowledge, skills, and perspectives, may have a positive impact. However, some previous studies suggest that cognitive diversity can lead to affective conflict and impede information processing. In organizations with highly homogeneous social and cultural backgrounds, cognitive diversity may not be effectively utilized in the information elaboration process, potentially yielding negative effects. Authentic leadership is recognized as a significant contributor to facilitating team processes including information processing, with various studies demonstrating its effectiveness. This study hypothesized that cognitive diversity negatively affects the information elaboration process, while authentic leadership has a positive effect. To test these hypotheses, we employed multilevel structural equation modeling analysis based on data collected from 375 respondents in 90 teams across various industries in Japan. The results showed that cognitive diversity negatively affects information elaboration at the individual level. By contrast, authentic leadership positively affects information elaboration at both individual and team levels. These findings suggest that the effect of cognitive diversity on information processing in the workplace may not always be positive, particularly in a sociocultural context that values homogeneity, as observed in Japanese organizations. This study advances the literature on authentic leadership by validating its effect on information elaboration and provides practical implications for diversity management. Additionally, it underscores the effectiveness of authentic leadership in leveraging team members' cognitive diversity to facilitate information elaboration.

An authentic leadership training programme to increase nurse empowerment and patient safety: A quasi-experimental study

BACKGROUND

Authentic leadership and empowered nurses are necessary if a healthy work environment is to be created and patient safety maintained; however, few studies have examined the impact of authentic leadership, on nurse empowerment and the patient safety climate.

PURPOSE

The aim of the study was to investigate the impact of an educational intervention delivered through a multi-faceted training programme on nurses' perceptions of authentic leadership, nurse empowerment (both structural and psychological) and the patient safety climate.

DESIGN

A quasi-experimental study using a one-group pretest-posttest design consistent with TREND guidelines.

METHODS

The study was conducted in a university hospital between December 2018 and January 2020. Participants were followed for 6 months. The programme involved 36 head nurses (leaders) and 153 nurses (followers). The effectiveness of the programme was evaluated using repeated measures of analysis of variance, dependent sample t-tests and hierarchical regression analysis.

RESULTS

Following the intervention, safety climate and authentic leadership scores increased among both leaders and followers. Structural and psychological empowerment scores also increased among followers. We found that authentic leadership and structural empowerment were predictors of safety climate.

CONCLUSION

The implementation of the education programme resulted in positive changes in participants' perceptions of authentic leadership and empowerment, which can enhance patient safety.

IMPLICATIONS

Healthcare organizations can implement similar multi-faceted training programmes focused on authentic leadership, and nurse empowerment to increase patient safety. Achieving effective results in such programmes can be facilitated by motivating participants with the support of the top management.

PATIENT OR PUBLIC CONTRIBUTION

The study included nurses in the intervention and the data collection processes.

IMPACT

Patient safety is a global concern, and improving patient safety culture/climate is a key strategy in preventing harm. Authentic leadership and nurse empowerment are essential in creating healthy work environments and delivering safe, high-quality care. Training programmes addressing these issues can help bring about improvements in healthcare organizations.

Innovative leadership characteristics of Generation X and Y nurses: A cross-sectional study

The study aimed to identify the innovative leadership qualities of Generation X and Y nurses and explore factors affecting these qualities in both generations. This cross-sectional study was conducted with 324 teaching and research hospital nurses. Data were gathered using a Personal Information Form and the Innovative Leadership Scale from October 2021 to March 2022. Descriptive statistics were applied, followed by Mann-Whitney U, Kruskal-Wallis H tests, and multiple linear regression. Of the nurses, 34% were Generation X, while 66% were Generation Y. Both Generation X and Y nurses exhibited high scores of innovative leadership, with no significant difference in their overall scale scores. Generation X nurses scored higher on average in the subscales of being entrepreneur, motivating others, and being energetic. In contrast, Generation Y nurses excelled in being open to new ideas and being a changemaker. The factors influencing nurses' innovative leadership qualities included their educational level, position, work clinic, clinical experience, shift type, and perception of themselves as leaders. These results suggest that nurses from both generations manifest differing innovative leadership qualities.

The mediating role of psychological capital on the relationship between authentic leadership and innovative behaviour among Chinese nurses

AIM

To explore the mediating role of psychological capital between authentic leadership and innovative behaviour among Chinese nurses.

DESIGN

A cross-sectional study.

METHODS

In December 2021, online surveys were delivered among nurses from 37 hospitals in Anhui Province by convenience sampling approach. The data was collected using the Chinese version of the Authentic Leadership Questionnaire, Nurse Psychological Capital Questionnaire and Nurse Innovative Behaviour Scale. The structural equation model and bootstrap test examined the mediating role of psychological capital between authentic leadership and innovative behaviour.

RESULTS

3495 Chinese nurses from 37 Anhui Province hospitals participated in this study. The mean item score of authentic leadership was 3.25 (SD 0.83), psychological capital was 4.85 (SD 0.89), and innovative behaviour was 2.82 (SD 0.84). Authentic leadership perceived by nurses, psychological capital, and innovative behaviour were statistically significant and positively correlated with each other (r = 0.524 ~ 0.806, p < 0.01). Psychological capital significantly mediated the association between authentic leadership and innovative behaviour (β = 0.449, p < 0.001), and its mediating effect accounted for 76.75% of the total effect.

CONCLUSION

Results suggest the importance of developing nurse managers' authentic leadership to foster nurses' psychological capital and innovation behaviour.

Trust in leadership and perceptions of justice in fostering employee commitment

In a period of uncertainty, trust in leadership and perceptions of fairness have emerged as pivotal factors for fostering employee identification and affective commitment. Drawing from authentic leadership theory, this leadership style is identified as a crucial antecedent of affective commitment, examining the mediating role of distributive justice and the moderating role of interactional justice. A quantitative approach was employed, utilizing data from 302 questionnaires completed by Spanish retail workers. For data analysis, SPSS v.25 was used to generate descriptive statistics, while partial least squares structural equation modeling was applied to test the proposed hypotheses. Our findings revealed that authentic leadership is positively associated with the development of affective commitment, with distributive justice acting as a mediating factor between the two. Furthermore, interactional justice negatively moderates the relationship between distributive justice and affective commitment. Contrary to initial expectations, the second moderation, between authentic leadership and affective commitment, was not found to be significant. The research concludes by discussing the practical implications of the results.

Identifying the predictors of turnover intention based on nurse managers' toxic leadership behaviors among nurses in Iran: a cross-sectional correlational study

BACKGROUND

Unfavorable leadership practices are a growing concern in the field of healthcare and nursing that have adverse consequences on nurses' career outcomes. One of the undesirable leadership styles is the toxic leadership style. Considering the importance of nursing managers' leadership style and its impact on nurses' performance and the scarcity of studies in this field, the present study was conducted to determine toxic leadership behaviors in nursing managers and their relationship with the turnover intention among nurses.

METHODS

A multicenter cross-sectional correlational study. This study involved 551 nurses from 5 educational-medical centers in Ardabil province, north-western Iran. Three self-report scales, including The demographic and occupational information form, the Toxic Leadership Behaviors of Nurse Managers Scale (ToxBH-NM), and the turnover intention questionnaire were adopted for assessment purposes in this study. Data were analyzed using SPSS (Version 22) software using descriptive statistics, Pearson correlation coefficient test, t-test, ANOVA test, and multiple linear regression analysis.

RESULTS

Overall, 551 nurses participated in this research. There was a significantly positive relationship between Turnover intention and Toxic leadership behavior Subscales (r = 0.475, p < 0.001). Furthermore, multiple linear regression analysis showed Toxic leadership behavior Subscales (Intemperate behavior, Narcissistic behavior, Self-promoting behavior, and Humiliating behavior), Hospital, unit, Age, and Marital status predict Turnover intention when other variables are controlled.

CONCLUSION

A leader who directly and indirectly adopts toxic behavior toward their employees destructively affects both individuals and organizations. Nurses who work for a manager exhibiting toxic leadership behaviors demonstrated higher turnover intention.

Using coaching skills in paediatric practice: a summary of use and benefits

This paper sets out the use and benefits of adopting a coaching style of conversation within our everyday practice. Here, we present two case examples within a paediatric setting which applies coaching skills to different contexts to help progress meaningful conversations.

Association Between Authentic Leadership in Nurse Managers and Performance and Intention to Leave Among Registered Nurses

BACKGROUND

Authentic leadership in nurse managers has been identified as a strong predictor of multiple nurse outcomes. However, its association with staff performance and nurses' intention to leave has yet to be established.

PURPOSE

This study was designed to identify the predictive effect of sociodemographic variables on nurse performance and intention to leave and to examine the relationship between authentic leadership in nurse managers and, respectively, nurse performance and intention to leave.

METHODS

A comparative and correlational design and a cross-sectional survey approach were used. A convenience sample of 166 registered nurses working in a government hospital in Jordan was recruited. Data collection was performed online using the sociodemographics questionnaire, the Authentic Leadership Questionnaire, the Turnover Intention Scale, and the Six Dimensions of Nurse's Performance Scale. Data were analyzed using descriptive statistics, independent t test, one-way analysis of variance, Pearson correlation, and multiple hierarchical linear regression.

RESULTS

The overall mean score was 2.08 (SD = 0.87) for the Authentic Leadership Questionnaire, 3.57 (SD = 1.76) for the Turnover Intention Scale, and 3.00 (SD = 0.51) for the Staff Performance Scale. Mean nursing performance differed significantly based on marital status, whereas intention to leave differed significantly based on marital status and the respondent's perception of their first-line manager. A statistically significant, positive correlation between authentic leadership and staff performance and a statistically significant, negative correlation between authentic leadership and intention to leave were found. In addition, authentic leadership was uniquely associated with staff performance (B = 0.19, p < .05) and intention to leave (B = -0.39, p < .05) in the hierarchical regression analysis after controlling for sociodemographic variables.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Authentic leadership from nurse managers is associated with improved nurse performance and lower nurse intention to leave. Nurse managers may enhance authentic leadership attributes to better retain nurses in hospitals and improve nurse job performance.

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.

The influence of nurse managers' authentic leadership style and work environment characteristics on job burnout among emergency nurses

BACKGROUND

Emergency nurses experience excessive workloads and high job burnout. Limited evidence exists exploring the role of authentic leadership and nurse work environment on job burnout among emergency nurses.

OBJECTIVE

To assess the influence of nurse managers' authentic leadership and nurse work environment on job burnout among emergency nurses.

METHODS

A cross-sectional study was conducted among 160 emergency nurses working in six hospitals in the Sultanate of Oman. The Maslach Burnout Inventory, Authentic Leadership Questionnaire, and the Practice Environment Scale of the Nursing Work Index were used to assess study variables.

RESULTS

Of the 233 distributed surveys, 160 emergency nurses responded resulting in a response rate of 69%. More than two thirds of emergency nurses (72.1%) reported high levels of burnout. Authentic leadership and a favorable work environment were significantly associated with lower job burnout. Nurse managers' transparency (β = - 0.481, p = 0.031), ethical/moral conduct (β = - .408, p = 0.043), managerial ability and support (β = - 0.497, p = 0.018), and adequate staffing and resources (β = -.068, p = 0.028) were all associated with lower job burnout.

CONCLUSIONS

Results suggest the importance of providing effective leadership, adequate support to staff, maintaining optimum staffing and resources, and developing nurse managers' authentic leadership to reduce nurses' job burnout.

How does authentic leadership influence the safety climate in nursing?

BACKGROUND

Authentic leadership controls quality care and the safety of patients and healthcare professionals, especially nurses.

AIM

This study examined the influence of nurses' authentic leadership on the safety climate.

METHODS

In this predictive research, 314 Jordanian nurses from various hospitals were convenience sampled for cross-sectional and correlational design. This research included all hospital nurses with 1 year of experience, at least at the present hospital. SPSS (V.25) conducted descriptive statistics and multivariate analyses. As needed, sample variables' means, SD and frequencies were supplied.

RESULTS

The mean scores on the entire Authentic Leadership Questionnaire and its subscales were moderate. The mean score of the SCS was below 4 (out of 5), indicating negative safety climate perceptions. A significant positive moderate association was found between nurses' authentic leadership and safety climate. Nurses' authentic leadership predicted a safe climate. Internalised moral and balanced processing subscales were significant predictors of safety climate. Being woman and having a diploma inversely predicted the nurses' authentic leadership; however, the model was insignificant.

CONCLUSION

Interventions are needed to enhance the perception of the safety climate in hospitals. Nurses' authentic leadership increases their perceptions of a positive safety climate, and thus different strategies to build on nurses' authentic leadership characteristics are warranted.

IMPLICATIONS FOR NURSING MANAGEMENT

The negative perceptions of the safety climate mandate that organisations create strategies to increase nurses' awareness about the safety climate. Shared leadership, learning environments and information sharing would improve nurses' perceptions of the safety climate. Future studies should examine other variables influencing safety climate with a more extensive and randomised sample. Safety climate and authentic leadership should be integrated into the nursing curricula and continuing education courses.

PROTOCOL: Do hospital leadership styles predict patient safety indicators? A systematic review

This is the protocol for a Campbell systematic review. The objectives are as follows: The main aim of this systematic review is to identify whether hospital leadership styles predict patient safety as measured through several indicators over time. The second aim is to assess the extent to which the prediction of hospital leadership styles on patient safety indicators varies as a function of the leader's hierarchy level in the organization.

Relationships between nursing leadership and organizational, staff and patient outcomes: A systematic review of reviews

AIM

To assess and describe reviews of nursing leadership styles associated with organizational, staff and patient outcomes.

DESIGN

A systematic review of reviews.

METHODS

Reviews describing a search strategy and quality assessment. The review followed the PRISMA statement. Nine databases were searched in February 2022.

RESULTS

After screening 6992 records, 12 reviews were included reporting 85 outcomes for 17 relational, nine task-oriented, five passive and five destructive leadership styles. Transformational leadership, which is one of the relational styles, was the most studied among all the styles. Of the outcomes, staff outcomes were the most reported, notably job satisfaction, and patient outcomes were less reported. Also, mediating factors between relational leadership styles and staff and patient outcomes were identified.

CONCLUSION

Extensive research shows the beneficial impacts of relational leadership; however, destructive leadership research is lacking. Relational leadership styles should be conceptually assessed. More research is needed on how nurse leadership affects patients and organizations.

The role of authentic leadership in nurses' stress and burnout in emergency departments

PURPOSE

Nurses are one the essential health-care providers within society, seeking the employment of authentic leadership approaches to reduce the burnout and stressors established within the emergency departments. Burnout has been vitally documented as a psychological impulse that emerges due to the prevalence of chronic job stressors. Authentic leadership approaches will act as an affirmative organizational resource that could help to minimize burnout in the work environments. Therefore, this study aims to evaluate the role of authentic leadership in stress and burnout among nurses in emergency departments.

DESIGN/METHODOLOGY/APPROACH

This study used a quantitative, cross-sectional design. A package of surveys was distributed to nurses working in emergency departments using standardized questionnaires that measured the study variables. A total of 188 nurses participated in the study. SPSS was used to analyze data.

FINDINGS

The study's results supported the hypotheses and found that authentic leadership significantly and negatively influenced nurses' job stress R = -0.169, p = 0.0205. Also, the results of this study found that the relationship between authentic leadership and burnout was significant and negative R = -0.245, F (1,186) = 11.8, p = 0.0007.

ORIGINALITY/VALUE

Nurse leaders can introduce flexible working hours and develop coordination and cooperation among nurses, and management of the hospitals needs to focus on improving the structure and enhancing nurses' outcomes that could affect patients' and organizations' outcomes.

Organizational health climate as a precondition for health-oriented leadership: expanding the link between leadership and employee well-being

The link between leadership and employee well-being is long established. In particular, health-oriented leadership is discussed as a leadership style specifically promoting employee well-being. However, the preconditions of health-oriented leadership remain largely unexplored. From the perspective of conservation of resources theory, leaders can only provide resources when receiving some themselves. We propose that organizational health climate (OHC) is an important organization-based resource for a health-oriented leadership style. More specifically, we hypothesize that the relationship between OHC and employee job satisfaction and emotional exhaustion is mediated by health-oriented leadership. We thereby differentiate two levels of analysis: a within-team level and a between-team level. We examined 74 teams with 423 employees of childcare centers at three time points, each 6 months apart. By means of multilevel structural equation modeling, we found OHC to be a significant antecedent of health-oriented leadership at the between-team level. The relationship between OHC and employee job satisfaction was mediated by health-oriented leadership at the between-team level, but not at the within-team level. The relationship between OHC and employee exhaustion showed another pattern of relationships at the different levels of analysis, while it was not significantly mediated by health-oriented leadership. This indicates the value of differentiating between levels of analysis. We discuss the implications for theory and practice that can be drawn from our findings.

Measuring the Work Environment: The Voice of the Staff Nurse

OBJECTIVE

The aims of this study were to obtain direct care hospital nurse input on the relevance of the Practice Environment Scale of the Nursing Work Index (PES-NWI) and to determine whether additional items are needed to measure the contemporary nursing work environment (NWE).

BACKGROUND

Instruments accurately measuring the NWE are essential due to the NWE's association with nurse, patient, and organizational outcomes. However, the most frequently used instrument for measuring the NWE has not been scrutinized by today's practicing direct care nurses to ensure its current relevancy.

METHODS

Researchers administered a survey with a modified PES-NWI and open-ended questions to a national sample of direct care hospital nurses.

RESULTS

Three items from the PES-NWI may be suitable for removal, and additional items may be added to accurately measure the current NWE.

CONCLUSION

Most PES-NWI items remain relevant for modern nursing practice. However, some revisions could enable greater precision in measuring the current NWE.

The effects of leadership for self-worth, inclusion, trust, and psychological safety on medical error reporting

BACKGROUND

Although trust and psychological safety (PS) are critical for improving patient safety and medical error reporting, little is known about how they work together and how health care systems promote PS.

PURPOSE

This study examined how leadership for self-worth, inclusion, and trust may work together to foster PS and how this influences medical error reporting.

APPROACH

Data were collected in 2019 from 373 employees (24% response rate) in 85 hospital departments (54% response rate) in a nonprofit health care system in the eastern United States. Constructs were operationalized at the department level.

RESULTS

Negative binomial path model results found several direct effects. Leadership for self-worth was positively associated with inclusion, inclusion was positively associated with trust and PS, trust was positively associated with reported medical errors, and PS was negatively associated with reported medical errors. Indirect effects uncovered leadership for self-worth was positively associated with PS by enhancing inclusion. In addition, leadership for self-worth increased inclusion, which increased trust and ultimately encouraged PS. Leadership for self-worth was associated with fewer reported medical errors through increasing inclusion, trust, and PS.

PRACTICAL IMPLICATIONS

Trust encourages the formal reporting of medical errors whereas PS encourages learning from mistakes and improving care to reduce future errors (and consequently the number of reported errors). Leaders who understand employees' unique needs, express confidence in employees' abilities, and encourage employees to share their ideas, create inclusive and trusting work environments that encourage PS and ultimately help reduce reported medical errors.

Authentic leadership, organizational culture and the effects of hospital quality management practices on quality of care and patient satisfaction

AIM

To examine the influence of hospital culture and authentic leadership on the effects of quality improvement practices on patient satisfaction.

BACKGROUND

Nurses in formal leadership roles shape and are shaped by organizational culture to achieve high performance standards to influence quality of care.

DESIGN

Using structural equation modelling, we tested a model on quality improvement practices across three participant groups that differed based on authentic leadership and hospital culture.

METHODS

We used survey data from a cross-sectional study conducted in 2015 measuring nurse. Managers' perceptions of authentic leadership, implementation of quality improvement, and organizational culture in Canadian hospitals.

RESULTS

226 nurse managers participated. Our model estimations fit for the high-relational group and mixed group. Our model explained 50.7% and 39.5% variance in our outcome variable of patient satisfaction for the high-relational group and mixed group, respectively. Our model failed to fit the low-relational group.

CONCLUSION

Authentic leadership and developmental/group hospital cultures improve quality management practices, quality of care and patient satisfaction. In organizations with low authentic leadership and hierarchical/rational cultures, strategies should target increasing authentic leadership and shifting to developmental cultures. Organizations with high authentic leadership and/or developmental/group cultures should target employee engagement, autonomy and teamwork.

IMPACT

We examined how different combinations of authentic leadership and hospital culture influence the effects of quality management practices on quality improvement and patient satisfaction. Findings demonstrate that having both high authentic leadership and developmental or group hospital cultures are essential for quality improvement practices to enhance the quality of care and patient satisfaction. These organizations would benefit the most from systemic programs aimed at standardizing quality management practices as they have the culture and leadership to support these practices. For hospitals with hierarchical/rational cultures and/or low authentic leadership, enhancing hospital culture and leadership through leadership training and accreditation programs is critically needed.

PATIENT OR PUBLIC CONTRIBUTION

The College and Association of Registered Nurses of Alberta contributed to this study by facilitating data collection and supporting the conduct of the study through messaging to its members.

Povezava lastnosti vodje in vodenja s kakovostjo storitev v zdravstveni negi

Uvod: Vodenje je proces, ki se nanaša na zmožnost vplivati na zaposlene, jih usmerjati in motivirati. Namen članka je bil raziskati povezavo med kakovostjo zdravstvene nege z vodenjem in lastnostmi vodje tima zdravstvene nege.Metode: Uporabljena je bila opisna metoda dela, s katero je bil med 2018 in 2020 izveden sistematični pregled literature po bazah podatkov Medline, CINAHL, Cochrane Library in PubMed. Iskalna strategija je sledila protokolu PICO. Iskalni pojmi so bili: leader, leadership, leaders competencies, quality indicators, health care, nursing leadership, patient outcomes, personnel management, outcome assesment, patient satisfaction.Rezultati: Identificiranih je bilo 462 zadetkov, med katerimi je bilo za analizo izbranih 20 prispevkov, objavljenih med letoma 2010 in 2020. Deset raziskav je bilo sistematičnih pregledov literature, devet kvantitativno presečnih ter ena eksperimentalna raziskava. Prispevki so bili kritično ovrednoteni z orodji JBI. V analizi je bilo identificiranih 163 kod, ki so bile združene v šest kategorij: slogi vodenja v zdravstvu; lastnosti dobrega vodje v zdravstvu; učinkovitost zdravstvenega tima, dejavniki, ki vplivajo na kakovost zdravstvene nege; izidi zdravstvene nege; izidi negativnega delovnega okolja.Diskusija in zaključek: V kliničnem okolju je najpogosteje omenjen in priporočen transformacijski slog vodenja, v katerem ima vodja posluh za zaposlene, vodenje je usmerjeno v odnose. Med zaposlenimi se ustvarja klima zaupanja, ki vpliva na zadovoljstvo zaposlenih in posledično pozitivno tudi na kakovost zdravstvene nege.

The lens of Yin-Yang philosophy: the influence of paradoxical leadership and emotional intelligence on nurses' organizational identification and turnover intention

PURPOSE

This study aims to use "both-and" thinking of Yin-Yang philosophy to extend the field of leadership literatures and explore the influences of paradoxical leadership and emotional intelligence on organizational identification and turnover intentions of nurses.

DESIGN/METHODOLOGY/APPROACH

The authors adopted a cross-sectional survey completed by 285 nurses in Taiwan. SPSS 22, PROCESS and AMOS 21 were used for data analysis.

FINDINGS

The results reveal that paradoxical leadership has a significant positive relationship with nurses' organizational identification and a significant negatively relationship with their turnover intentions, and organizational identification partially mediated the relationship between paradoxical leadership and turnover intentions. The results further show that emotional intelligence strengthens the effect of paradoxical leadership on organizational identification, and paradoxical leadership had a stronger indirect effect on turnover intentions through organizational identification under strong emotional intelligence.

ORIGINALITY/VALUE

Paradoxical leadership can strengthen managers' abilities in dealing with interrelated and substantial issues and correspond to organizing and belonging paradoxes in holistic thinking processes. Health-care organizations must shape a coordinated institution and offer training initiatives to increase managers' ability and attitude to control organizational rules and procedures while allowing employees' flexibility and autonomy according to the requirements of the situation, which will maintain both organizational short-term benefits and long-term growth.

Leadership Behavior Associations with Domains of Safety Culture, Engagement, and Health Care Worker Well-Being

BACKGROUND

Leadership is a key driver of health care worker well-being and engagement, and feedback is an essential leadership behavior. Methods for evaluating interaction norms of local leaders are not well developed. Moreover, associations between local leadership and related domains are poorly understood. This study sought to evaluate health care worker leadership behaviors in relation to burnout, safety culture, and engagement using the Local Leadership scale of the Safety, Communication, Operational Reliability, and Engagement (SCORE) survey.

METHODS

The SCORE survey was administered to 31 Midwestern hospitals as part of a broad effort to measure care context, with domains including Local Leadership, Emotional Exhaustion/Burnout, Safety Climate, and Engagement. Mixed-effects hierarchical logistic regression was used to evaluate the relationships between local leadership scores and related domains, adjusted for role and work-setting characteristics.

RESULTS

Of the 23,853 distributed surveys, 16,797 (70.4%) were returned. Local leadership scores averaged 68.8 ± 29.1, with 7,338 (44.2%) reporting emotional exhaustion, 9,147 (55.9%) reporting concerning safety climate, 10,974 (68.4%) reporting concerning teamwork climate, 7,857 (47.5%) reporting high workload, and 3,436 (20.7%) reporting intentions to leave. Each 10-point increase in local leadership score was associated with odds ratios of 0.72 (95% confidence interval [CI] 0.71-0.73) for burnout, 0.48 (95% CI 0.47-0.49) for concerning safety climate, 0.64 (95% CI 0.63-0.66) for concerning teamwork climate, 0.90 (95% CI 0.89-0.92) for high workload, and 0.80 (95% CI 0.78-0.81) for intentions to leave, after adjustment for unit and provider characteristics.

CONCLUSION

Local leadership behaviors are readily measurable using a five-item scale and strongly associate with established domains of health care worker well-being, safety culture, and engagement.

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.

Nursing Leaders as Visionaries and Enablers of Action

OBJECTIVES

The engagement of nursing leaders is critical for the future of the cancer nursing profession, quality cancer care, and the overall health care system. The field of cancer care is facing enormous challenges, requiring strong nursing leadership. Cancer nursing leadership is needed to overcome the challenges caused by workforce shortages, restricted resources, historic and ongoing under-recognition of nursing, unsafe working conditions, and unequal access to education. The aim of this article is to contribute to the discussion about how cancer nursing leaders can act as visionaries and support transformation of cancer nursing for the future.

DATA SOURCES

Author experience, journal articles and organizational position papers were used.

CONCLUSION

To improve the state of cancer nursing and the working conditions of the cancer nursing workforce, nursing leadership practices need to be embraced on all governance levels in clinical practice and academia. When effective and high-quality nursing leadership is enacted, positive outcomes for people affected by cancer, nursing, and health care systems can be achieved. Cancer nursing leadership needs to be supported through nursing scholarship, influencing national and global policies and strategies and by active involvement in national and international health care management.

IMPLICATIONS FOR NURSING PRACTICE

Nursing leadership and governance is critical to strengthening the cancer nursing workforce. Strong nursing leadership is required to realize the vision for transforming the health care systems and cancer care. Therefore, collaboration among multidisciplinary leadership, health care organizations, academic institutions, professional organizations, and policy-making structures is warranted.

The role of HEXACO in the development of authentic leadership and its consequences on task performance

Purpose

The objectives of the current study were to identify the antecedents and outcomes of authentic leadership. For antecedents, the research considered the HEXACO (Honesty-Humility, Emotionality, eXtraversion, Agreeableness, Conscientiousness, Openness to Experience) personality model and thereby identified the impact of authentic leadership on employee performance with the mediating role of psychological safety and employee engagement by using the trait theory.

Design/methodology/approach

The current study adopted a positivism research philosophy followed by a deductive approach. Overall, 347 samples were collected from the public sector organizations using quantitative research techniques, and data were gathered through a self-administrated questionnaire. Exploratory and confirmatory factor analyses were used through structural equation modeling (SEM)-Mplus to generate the results and test the formulated hypotheses.

Findings

The results revealed that honesty-humility significantly impacts authentic leadership (β = 0.094 and p < 0.05). Similarly, other dimensions of HEXACO also play a significant role in forming authentic leadership. After analyzing the HEXACO as the antecedent of authentic leadership, sequential mediation of psychological safety and employee engagement was checked and identified that authentic leadership in the presence of mediators was insignificant. Hence the full mediation has been recorded.

Originality/value

Since its inception, a plethora of research has been available on the authentic leadership theory. However, the empirical evidence revealed that most research is related to outcomes of authentic leadership. As far as antecedents of authentic leadership are concerned, the literature is still silent, specifically on the development of authentic leaders. The current study is significantly contributing to the theory of authentic leadership, and in this context, the study is unique since it is taking the HEXACO personality model as an antecedent of authentic leadership to investigate its role in the development of authentic leaders. Moreover, the study is also identified as the impact of authentic leadership on task performance, not in isolation, but by taking psychological safety and employee engagement as a mediating mechanism.

Authentic leadership and employee resilience during the COVID-19: The role of flow, organizational identification, and trust

The present work investigated fundamental mediating mechanisms (i.e., flow experience, organizational identification, and trust), underlining the impact of authentic leadership on employee resilience during the turbulent COVID-19 pandemic. A total of 901 frontline employees working in a construction engineering company in China participated in this study. They were asked to respond to a battery of questionnaires comprising Trust Scale (affective-based, cognitive-based, and competence-based), Flow Proneness Questionnaire (FPQ), Organizational Identification Scale, Authentic Leadership Questionnaire, and Employee Resilience Scale. Results of structural equation modeling indicated that: (1) Authentic leadership positively predicted employee resilience in the COVID-19 pandemic, directly and indirectly. (2) As for the indirect relationship, two parallel mediation effects and one chain mediation were detected: employees' flow at work and organizational identification respectively and dependently mediated the relationship between authentic leadership and employee resilience; trust and organizational identification played as a chain mediation role within authentic leadership-employee resilience association. The study provides empirical evidence for organizations' resilience-building and leadership training programs. Findings also contribute to the literature by facilitating flow intervention, promoting organizational identification and trust to enhance the effect of authentic leadership in promoting positive psychological functioning of employee resilience. Limitations with respect to future research directions were also outlined.

Authentic leadership, perceived organizational support, and psychological capital: Implications for job performance in the education sector

The present study sifts the indirect role of psychological capital (PsyCap) in linking authentic leadership (AL) and job performance (JP). Furthermore, this study investigates the interplay of AL and perceived organizational support (POS) in PsyCap. We tested these assumptions through PROCESS macro with two sources of data collected from 350 employees and their respective colleagues working in education sector organizations in China. The study findings established that AL positively influences employee performance directly and indirectly through PsyCap. POS moderates the effects of AL on PsyCap such that this relationship gets more pronounced in individuals with high levels of POS. All organizations in the education sector can benefit from the current study's practical application. We recommend that firms create and implement these training programs to improve JP since AL is favorably correlated with JP. The organization should pick executives with a vision to encourage e-JP. To promote this behavior, firms can also hold management training seminars, conferences, and programs. Making performance a clear necessity within job criteria will encourage it among personnel. To achieve great results, top management and leadership must inform the workforce about the importance of authentic behavior in the workplace.

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.

The Relationship Between Authentic Leadership and Nurses' Resilience: A Mediating Role of Self-Efficacy

Introduction

Authentic leadership has been identified as a style needed to promote quality patient care and nurses' retention.

Objective

The objective of this study was to investigate the correlation between the authentic leadership exhibited by nurse managers and the levels of resilience and self-efficacy among nurses.

Methods

A descriptive correlational study was conducted in an Egyptian hospital. A sample of convenience nurses (N = 285) completed the Authentic Leadership Inventory, the Connor-Davidson Resilience Scale, and the General Self-Efficacy Scale. The data were analyzed with correlation and structural equation modeling.

Results

The highest percentages of nurses (53.33% and 45.96%) perceived their nurse managers as having either moderate or high levels of authentic leadership. The majority of nurses rated themselves as moderately resilient (63.98%, 25.59 ± 6.56) and highly efficacious (76.70%, 30.68 ± 4.95). Furthermore, the analysis conducted using SPSS-AMOS reveals a significant positive association between the variables. Specifically, authentic leadership, along with its constituent components, accounts for approximately 22% of the overall variance observed in nurses' resilience. Additionally, it is shown that these same factors explain approximately 34% of the variance in nurses' self-efficacy. Moreover, the mediating role of self-efficacy was found to explain 49.3% of the variability in nurses' resilience.

Conclusion

Nurse leaders should be aware of and implement effective and authentic leadership behaviors and apply tailored strategies for fostering nurses' resilience and self-efficacy to deal with the challenging healthcare environment.

New Graduate Nurses’ Incivility Experiences: The Roles of Workplace Empowerment, Nursing Leadership and Areas of Worklife

Aims

To determine what extent are workplace empowerment, New Graduate Nurses’ (NGN) perceptions of nurse leaders, trust in management, and areas of worklife predict coworker incivility experiences?

Background

NGNs’ perceptions of nursing leaderships’ control over workload contribute to coworker incivility experiences were tested. The relationship between workplace empowerment, authentic leadership, and areas of work life (workload control and fair resource allocation) to coworker incivility experiences were examined.

Design

Secondary analysis of Starting Out, national survey, Time 1 dataset. Select factors of workplace empowerment, authentic leadership, areas of worklife, trust in management and NGNs’ co- worker incivility experiences were situated within an ecological approach. Multiple linear regression was used to test whether a negative relationship of workplace empowerment, areas of worklife and authentic leadership to NGNs co-worker incivility experiences and important new findings were discovered.

Results

First, NGNs’ perceptions of workplace empowerment predict coworker incivility experiences when controlling for authentic leadership and trust in management. Second, NGNs’ perceptions of areas of worklife predict coworker incivility experiences when controlling for authentic leadership, trust in management, and workplace empowerment. Third, NGNs’ perceptions of authentic leadership do not predict coworker incivility experiences when controlling for workplace empowerment and trust in management. Finally, NGNs’ perceptions of authentic leadership do predict coworker incivility experiences when trust in management and workplace empowerment are not controlled.

Conclusions

NGNs’ perceptions of authentic leadership would benefit from workplace empowerment of the nurse leader in workplace environments to mitigate coworker incivility experiences.

The Effect of Authentic Leadership on Nurses' Trust in Managers and Job Performance: A Cross-Sectional Study

BACKGROUND

Nurse leaders have the responsibility to build healthy work environments for staff nurses and enhance nurses' outcomes. Authentic leadership is one of the leadership theories that have been shown to have positive impacts on nurses' outcomes. The goal of this study was to test the effect of authentic leadership on trust in managers and job performance among nurses in Saudi Arabia.

METHODS

A non-experimental, cross-sectional design was applied. A total of 116 nurses who met the inclusion criteria completed the survey. To test the study variables, three different scales were used. The data in this study were analyzed using SPSS version 28.0.1.1.

RESULTS

The findings of this study showed that there were significant and positive effects of authentic leadership and its four components on trust in managers. However, no relationships were found between authentic leadership and its four elements, and job performance.

CONCLUSIONS

Authentic leaders have the ability to improve work environments by building a trustful relationship with nurses. This study focuses on the role of authentic leadership in nursing practice and its essential effects to enhance the work environments. It also provides future researchers in Saudi Arabia with comprehensive knowledge about conducting studies of authentic leadership in nursing and examine its effects on outcomes related to nurses.

Factors leading to disruptive behaviours at central hospitals in Harare Metropolitan Province: Radiography managers perspectives

BACKGROUND

The negative consequences of disruptive behaviours involving healthcare workers threatens the institution's image, staff morale, finances, and patient safety. While all kinds of health organisations or settings are potentially exposed to disruptive behaviours, some are at higher risk than others because of both environmental and cultural factors. Such risk should be assessed having regard to the specific situation and conditions in which each healthcare organization operates.

AIM

The aim of this study was to explore radiography manager's perspectives on the environmental and cultural factors leading to DBs involving radiographers at central hospitals in Harare Metropolitan Province.

METHODS

An exploratory qualitative study employing in-depth interviews with 11 radiography managers across five departments at three central hospitals selected by criterion purposive sampling was done. The interview data were analysed using Tesch's method of qualitative analysis.

RESULTS

The key environmental and cultural factors identified included three themes: power hierarchy, work environment and reporting framework. Power hierarchy comprised categories, superiority, professional boundaries and representation. The work environment incorporated categories, trust in leadership, burnout and fatigue and remuneration. Lastly, reporting framework included categories, lack of protocol and reporting culture.

CONCLUSION

Radiography managers believe that environmental factors play a bigger role in leading to disruptive behaviours that involve radiographers at central hospitals in Harare Metropolitan Province. This underscores the need for hospital and radiography managers to pay particular emphasis on these when formulating policies and procedures to address these behaviours. Addressing DBs ensures that healthy work environments are promoted which in turn ensures that patients receive optimum and safe care.

IMPLICATIONS FOR PRACTICE

The paper provides an insight into the environmental and cultural dynamics that may trigger disruptive behaviours involving radiographers. This information is invaluable in formulating policies and procedures for addressing these unprofessional behaviours.

"Doing good and feeling good" Relationship between authentic leadership with followers' work engagement: The mediating role of hedonic and eudaimonic wellbeing

The positive behavioral style of authentic leadership has attracted academicians' and practitioners' attention to focus more on a healthy workplace environment and its influence on followers' valued workplace relationship outcomes, such as employees' work engagement. From the lens of social exchange perspective, we tested a unified model of authentic leadership and its influence on the followers' wellbeing (hedonic and eudaimonic wellbeing) and work engagement. We also examined the mediating role of hedonic and eudaimonic wellbeing on followers' work engagement. Using a time-lagged design, we collected data from 250 telecom sector workers employed in the capital city of Islamabad, Pakistan. The results indicate the positive influence of authentic leadership on followers' work engagement and employees' hedonic and eudaimonic wellbeing. Hedonic and eudaimonic wellbeing also positively mediated the relationship between authentic leadership and followers' work engagement. The theoretical and practical implications of the study are also discussed.

The influence of authentic leadership on nurses' turnover intentions and satisfaction with quality of care in Saudi Arabia: A structural equation modelling study

AIM(S)

The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care.

BACKGROUND

Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions.

METHOD(S)

A non-experimental, cross-sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included.

RESULTS

Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care.

CONCLUSION(S)

Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments.

IMPLICATIONS FOR NURSING MANAGEMENT

Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses.

The impact of digital leadership on sustainable performance: a systematic literature review

Purpose

In today's constantly changing workplace, leaders encounter new challenges consequent to rising digitization. Tackling these problems effectively requires digital leadership, a prominent idea in discussions about what abilities the managers need to be developed in the digital age. The study analyses the leadership elements needed and determines the impact of digital leadership on sustainable performance. The aim of this systematic literature review (SLR) is to identify the relationship between digital leadership concepts and leadership development by proposing digital leadership for management development to ensure sustainable performance in an organisation.

Design/methodology/approach

ROSES (RepOrting Standards for Systematics Evidence Syntheses) was used as the publication standard for this systematic literature review, which incorporated a variety of research approaches. For this study's article selection, one of the most important scientific databases, Scopus, was used. Only articles published between 2001 and 2021 were reviewed. The focus of the article was on digital leadership and performance.

Findings

This review identified five main themes: leadership styles, measurements of leadership, antecedents to good leadership, outcomes of good leadership and gaps in current research areas. An additional ten sub-themes were derived from the five primary topics.

Originality/value

This paper systematically reviewed two decades of literature related to digital leadership and its impact on sustainable performance. The findings allow leaders to better understand the leadership trend and develop appropriate leadership practices to overcome future challenges for sustainable performance.

The Effectiveness of Community Mental Health Teams in Relation to Team Cohesion, Authentic Leadership and Size of the Team: A study in the North West of Ireland

Community Mental Health Teams (CMHTs) are increasingly being considered effective models of recovery focused care, however their effectiveness and factors that may affect it have not fully evaluated. Cross-sectional study in Ireland included 106 members from 8 CMHTs. We examined CMHT's effectiveness and the effects of authentic leadership, team cohesion, team members' experience and team tenure on effectiveness, by administering the Team Effectiveness Scale, Authentic Leadership Questionnaire, and Organizational Cohesion Scale. Data on demographics, discipline, years of experience, tenure in the same team, full or partial membership, and number of team members were collected. Results from multilevel regression analysis indicated significant association (p < 0.05) between effectiveness of CMHTs and factors including team cohesion, authentic leadership, size of the team and full membership. Therefore, to increase CMHTs effectiveness, interventions are needed to those areas: a switch to make leadership styles more authentic, to improve team cohesion, smaller team size and full membership.

Authentic leadership in the educational system and in nursing education: an integrative review

OBJECTIVES

to identify and analyze the knowledge produced in literature about authentic leadership in the educational system, as well as in nursing education.

METHODS

an integrative review, carried out in the Scopus, Web of Science, CINAHL, MEDLINE/PubMed, ERIC, LILACS databases. Articles that addressed authentic leadership in the educational system from a general perspective and within the nursing scope, as well as teaching practices of this leadership model, were eligible.

RESULTS

twenty-three articles met the inclusion criteria, most published in 2019, highlighting studies in the context of teaching, with a predominance in the nursing course and which were synthesized into three thematic categories.

FINAL CONSIDERATIONS

it was found that the higher the levels of authentic leadership in the educational system, the higher the rates of other positive factors related to it, such as trust, involvement, academic optimism, responsibility, creativity, among others.