A model of abusive supervision, self-efficacy, and work engagement among Chinese registered nurses: The mediating role of self-efficacy

Stress as a mediator between abusive supervision and clinical nurses' work outcomes

AIMS

This study aimed to test whether stress could mediate the association between abusive supervision and nurses' work engagement, absenteeism, and turnover intention.

BACKGROUND

Abusive supervision has been attributed to suboptimal work performance and reduced productivity among employees in different sectors. While existing nursing literature links abusive supervision to a wide range of work-related outcomes in the nursing workforce, little is known regarding the mechanism underlying this relationship.

DESIGN

Data for this descriptive study were collected from 770 direct-care nurses from seven acute care hospitals in the Philippines, utilizing five standardized scales.

RESULTS

Abusive supervision had direct positive effects on absenteeism (β = .189, p < .001) and intent to leave (β = .138, p < .001) and a direct negative effect on job engagement (β = -.131, p < .001). The relationships between abusive supervision and absenteeism (β = .175, p < .001), intent to leave (β = .131, p < .001), and work engagement (β = -.122, p < .001) were partially mediated by stress.

CONCLUSIONS

Stress mediated the relationship between abusive supervision and nurses' work outcomes, including turnover intention, absenteeism, and work disengagement.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The evident connection between abusive supervision, stress, and work-related outcomes underscores the importance of focusing on enhancing managerial supervisory styles as a potential organizational strategy to enhance staff retention and well-being.

Abusive Supervision and Its Relationship With Nursing Workforce and Patient Safety Outcomes: A Systematic Review

Despite efforts to improve management and leadership behaviors among nurse managers, studies have shown the pervasive nature of abusive supervision in nursing practice, with strong evidence linking this type of behavior to reduced work productivity among nurses. This systematic review aimed to appraise and synthesize peer-reviewed studies that examine nurse-related and patient safety outcomes associated with abusive supervision. The review searched nursing literature from five databases (PubMed, CINAHL, Scopus, Web of Science, and PsycINFO) between August and November 2022. A total of 21 relevant studies were identified, with the Abusive Supervision Scale being the most frequently used measurement tool. Through content analysis, the review identified 29 outcomes which were categorized into six groups: (a) affective-based, (b) behavior/performance-based, (c) relationship-based, (d) cognitive-based, (e) health and well-being, and (f) nursing care. In addition, 10 mediators were identified and grouped into three categories: (a) affective-based, (b) motivation-based, and (c) health and well-being. The review findings provide compelling evidence regarding the detrimental effects of abusive supervision in the nursing workforce. Moreover, the review emphasizes the need for further research to explore how such behavior can impact patient safety outcomes. To address abusive supervision, it is crucial to promote positive behaviors among nurse managers through human resource mechanisms, relevant rules and policies, and theory-driven leadership development programs.