Dimensions of authentic leadership and patient care quality

Effect of authentic leadership and mindfulness educational program on nursing managers' competencies: a quasi-experimental study

BACKGROUND

Authentic leadership is an emerging perspective in leadership that focuses on leaders' values and beliefs. while the mindfulness perspective permits nurse managers to be fully present, aware of themselves and their impact on others, and aware of their reactions in stressful situations. so, authentic leadership and mindfulness if combined create nurse managers who have clearer, more focused thinking, and a growth mindset that help subordinates improve and grow. as well as mindfulness-based interventions help them to improve interpersonal relationships with patients and colleagues, and to take better care of themselves and others.

AIM

The present study aims to; explore the effect of authentic leadership and mindfulness educational program on nursing managers' competencies in hospital.

METHODS

A quasi-experimental design (Quantitative pre-, post-, and follow-up design) was used to conduct the study at Shirbeen General Hospital, Egypt. The study subjects consist of a purposive sample of 70 nurse managers and 226 nurses. Three tools used for data collection consisted of; the authentic leadership questionnaire, the five Facet Mindfulness Questionnaire, and the managerial competencies of Nurse Managers. Data analysis was performed using SPSS version 20, Qualitative categorical variables were compared using the chi-square test. A significant level value was considered when the p-value ≤ 0.05, and Cohen's d was used to measure the effect size which indicated there was a large effect of educational program on post and follow-up knowledge, authentic leadership, mindfulness, and managerial competencies scores.

RESULTS

The current study revealed that there were significant differences between nurse managers' knowledge, authentic leadership, mindfulness, and managerial competencies (P = 0.001) pre-, post-, and after 3 months of the program. As determined by Cohen's d test, there was a large effect of educational program on post and follow-up knowledge, authentic leadership, mindfulness, and managerial competencies scores.

CONCLUSION

The educational program about authentic leadership and mindfulness had a positive effect on nurse managers' managerial competencies.

TRIAL REGISTRATION NUMBER (TRN)

The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University, Egypt (code number: NUR 13/3/2022-11).

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.

Ethical leadership in physical therapy: a developing construct that demands consideration

PURPOSE

This paper aims to introduce the Theory of Ethical Leadership as a possible means of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives. Specific examples of how this can be applied directly to the profession of physical therapy will be presented.

DESIGN/METHODOLOGY/APPROACH

Leadership influences can profoundly affect a profession, an organization and an individual. This has led to exploring which leadership style would be most effective in moving their organization forward. Through a review of the literature, this viewpoint paper compares leadership theories present in the health-care literature, as well as why they may fall short of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives.

FINDINGS

Most research has separated ethics from leadership, but all agree that to be successful, the leader needs to exhibit a strong moral compass and demonstrate positive ethical behavior. At the intersection of ethics and leadership is the emerging theory of ethical leadership. Ethical leadership is based on the premise that employees look outside of themselves for ethical guidance and that leaders have an opportunity to provide this moral awareness by making an ethical message sufficiently salient to be recognized in the organizational context as well as allowing the leader to stand out against an ethically neutral ground.

ORIGINALITY/VALUE

This paper is an original work and has not been published previously, either in whole or in part. Additionally, this paper is not under consideration for publication by any other journal.

Nurse Managers' Leadership, Patient Safety, and Quality of Care: A Systematic Review

This review examined relationships between nurse unit managers' leadership and patient safety and quality of care outcomes in hospital settings. Employing four databases (CINAHL, Embase, PubMed, and Web of Science) and ancestry searches, we identified 14 English-language, peer-reviewed, primary studies that examined such relationships using quantitative analyses. The studies were published between 2012 and 2021, and most used a cross-sectional design. Each study's quality was assessed using the Mixed-Method Appraisal Tool. In synthesizing results by categorizing outcomes, we found a positive trend in associations between effective nurse unit manager leadership and better outcomes, including fewer patient adverse events, increased nurse error reporting, and higher patient satisfaction and care quality. However, the heterogeneity of leadership measurement approaches and outcomes limited integration of study findings. Future researchers should clearly define study concepts to support interpretation of their findings and should use a suitable theoretical framework to help determine appropriate units of analysis.

Adoption of social media-based knowledge-sharing behaviour and authentic leadership development: evidence from the educational sector of Pakistan during COVID-19

Purpose

This research paper aims to explore the influence of social media–based knowledge-sharing intentions (SMKI) on prospective authentic leadership development (ALD) to deal with the future crisis. In the existing literature, to the best of the authors’ knowledge, there is no significant empirical evidence to test the relationship between SMKI and ALD. Thus, this study contributes to the growing literature regarding the role of SMKIs, ALD, social media–based knowledge-sharing behavior (SMKB) and facilitating conditions (FCs). However, in this study, the authors developed a conceptual framework based on technology adoption and leadership theory. It was used to identify preservice educational leaders’ SMKIs and their effect on ALD to deal with an educational crisis during the COVID-19 pandemic. Furthermore, SMKIs are strengthening ALD, directly and indirectly, using SMKB and FCs.

Design/methodology/approach

In this study, the higher education students are considered preservice leaders who were enrolled in educational leadership and management programs. However, this study’s target population and sample are students enrolled in educational leadership and management programs. Therefore, higher education students are considered preservice educational leaders. Therefore, a multilevel questionnaire survey approach was adopted to collect data from preservice educational leaders (n = 451 at Time 1 and n = 398 at Time 2) enrolled in education departments in the selected universities in Pakistan. A total of 398 survey questionnaires were finalized with a return ratio of 89%. The partial least square structural equation modeling with SmartPLS 3.2.8 was used for the data analysis.

Findings

This research found that SMKIs are positively and significantly connected with ALD. This study also confirms that SMKB significantly and positively mediates the relationship between SMKIs and ALD. Therefore, this study concludes that preservice educational leaders were ready to adopt SMKB.

Practical implications

Social media–based knowledge sharing can be helpful to develop authentic leadership among preservice educational leaders during a crisis. Preservice educational leaders as authentic leaders can prove to be an asset in dealing with the COVID-19 pandemic crisis.

Originality/value

This research integrated the technology adoption model and leadership theory to provide empirical evidence of SMKIs’ direct and indirect influence on ALD through social media–based knowledge-sharing actual use behavior by preservice educational leaders during the COVID-19 pandemic. Moreover, the moderated mediating effect of the FCs was also studied in the relationship between SMKIs and actual user behavior as well as ALD.

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.

Exploring the role of authentic leadership in nursing

Authentic leadership is a relatively new concept in nursing, with limited studies undertaken into its application in healthcare. Authentic leadership emphasises the importance of the leader being true to their personal core values and developing honest relationships with team members, valuing their contributions, and behaving ethically and transparently. Trust is a central tenet of authentic leadership that aims to lead to increased staff engagement, and enhanced individual and team performance. This article explores the principles, benefits and challenges of authentic leadership, as well as examining its potential role in nursing.

The Trend of Authentic Leadership Skills in Nursing Education: The Key Role of Perfectionism and Self-Efficacy

(1) Background: Shaping leadership skills is a complex process, which may be modified by psychological factors such as self-efficacy and perfectionism. The aim of the study was to determine whether perfectionism can be a mediator between self-efficacy, and authentic leadership skills in nursing students; (2) Methods: The cross-sectional study included 615 Polish nursing students (women = 96.3%) was carried out at Medical University of Warsaw in 2019. The following research tools were used: Authentic Leadership Questionnaire, Almost Perfect Scale-Revised (APS-R), and General Self-Efficacy Scale (GSES); (3) Results: The level of perfectionism is a significant mediator of relations between self-efficacy as measured by the GSES and the level of authentic leadership (Sobel test: t = 6.958; p < 0.000). The relation, without a mediating factor, is positive, and the standardized beta coefficient for the feeling of self-efficacy totals beta = 0.470 (p < 0.000), while in the presence of a mediator the strength of the correlation is smaller and amounts to beta = 0.366 (p < 0.000); (4) Conclusions: Personality factors such as self-efficacy and perfectionism play an important role in shaping AL skills of nursing students. Therefore, academic teachers should pay special attention to strengthening students’ self-efficacy and adaptive perfectionism. In this context, adequate feedback and reflection may be important.

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.

Authentic leadership, nurse-assessed adverse patient events and quality of care: The mediating role of nurses' safety actions

BACKGROUND

Authentic leadership has been consistently cited as a strong precursor of sustained job performance and work effectiveness in nurses; however, studies linking authentic leadership with nurses' safety actions, nurse-assessed adverse patient events and nursing care quality are scarce.

AIM

To examine whether nurses' safety actions mediate the relationship between authentic leadership, nurse-assessed adverse events and nursing care quality.

METHODS

A multi-centre, cross-sectional study involving 1,608 nurses employed in acute care facilities in Oman. Multi-stage regression analysis was conducted in testing for the mediation model.

FINDINGS

Nurse managers in Oman were perceived to be highly authentic by their staff nurses. Authentic leadership significantly predicted nurses' safety actions (β = 0.168, p < .001), decrease in nurse-assessed adverse events (β = -0.017, p = .024) and increase in care quality (β = 0.121, p < .001). Further, the association between authentic leadership and nurse-assessed adverse events (β = -0.063, p = .057) and care quality (β = 0.038, p = .002) was mediated by nurses' safety actions.

CONCLUSION

Results suggest the importance of developing nurse managers' authentic leadership to foster nurses' safety actions and reduce adverse patient outcomes and promote nursing care quality.

IMPLICATIONS FOR NURSING MANAGEMENT

Organizational efforts to address patient safety issues should be directed towards developing authentic leadership in nurse managers through leadership programmes, periodic evaluation of leadership competencies (e.g., 360-degree or a bottom-up performance evaluation), and a creation of a safe culture in which nurses can openly report safety concerns for corrective action.