Influence of toxic and transformational leadership practices on nurses' job satisfaction, job stress, absenteeism and turnover intention: A cross‐sectional study

Labrague, Leodoro J.; Nwafor, Chidozie Edwin; Tsaras, Konstantinos

doi:10.1111/jonm.13053

Cited by 148 publications

(223 citation statements)

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“…The strong and significant influence of toxic leadership behaviours in NMs on nurse‐reported adverse events and the quality of care indicates that improving the leadership behaviours of NMs can be a potential strategy to reduce adverse events in patients and enhance the quality of nursing care in hospital units. Such a result is rather expected as toxic leaders often exhibit actions or behaviours that are destructive, causing anxiety, psychological distress (Labrague, Nwafor, et al., 2020), frustration and displeasure (Hadadian & Sayadpour, 2018; Morris, 2019) among nurses, leading to poor adherence to the nursing standard in nursing practice. Further, a leader practising toxic leadership, due to their narcissistic behaviours, is less likely to encourage interprofessional collaboration and promote the adoption of research‐based and evidence‐based practices (Lavoie‐Tremblay et al., 2016; Ma et al., 2015), which are essential to reduce or prevent the occurrence of adverse events and improve the quality of care in the unit.…”

Section: Discussionmentioning

confidence: 99%

“…Toxic leadership, another type of ineffective leadership, is increasingly becoming widespread in the management literature and has fascinated many researchers in the last few years (Einarsen et al, 2007; Hyson, 2016; Morris, 2019). Defined as a group of behaviours or actions that are destructive in nature, causing harm, indirectly or directly, to its followers and the organisation (Labrague, Nwafor, et al., 2020), toxic leadership behaviours may be categorized as intemperate, narcissistic, self‐promoting or humiliating (Labrague, Lorica, et al., 2020). While no specific theory is available to explain the occurrence of toxic leadership, previous studies have indicated a few factors within an organisation that could facilitate the occurrence of toxic leadership.…”

Section: Introductionmentioning

confidence: 99%

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Influence of nurse managers' toxic leadership behaviours on nurse‐reported adverse events and quality of care

Labrague

2020

J Nurs Manag

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Aim To assess the impact of toxic leadership behaviours among nurse managers on nurse‐reported adverse events and quality of care. Background Toxic leadership, a form of ineffective leadership, is increasingly becoming rampant in the field of nursing and has been strongly linked to poor nurse job outcomes including job dissatisfaction, higher stress levels, and increased turnover intention. To date, no studies have been conducted to examine how this type of leadership behaviours affects patient outcomes and care quality. Methods A multicentre, cross‐sectional study. This study involved a sample of 1,053 registered nurses working in 20 hospitals in the Philippines. Three standardized scales were deployed, including the Toxic Leadership Behaviors of Nurse Managers Scale, the Adverse Patient Events Scale and the single‐item quality‐of‐care‐measure. Results Overall, nurses (96.2%) appraised the quality of care of their respective units as ‘good to excellent’ and cited complaints from patients and their families as the most commonly reported adverse events. Toxic leadership behaviours in nurse managers were strongly associated with increased nurse‐reported adverse events including reports of complaints (β = .619; p < .001) and verbal mistreatment from patients and their families (β = .407; p < .001), patient falls (β = .834; p < .001), health care–associated infections (β = .629; p < .001) and errors in administering medication (β = .708; p < .001) and with decreased quality of care (β = −.216; p < .001). Conclusion Nurses who experience working under a nurse manager exhibiting toxic behaviours reported an increased frequency of nurse‐reported adverse events and poorer quality of care in the unit. Implications for Nursing Management Organizational measure to reduce the occurrence of adverse events and enhance the quality of care provided in medical units may include intervention to develop positive leadership practices among nurse managers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of nurse managers' toxic leadership behaviours on nurse‐reported adverse events and quality of care

Labrague

2020

J Nurs Manag

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“…Nurse managers rated each item on a 5‐point Likert scale (1 = not at all, 2 = once in a while, 3 = sometimes, 4 = fairly often and 5 = frequently). The ToxBH‐NM was found to have acceptable construct validity, criterion validity and internal consistency reliability of 0.975 (Labrague, et al, 2020). In the current study, Cronbach's α was 0.967.…”

Section: Methodsmentioning

confidence: 99%

“…Toxic leadership is increasingly becoming prevalent in the management literature and has fascinated many researchers in the last few years (Hadadian & Sayadpour, 2018; Hyson, 2016; Morris, 2019; Uysal, 2019), with only one study conducted in the nursing sector (Labrague, et al, 2020). Result of this single study showed that nurses who work for a manager exhibiting toxic leadership behaviours demonstrated lower job satisfaction, higher psychological distress, frequent absenteeism and increased professional turnover intention (Labrague, et al, 2020). Surprisingly, no study has yet been conducted to examine the different factors that promote toxic leadership behaviour in nurse managers.…”

Section: Introductionmentioning

confidence: 99%

Predictors of toxic leadership behaviour among nurse managers: A cross‐sectional study

et al. 2020

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Aim To identify the predictors of toxic leadership behaviour in nurse managers. Background Toxic leadership is becoming increasingly prevalent in nursing; however, the literature provides very limited evidence of the different factors that promote toxic leadership behaviour in nurse managers. Methods A descriptive, cross‐sectional design was used. Two hundred and forty nurse managers from ten hospitals in the Central Philippines were included in the study. Data were collected using the Nurse Information Form and the Toxic Leadership Behaviours of Nurse Managers Scale (ToxBH‐NM). Hierarchical multiple regression was used to analyse the data collected. Results The mean of average item score of the ToxBH‐NM was 1.250 (SD = 0.470). Multiple regression analyses identified the years of experience in a managerial role (β = −0.165, p = .031), job status (part time) (β = 0.177, p = .002), ward census (30 patients, 40 patients and above 40 patients) ([β = 0.231, p = .005]; [β = 0.345, p < .004]; [β = 0.262, p = .012]), number of units managed (2 units and > 3 units) ([β = 0.292, p < .001]; [β = 0.235, p < .001]), hospital type (private hospital) (β = 0.271, p = .007) and hospital level (secondary hospitals) (β = 0.226, p = .036) predicted toxic leadership behaviour in nurse managers. Conclusions Overall, nurse managers were appraised as non‐toxic leaders. Nurse managers who held a part‐time job status, those who had lower experience in the managerial role and those who were assigned to wards or units with high patient admission numbers reported increased toxic leadership behaviours. Further, nurse managers who managed more than 2 units, those who were employed in private hospitals and those who worked in secondary hospitals reported increased toxic leadership behaviours. Implications for Nursing Management Nurse administrators can consider the different predictors identified when planning and developing leadership interventions and organisational strategies (e.g. limiting the number of units per nurse manager, provision of full‐time job employment, assignment of assistant nurse managers, formulation of policy specific to managing toxic behaviours), which may assist in the determent of toxic behaviours in nurse managers.

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“…Several studies showed that greater work stress was associated with poorer job performance (Abualrub & Al‐zaru, 2008), job control (Chen et al., 2016), self‐perceived health status (Chen et al., 2016; Lin et al., 2014), job satisfaction (Brunetto et al., 2016; Chien & Yick, 2016; Hayes et al., 2015; Lautizi et al., 2009; Toh et al., 2012), sleep quality (Lin et al., 2014), social support (Liu & Aungsuroch, 2019) and self‐efficacy (Liu & Aungsuroch, 2019); and higher anxiety or worry (Chen et al., 2016; Lin et al., 2020), depression (Chen et al., 2016), intention to quit (Abualrub & Al‐zaru, 2008; Brunetto et al., 2016; Chien & Yick, 2016; Gardulf et al., 2005; Labrague et al., 2020; Yeh & Yu, 2009) and burnout (Liu & Aungsuroch, 2019; Toh et al., 2012; Zhang et al., 2018). Albion et al.…”

Section: Discussionmentioning

confidence: 99%

Validity and reliability of the Turkish version of the General Work Stress Scale

Teleş

2020

J Nurs Manag

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Aim To test the validity and reliability of the Turkish version of the General Work Stress Scale. Background Nursing is one of the most stressful professions. The primary measure that should be taken to ensure that nurses can cope with stress is determining their stress levels. Method The General Work Stress Scale was translated into Turkish via back‐translation. Its reliability and validity were analysed via item analyses, content and construct validities, exploratory and confirmatory factor analyses, Cronbach's alpha and Spearman–Brown reliability coefficients. Average and standard deviations of the scale items and the overall scale were calculated. Results The study was conducted with 276 nurses. The Cronbach's alpha of the whole scale was 0.91, and the Spearman–Brown reliability coefficient was 0.89. According to the resulting one‐dimensional structure, the factor loadings of the scale items were between 0.67 and 0.82, and this structure alone explained 58.72% of the total variance. The confirmatory factor analysis revealed perfect and good‐fit indices (χ2/df = 1.96; RMSA = 0.06; CFI = 0.99; IFI = 0.99; GFI = 0.97; RMR = 0.04; NFI = 0.99). The mean total score was 2.55 ± 0.87, while the items' means ranged from 2.10 ± 1.15 to 3.33 ± 1.13. Conclusion The Turkish version of the General Work Stress Scale is a valid and reliable tool for assessing nurses' general work stress. Nurses largely feel that their work makes them so stressed that they wish they had a different job. The items with high means suggest opportunities for improvement. Implications for practice The nurses or nursing services and units with low or high stress levels can be determined with the General Work Stress Scale. If necessary, measures aimed at eliminating or reducing the negative effects of those nurses or nursing services and units with high stress levels can be taken in a timely manner.

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Influence of toxic and transformational leadership practices on nurses' job satisfaction, job stress, absenteeism and turnover intention: A cross‐sectional study

Cited by 148 publications

References 46 publications

Influence of nurse managers' toxic leadership behaviours on nurse‐reported adverse events and quality of care

Influence of nurse managers' toxic leadership behaviours on nurse‐reported adverse events and quality of care

Predictors of toxic leadership behaviour among nurse managers: A cross‐sectional study

Validity and reliability of the Turkish version of the General Work Stress Scale

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