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

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Journal of Nursing Management
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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.
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Research Article
Authentic Leadership and Psychological Well-Being of Nurses: A
Mediated Moderation Model
Stephen Teo ,
1
Andrei Lux ,
2
and David Pick
3
1
Northumbria University, Newcastle Upon Tyne, UK
2
Edith Cowan University, Perth, Australia
3
Curtin University, Perth, Australia
Correspondence should be addressed to Stephen Teo; stephen.teo@northumbria.ac.uk
Received 31 October 2022; Revised 4 February 2023; Accepted 8 February 2023; Published 27 February 2023
Academic Editor: Bing-Qian Zhu
Copyright ©2023 Stephen Teo et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Aims. is study investigates how authentic leadership inuences 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) t 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 inuence 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 (N230,
response rate 38.3%) to minimize the potential eects of common source bias. e hypotheses were tested using Hayes Process
Macro (Model 14) on IBM SPSS. Results. e hypothesized model had good t indices and supported the mediated moderation
model. ere was no support for the direct association between authentic leadership and PWB. e supervisor authentic
leadership behavior was negatively associated with workplace incivility and PWB. e association between incivility and PWB was
positively associated with P-O t. Nurses with high P-O t reacted strongly to the positive eect 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. ey will then be better equipped to improve the PWB of their followers by minimizing the prevalence of
workplace incivility. Impact: the study found a signicant indirect relationship between authentic leadership behavior and psychological
well-being, as mediated by workplace incivility and moderated by person-organization t. e ndings highlight the importance of
positive leadership behaviors on the well-being outcomes of nurses in Australia.
1. Introduction
Nurses work in a high-stress, high-demand environment
that creates considerable job strain [1]. is challenging
work context is made even more dicult by mis-
treatments such as workplace incivility [2], which is
a source of psychological stress [3]. Workplace incivility is
the result of workplace interpersonal as conict, evident
by rude, disrespectful, and discourteous behaviors that are
in violation of mutual respect [4, 5]. Workplace incivility
behaviors create situations where nursing and allied sta
are distracted from their duties in ways that could
compromise the quality of nursing care [6]. Workplace
incivility tends to be lower in intensity than most
workplace deviant behaviors and has an ambiguous intent
to cause harm to others, which makes monitoring and
dealing with perpetrators and targets a challenging task
[5]. Where it occurs, workplace incivility is disruptive to
the work environment because it breaches accepted
standards of professional conduct and norms of civility
[7]. Such behaviors could result in signicant harm to
employees, to the organization, and patients [8] and could
aect nurses’ intention to stay [9]. In this study, we will
focus on workplace incivility and the extent to which
Hindawi
Journal of Nursing Management
Volume 2023, Article ID 7593926, 9 pages
https://doi.org/10.1155/2023/7593926
authentic leadership can help reduce its prevalence and
mitigate its negative eect on PWB. e inuence of
leadership behaviors on followers’ well-being is an under-
researched topic generally [10] and in the nursing man-
agement literature (see [11]).
In this paper, authentic leadership is dened as “a
pattern of transparent and ethical leader behavior that
encourages openness in sharing information needed to
make decisions while accepting input from those who
follow” [12], (p. 424). Lemoine et al. [13]; (p. 2051) noted
that “authentic leadership is primarily concerned with
a leader’s self-awareness, self-regulation, and self-
concordance, and modeling these characteristics to sub-
ordinates. . ..” is positive, relational leadership behavior
[14] is particularly relevant in the healthcare setting [15].
Authentic leaders promote healthy work environments to
mitigate workplace incivility and, in turn, enhance their
followers’ well-being [13]. Authentic leaders are self-
reective, listen to feedback, and practice empowerment,
which impact positively on nurses’ well-being [15]. Nursing
leaders who exhibit authentic leadership behavior are
grounded in their moral and ethical values.
Nelson et al. [11] note that dierent ways of oper-
ationalizing PWB include a plethora of approaches that
range from perceived work stress [16] to exhaustion [2] and
psychological distress [17]. We deployed “psychological
distress” to conceptualize and measure PWB [18] because
PWB is an outcome of the interplay between interpersonal
relationships at work [19]. is particular approach to
operationalizing “psychological distress” is commonly found
in other studies conducted on the work and well-being of
nurses [17, 20, 21]. Psychological distress has been used as an
indicator of well-being by the World Health
Organization [22].
To the best of our knowledge, the hypothesized indirect
relationships have not been empirically tested. e mediated
moderation model we propose (see Figure 1) is theoretically
informed by social learning theory (SLT) [23, 24]. SLT is
used to conceptualize why followers learn from their leader’s
authentic, moral, and ethical behaviors to minimize work-
place incivility. Followers learn what is socially acceptable by
observing the values and behavior exhibited by their su-
pervisors. When supervisors display authentic leadership
behaviors, those they supervise are likely to adopt similar
work values and behave accordingly. P-O t is a form of
subjective value congruence and is dened as the “com-
patibility between people and the organizations in which
they work” [25], p. 1). e alignment of one’s own values
with their organization’s values is critical to employees’ work
attitudes [26] and stress [27].
In this study, workplace incivility is an example of
workplace mistreatment that impacts negatively on the PWB
of nurses. It is hypothesized as a mediator, while person-
organizational (P-O) t is hypothesized as a moderating
variable of the direct association between authentic lead-
ership and PWB. is study contributes to the literature by
unpacking the indirect (mediation and moderation)
mechanisms driving the direct and indirect inuence of
authentic leadership on PWB.
2. Background
2.1. Direct Relationship: Authentic Leadership and PWB.
Nursing is an occupation where employees regularly en-
counter high levels of psychological stress, which often leads
to chronic health problems [1]. Psychological stress is de-
ned as “a particular relationship between the person and
the environment that is appraised by the person as taxing or
exceeding his or her resources and endangering his or her
well-being” [19], p. 19). As an example of PWB [18], psy-
chological distress is an outcome of the interplay between
a person and their work environment [19]. Underpinned by
positive psychology, authentic leadership has been proposed
to be an eective tool for improving the PWB of nursing
professionals [28]. Authentic leaders “are guided by sound
moral convictions and act in concordance with their deeply
held values, even under pressure, and strive to understand
how their leadership impacts others” [29], p. 332). Authentic
leadership is comprised of four components: self-awareness,
internalized moral perspective, balanced processing, and
relational transparency [28]. Authentic leadership contrib-
utes to a healthy work environment, which is benecial for
sta and patients [28]. Authentic leadership has the potential
to build trust and condence, which in turn results in higher
PWB when employees feel valued and respected [11]. Fol-
lowers’ experiences of leader authenticity can be concep-
tualized as a resource that can be deployed to help improve
their well-being at work [16]. We hypothesized that:
H1. ere is a positive, direct association between the
supervisor’s enactment of authentic leadership behaviors
and followers’ PWB.
2.2. Authentic Leadership, Workplace Incivility, and PWB.
We theorize that the direct relationship between authentic
leadership and PWB is mediated by workplace incivility. To
our knowledge (see the systematic review by [28]), there are
few empirical studies that examine this mediation relation-
ship. To address this gap in our knowledge, we contend that
authentic leadership can help to eliminate workplace in-
civility, which then improves followers’ PWB. While au-
thentic leadership has the potential to reduce the incidence of
workplace incivility, our review of existing research brought
to light only one study in the context of nursing [2].
Workplace incivility has received considerable research
attention over the past three decades (e.g., [5]). Incivility is
a “subtype of workplace mistreatment that is characterized
by low-intensity social interactions that violate norms of
respect and whose harmful intent is ambiguous” [30], p. 316.
Authentic
Leadership
P-O Fit
Workplace
Incivility
Psychological
Wellbeing
H2
H1
H3
H2
Figure 1: Proposed mediated moderation model.
2Journal of Nursing Management
It occurs far more frequently [4] and can be just as harmful
[31] as other forms of harmful behavior. Workplace in-
civility has a negative association with the PWB of targets
[31, 32].
Bandura’s [23] SLT can be used to explain the indirect
association between authentic leadership and PWB in that
while authentic leaders inuence the ethical conduct of their
followers as a result of role modeling, they also create the
work environment by signaling to their team the importance
of respect and trust in the workplace [28]. ese behaviors
form the acceptable standard, which then diuses across and
trickles down the organization via social learning [33],
encouraging others to behave in a similar manner. In this
way, authentic leaders encourage employees to treat others
fairly and with respect while discouraging violations of these
expectations [34]. is social learning process can be an
inuential mechanism through which authentic leaders can
aect followers’ well-being at work [35] by encouraging
civility norms [2]. We hypothesize the following
relationship:
H2. Workplace incivility has an indirect mediation eect
on the association between the enactment of authentic
leadership behaviors and followers’ PWB.
2.3. P-O Fit as Moderator. As an example of value con-
gruence [36], P-O t allows “judgments of congruence
between an employee’s personal values and an organiza-
tion’s culture” [36], p. 875). Avolio and Gardner [37] noted
that leaders who exhibit authentic leadership behaviors tend
to develop and foster high relational quality and close re-
lationships with their followers, which, in turn, foster greater
value congruence (or P-O t) and follower reciprocation in
the behaviors consistent with the leaders’ values. Such
reciprocity is acquired in the process of social learning and
aects followers’ well-being (Zheng et al., 2022). Mackey
et al. [27] conceptualize P-O t as a personal resource to
buer workplace stress “because perceptions of organiza-
tional t are generally sought after and valued, which
provides stress-resistance potential” (p. 459) as it improves
employees’ health and well-being. Meta-analytical review
ndings from Kristo-Brown et al. [26] support the notion
that higher levels of P-O t are associated with lower levels of
work-related stress as employees tend to express a higher
level of well-being when they perceive a t of their own
values with their employers. Workplace incivility as an
example of stressful work events in the healthcare setting
[2, 28] could then be buered by the extent to which nurses
perceived P-O t. We therefore hypothesize that:
H3. e relationship between workplace incivility and
PWB is moderated by P-O t such that when value con-
gruence is high, the negative eects of workplace incivility
on PWB will be weaker.
3. Methods
At the time of data collection, there were 352,838 registered
nurses and midwives (including registered nurses, enrolled
nurses, and midwives), as reported by the Australian
Institute of Health and Welfare [38]. PureProle, a research
company based in Australia, was engaged to assist with
sending out an online survey to their panel members (in-
clusion criteria: nurses from Australia, between 18 and
65 years old, full and part-time employment, employment in
public, private, and not-for-prot hospitals). is re-
cruitment strategy is common in the literature (e.g., [39].
Our exclusion criteria included those who were not residents
of Australia at the time of the study, not qualied as “nurses”
as dened by the Australian Health Practitioner Regulation
Agency, and those who were older than 65 years old.
We received useable responses from 600 Australian
nurses in Wave 1 of data collection. ey provided data on
demographic and control variables, authentic leadership and
P-O t, and workplace incivility. e respondents were
contacted again six months later to provide their responses
for their PWB at Time 2. In this cross-sectional study, we
obtained 230 useable matched responses (response rate-
38.3%). We decided to use a six-month temporal sepa-
ration between waves as informed by the incivility literature
(see [40]). GPower analysis concluded that this sample size
has sucient power and eect size to yield signicant ac-
curacy and exibility of predictions with three
predictors [41].
3.1. Measures. We adopted previously validated scales in
this study. e composite reliability coecient (CR), average
variance estimate (AVE), and maximum shared variance
(MSV) are reported below.
3.1.1. Authentic Leadership. We used the 16-item Authentic
Leadership Questionnaire (ALQ) from Walumbwa et al. [14]
to measure respondents’ perceptions of their immediate
supervisor’s authentic leadership behaviors. It is deemed
appropriate to ask employees to provide an assessment of
their supervisor’s leadership behavior if they have daily
interaction with them and can observe whether they dem-
onstrate those behaviors [34]. Sample item includes “Dis-
plays emotions exactly in line with feelings.” e items were
rated on a ve-point Likert type scale, ranging from 1 “not at
all” to 5 “frequently, if not always” (CR 0.98, AVE 0.93, and
MSV 0.32).
3.1.2. Person-Organization Fit (P-O Fit). We used the 3-item
scale developed by Cable and DeRue [36] to operationalize
P-O t. is scale has been used in the literature [42]. A
sample item reads: “My personal values match the organi-
zation’s values.” ese were rated on a seven-point Likert
type scale, ranging from 1 “strongly disagree” to 7 “strongly
agree” (CR 0.95, AVE 0.83, and MSV 0.32).
3.1.3. Workplace Incivility. We used the 5-item scale from
Cortina et al. [31] to measure workplace incivility. A sample
item asks respondents if they had experienced various
workplace incivility in the previous six months, such as
“Addressed you in unprofessional terms, either publicly or
privately?” (ranging from 0 “never” to 4 “frequently “at least
Journal of Nursing Management 3
once a day”)”. e content and discriminant validity of this
scale are well established [31]. In this study, we found the
validity and reliability coecients to be satisfactory (CR 0.95,
AVE 0.74, and MSV 0.13).
3.1.4. Psychological Well-Being (PWB). We used the Kessler
K-10 Psychological Stress Scale [43] to measure PWB at
Time 2. is scale is comprised of 10 commonly found stress
symptoms, and in Australia, the K-10 scale has been used as
an indicator of well-being in the 2017–18 National Health
Survey [44]. It has been used to measure PWB in the nursing
profession [17, 20] and in workplace incivility research [45].
Respondents were asked to indicate how frequently they
have experienced these stress symptoms over the past
30 days (sample item: “Did you feel that everything was an
eort?”). Responses were recorded on a ve-point Likert
type scale ranging from 1 “none of the time” to 5 “all of the
time.” is scale was reverse-coded such that low scores
represent distress (low PWB). Validity and reliability co-
ecients were found to be satisfactory (CR 0.95, AVE 0.64,
and MSV 0.13).
3.1.5. Control Variables. In addition to adopting temporal
separation in data collection [46], we also controlled for the
eects of gender, age, the average number of patients per
shift, and organizational tenure because these variables have
previously been found to be associated with incivility [47].
3.2. Ethical Considerations. Ethics approval was obtained
before data collection from Curtin University (reference:
SOM 19–12). Consistent with good practice, we assured the
participants’ anonymity and condentiality in the partici-
pant information letter.
3.3. Data Analysis. We used IBM SPSS v.25 to perform
bivariate correlations and descriptive statistics. Conrma-
tory factor analysis was conducted within IBM AMOS v25,
and model testing was completed using Model 14 of Hayes’
[48] Process Macro within IBM SPSS v27.
3.4. Validity and Reliability. All of the scales exceed the
recommended reliability thresholds [49]. e Fornell and
Larcker’s [50] Average Variance Extracted (AVE) test was
used to establish the discriminant validity of the scales used
in the survey. All of the scales met the 0.50 threshold for
AVE, and the square root of the AVE for each scale was
higher than its correlation with any other scale. is nding
indicates that the scales measured distinct latent constructs.
We used a time-lag research design [46] to minimize
common method variance (CMV). As noted by Podsako
et al. [46], the inclusion of a moderator (incivility ×P-O t)
in the model ensures that CMV would not produce statis-
tically signicant eects. We also employed proactive pro-
cedural remedies such as the random ordering of survey
items and ex-post statistical tests (see [46]) to further
minimize any potential eects of CMV. To this end, we also
conducted Harman’s single factor test by subjecting all items
to an unrotated exploratory factor analysis which revealed
a single largest factor that explained 29.9% of the variance.
Given this result, we were condent that CMV eects were
not present.
Before testing the 4-factor hypothesized model (that is,
authentic leadership, workplace incivility, P-O Fit, and
PWB), we conducted several nested measurement model
comparisons against three (authentic leadership + workplace
incivility, P-O Fit, and PWB), two (authentic leader-
ship + workplace incivility, P-O Fit and + PWB) and single
(authentic leadership + workplace incivility + P-O
Fit + PWB), factor alternate models. e results indicate
that the hypothesized 4-factor model was the best t to the
data (χ
2
/df1.33, CFI 0.98, TLI 0.98, RMSEA 0.04,
SRMR 0.04) and corresponds with our hypothesized
framework.
4. Results
As previously reported, 230 Australian nurses completed the
two-wave online questionnaire. e majority of the re-
spondents were female (84.3%). Half of the respondents
worked part-time (53.5%), and most were employed by
public and not-for-prot sector health care organizations
(66.1%). Respondents were from New South Wales (33.9%),
Victoria (23.0%), Queensland (16.5%), South Australia
(12.6%), and Western Australia (9.1%). Over half of the
respondents were between 41 and 60 years old (53.9%),
followed by those who were 31–40 years old (20.0%), which
matches the 2017 data produced by the [51] report (53.6%
and 19.6%, respectively) and is consistent with the na-
tionwide health workforce data for nurses and midwives.
e largest group of nurses had greater than ten years of
organizational tenure (30.4%), followed by those with six to
ten years (23.9%), and then those with three to ve years
(16.1%). e respondents had on average 18.7 patients per
shift (SD 36.7).
Descriptive statistics and zero-order correlations are
reported in Table 1. On average, nurses reported their im-
mediate supervisor’s leadership behavior to be moderately
authentic (M3.27, SD 0.87). Ratings of incivility fre-
quency showed 40 nurses had no experience with incivility
(17.4%), 78 experienced incivility once every few months or
less (34.0%), 51 experienced incivility once a month (22.2%),
46 experienced incivility at least once a week (20.0%), and 15
nurses experienced incivility at least once a day (6.4%). is
nding is consistent with the literature, as nurses tend to
experience a high level of workplace incivility (see [45, 52]).
ey also reported a moderate level of value congruence with
their organization (M4.06, SD 1.55).
To test the hypothesized relationships, we conducted
a multiple regression analysis using Model 14 of Hayes’s [46]
PROCESS macro with 10,000 bootstrapped subsamples
using IBM SPSS v25. Control variables were also entered
into the model. ere was a positive association between
workplace incivility and average patients per shift (β0.17,
p<0.05) and a negative association with age (β 0.07, p
<0.05). ere was a positive association between PWB and
4Journal of Nursing Management
gender (β0.31, p<0.001) and a negative association with
supervisory position (β 0.23, p<0.01). ere was no
support for a direct relationship between authentic lead-
ership and PWB (hypothesis 1), while the remaining hy-
potheses were supported (see Table 2). ere was a negative
association between nurses’ perception of their supervisor’s
authentic leadership and workplace incivility (β 0.33, p
<0.001). Workplace incivility had a negative association
with PWB (β 0.53, p<0.05).
Results of the indirect paths are reported in Table 3.
Workplace incivility mediated the eect of authentic lead-
ership on PWB (eect 0.13, SE 0.05, 95% CI [0.24, 0.03]),
and there was support for P-O t to moderate the full
mediation of authentic leadership on PWB (eect 0.048, SE
0.017, 95% CI [0.084, 0.016]). Hypothesis 2 was sup-
ported. Nurses’ P-O t moderated the negative relationship
between workplace incivility and PWB (β= 0.16, p<0.01).
e moderation plot (see Figure 2) indicates that P-O t
minimized the negative association between workplace in-
civility and PWB. As shown in Table 3, these results provide
evidence to support a mediated moderation model.
5. Discussion
e main aim of this study was to respond to the call in the
literature to investigate the impact of leadership behaviors
on the well-being of followers. As part of this research, we
tested the mediator eect of workplace incivility and value
congruence (measured by P-O t) as a moderator. Our
ndings have three main implications.
First, our study contributes to the literature by en-
hancing our understanding of authentic leadership [2, 28] in
PWB, especially in minimizing psychological distress. is
nding contributes to the underresearched topic of how
leadership behaviors aect followers’ well-being [10, 11]. By
establishing an indirect association between authentic
leadership and PWB, our study has provided additional
evidence of the eect of authentic leadership in minimizing
workplace incivility, and in doing so, sheds light on how
authentic leadership inuences the PWB of nurses at dif-
ferent stages of their work tenure beyond early career and
initial job experiences [2, 53].
e application of social learning theory [23] allows us to
unpack how this process takes place in the nursing context
[24]. Supervisors who engage in authentic leadership be-
haviors are likely to discourage workplace incivility by
openly displaying and upholding ethical norms and values
regarding acceptable workplace conduct [2]. Followers learn
that this is the accepted social norm and imitate their leader’s
positive behaviors. is in turn reduces the prevalence of
workplace incivility and improves PWB. Authentic leader-
ship behaviors enable nurse managers to create a more civil
work environment and enhance employees’ well-being at
work (e.g., [35]).
Second, we found workplace incivility (a form of
workplace deviance) had a negative association with nurses’
PWB. While there are a variety of approaches to oper-
ationalizing and measuring PWB evident in previous re-
search, in this study we have demonstrated how
psychological distress as an indicator for PWB [18] could be
enhanced by minimizing interpersonal deviance at work.
Workplace incivility depletes the psychological resources of
those who are aected by the behaviors [27]. Employees
could learn positive leadership behaviors by mirroring the
authentic behaviors of their supervisors, which in turn helps
to minimize the prevalence of workplace mistreatment
across the organization [54].
ird, P-O t was found to be a moderator of the
association between workplace incivility and PWB. As
indicated by the moderation plot, the moderation eect
occurs when the P-O t is high. What we have is a situation
where the enactment of authentic leadership behaviors
leads to less workplace incivility. is leads to a higher level
of PWB for nurses who exhibit a high level of P-O t. P-O
t, as a form of value congruence, could be treated as
a resource that nurses could draw upon to maximize the
positive consequences of civility. is moderation nding
represents a contribution to the literature as it has not been
empirically tested [27]. Our nding also adds to our un-
derstanding of the contribution of P-O t on employee
well-being outcomes at work [26].
5.1. Practical Implications. is study has implications for
nurse managers as well as managers in the health and public
sectors generally. Our ndings suggest that health care
managers should be trained to develop their positive, re-
lational leadership styles. e enactment of authentic
leadership behaviors by frontline supervisors combats
workplace stressors and improves well-being by minimizing
workplace incivility in healthcare settings. Authentic lead-
ership could lead to the development of more civil [2],
heathy, and safe workplaces that minimize employee mis-
treatment [54]. is inuence is reinforced through an
improvement in the P-O t between nurses’ personal values
and those of the organization where they work. As a form of
ethical leadership behavior, authentic leadership has the
potential to signicantly reduce workplace incivility and
increase PWB among employees in high-demand work
environments like nursing.
Table 1: Descriptive statistics and intercorrelations.
Mean SD 1 2 3 4
1. Authentic leadership (T1) 3.27 0.87 0. 8
2. Workplace incivility (T1) 1.14 1.03 0.40
∗∗∗
0. 5
3. P-O t (T1) 4.05 1.54 0.53
∗∗∗
0.34
∗∗∗
0. 5
4. Psy well-being (T2) (Low scores in psychological well-being scale represent
distress) 2.06 0.94 0.09 0.49
∗∗∗
0.07 0. 5
Note.N230.
∗∗∗
p<.001. Correlations of control variables are not reported. Bold, italicized text: Composite Reliability Coecient. T1: time 1. T2: time 2.
Journal of Nursing Management 5
Workplace incivility could be minimized by introducing
workplace civility programs, which could be used to reduce
incivility in order to improve job attitudes and well-being
[2, 55]. An example is the 6-month workplace intervention
model known as CREW - Civility, Respect, and Engagement
at Work [56]. As part of the intervention, nurses would meet
with their coworkers within their workplace on a weekly or
biweekly basis to work on eective interpersonal interactions
at work” [56]. Trained facilitators would provide guidance to
the groups on how to improve workplace communication.
is intervention seeks to improve workplace social re-
lationships in order to enhance respect. A civility toolkit could
also be produced, similar to the one proposed by the UK’s
National Health Service (NHS). e NHS used the toolkit to
create a civil and respectful culture to improve employee well-
being and patient care [52]. ese organizational practices are
important as they could improve nurses’ person-organization
t and are likely to reciprocate with aective commitment and
a greater sense of belongingness. Nursing supervisors who
exhibit authentic leadership behavior in the workplace by
striving to build open, genuine relationships and by helping
their followers t in with their workplace create more civil
work environments that promote employees’ well-being and,
ultimately improve the quality of care [6].
5.2. Limitations and Future Research Implications.
Focusing on nurses in the Australian health care sector limits
the generalizability of our ndings. We applied procedural
and statistical remedies to provide assurance that common
method bias did not aect our results [46]. Control variables
were incorporated to control for confounding eects. We
should note the potential for reverse causality remains.
Future studies should test the possibility of a reverse causal
relationship between authentic leadership and PWB by
collecting longitudinal data. Multisource data could be used
to develop our ndings by better isolating the predictors of
PWB. It might also be valuable to explore further the extent
to which and how authentic leadership is being measured by
using experimental design or implicit measures, or to
Table 2: Results of mediated moderation analysis using Hayes process macro model 14.
Unstandardized βSE TpLLCI ULCI
DV workplace incivility (R-sq 0.2522)
Constant 0.0498 0.1049 0.4744 0.6357 0.2565 0.1569
Gender 0.0650 0.0636 1.0225 0.3077 0.1904 0.0603
Employment status 0.0004 0.0011 0.3842 0.7012 0.0017 0.0025
Average patients per shift 0.1725 0.0854 2.0199 0.0446 0.0042 0.3408
Age 0.0687 0.0283 2.4298 0.0159 0.1245 0.0130
Authentic leadership T1 0.3247 0.0425 7.6362 0.0000 0.4085 0.2409
DV PWB (R-sq 0.1208)
Constant 2.5356 0.3226 7.8599 0.0000 1.8998 3.1714
Gender 0.3064 0.1011 3.0318 0.0027 0.1072 0.5055
Employment status 0.0279 0.0621 0.4487 0.6541 0.0945 0.1502
Average patients per shift 0.0005 0.0010 0.4706 0.6384 0.0025 0.0015
Supervisory position 0.2252 0.0829 2.7170 0.0071 0.3885 0.0618
Age 0.0340 0.0285 1.1932 0.2341 0.0901 0.0221
Authentic leadership T1 0.0273 0.0531 0.5153 0.6069 0.0772 0.1319
Workplace incivility T1 0.3366 0.1419 2.3714 0.0186 0.6163 0.0569
P-O t T1 0.0706 0.0420 1.6834 0.0937 0.1533 0.0121
Wk incv ×P-O t (interaction) 0.1227 0.0384 3.1943 0.0016 0.0470 0.1984
N230.
Table 3: Results of mediated moderation analysis.
Direct eect of authentic leadership on PWB (hypothesis 1)
Eect se tpLLCI ULCI
0.0273 0.0531 0.5153 0.6069 0.0772 0.1319
Conditional indirect eects of Xon Y
Indirect eect: authentic leadershipworkplace incivilityPWB (hypothesis 2)
P-O t (moderator) Eect BootSE BootLLCI BootULCI
2.2765 0.0186 0.0263 0.0319 0.0717
3.6357 0.0356 0.0222 0.0807 0.0071
4.995 0.0897 0.0314 0.1541 0.0300
Index of mediated moderation (hypothesis 3)
Index BootSE BootLLCI BootULCI
P-O t (moderator) 0.0398 0.0137 0.0680 0.0140
6Journal of Nursing Management
explore the relationship between leaders’ intentions and
followers’ perceptions of authentic leadership behavior [57].
Recall bias could be another potential limitation, which can
be addressed by using a daily diary design [58].
6. Conclusion
Our study aimed to examine how authentic leadership
behavior aects the well-being of nurses where workplace
incivility is present. Using data collected from a sample of
nurses working in Australian health care organizations, we
found evidence to support the argument that workplace
incivility has a deleterious eect on PWB. Our study suggests
that nursing managers have an important role to play in
protecting and improving the well-being of those they su-
pervise, and authentic leadership behavior is an additional
and eective skill in this endeavor [59–63].
Data Availability
e survey data used to support the ndings of this study
have not been made available because of restriction imposed
by institutional review board for sharing data. is was part
of the ethics approval conditions.
Conflicts of Interest
e authors declare that they have no conicts of interest.
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... As well Zhao, Ahmed, and Faraz (2020) suggested that by fostering a psychologically secure atmosphere, an inclusive leadership style can act as a strategy to prevent or limit psychological suffering for healthcare professionals. Studies like Nelson et alii (2014) and Teo, Lux, and Pick (2023) reported that authentic leadership increases or improves the levels of psychological well-being in the healthcare setting. Through the paper done by Zhang et alii (2023), our review also showed that authentic leadership needs psychological capital to impact nurses' caring behavior. ...
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The healthcare setting is a complex and dynamic workplace that interacts with the worker’s well- being. Interventions that aim to protect the healthcare workforce from workplace pressure should consider, among other targets, management or leadership styles. We aimed to describe the effects of leadership style on healthcare workers’ psychological well-being. A scoping review was conducted by synthesizing the peer-reviewed original research accepted or published about the effect of leadership styles on mental well-being in French and English from the databases PubMed and Google Scholar during the past decade (2013-2024). We got from the research strategy 516 records, and 13 studies in English from 7 countries were included for synthesis. Leadership styles such as abusive and exploitative interact negatively with healthcare workers’ mental well-being in the form of emotional pressures, cognitive pressures, or mental pressures, psychological distress, stress, exhaustion, and interfering with psychological capital and ownership. Whereas leadership styles such as transformational, supportive, authentic, and inclusive leadership styles safeguard the health staff’s mental well-being. The result of this review recommends putting in place leadership development programs to introduce leadership development into the health school students’ curriculum. Our study proposes also conducting research with analytic and experimental designs, as well as extending studies to other healthcare professionals and healthcare settings. Key words: leadership styles, healthcare worker, psychological well-being.
... This result was similar to Wong et al., (2020) who conducted a study in Canada to assess authentic leadership and job satisfaction among long-term care nurses, and found that more than half of studied nurses perceived moderate authentic leadership. Also, this result was supported by Teo et al., (2023) whose study aimed to investigate how authentic leadership influences the psychological wellbeing of Australian nurses, and stated that nurses reported their immediate supervisor's leadership behavior to be moderately authentic. ...
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Purpose There have been strides in workplace incivility (WI), but in what direction, angles and theoretical streams are they taking place? In light of it, the purpose of this review is to analyze the overall WI research output yielded in the initial decades of this century. Design/methodology/approach This investigation searched exclusively for empirical articles written in English that matched the terms incivility and WI in the websites of prominent peer-review publications covering the period of 19 years (i.e. 2000–2019). As a result, 93 peer-reviewed empirical studies were properly gathered and classified. Findings WI is one of the most relevant topics in OB studies under scrutiny in this moment. Corroborating such a perception is the huge amount of outlets that have been publishing about WI. In this sense, it is a topic that has gained strong interdisciplinary status, given the manifested interest of very distinct areas. Cross-sectional studies have prevailed in terms of method preferences, yet other approaches have been used. Of noteworthy is the shortage of qualitative and meta-analytic studies. Data provided evidence that a very limited number of nations (only 18 countries) have been investigated and it is not exactly surprising that the United States be the target of the majority of studies in this field. The antecedents and consequences of WI are the major focus of the investigations. But I found some evidence that that WI has been tested as performing the role of measure, mediator and moderator. Research limitations/implications It focused exclusively on peer-review journals and articles written in English. Originality/value This endeavor contributes to the theory of WI by encompassing crucial aspects such as time horizon, major outlets, study types, country-level output, samples features, constructs perused, theoretical function of WI and research outcomes. In addition, it points out new potential research streams.