Toxic leadership, mental well-being and work engagement among nurses: a scale adaptation study and structural equation model approach.

PURPOSE: Although the background on positive and supportive leadership styles and their positive effects is constantly increasing, it is known that negative and destructive leadership styles are less researched. Thus, examining the toxic leadership behaviors of nurse managers and the effects of these on nurses has a critical significance. When the measurement tools evaluating toxic leadership are examined, it is seen that there is a need for measurement tools that evaluate the toxic leadership behaviors of nurse managers. This study's purpose is to psychometrically examine the Turkish version of the Toxic Leadership Behaviors of Nurse Managers (ToxBH-NM-TR) Scale and test the hypothesized conceptual model that includes the relationships between toxic leadership, mental well-being and work engagement. DESIGN/METHODOLOGY/APPROACH: This quantitative research was carried out in psychometric, correlational and cross-sectional design. A total of 559 nurses were included in the study by using the convenience sample method. The ToxBH-NM-TR Scale, Warwick-Edinburg Mental Well-Being Scale and Utrecht Work Engagement Scale (UWES) were used to measure the latent variables of the study. The data were collected between June and October 2020 with the online survey method. IBM SPSS Statistics 24 and Amos 21 statistical programs were used to analyze the data. FINDINGS: The scale-content validity index of the ToxBH-NM-TR was 0.88. Confirmatory factor analysis results showed that the fit indices were acceptable. The ToxBH-NM-TR had high internal consistency and temporal stability. In addition, the relationships between the latent variables of the study were in the expected direction and statistically significant (p < 0.001). The hypothesized conceptual model showed an acceptable or good fit to the data. Mental well-being partially mediated the relationship between toxic leadership and work engagement. The study showed that the ToxBH-NM-TR is a valid and reliable instrument and provided evidence that confirmed the hypothesized conceptual model. RESEARCH LIMITATIONS/IMPLICATIONS: The first of these is the fact that managers' toxic leadership behaviors were determined based on nurses' self-report. For this reason, participants' potential prejudices may have affected the results of the study. The second limitation concerns the data collection technique. Using face-to-face data collection techniques during the COVID-19 pandemic could create a danger/risk for the health of nurses, researchers and patients. Therefore, the nurses in this research were reached through an online survey on social media platforms. The participants of the study were limited to those who had access to social media. Finally, some socio-demographic and professional characteristics of the participants may be a confounding variable for the model. For this reason, this conceptual model needs to be validated on other samples in different countries to increase the generalizability of the research results. PRACTICAL IMPLICATIONS: The characteristics of this leadership style should be understood, and its effects on employees and organizations should be evaluated by screening regularly to prevent the development of toxic leaders and to eliminate the harmful effects of their behavior. The nurses should respond decisively to the forces that cause them to submit in order not to encourage a toxic leadership style. Healthcare institutions should develop procedures and take a proactive approach to destructive and negative leadership behaviors and practices. In addition, nurse managers should get feedback by using informal networks and 360-degree assessment tools and evaluate whether their leadership has a toxic function by regularly screening the effects of their leadership. ORIGINALITY/VALUE: The results of this study offer important implications for nurses, managers and healthcare institutions and can be useful in gaining awareness about the negative effects of a toxic leadership style. In addition, the study provides a valid and reliable scale that will enable the identification of managers with this leadership style to prevent the development of toxic leaders and eliminate the harmful effects of their behavior.

Psychometric properties of the Gender Role Attitudes Scale among Turkish nursing students and factors affecting their attitudes.

PURPOSE: This study aimed to test the psychometric properties of the Gender Roles Attitudes Scale-Turkish Version (GRAS-TR) and evaluate nursing students' gender role attitudes. DESIGN AND METHODS: This was a psychometric and descriptive study. The sample consisted of 916 nursing students at two state universities in Turkey. FINDINGS: The content validity index of the scale was 0.89. The confirmatory factor analysis revealed that the fit indices were acceptable/good. Test-retest results and Cronbach alpha coefficient showed that the scale has high reliability. Nursing students scored above midlevel from GRAS-TR. PRACTICE IMPLICATIONS: GRAS-TR is a valid and reliable instrument. Nursing students who were women, had postgraduate education, few siblings, and were not born/raised in the eastern region had a more egalitarian attitude.

Nurses' views on change management in health care settings: A qualitative study.

AIM: To discover nurses' views on change management processes in health care settings. BACKGROUND: Because 'change' is an inevitable fact of today's health care environments, developing change management competencies at all levels is a must to survive and compete for the organisations and professionals in the health care systems. METHODS: A descriptive qualitative approach was used. The sample consisted of 18 nurses reached by using snowball sampling. The data were collected through semi-structured interviews and analysed using the Colaizzi method in the NVivo12 program. RESULTS: The results of the study were collected under three main themes: 'general approaches and initial responses to change', 'factors affecting attitudes toward change' and 'strategic mistakes made by managers during the change process'. CONCLUSION: The study showed that nurses show different reactions to change. Their attitudes towards change could be affected positively and negatively by the relevant factors. Nurses thought that managers were making strategic mistakes during the change process. IMPLICATIONS FOR NURSING MANAGEMENT: Recognizing the approaches of nurses and managers towards change and increasing awareness of the mistakes during the change process may contribute to the achievement of the change processes in health care settings.

Mental health and factors related to life satisfaction in nursing home and community-dwelling older adults during COVID-19 pandemic in Turkey.

BACKGROUND: The geriatric population is supposed to be at high risk for psychological distress as well as adverse outcomes and mortality during the COVID-19 pandemic. This study aimed to investigate the levels of depression, anxiety, death anxiety and life satisfaction levels and factors related to life satisfaction in individuals aged 65 years and older during the pandemic and to compare these variables between nursing home (NH) and community-dwelling older adults. METHOD: This study has a cross-sectional and descriptive design, and a total of 133 nursing NH and community-dwelling older adults were enrolled in the study. Turkish death anxiety scale (TDAS), life satisfaction scale (SLS) and depression anxiety stress scale-21 (DASS-21) were used for the assessment. RESULTS: The majority of the older adults had no or mild depression, anxiety and stress symptoms in spite of the prolonged confinements, and were slightly satisfied with their lives. However, depression, anxiety, stress and TDAS levels were higher in participants aged 80 years and older. Residents of NHs had higher TDAS, depression and anxiety levels and lower SLS levels than community-dwelling older adults. Participants who were meeting their children and/or grandchildren less than 2 h a week, were found to have significantly lower SLS and higher depression scores. The increase in depression and TDAS scores predicted a decrease in SLS scores in older adults. CONCLUSIONS: As NH resident older adults have higher psychological distress and decreased life satisfaction due to the social isolation caused by the prolonged confinements, NH staff should be regularly informed on both preventive measures and mental health consequences of the pandemic, and should be trained for basic therapeutic interventions. Older adults should be supported to use telecommunication technologies to contact their families and friends, and participate in safe and accessible person-centred activity programs.

Gender roles during COVID-19 pandemic: The experiences of Turkish female academics.

This study aims to explore the COVID-19 experiences of Turkish female academics in terms of gender roles by focusing on how these women have dealt with domestic and academic responsibilities. The study group consisted of 21 female academics working from home, along with their spouses. Interpretative phenomenological analysis was used to analyze the data collected through semistructured telephone interviews. The findings were clustered under five main themes: the early days of the pandemic, work life after the pandemic, domestic responsibilities after the pandemic, family relationships after the pandemic, and the perception of gender roles. The results indicate that the pandemic has deepened gender inequalities, and the academic life of female academics has changed in terms of academic productivity. Therefore, we recommend that more research examining the quarantine process and involving women in other occupations and of different socioeconomic statuses should be done to develop more effective social policies.

Development and psychometric properties of the attitude scale towards female workers in the healthcare settings.

AIM: The aim of this study was to develop a new instrument to evaluate healthcare professionals' attitudes towards female workers in the healthcare settings-the Attitude Scale Towards Female Workers (ASTFW)-and test its psychometric properties. DESIGN: This is a scale development study. METHOD: A three-phase structure was used: (1) creating the item pool, (2) preliminarily evaluating items and (3) refining the scale and evaluating psychometric properties. The scale's content validity, construct validity, internal consistency and temporal stability were evaluated according to the scale development guidelines. The scale's psychometric properties were tested with 1,635 healthcare professionals working in six different hospitals. The data were collected between November 2018 and July 2019. RESULTS: The scale items were obtained from face-to-face, semi-structured, in-depth individual interviews with the healthcare professionals. The scale's content validity index was 0.96. According to exploratory factor analysis, the scale consisted of 30 items and five subdimensions; the subdimensions were found to explain 54.48% of the total variance. Fit indices obtained with confirmatory factor analysis were at acceptable and good levels. The scale was found to have high internal consistency and temporal stability. CONCLUSION: The ASTFW is a psychometrically valid and reliable measurement instrument. The 30-item scale consists of five subdimensions: performance, gender roles, recruitment and retention, career, and emotionality. Impact This scale, which has good psychometric properties, can be used to perform a multidimensional evaluation of the attitudes of healthcare professionals in healthcare workplaces towards female workers. This scale can be useful in shedding light on negative attitudes towards female healthcare professionals in the health sector.

The experiences of nurses who studied abroad with The Erasmus program during undergraduate education: A qualitative study.

The globalization of healthcare systems and information has increased the importance of international learning and mobility programs in nursing education. This research aimed to explore and describe the lived experiences of nurses studying abroad with the Erasmus program during their undergraduate education. This is a descriptive phenomenological study. The study sample consisted of 12 nurses who studied abroad during their undergraduate education. The data were collected through semi-structured, face to face in-depth interviews. Colaizzi's seven-step method and NVivo12 software were used to evaluate the data. The study results had five main themes: (1) adaptation process, (2) sources of support, (3) differences, (4) difficulties, and (5) benefits. The nurses considered studying abroad with the Erasmus program as an important opportunity. They reported that this experience made significant positive contributions to them in the personal, professional, cultural, and social aspects.