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.

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.

Defining the patient safety attitudes and influencing factors of health professionals working at maternity hospitals.

AIM: To determine patient safety attitudes of midwives, nurses and physicians and to examine the difference or correlation in patient safety attitudes of midwives, nurses and physicians working in maternity hospitals. BACKGROUND: It has been suggested that it is necessary to define the factors affecting patient safety attitudes of health professionals working in maternity hospitals. METHODS: A descriptive and correlational design was employed.The sample comprised 58 midwives, 134 nurses and 63 physicians (255) in two maternity hospitals in Istanbul, Turkey. The data were collected using an 'information form' and a 'Patient Safety Attitude Questionnaire'. RESULTS: The safety attitudes of participants were generally found to be negative. However, midwives had more positive patient safety attitudes and the age, unit, adequacy of patient safety training and the importance of patient safety were the most effective variables. CONCLUSIONS: As health professionals working in maternity hospitals generally have negative patient safety attitudes and because patient safety training provided better attitudes among the participants, these training programmes should be developed and implemented considering the differences among age groups and units. IMPLICATIONS FOR PRACTICE: Health professionals have different views on the patient safety culture; therefore, training needs to involve everyone to create a shared vision for patient safety.