Status and Influencing Factors of Nurses’ Perception of Toxic Leadership Behavior: A Cross-Sectional Study

Abstract

Aim. The aim of this study is to analyse the toxic leadership behavior of nurse managers perceived by nurses and its related factors. Background. Toxic leadership is becoming more common as a risk factor in nursing. However, there is a scarcity of research on the elements that influence toxic leadership practices from the perspective of nurses’ perceptions. Methods. A cross-sectional study was conducted with 455 nurses from August to October 2022. A demographic information questionnaire and a negative behavior scale for nurse managers were used. Descriptive statistics, Kruskal–Wallis H test or Mann–Whitney U test, and multiple linear regression were used to explore the relevant factors of nurses’ perceived toxic leadership behaviors of nurse managers. Results. The population was dominated by 423 (92.97%) females, 318 (69.89%) married, and 420 (92.31%) with a bachelor’s degree. The toxic leadership behavior scale score for nurse managers was 109 (87, 123) and the score for each entry was (2.94 ± 0.92). Gender, educational level, department, number of night shifts, and nature of employment were the influencing factors of the negative leadership behavior of nurse leaders as perceived by nurses ( $P$  < 0.05), explaining a total of 43.1% of the total variance. Conclusion. In general, nurses’ perceived toxic leadership behaviors of nurse managers were at a moderate level. More toxic leadership behaviors were observed by nurses who were female, less educated, on busy units, with unstable nature of appointments, and with frequent night shift rotation. Implications for Nursing Management. Focus on the psychological condition of nurses who are female, less educated, work in busy units, have an unstable nature of employment, and rotate night shifts frequently. The negative impacts of toxic leadership behaviors might be lessened as a result.