Head nurse ethical competence and transformational leadership: a cross-sectional study

Ethical competency is important to head nurses' transformational leadership, however, few researches have explored their correlation, Additionally, most studies used variable-oriented approach to examine ethical competence, without considering it as a multidimensional concept. This study aimed to identify the latent profiles of head nurses' ethical competence and examine differences in transformational leadership across latent profiles.

Convenience sampling was used to recruit 329 head nurses from four tertiary hospitals in Changsha, Hunan province, China. This study collected data by using social-demographic survey, Ethical Competence Questionnaire, and Head Nurse's Transformational Leadership Self-rating Scale between July and August 2023. Latent profile analysis (LPA) was employed to identify latent profiles of ethical competency. One-way ANOVA test and the Kruskal-Wallis test were used to compare the transformational leadership scores across latent profiles of ethical competency.

The mean scores of ethical competence and transformational leadership were 4.045 ± 0.394 and 4.555 ± 0.419, respectively. This study identified three latent profiles of head nurses' ethical competence, and those profiles labelled "low ethical competence" (n = 60, 18.2%), "moderate ethical competence" (n = 217, 66.0%) and "high ethical competence" (n = 52, 15.8%). The average score of transformational leadership was also statistically different (F = 26.446, p = 0.000) across the three profiles.

Our findings underscore the importance of tailoring interventions to address the varying profiles of ethical competence among head nurses. Enhancing ethical competence can strengthen transformational leadership, ultimately leading to improved patient outcomes and overall healthcare quality.