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Psychological Well-Being as a Mediator Between Paternalistic Leadership and Organisational Dissent in Critical Care
Amal Diab Ghanem Atalla1, Haitham Mokhtar Mohamed Abdallah2,3, Rabab Saleh Mohamed Shaheen1
1Department of Nursing Administration, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Background:
Leadership styles play a crucial role in shaping nurses' psychological well-being and communication behaviours, especially in high-stress settings like critical care. Paternalistic leadership-characterised by benevolence, moral integrity and authority-has gained recognition for its impact on healthcare outcomes. However, its influence on organisational dissent, particularly through the lens of psychological well-being, remains underexplored.
Aim:
To Investigate the Mediating Role of Psychological Well-Being in the Relationship Between Paternalistic Leadership and Organisational Dissent Among Nurses in Critical Care Settings.
Study Design:
A cross-sectional descriptive study was conducted. A convenience sample from 23 critical care units in a large educational government hospital participated. Data were collected using the Paternalistic Leadership Scale, Psychological Well-Being Scale and Organisational Dissent Scale. Statistical analyses included Pearson correlation, regression and path analysis.
Results:
Among 460 nurses, paternalistic leadership was positively correlated with psychological well-being (r = 0.263, p < 0.001) and negatively correlated with organisational dissent (r = -0.278, p < 0.001). Psychological well-being also negatively correlated with dissent (r = -0.258, p = 0.001). Regression and path analysis confirmed that psychological well-being partially mediated the relationship between paternalistic leadership and organisational dissent. The mediation model showed statistically significant direct and indirect effects.
Conclusions:
Paternalistic Leadership Enhances Nurses' Psychological Well-Being and Reduces Organisational Dissent. Psychological Well-Being Acts as a Partial Mediator, Emphasising Its Importance in Translating Leadership Support Into Reduced Dissent Behaviours.
Relevance To Clinical Practice:
Fostering paternalistic leadership and supporting nurses' psychological well-being are critical to maintaining constructive communication and reducing harmful dissent. Healthcare institutions should implement leadership development and mental health support initiatives to improve workforce morale and patient care.
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