Exploring the Associations Between Empowering Leadership, Work Environment and Moral Injury Among Nurses: A
Stefano Ardenghi1, Selena Russo2, Rossana De Palma2
1Psychotherapist, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy, IRCCS San Gerardo dei Tintori, Monza, Italy.
Nursing Leadership (Toronto, Ont.)
|May 4, 2026
Summary
Empowering leadership can protect nurses from moral injury in unhealthy work environments. This leadership style is crucial for improving nurse well-being and patient care in demanding healthcare settings.
Area of Science:
- Nursing
- Healthcare Management
- Occupational Health Psychology
Background:
- Leadership significantly influences nurses' well-being, job satisfaction, and patient care quality.
- This study investigates empowering leadership's impact on nurses' perceptions of healthy work environments (HWE) and moral injury.
Purpose of the Study:
- To examine the relationship between empowering leadership, healthy work environment perceptions, and moral injury among nurses.
- To understand how leadership styles mitigate negative outcomes in healthcare settings.
Main Methods:
- Cross-sectional study with 155 nurses from an Italian healthcare organization.
- Online survey utilizing the Empowering Leadership Questionnaire (ELQ), N2N-HWE, and Moral Injury Events Scale (MIES).
- Pearson's correlations and multivariable linear regression analyzed the data.
Main Results:
- A significant majority of nurses (92.9%) perceived their work environment as unhealthy, and 31.6% reported high moral injury.
- No direct association was found between HWE and moral injury.
- A significant interaction effect indicated empowering leadership buffers the impact of unhealthy work environments on moral injury.
Conclusions:
- Empowering leadership plays a protective role against moral injury in nurses experiencing unhealthy work environments.
- Leadership-focused interventions are recommended for high-demand healthcare settings to support nurses.
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