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Self-Leadership Based on Caring in Primary Nursing: Developing and Validating a Conceptual Model Through a Delphi
Mahmud Ady Yuwanto1,2, Iyus Yosep3, Iqbal Pramukti3
1Doctoral Study Program in Medical Science, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia, unpad.ac.id.
Journal of Nursing Management
|August 13, 2026
Summary
This study developed a self-leadership model for nurses, integrating caring and self-leadership theories. It shows how caring enactment translates leadership skills into accountable nursing practice and improved patient care outcomes.
Area of Science:
- Nursing
- Leadership Studies
- Organizational Psychology
Background:
- Self-leadership theory and caring theories offer distinct perspectives on individual and relational aspects of professional practice.
- Integrating these theories is crucial for understanding complex nursing roles and enhancing primary nursing.
- Existing models often focus on intrapersonal aspects, neglecting the relational and practice-oriented dimensions of nursing leadership.
Purpose of the Study:
- To develop and validate a conceptual model of self-leadership grounded in primary nursing practice.
- To integrate empirical findings with established self-leadership (Manz-Neck) and caring (Watson-Swanson) theories.
- To provide a framework for understanding how nurses translate self-leadership capacities into accountable professional action.
Main Methods:
- A preliminary conceptual model was synthesized from qualitative and quantitative studies.
- The model was informed by self-leadership and caring theories.
- An expert panel of nursing professionals evaluated and refined the model using a Delphi process.
Main Results:
- Caring enactment was identified as the central mechanism linking self-leadership capacities to accountable professional agency and practice outcomes.
- Reflexive feedback mechanisms support continuous leadership development through reflective learning and experience.
- The refined model extends self-leadership beyond intrapersonal focus to accountable professional practice.
Conclusions:
- The developed model advances nursing leadership scholarship by integrating self-leadership and caring enactment.
- It offers a theoretically grounded framework for frontline nurses to translate self-leadership into accountable actions and sustained outcomes.
- The model provides a practical framework for nursing managers to enhance frontline leadership and primary nursing implementation.
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