Positive aspects of authentic leadership in nursing work: integrative review

This is an integrative literature review. The databases used were Scientific Electronic Library Online; Latin American and Caribbean Literature on Health Sciences; and National Library of Medicine - National Institutes of Health.

Results:

In this study, 17 articles were selected for analysis; 1 study (6%) was published in a national journal, and 16 (94%) were international studies. Of the 17 (100%) articles studied, 11 (65%) were developed in Canada. The hospital environment was present in the 17 (100%) articles.

Final considerations:

Authentic leadership has several positive aspects that significantly influence the nurse’s work process, such as engagement and job satisfaction, retention of new nurses, organizational commitment, among others.

Descriptors:
Leadership; Nurse; Nursing team; Nursing Supervision; Management

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[1] Corresponding author: Vanessa Gomes Maziero E-mail: vamaziero@yahoo.com.br

Titles	Authors/Country/Year	Research design	Objective	Outcomes
Authentic leadership and personal and professional profile of nurses	Carvalho et al. Brazil, 2016⁽¹²12 Carvalho AGF, Cunha ICKO, Balsanelli AP, Bernardes A. Liderança autêntica e perfil pessoal e profissional de enfermeiros. Acta Paul Enferm [Internet]. 2016 [cited 2018 Sep 09];29(6):618-25. Available from: http://www.scielo.br/pdf/ape/v29n6/1982-0194-ape-29-06-0618.pdf http://www.scielo.br/pdf/ape/v29n6/1982-... ⁾.	Quantitative correlational study. Application of a personal and professional profile instrument and the Authentic Leadership Questionnaire (Self) instrument. Analysis of data using descriptive statistics. Study population was 69 nurses.	To verify the association of authentic leadership with the personal and professional profile of nurses	Nurses presented characteristics of authentic leaders. Self-awareness was more valuable in nursing assistants than in clinical nurses. The other variables did not show significant relationships.
A thematic analysis of self-described Authentic Leadership behaviors among experienced nurse executives.	Alexander, Lopez. USA, 2018⁽¹³13 Alexander C, Lopez RP. A Thematic Analysis Of Self-Described Authentic Leadership Behaviors Among Experienced Nurse Executives. J Nurs Adm [Internet]. 2018 [cited 2018 Sep 09];48(1):38-43. Available from: https://insights.ovid.com/pubmed?pmid=29219909 https://insights.ovid.com/pubmed?pmid=29... ⁾.	Qualitative, descriptive study. Semi structured interview. Thematic Analysis. Study with 17 nursing leaders.	To understand the behaviors that experienced nurses use to create healthy work environments.	All participants agreed on the importance of healthy work environments and their role in creating them. The behaviors described by the participants corroborate the categories of authentic leadership.
The influence of authentic leadership on safety climate in nursing.	Dirik, Intepeler. Turkey, 2017⁽¹⁴14 Dirik HF, Intepeler SS. The influence of authentic leadership on safety climate in nursing. J Nurs Manag. 2017;25(5):392-401. doi: 10.1111/jonm.12480 https://doi.org/10.1111/jonm.12480... ⁾.	Quantitative study. The Authentic Leadership Questionnaire e o Safety Climate Survey was used. Hierarchical regression analysis. Study with 350 nurses in three Turkish hospitals.	The study analyzed the nurses' perception of authentic leadership and a climate of security; and examined the contribution of authentic leadership to the security climate.	The security climate was significantly and positively correlated with authentic leadership, which is able to increase positive perceptions of the security climate.
The effects of authentic leadership, organizational identification, and occupational coping self-efficacy on new graduate nurses' job turnover intentions in Canada.	Fallatah, Laschinger, Read. Canada, 2017⁽¹⁵15 Fallatah F, Laschinger HKS, Read EA. The effects of authentic leadership, organizational identification, and occupational coping self-efficacy on new graduate nurses’ job turnover intentions in Canada. Nurs Outlook. 2017;65(2):172-83. doi: 10.1016/j.outlook.2016.11.020 https://doi.org/10.1016/j.outlook.2016.1... ⁾.	Quantitative study. Analysis of secondary data from a cross-sectional study. Used tools: Authentic Leadership Questionnaire (ALQ), Personal Identification (PI), Organizational Identification (OI), Occupational Coping Self-Efficacy (OCSE) e Job Turnover Intentions (JTO). Analysis using structural equation modelling. Population of 998 recently graduated nurses.	To examine the influence of authentic leadership on new nurses' job rotation intentions through their personal identification with the leader, organizational identification and self-efficacy in occupational coping.	Authentic leaders have the ability to influence the work attitudes and behavior of their followers. Authentic leadership plays an essential role in retaining new nurses. Raises confidence in your ability to manage work-related challenges and brings positive results to recently graduated nurses and the organization.
Authentic leadership and its impact on creativity of nursing staff: A cross sectional questionnaire survey of Indian nurses and their supervisors.	Malik, Dhar, Handa. India, 2016⁽¹⁶16 Malik N, Dhar RL, Handa SC. Authentic leadership and is impact on creativity of nursing staff: a cross sectional questionnaire survey of Indian nurses and their supervisors. Int J Nurs Stud. 2016;63:28-36. doi: 10.1016/j.ijnurstu.2016.08.004 https://doi.org/10.1016/j.ijnurstu.2016.... ⁾.	Quantitative study. Data collected through questionnaires: Authentic Leadership, Knowledge Sharing Behaviour, Information Technology usage e Employees Creativity. Confirmatory Factor Analysis and hypothesis tests - Process. Sample of 405 nurse staff and 81 supervisors.	To examine the relationship between authentic leadership and employee creativity, while determining the mediating effect of knowledge-sharing behavior and the moderating effect of the use of information technology on this association.	Authentic leadership was positively linked to employee creativity. Knowledge sharing is mediated by the relationship between authentic leadership and employee creativity, and the use of information technology acts as a moderator between employee knowledge sharing and creativity behavior.
Authentic leadership and thriving among nurses: the mediating role of empathy.	Mortier, Vlerick, Clays. Belgium, 2016⁽¹⁷17 Mortier AV, Vlerick P, Clays E. Authentic leadership ant thriving among nurses: the mediating role of empathy. J Nurs Manag. 2016;24(3):357-365. doi: 10.1111/jonm.12329 https://doi.org/10.1111/jonm.12329... ⁾.	Quantitative, cross-sectional study. Used the Authentic Leadership Inventory (ALI) questionnaires, Quantitative, cross-sectional study. Uses Prosperity Scale and Emotional Intelligence Scale. Hypotheses tested through hierarchical regression analysis. Sample of 360 nurses or questionnaires.	To investigate the relationship between perceived authentic leadership and the dimensions of prosperity (learning and vitality) among nurses and the role of empathy in this relationship.	The results showed a positive association between authentic leadership and the dimensions of prosperity studied. The positive association between learning and authentic leadership was not explained by the empathy of the leader.
Linking Nurses' Perceptions of Patient Care Quality to Job Satisfaction.	Laschinger, Fida. Canada, 2015⁽¹⁸18 Laschinger HKS, Fida R. Linking nurses’ Perceptions of Patient care Quality to Job Satisfaction. JONA. 2015;45(5):276-83. doi: 10.1097/NNA.0000000000000198 https://doi.org/10.1097/NNA.000000000000... ⁾.	Quantitative, cross-sectional study. Instruments used were Authentic Leadership, Work Effectiveness-II (CWEQ-II), Nursing Work Index- Revised (NWI-R), a single item Bhow and Health Professionals 'Job Satisfaction. Descriptive statistics and reliability of the scales were analyzed. Structural equation modelling. Sample of 723 nurses.	To test the connection between authentic leadership, structure, professional support, quality of patient care and job satisfaction.	Authentic leaders play an important role in creating work environments that support professionals, promote high quality care and job satisfaction.
The effects of authentic leadership, six areas of work life, and occupational coping self-efficacy on new graduate nurses' burnout and mental health: A cross-sectional study.	Laschinger, Borgoni, Read. Canada, 2015⁽¹⁹19 Laschinger HKS, Borgogni L, Consiglio C, Read E. The effects of authentic leadership, six areas of worklife, and occupational coping self-efficacy on new graduate nurses’ burnout and mental health: a cross-sectional study. Int J Nurs Stud. 2015;52(6):1080-89. doi: 10.1016/j.ijnurstu.2015.03.002 https://doi.org/10.1016/j.ijnurstu.2015.... ⁾.	Quantitative, cross-sectional study. Instruments used were Authentic Leadership Questionnaire, Areas of Work life Scale, Occupational Coping Self-Efficacy Scale, subscales Maslach Burnout Inventory-General Survey e Symptoms Scale of the General Health Questionnaire. Descriptive statistics and reliability of the scale were analyzed. Structural equation modelling with maximum likelihood estimation. Total of 1,009 nurses with less than three years of experience.	To test a model that unites authentic leadership, areas of professional life, self-efficacy, occupational coping, burnout and mental health among recent graduates, in addition to the validity of the concept of interpersonal tension at work as a facet of burnout.	Authentic leadership had a positive effect in areas of professional life, an effect on self-efficacy in occupational coping, resulting in less stress and less mental health problems.
The influence of empowerment, authentic leadership, and professional practice environments on nurses' perceived interprofessional collaboration.	Regan, Laschinger, Wong. Canada, 2016⁽²⁰20 Regan S, Laschinger HKS, Wong CA. The influence of empowerment, authentic leadership, and professional practice environments on nurses’ perceived interprofessional collaboration. J Nurs Manag. 2016;24(1):54-61. doi: 10.1111/jonm.12288 https://doi.org/10.1111/jonm.12288... ⁾.	Quantitative design, non-experimental predictive analysis. Instruments used were Conditions of Work Effectiveness Questionnaire-II (CWQ-II), Authentic Leadership Questionnaire (ALQ), Nursing Work Index-Revised (NWI-R) e o Interprofessional Collaboration Scale (IPCS). Multiple hierarchical regression analysis. Total of 220 experienced nurses.	To examine the influence of structural factors of empowerment, authentic leadership and professional nursing environments on the perceptions of experienced nurses on interprofessional collaboration.	Structural strengthening, authentic leadership and a nursing practice environment can improve enhanced interprofessional collaboration (IPC).
The influence of authentic leadership and empowerment on nurses' relational social capital, mental and job satisfaction over the first year of practice.	Read, Laschinger. Canada, 2015⁽²¹21 Read EA, Laschinger HKS. The influence of authentic leadership and empowerment on nurses’ relational social capital, mental and job satisfaction over the first year of practice. J Adv Nurs. 2015;71(7):1611-23. doi: 10.1111/jan.12625 https://doi.org/10.1111/jan.12625... ⁾.	Longitudinal quantitative design. Instruments used were Authentic Leadership Questionnaire (ALQ), Conditions of Work Effectiveness II (CWEQ-II), Areas of Work life Scale, Community Subscale, Mental Health Inventory-5 and Unnamed. Modelling analysis of structural equations with maximum probability estimate. Total of 191 nurses graduated less than two years ago.	To examine the theoretical model that tests the effect of authentic leadership, empowerment structure and relational social capital on mental health and job satisfaction of nurses in the first year of practice.	Authentic leaders, by creating structurally strong work environments, promote relational social capital among new nurses, leading to positive health and retention results at work, as well as a positive effect on job satisfaction.
Authentic Leadership, performance, and job satisfaction: The mediating role of empowerment.	Wong, Laschinger, Canada, 2013⁽²²22 Wong CA, Laschinger HKS. Authentic Leadership, performance, and job satisfaction: The mediating role of empowerment. Adv Nurs. 2013;69(4):947-59. doi: 10.1111/j.1365-2648.2012.06089.x https://doi.org/10.1111/j.1365-2648.2012... ⁾.	Quantitative design, non-experimental predictive analysis. Authentic Leadership Questionnaire, Conditions of Work Effectiveness Questionnaire, Global Job Satisfaction Survey and General Performance Scale. Structural equation modelling analysis. Sample of 280 nurses.	To test a model that links the authentic leadership of managers with nurses' perceptions of structural empowerment, performance and job satisfaction.	The more managers are seen as authentic, the more nurses perceive structural empowerment, the greater job satisfaction and performance.
Authentic leadership and nurse-assessed adverse patient outcomes.	Wong, Giallonardo. Canada, 2013⁽²³23 Wong CA, Giallonardo LM. Authentic leadership and nurse-assessed adverse patient outcomes. J Nurs Manag[Internet]. 2013 [cited 2018 Sep 09];21(5):740-52. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jonm.12075 https://onlinelibrary.wiley.com/doi/pdf/... ⁾.	Quantitative study, secondary analysis of data collected in a cross-sectional study. Instruments used: Authentic Leadership Questionnaire (ALQ), Trust in Management Scale, Areas of Work life Scale (AWS). Nursing Quality Indicators. Structural equation modelling analysis. Sample with 280 nurses.	To test a model by examining the relationships between authentic leadership, nurses' trust in their manager, areas of professional life and assessment of adverse patient outcomes.	Nurses who see their managers as having a high level of authentic leadership have greater confidence, congruence in the areas of professional life and lower frequencies of adverse effects on patients.
Simulations in nursing practice: toward authentic leadership.	Lishchinsky. Israel, 2014⁽²⁴24 Lishchinsky OS. Simulations in nursing practice: toward authentic leadership. J Nurs Manag. 2014;22(1):60-9. doi: 10.1111/j.1365-2834.2012.01426.x https://doi.org/10.1111/j.1365-2834.2012... ⁾.	Qualitative study; used the database based on the Grounded Theory. Sample with 50 nurses from ten health institutions in Israel.	To explore nurses' ethical decision making in team simulations and identify the benefits of these simulations for authentic leadership.	Team simulation as a training tool can lead to authentic leadership among nurses.
The influence of authentic leadership and areas of work-life on work engagement of registered nurses.	Bamford, Wong, Laschinger. Canada, 2013⁽²⁵25 Bamford M, Wong CA, Laschinger H. The influence of authentic leadership and areas of worklife on work engagement of registered nurses. J Nurs Manag. 2013;21(3):529-40. doi: 10.1111/j.1365-2834.2012.01399.x https://doi.org/10.1111/j.1365-2834.2012... ⁾.	Quantitative study, secondary analysis of data collected from a non-experimental predictive analysis. Instruments used were the Authentic Leadership Questionnaire (ALQ), Areas of Work life Scale (AWS) and Utrecht Work Engagement Scale. Multiple hierarchical regression analysis and measurement. Sample with 280 nurses working in intensive care.	To examine the relationships between nurses' perceptions of the authentic leadership of nursing managers; general correspondence of the person-job in the six areas of life at work; and engagement at work.	Nurses reporting to managers who demonstrate higher levels of authentic leadership report greater correspondence between person and job in the six areas of professional life and greater engagement at work.
Authentic Leadership, empowerment and burnout: a comparison in new graduates and experienced nurses.	Laschinger, Wong, Grau. Canada, 2013⁽²⁶26 Laschinger HKS, Wong CA, Grau AL. Authentic Leadership, empowerment and burnout: a comparison in new graduates and experienced nurses. J Nurs Manag. 2013;21(3):541-2. doi: 10.1111/j.1365-2834.2012.01375.x https://doi.org/10.1111/j.1365-2834.2012... ⁾.	Quantitative study, secondary analysis of data from two studies. Authentic Leadership Questionnaire (ALQ), Conditions of Work Effectiveness Questionnaire-II (CWEQ –II) and Maslach Burnout Inventory-General Survey. Structural equation modelling analysis. Samples with 342 recently graduated nurses, 273 nurses with more than two years of experience.	To examine the effect of authentic leadership and structural strengthening on the emotional exhaustion and cynicism of recently graduated and experienced intensive care nurses.	The authentic behavior of the leader is important for nurses providing structurally strengthening conditions in the work environment, regardless of the level of experience.
Authentic Leadership of preceptors: predictor of new graduate nurses' work engagement and job satisfaction.	Giallonardo, Wong, Iwasiw. Canada, 2010⁽²⁷27 Giallonardo LM, Wong CA, Iwasiw CL. Authentic Leadership of preceptors:predctor of new graduate nurses’ work engagement and job satisfaction. J Nurs Manag [internet]. 2010 [cited 2018 Sep 09];18(8):993-1003. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2834.2010.01126.x https://onlinelibrary.wiley.com/doi/pdf/... ⁾.	Quantitative design, non-experimental predictive. Instruments used: Authentic Leadership Questionnaire (ALQ), Utrecht Work Engagement Scale, Index of Work Satisfaction Scale (IWS). Multiple hierarchical regression analysis and measurement. Sample with 170 nurses graduated less than three years ago.	To examine the relationships between the recently graduated nurses and the perception of the authentic leadership of the preceptor; Engagement; and job satisfaction.	The study supports the link between authentic leadership, work engagement and job satisfaction.
Authentic leadership and nurses' voice behavior and perceptions of care quality.	Wong, Laschinger, Cummings. Canada, 2010⁽⁵5 Wong CA, Laschinger HKS, Cummings GG. Authentic leadership and nurses’ voice behavior and perceptions of care quality. J Nurs Manag [Internet]. 2010 [cited 2018 Sep 09];18:889-900. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2834.2010.01113.x https://onlinelibrary.wiley.com/doi/full... ⁾.	Quantitative design, non-experimental predictive analysis. Instruments used were Authentic Leadership Questionnaire (ALQ), Personal and Social Identification, Trust in Management Scale, Utrecht Work Engagement Scale (UWES) short version, Voice Subscale da Helping and Voice Behaviours Scale, one item from the International Survey of Hospital Staffing and Organization of Patient Outcomes. Structural equation modelling analysis. Sample with 280 nurses working in intensive care.	To test the theoretical model of connection between authentic leadership with team nurses, trust in their manager, engagement at work, vocal behavior and perceived quality in the care provided at the unit.	The results suggest that authentic leadership and trust in the manager play a role in promoting trust, engagement at work, vocal behavior and perceived quality of care.