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J Adv Nurs ; 2020 Nov 24.
Article in English | MEDLINE | ID: covidwho-960905


AIMS: Nurses are at the forefront of public health emergencies facing psychological pressures ensuing from the loss of patients and potential risk of infection while treating the infected. This study examines whether inclusive leadership has a causal relationship with psychological distress and to assess the mediation effect of psychological safety on this relationship in the long run. The hypotheses are developed and interpreted with the help of theoretical underpinnings from job demands resources theory and the theory of shattered assumptions. DESIGN: Three-wave longitudinal study. METHODS: Questionnaire was used to carry out three waves of data collection from 405 nurses employed at five hospitals in Wuhan during the COVID-19 outbreak between the months of January-April 2020. Partial least square structural equation modelling (PLS-SEM) was used to analyze data while controlling for age, gender, education, experience, and working hours. RESULTS: Results supported the hypothesized relationships where inclusive leadership indicated significant inverse causal relationship with psychological distress and a positive causal relationship with psychological safety. Mediation effect of psychological safety was found significant, while the model explained 73.9% variance in psychological distress. CONCLUSION: Inclusive leadership, through its positive and supportive characteristics, can pave way for such mechanisms that improve the psychological safety of employees in the long run and curbs psychological distress. IMPACT: This is the first longitudinal study to examine the relationship between inclusive leadership and psychological distress in health care and also examines the mediating mechanism of psychology safety. There is scarcity of empirical research on factors that determine and affect behavioural mechanism of healthcare workers during traumatic events and crisis. Clinical leaders and healthcare policy makers must invest in and promote inclusive and supportive environment characterized with open and accessible leaders at workplace to improve psychological safety; it helps reduce levels of psychological distress.

Front Psychol ; 11: 1898, 2020.
Article in English | MEDLINE | ID: covidwho-732840


Traumatic events such as a pandemic shatter the assumption of the workplace as a safe place. Nurses face risks of life-threatening infection, which can create psychological distress. Quality of care for infected patients depends on mental well-being of nurses which calls for research on predictors of stress among health care workers. Responding to a call for research on the effects of leadership styles on psychological distress during traumatic events, this paper uses the theoretical lens of social exchange theory and contributes to literature on relationships between inclusive leadership, psychological distress, work engagement, and self-sacrifice. Participants of this cross sectional study included 497 registered nurses from five hospitals in Wuhan. Data were collected with temporal separation through an online questionnaire. Partial least-squares structural equation modeling was used to analyze data. Results show inclusive leadership has a significant negative relationship with psychological distress. Work engagement mediates this relationship, and nurses' self-sacrificial behavior moderates it. Findings indicate inclusive leadership style serves as a sustainable mechanism to reduce psychological distress during pandemics. It can operationalize the delivery of mental health support in real-time in work settings. Results provide empirical support for social exchange theory through high work engagement to help control psychological distress among nurses.

Int J Nurs Stud ; 110: 103725, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-689158


BACKGROUND: Public health emergencies and epidemics shatter the assumptions of the world as a safe place. Healthcare workers are at the forefront of such pressures resulting from a persistent threat to their safety and well being. It is therefore important to study such mechanisms that can influence and predict the psychological distress of nurses OBJECTIVES: While there is an increasing number of studies on positive outcomes of leadership styles, their influence on curbing unwanted adverse outcomes is scarce. This study aims to observe the influence of an inclusive leadership style on psychological distress while assessing the mediating role of psychological safety. It uses the theoretical lens of job demands-resources theory and the theory of shattered assumptions to develop and test hypotheses. DESIGN: Cross-Sectional Study with Temporal Separation SETTINGS AND PARTICIPANTS: The researchers recruited 451 on-duty registered nurses from 5 hospitals providing patient care during the highly infectious phase of COVID-19 in January 2020 in Wuhan city, the epicentre of the outbreak in China METHODS: After obtaining permission from hospital administration, data were collected through an online questionnaire survey in three stages with temporal separation to avoid common method bias. Partial least square structural equation modelling was used to analyze data. The study controlled for effects of age, gender, experience, working hours and education. RESULTS: Hypothesized relationships proved significant. Inclusive leadership has an inverse relationship with psychological distress with a strong path-coefficient. Psychological safety mediates the relationship between inclusive leadership and psychological distress while explaining 28.6% variance. Multi-group analysis results indicate no significant differences between respondents based on these control variables CONCLUSIONS: Recurring or prolonged experiences of stress and anxiety at the workplace, without a mechanism to counter such effects, can culminate into psychological distress. Inclusive leadership style can serve as such a mechanism to curb psychological distress for healthcare workers by creating a psychologically safe environment.

Betacoronavirus/isolation & purification , Caregivers/psychology , Coronavirus Infections/nursing , Disease Outbreaks , Nursing Staff, Hospital/psychology , Pneumonia, Viral/nursing , Psychological Distress , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Cross-Sectional Studies , Humans , Leadership , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Surveys and Questionnaires , Workplace/psychology