Influence of Nursing Manager's Ethical Leadership Perceived by Nurses in Patient-Engaged Nursing Services : Mediating Effect of Patient Participation Culture

Abstract

Purpose : This study investigated the mediating effect of patient participation culture in the relationship between ethical leadership and performance in patient-engaged nursing services. Methods : This study employed a cross-sectional descriptive online survey design. The sample comprised 104 nurses from small- and middle-sized Korean hospitals. Data were collected between May 10 and September 10, 2019 using the Smart Patient Engagement Assessment Checklist, Korean versions of the Patient Participation Culture Tool for healthcare workers, the Ethical Leadership Scale, and a questionnaire about nurses' demographic and work characteristics. A mediation analysis was conducted using multiple regression and a simple model applying the PROCESS macro using SPSS/WINdows software version 26.0. Results : Ethical leadership directly affected (c'=0.28, p<.001) performance in patient-engaged nursing services. Patient participation culture partially mediated the relationship between ethical leadership and performance in patient-engaged nursing services (a · b=0.51×0.20=0.10, 95% Boot CI=0.18~0.20). Conclusion : Optimizing the patient participation culture and adherence to ethical leadership among hospital administrators and managers can improve nurses' performance in patient-engaged nursing services. Nurse managers' ethical leadership should be strengthened, and patient participation culture should be encouraged at policy levels through systematic nurse education on patient safety and engagement to enhance performance-engaged nursing services.