Manuscript Title:

TOXIC LEADERSHIP AND NURSES’ PSYCHOLOGICAL RESOURCES: A STRUCTURAL EQUATION MODELING STUDY IN SAUDI GOVERNMENT HOSPITALS

Author:

SAAD AQEEL ALSHAMMARI

DOI Number:

DOI:10.5281/zenodo.23134584

Published : 2026-09-23

About the author(s)

1. SAAD AQEEL ALSHAMMARI - Faculty of Nursing, Cairo University, Egypt. Study Setting: Seven Governmental Hospitals, Hafr Al-Batin, Saudi Arabia. *Corresponding Author

Full Text : PDF

Abstract

Background: Toxic leadership is increasingly recognized as a workforce and patient-safety concern in nursing, yet evidence linking it simultaneously with nurses’ self-efficacy, resilience, and psychological wellbeing remains limited in Saudi Arabia. Objective: To examine the interrelationships between toxic leadership and three psychological resources among Saudi nurses and to estimate the direct structural paths from toxic leadership to self-efficacy, resilience, and psychological well-being. Methods: A crosssectional correlational study was conducted among 296 Saudi nurses selected from seven governmental hospitals in Hafr Al-Batin. Data were collected using the Toxic Leadership Behaviors of Nurse Managers Scale, General Self-Efficacy Scale, Connor-Davidson Resilience Scale, and Ryff Psychological Well-Being Scale. Spearman correlations and structural equation modeling with bootstrap estimation were used. Results: Toxic leadership was negatively correlated with general self-efficacy (r=−.974), resilience (r=−.601), and psychological well-being (r=−.517), all p<.01. Self-efficacy, resilience, and psychological well-being were positively intercorrelated. Structural models showed significant negative paths to selfefficacy (β=−.9877, p=.0021, R²=.908), resilience (β=−.4800, p=.0015, R²=.380), and psychological wellbeing (β=−.2879, p=.0010, R²=.233). The self-efficacy estimate was unusually large and is interpreted cautiously because of potential discriminant-validity and common-method concerns. Conclusion: Toxic leadership was consistently associated with lower psychological resources among Saudi nurses. The systematic gradient across outcomes is a potentially important finding but requires replication using longitudinal, multisource designs.


Keywords

Toxic Leadership; Nurse Managers; Self-Efficacy; Resilience; Psychological Well-Being; Nursing Leadership; Saudi Arabia; Structural Equation Modeling.