Zeng Mengmeng, Zhang MengChao, Ni Qiqi, Wang Yuezhong, Gong Xiaoyan, Zhuang Yiyu
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
J Nurs Manag. 2025 Apr 11;2025:6625892. doi: 10.1155/jonm/6625892. eCollection 2025.
This study aims to explore the relationship of head nurses' ambidextrous leadership with staff nurse clinical leadership and the mediating effect of nursing organizational culture. Clinical nurses are an important part of the nursing team, and their clinical leadership is of great significance to improving the quality of nursing and developing a nursing career. The ambidextrous leadership of head nurses, which combines transformational and transactional leadership, is a new leadership style. There are few studies on the effect of head nurses' ambidextrous leadership on staff nurse clinical leadership. This study was a cross-sectional study, and convenient sampling method was used to extract 500 nurses from first-class comprehensive hospital in Hangzhou City, Zhejiang Province, as research participants. The participants were administered an electronic questionnaire consisting of the General Information Questionnaire, Ambidextrous Leadership Style Scale, the Chinese version of Nursing Culture Assessment Tool, and the Chinese version of Clinical Leadership Survey. All the three scales used in this study had satisfactory construct validity, content validity, and reliability. Multiple stepwise linear regression analysis was used to explore the influencing factors of staff nurse clinical leadership. AMOS 24.0 software was used to construct a structural equation model to verify the mediating effect of nursing organizational culture between the ambidextrous leadership of head nurses and staff nurse clinical leadership. The score of staff nurse clinical leadership was 66.69 ± 7.42. Significant positive correlations were noted between staff nurse clinical leadership and head nurses' ambidextrous leadership ( = 0.461, < 0.01), between nursing organizational culture and staff nurse clinical leadership ( = 0.685, < 0.01), and between ambidextrous leadership and organizational culture ( = 0.641, < 0.01). Professional title, role at work, marital status, participation in leadership training, and nursing organizational culture were the main predictors of staff nurse clinical leadership, collectively accounting for 49.8% of the total variation. Nursing organizational culture played a complete mediating role between head nurses' ambidextrous leadership and staff nurse clinical leadership, and the mediating effect was 0.555 (95% CI [0.454, 0.692]), accounting for 98.8% of the total effect. Staff nurse clinical leadership represents the upper-middle level of clinical leadership. Nursing organizational culture can independently predict the level of staff nurse clinical leadership and has a complete mediating effect between head nurses' ambidextrous leadership and staff nurse clinical leadership. However, due to time, energy, and sampling methods, this study's sample is insufficient to represent the national nursing staff. Future research should further expand the survey's geographical scope and sample size. Senior managers can encourage the head nurses to adopt the ambidextrous leadership style and consequently raise the enthusiasm of the organizational culture to improve staff nurse clinical leadership. Managers should rework the rules and regulations and increase work enthusiasm among nurses. Furthermore, they should carry out hierarchical training of clinical leadership for nurses and reasonably empower them to increase their work autonomy and self-efficacy and to encourage and support them in their clinical leadership practice.
本研究旨在探讨护士长的二元领导与护士临床领导力之间的关系以及护理组织文化的中介作用。临床护士是护理团队的重要组成部分，其临床领导力对于提高护理质量和推动护理事业发展具有重要意义。护士长的二元领导将变革型领导与交易型领导相结合，是一种新的领导风格。目前关于护士长二元领导对护士临床领导力影响的研究较少。本研究为横断面研究，采用便利抽样法从浙江省杭州市某三甲综合医院抽取500名护士作为研究对象。研究对象接受了一份电子问卷，问卷包括一般信息问卷、二元领导风格量表、中文版护理文化评估工具和中文版临床领导能力调查问卷。本研究使用的三个量表均具有良好的结构效度、内容效度和信度。采用多元逐步线性回归分析探讨护士临床领导力的影响因素。使用AMOS 24.0软件构建结构方程模型，以验证护理组织文化在护士长二元领导与护士临床领导力之间的中介作用。护士临床领导力得分66.69±7.42。护士临床领导力与护士长的二元领导之间存在显著正相关（r = 0.461，P < 0.01），护理组织文化与护士临床领导力之间存在显著正相关（r = 0.685，P < 0.01），二元领导与组织文化之间存在显著正相关（r = 0.641，P < 0.01）。职称、工作角色、婚姻状况、参加领导力培训情况以及护理组织文化是护士临床领导力的主要预测因素，共解释总变异的49.8%。护理组织文化在护士长二元领导与护士临床领导力之间起完全中介作用，中介效应为0.555（95%CI[0.454，0.692]），占总效应的98.8%。护士临床领导力处于临床领导力的中上等水平。护理组织文化能够独立预测护士临床领导力水平，且在护士长二元领导与护士临床领导力之间起完全中介作用。然而，由于时间、精力和抽样方法的限制，本研究样本不足以代表全国护理人员。未来研究应进一步扩大调查的地域范围和样本量。高级管理人员可鼓励护士长采用二元领导风格，进而提升组织文化的积极性，以提高护士临床领导力。管理人员应修订规章制度，提高护士的工作积极性。此外，应为护士开展临床领导力分层培训，并合理授权，以提高其工作自主性和自我效能感，并鼓励和支持他们在临床领导实践中发挥作用。
