Leadership in Health Services最新文献

{"title":"Leadership dynamics in nursing: a comparative study of paternalistic approaches in China and Pakistan","authors":"Samyia Safdar, Shazia Faiz, Namra Muabark","doi":"10.1108/lhs-03-2024-0028","DOIUrl":"https://doi.org/10.1108/lhs-03-2024-0028","url":null,"abstract":"\u0000Purpose\u0000This study aims to examine the impact of nurses’ paternalistic leadership style on performance, in the presence of underlying mechanisms, i.e. self-efficacy as a mediator in the high-power distance societies, namely, China and Pakistan, based on social exchange theory. Both healthcare sectors have seen several behavioral advancements in recent years. To improve things, even more, behavioral elements such as the influence of leadership styles, personality traits and so on have become more important. However, leadership styles, particularly paternalistic leadership, have received little attention in this field and need to be highlighted along with the mediating and moderating effects.\u0000\u0000\u0000Design/methodology/approach\u0000Data were collected from public and private sector hospitals in China and Pakistan using a 6-week time lag technique. Firstly, 356 Chinese and 411 Pakistani nurses were surveyed about their perceptions of power distance, self-efficacy and paternalistic leadership. Their managers were called six weeks later for a dyadic response to provide feedback on nurses’ performance. For confirmatory factor analysis, AMOS 22 and for regression analysis, SPSS 22 was used.\u0000\u0000\u0000Findings\u0000According to the study's findings, nurses in both countries perform well when led by a paternalistic leader. Furthermore, self-efficacy explains the relationship between paternalistic leaders and nurses’ performance. The moderated-mediation result also supported the importance of power distance.\u0000\u0000\u0000Originality/value\u0000This study highlights the kind of nursing leadership which is beneficial in high-power-distance societies and leads to better performance. According to this research, paternalistic leadership improves nurses’ performance in both China and Pakistan. As a result, this study will be useful in high-power-distance societies, where hospital administrators can ensure that paternalism is implemented in leadership, thereby improving nurse performance.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"104 13","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and social care leaders’ and employees’ perceptions of remote leadership and the associated factors","authors":"Anja Terkamo-Moisio, Elsa Paronen, A. Häggman-Laitila, Johanna Lammintakanen","doi":"10.1108/lhs-01-2024-0010","DOIUrl":"https://doi.org/10.1108/lhs-01-2024-0010","url":null,"abstract":"Purpose\u0000The purpose of this study was to describe health and social care leaders’ and employees’ perceptions of remote leadership and the associated factors.\u0000\u0000Design/methodology/approach\u0000A total of 45 leaders and 177 employees from one Finnish health and social care organization completed an electronic questionnaire between October and November 2020. The questionnaire included questions related to background information, along with structured and open-ended questions addressing remote leadership and the associated factors. The collected quantitative data was analyzed with statistical methods, while inductive content analysis was used to analyze the qualitative data.\u0000\u0000Findings\u0000Remote leadership emerged as a developing form of leadership that was part of everyday life at a regional health and social care organization. However, it was also considered by some as a distanced and authoritarian form of leadership that reduced communication to a one-way flow of information. Remote leadership and digitalization in health and social care were generally perceived positively, especially among higher educated participants and those working mainly in a remote context. However, digitalization was also perceived as a burden and remote leadership as a source of uncertainty at work, especially among lower educated participants and those who worked mainly in traditional contexts.\u0000\u0000Originality/value\u0000This study expands the little-researched area and provides insights that can be used to further develop remote leadership and the related education.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of political disagreements and corruption on state health leader turnover during the COVID-19 pandemic in Brazil.","authors":"Lorena G Barberia, Gilmar Masiero, Iana Alves de Lima, Luciana Santana, Tatiane C Moraes de Sousa","doi":"10.1108/LHS-01-2024-0008","DOIUrl":"10.1108/LHS-01-2024-0008","url":null,"abstract":"<p><strong>Purpose: </strong>Governments faced formidable challenges in coordinating public health responses to the COVID-19 pandemic. This study aims to enhance the understanding of effective organizational leadership during crises by investigating the factors influencing the turnover of health leaders during the COVID-19 pandemic in Brazil.</p><p><strong>Design/methodology/approach: </strong>Using primary data encompassing all appointments and dismissals of federal and state health secretaries, this paper conducted a quantitative analysis of the relational and reputational factors that contributed to leader turnover during the COVID-19 pandemic. This paper also examined whether leaders' management and public health experience increase the duration of tenure.</p><p><strong>Findings: </strong>States encountered significant challenges in retaining experienced and effective leadership during the health emergency, primarily due to political conflicts in policymaking and, to a lesser extent, allegations of corruption. Furthermore, leaders with expertise in public health were found to be less likely to be removed from office. However, managerial experience did not prolong the tenure of state health secretaries during the emergency.</p><p><strong>Research limitations/implications: </strong>Since most health leaders have public health and management experience, the contributions of each factor to the duration of a secretary's tenure are difficult to separate and analyze separately.</p><p><strong>Practical implications: </strong>This study provides empirical insights into what factors drive health leader turnover during major health emergencies.</p><p><strong>Social implications: </strong>During major health emergencies, health leaders often strongly disagree with elected officials on the response. This paper test how crisis leadership theories help explain state health leaders' duration in one of the world's largest public health systems during the COVID-19 pandemic. This paper find that policy disagreements contributed to significant turnover.</p><p><strong>Originality/value: </strong>To the best of the authors' knowledge, this paper is the first that are aware of that uses novel primary data on public health executive leader characteristics and turnover causes in the context of the COVID-19 pandemic. It provides empirical evidence contributing to the crisis leadership literature by examining health leader turnover in one of the world's largest public health systems.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":"511-525"},"PeriodicalIF":1.8,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID again? Health workers' burnout and turnover intentions: possible impacts of coronavirus-induced anxiety and first-level servant leaders.","authors":"Erman Kılınç, Berat Çiçek","doi":"10.1108/LHS-10-2023-0078","DOIUrl":"10.1108/LHS-10-2023-0078","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Building on social exchange and leader-member exchange theories, this paper aims to propose a model of the impact of coronavirus-induced anxiety on health-care professionals' burnout and turnover intention through the mediation role of servant leadership.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;This model was examined by adopting partial least square-based structural equation modeling using data collected from 271 health professionals (doctors, nurses, midwives and analysts) from Turkey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The findings of the research illustrate that coronavirus-induced anxiety is positively associated with burnout and turnover intention. Furthermore, servant leadership mediates the relationship between coronavirus-induced anxiety, burnout and turnover intention. Yet, according to factor loadings, the mediating role of servant leadership is not strong (β : 0.035 and 0.053, respectively).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;First, this study targeted the health-care professionals from Turkey. Therefore, this population may not be able to provide general information on the topic. Thus, this study suggests that the subject be addressed in other populations as well. Second, the data were self-reported by the participants. Although common method bias and social desirability bias were not an issue in this study, it should be known that the results are based on the subjective judgments of the participants. Third, this study was limited to investigating the mediating role of servant leadership only.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical implications: &lt;/strong&gt;This study gives much beneficial information to both administrators and organizations by mirroring highly stressed workers' inside throughout statistically results. Hence, it is assumed that the findings will help leaders to cope with several difficult situations, especially in crisis moments. As the chaotic circumstances occurred, achieving organizational goals became more and more difficult. To do this, some leaders play critical roles for members like servant leaders by contributing uniquely spiritual dimensions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Social implications: &lt;/strong&gt;Struggling with the COVID-19 pandemic has aggravated the health-care professionals' existing mental health and has loaded more agitation on them. According to Mozes (2021), suicide cases among nurses have doubled the number of women in the general population. Thus, leaders should do something to lower those ratios. This study points out that servant leaders could break down those unwanted issues by decreasing burnout and turnover intention rates of health workers. Barbuto and Wheeler (2006) highlighted this situation by creating a dimension called \"The Natural Desire to Serve Others.\"&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Originality/value: &lt;/strong&gt;To the best of the authors' knowledge, to date, this study is the first to examine the mediating role of servant leadership in the effect of coronavirus-induce","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do health-care institutions perform better under leaders with medical or non-medical backgrounds? A scoping review.","authors":"Shazwani Mohmad, Kun Yun Lee, Pangie Bakit","doi":"10.1108/LHS-11-2023-0084","DOIUrl":"10.1108/LHS-11-2023-0084","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background.</p><p><strong>Design/methodology/approach: </strong>A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords \"performance,\" \"impact,\" \"physician,\" \"medical,\" \"doctor,\" \"leader,\" \"healthcare institutions\" and \"hospital.\" Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings.</p><p><strong>Findings: </strong>A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (<i>n</i> = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance.</p><p><strong>Practical implications: </strong>While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance.</p><p><strong>Originality/value: </strong>The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders' background.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"37 5","pages":"142-156"},"PeriodicalIF":1.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the mechanisms by which inclusive leadership influences the good soldier syndrome among health-care employees.","authors":"Lishin Joshy, Ranjana Varghese","doi":"10.1108/LHS-11-2023-0089","DOIUrl":"10.1108/LHS-11-2023-0089","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to investigate the relationship between inclusive leadership (IL), psychological safety (PS), affective commitment (AC) and organizational citizenship behavior (OCB) at the workplace. By understanding the sequential linkages, the research aims to provide insights for fostering a positive organizational culture that promotes employee commitment and employees' willingness to go the extra mile for the organization.</p><p><strong>Design/methodology/approach: </strong>The authors study how IL and OCB are related through PS and AC. For this purpose, cross-sectional data from 384 nursing professionals in India was collected and structural equation modeling was conducted on the same using IBM AMOS.</p><p><strong>Findings: </strong>The study found that IL has a major impact on OCB. The study further found that perceived IL leads to PS which is associated with OCB through AC.</p><p><strong>Research limitations/implications: </strong>The study has many theoretical and practical implications. This study uses a framework that is based on Affective events theory. In a health-care environment, IL can foster AC by promoting a culture of respect, collaboration and value for diverse perspectives, which enhances health-care professionals' emotional attachment to their work and the organization. Additionally, by encouraging open communication and a sense of belonging, IL contributes to OCB, as health-care staff are more likely to engage in discretionary behaviors that support the overall effectiveness and positive functioning of the health-care team if PS is improved, ultimately improving patient care outcomes.</p><p><strong>Originality/value: </strong>To the best of the authors' knowledge, this is one of the primary studies that looks into the sequential mechanism through which IL impacts OCB.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global research trends in nursing leadership from 1985 to 2022: a bibliometric analysis.","authors":"Changchang Chen, Xutong Zheng, Wenjie Chen, Hezi Mu, Man Zhang, Hongjuan Lang, Xuejun Hu","doi":"10.1108/LHS-09-2023-0074","DOIUrl":"10.1108/LHS-09-2023-0074","url":null,"abstract":"<p><strong>Purpose: </strong>Developing nursing leadership has become a key policy priority to achieve universal health coverage. This study aims to explore the current status, developing trends and research frontiers in the field of nursing leadership.</p><p><strong>Design/methodology/approach: </strong>In total, 1,137 articles and reviews on nursing leadership from 1985 to 2022 were retrieved from the Web of Science Core Collection database. Trends of publications, journals, countries/regions, institutions, documents and keywords were visualized and analyzed using Microsoft Excel and CiteSpace software.</p><p><strong>Findings: </strong>Nursing leadership research showed an overall increase in number despite slight fluctuations in annual publications. The USA was the leading country in nursing leadership research, and the University of Alberta was the most productive institution. The <i>Journal of Nursing Management</i> was the most widely published journal that focused on nursing leadership, followed by the <i>Journal of Nursing Administration</i>. Keyword analysis showed that the main research hotspots of nursing leadership are improvement, practice and impact of nursing leadership.</p><p><strong>Originality/value: </strong>This article summarizes the current state and frontiers of nursing leadership for researchers, managers and policy makers, as well as follow-up, development and implementation of nursing leadership. More research is needed that focuses on the improvement, practice and impact of nursing leadership, which are cyclical, complementary and mutually reinforcing. Longitudinal and intervention studies of nursing leadership, especially on patient prognosis, are also particularly needed.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of authentic leadership on nurses' stress, burnout, presenteeism during COVID-19.","authors":"Preeadashnie Pillay, Caren Brenda Scheepers, Rick Diesel","doi":"10.1108/LHS-10-2023-0082","DOIUrl":"10.1108/LHS-10-2023-0082","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic has burdened the health-care system and exposed nurses to immense stress. This study therefore aims to investigate nurses' mental well-being who are working with COVID-19-positive patients. Burnout leads to decreased productivity and manifests as emotional exhaustion, depersonalisation (cynicism) and low personal accomplishment (professional efficacy). Authentic leadership is built on a humanistic value system, which is the core value of nurses and other health-care professionals. This study therefore used authentic leadership as the independent variable.</p><p><strong>Design/methodology/approach: </strong>A cross-sectional quantitative research method was adopted by distributing validated online questionnaires to 1,334 nurses in a private pathology laboratory and 241 questionnaires were analysed with 93.4% female respondents. Multiple linear regression model testing was conducted.</p><p><strong>Findings: </strong>Multiple regression analyses showed statistically significant negative correlations between authentic leadership and emotional exhaustion, cynicism, job stress and job-stress-related presenteeism, and a positive correlation between authentic leadership and professional efficacy.</p><p><strong>Practical implications: </strong>This study provides empirical data to encourage organisations to focus on developing authentic leaders to decrease nurses' burnout, job stress and presenteeism. The health-care sector should strive to create an environment where nurses are valued and their talent is recognised to increase employee engagement and commitment.</p><p><strong>Originality/value: </strong>There were two contributions in this study: first, to determine whether there is a relationship between authentic leadership job stress and job-stress-related presenteeism. Second, to determine whether there is a relationship between authentic leadership and the three sub-constructs of burnout.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excellence in healthcare: nurturing servant leadership, fostering collaborative culture and promoting social sustainability in the UAE - strategies for transformation.","authors":"Divya Upadhyay","doi":"10.1108/LHS-01-2024-0012","DOIUrl":"10.1108/LHS-01-2024-0012","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the healthcare sector of the United Arab Emirates (UAE) to explore the significance of servant leadership and collaborative culture in fostering social sustainability. The primary objective of this paper is to investigate how servant leadership and a collaborative culture contribute to social sustainability in health care in the UAE. With a focus on promoting well-being within healthcare organizations, the paper aims to uncover the synergies between servant leadership, collaborative culture, and social sustainability.</p><p><strong>Design/methodology/approach: </strong>This paper conducted a multilayer literature review of existing literature on servant leadership, collaborative culture and social sustainability in health care, both globally and specifically in the UAE context, and a conceptual model was proposed.</p><p><strong>Findings: </strong>Servant leadership proves to be a culturally pertinent and effective leadership model within the UAE due to its alignment with cultural values, emphasis on community support, and the robust health-care system that contributes to individual well-being. This combination establishes a solid foundation for fostering a healthy and sustainable society.</p><p><strong>Research limitations/implications: </strong>Limitations and implications are discussed. The current research has not identified the boundary conditions under which servant leadership and collaborative culture may be more or less effective. This could involve exploring industry-specific influences or contextual factors. Theoretical and practical implications are discussed.</p><p><strong>Originality/value: </strong>The research seeks to unravel the interconnections between servant leadership, collaborative culture and social sustainability. To the best of the author's knowledge, none of the studies have explored the interrelationships of these constructs, particularly in the UAE context.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What keeps you up at night? Moral distress in nurse leaders in the USA, Germany, Austria and Switzerland.","authors":"M. Beil-Hildebrand, Firuzan Kundt Sari, P. Kutschar, Lorri Birkholz","doi":"10.1108/LHS-09-2023-0075","DOIUrl":"https://doi.org/10.1108/LHS-09-2023-0075","url":null,"abstract":"PURPOSE\u0000Nurse leaders are challenged by ethical issues in today's complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.\u0000\u0000\u0000DESIGN/METHODOLOGY/APPROACH\u0000This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.\u0000\u0000\u0000FINDINGS\u0000The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.\u0000\u0000\u0000ORIGINALITY/VALUE\u0000Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"19 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140671261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}