Ethical Leadership of Head Nurses as Perceived by Nurses and Its Relationship With Nurses' Organisational Justice.

Aim: To investigate the level of ethical leadership among head nurses and its relationship with nurses' perceived organisational justice.

Design: A cross-sectional study.

Methods: This cross-sectional study was conducted with a convenience sample of 501 clinical nurses from four tertiary-level hospitals in Zhengzhou, Henan Province of China, in May 2023. The Ethical Leadership at Work Questionnaire and the Organisational Justice Scale were used as data collection instruments. Multiple stratified linear regression was used to analyse the relationships.

Results: The mean score of ethical leadership of head nurses was 4.13 ± 0.46, which is at a high level. Marital status, department and monthly income were the influencing factors of nurses' perceived ethical leadership. Head nurses' ethical leadership was positively correlated with nurses' organisational justice (r = 0.513, p < 0.01). Stratified linear regression analysis showed that the people orientation, power sharing and sustainability dimensions explained 23.0% of the variance in nurses' organisational justice (p < 0.05). Head nurses' ethical leadership plays a critical role in helping nurses improve their sense of organisational justice. Nurse managers need to pay more attention to nurses' personal development and needs, give them more opportunities to participate in decision-making and strengthen their organisational justice.

Patient or public contribution: We would like to thank the nurses who were recruited and the hospital administrators who supported the study in the research process. Our study utilised the online questionnaire star platform to conduct an online questionnaire survey. After obtaining the consent of the hospital administrators, a nurse in the selected department was contacted as a research investigator, and after clarifying the purpose, methodology, significance and precautions for completing the questionnaire, the investigator distributed the electronic questionnaire in the form of a web link using a uniform guideline to nurses in the department who met the inclusion criteria.