# Authority, favoritism, and fairness: how paternalistic leadership and nepotism shape nurses’ perceptions of justice

**Authors:** Hend Sabry Saad Habaza, Heba Rabea Hagras, Hanan Elsaid Elsabahy, Manal Saleh Moustafa Saleh, Hamad Ghaleb Dailah, Ahmed Hendy, Hussain Ali Shobaili

PMC · DOI: 10.1186/s12912-025-03888-y · BMC Nursing · 2025-10-30

## TL;DR

The study explores how paternalistic leadership and nepotism affect nurses' perceptions of fairness in a hospital setting.

## Contribution

It identifies how paternalistic leadership can promote fairness and reduce nepotism in nursing environments.

## Key findings

- Paternalistic leadership is positively correlated with organizational justice (r = 0.549).
- Nepotism is negatively correlated with organizational justice (r = -0.337).
- Most nurses perceive moderate levels of paternalistic leadership and organizational justice.

## Abstract

Paternalistic leaders serve as role models for their followers so that they understand the kind of behavior that is ethically unacceptable as nepotism and understand how ethical issues are handled as organizational justice.

This study aimed to investigate the effects of Paternalistic Leadership and Nepotism on Nurses’ Perception of Justice.

A descriptive correlational design was employed with a Convenience sample of 267 staff nurses from one hospital, who had a minimum of two years of professional experience in the field and were willing to participate in the study. This prerequisite helps ensure that participants have a deep, practical understanding of the hospital’s culture and management. A nurse with two years of experience has moved beyond the initial training and orientation phase. They have a more comprehensive view of the workplace dynamics and have likely witnessed or been affected by various personnel decisions. Three instrument tools were used for data collection: The Paternalistic Leadership Questionnaire, which consisted of 15 items representing three dimensions; the Nepotism Questionnaire, which consisted of 12 items; and the Organizational Justice Questionnaire, which consisted of 44 items in five dimensions.

A statistically significant positive correlation was found between total paternalistic leadership style and organizational justice (r = 0.549), and a statistically significant negative correlation was found between total nepotism practice and organizational justice (r = -0.337). More than half of the studied nurses perceive a moderate level of paternalistic leadership, less than half perceive a moderate level of nepotism practice, and less than half perceive a moderate level of organizational justice.

Based on the results of this study, we can conclude that the characteristics of paternalistic leadership, in the form of a good personality, being responsible, disciplined, and unselfish, as well as providing an example for subordinates. These moral values of paternalistic leaders regulate the ethical approach to decision-making and can create a fair environment, and be free from nepotism in an organization.

Develop a comprehensive onboarding program that includes orientation sessions, job-specific training, and mentorship programs related to paternalistic leadership style, nepotism practices, and principles of organizational justice.

Fairness is a critical leadership tool. Proactive nursing management must address issues of perceived injustice and nepotism head-on to build a resilient, engaged, and high-performing nursing staff. When nurses feel that leadership decisions are unfair or that nepotism is at play, it erodes morale and fuels burnout.

Not applicable.

## Full-text entities

- **Diseases:** confusion (MESH:D003221), burnout (MESH:D002055)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

5 references — full list in the complete paper: https://tomesphere.com/paper/PMC12577053/full.md

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Source: https://tomesphere.com/paper/PMC12577053