Authentic Leadership of Nurses in the Hospital: A Scoping Review

TL;DR

This scoping review explores how authentic leadership by hospital nurses is linked to better team performance, job satisfaction, and patient outcomes.

Contribution

The study systematically identifies and analyzes the characteristics and impacts of authentic leadership in hospital nursing through recent scientific evidence.

Findings

Authentic leadership in nurses is associated with improved team performance and organizational commitment.

It correlates with reduced burnout and healthier work environments.

Discrepancies exist between leaders' and subordinates' perceptions of authentic leadership.

Abstract

Background: The new challenges facing the healthcare sector require nursing leaders who are prepared to respond to patients’ healthcare needs and keep professionals motivated and satisfied while meeting the organisation’s objectives. To overcome these challenges, interest has grown in positive leadership styles, which in turn has sparked interest in authentic leadership. This line of thought on leadership has been predictive of various positive outcomes in the hospital context. Objective: Examine the characteristics of authentic leadership among nurses in the hospital context based on scientific evidence. Methods: Scoping review according to the Joanna Briggs Institute, consisting of three stages of research. First, a search was conducted in MEDLINE Ultimate, CINHAL Ultimate and MedicLatina through the EBSCOHost platform, LILACS and RCAAP for grey literature. Then, using the same keywords, we conducted a search in Scopus and ScienceDirect. Both searches covered the period between 2019 and 2024. Studies were included if they focused on authentic leadership in nurses working in hospital contexts; non-empirical studies, reviews, and those outside the nursing field were excluded. Results: Sixteen articles were included, 13 of which were cross-sectional, descriptive and/or correlational, 2 were quasi-experimental and 1 employed an exploratory and confirmatory factor analysis approach. The Authentic Leadership Questionnaire was used in a total of 11 articles. The studies showed that authentic leadership by nurses in a hospital context is significantly associated with relevant organisational and individual variables, such as team performance, organisational commitment, job satisfaction, reduced burnout, and the promotion of healthy work environments. The data also revealed discrepancies between the perceptions of leaders and their subordinates. Conclusion: Authentic leaders have a positive impact on the quality of nursing care, patient health outcomes, professional satisfaction and motivation to lead and the achievement of healthcare institution goals. Consequently, authentic leadership is a fundamental pillar for strengthening nursing teams, promoting trust, well-being and improvements in the quality of care. Nevertheless, the strength of the evidence is limited, given the predominance of cross-sectional studies and potential contextual biases, which should be considered when interpreting the findings.

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