# Assessing the Impact of Ambidextrous Leadership on Nurses’ Presenteeism: A Latent Profile and Mediation Analysis Study

## TL;DR

This study explores how different leadership styles affect nurses' presenteeism and finds that leadership style impacts through relationships with nurses.

## Contribution

The study identifies three distinct ambidextrous leadership profiles and their impact on nurse presenteeism via leader–member exchange.

## Key findings

- Three ambidextrous leadership profiles were identified: ambidextrous lagging, vision-oriented, and ambidextrous synergistic.
- Leader–member exchange mediates the relationship between ambidextrous leadership and nurses’ presenteeism.
- Nursing managers should adapt leadership styles to reduce presenteeism.

## Abstract

The high incidence of nurse presenteeism significantly impact quality of care delivery. Leader–member exchange and clinical leadership have been identified as factors influencing nurses’ presenteeism. However, there are few studies investigating the relationship between these variables. This study aimed to investigate the heterogeneity of ambidextrous leadership and its relationships with nurses’ presenteeism using latent profile analysis, while also examining the mediating role of leader–member exchange.

A multicenter cross‐sectional survey was conducted from December 2024 to January 2025, involving clinical nurses from three tertiary general hospitals in Guangzhou. Sociodemographic Characteristics Questionnaire, Ambidextrous Leadership Scale, Leader–Member Exchange Scale, and Stanford Presenteeism Scale were used. Latent profile analysis was performed using Mplus 8.3, and mediation effects were tested through PROCESS 4.2 in SPSS 27.0.

A total of 513 valid questionnaires were collected. Three ambidextrous leadership profiles were identified: ambidextrous lagging, vision‐oriented, and ambidextrous synergistic. These profiles showed significant differences in the leader–member exchange and presenteeism scores. Moreover, leader–member exchange significantly mediated the relationship between ambidextrous leadership and nurses’ presenteeism.

Ambidextrous leadership is heterogeneous. The leader–member exchange mediates ambidextrous leadership and nurses’ presenteeism. Therefore, nursing managers should be flexible in changing their leadership styles to reduce nurses’ presenteeism.

There should be further intensive training for nursing managers to implement scientifically sound leadership functions, enhance clinical nurse–manager relationships, and increase nurses’ motivation, thereby reducing the incidence of presenteeism.