# Exploring the Relationship Between Authentic Leadership and Nurses’ Caring Behavior: The Mediating Effect of Occupational Coping Self‐Efficacy

## TL;DR

This study finds that nurses' caring behavior is influenced by authentic leadership through their coping self-efficacy, suggesting ways to improve care quality.

## Contribution

This study identifies occupational coping self-efficacy as a full mediator between authentic leadership and nurses' caring behavior in a Chinese context.

## Key findings

- Occupational coping self-efficacy fully mediates the relationship between authentic leadership and caring behavior.
- Authentic leadership and occupational coping self-efficacy are both positively correlated with caring behavior.
- Caring behavior scores were moderate to high, indicating a generally positive care environment.

## Abstract

Nurses’ caring behavior impacts patient outcomes. Studies have shown that authentic leadership and occupational coping self‐efficacy correlate with nurses’ caring behavior, but the mediating role of occupational coping self‐efficacy remains underexplored among Chinese nurses.

This study aims to explore the relationship between authentic leadership and nurses’ caring behavior, as well as the mediating role of occupational coping self‐efficacy in this relationship.

We recruited 436 nurses from 5 hospitals in Jiangxi and Zhejiang provinces, China, from November 2024 to January 2025. They completed online questionnaires, including general demographic information, the authentic leadership questionnaire, the occupational coping self‐efficacy questionnaire, and the caring behavior scale. A total of 436 questionnaires were collected, of which 418 were valid and included in the analysis. Structural equation modeling (SEM) and bootstrapping procedures were used to examine the mediating role of occupational coping self‐efficacy.

Clinical nurses scored 72.00 (64.00, 80.00) for authentic leadership, 37.00 (34.00, 43.00) for occupational coping self‐efficacy, and 137.00 (120.00, 144.00) for caring behavior. Authentic leadership was positively correlated with occupational coping self‐efficacy and caring behavior (r = 0.652, p < 0.001; r = 0.634, p < 0.001), and caring behavior was positively correlated with occupational coping self‐efficacy (r = 0.748, p < 0.001). The direct effect of authentic leadership on the caring behavior of nurses was not significant (β = 0.061, p = 0.448, 95% CI: −0.091–0.205); occupational coping self‐efficacy exerted a total mediating role between authentic leadership and caring behavior (β = 0.441, p < 0.001, 95%CI: 0.341–0.567).

The scores for caring behavior, occupational coping self‐efficacy, and authentic leadership were all at a moderate to high level. Both authentic leadership and occupational coping self‐efficacy were crucial in promoting nurses’ caring behavior, with occupational coping self‐efficacy fully mediating the effect of authentic leadership on caring behavior. However, due to the cross‐sectional design of this study, causal relationships between the variables cannot be established. Future research should employ longitudinal designs to further investigate these relationships.

Nursing administrators should focus on the impact of occupational coping self‐efficacy and authentic leadership on caring behavior. In addition to authentic leadership training, situational simulation exercises and peer support programs can be used to increase nurses’ occupational coping self‐efficacy, which will help to promote caring behavior and enhance the quality of care.