Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeism

Abstract Objective This study aimed to investigate the mediating role of psychological safety in the relationship between inclusive leadership and implicit absenteeism among nurses. Design A descriptive, correlational cross-sectional design was conducted in accordance with the STROBE guidelines. Met...

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Main Authors: Ayman Mohamed El-Ashry, Bashair Mohamed Elsayed Abdo, Mahmoud Abdelwahab Khedr, Mona Metwally El-Sayed, Islam Sameh Abdelhay, Mennat-Allah G. Abou Zeid
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03464-4
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author Ayman Mohamed El-Ashry
Bashair Mohamed Elsayed Abdo
Mahmoud Abdelwahab Khedr
Mona Metwally El-Sayed
Islam Sameh Abdelhay
Mennat-Allah G. Abou Zeid
author_facet Ayman Mohamed El-Ashry
Bashair Mohamed Elsayed Abdo
Mahmoud Abdelwahab Khedr
Mona Metwally El-Sayed
Islam Sameh Abdelhay
Mennat-Allah G. Abou Zeid
author_sort Ayman Mohamed El-Ashry
collection DOAJ
description Abstract Objective This study aimed to investigate the mediating role of psychological safety in the relationship between inclusive leadership and implicit absenteeism among nurses. Design A descriptive, correlational cross-sectional design was conducted in accordance with the STROBE guidelines. Methods Data were collected from 407 nurses working in two public hospitals in El-Behara Governorate, Egypt, using validated Arabic versions of the Inclusive Leadership Scale, Psychological Safety Scale, and the Stanford Presenteeism Scale (SPS-6). Descriptive statistics, Pearson’s correlations, multiple regression, and structural equation modeling (SEM) were employed to analyze the data using SPSS and AMOS (version 26). Results Inclusive leadership was significantly and negatively associated with implicit absenteeism (r = − 0.207, p = 0.030) and positively associated with psychological safety (r = 0.204, p = 0.036). Psychological safety was also negatively correlated with implicit absenteeism (r = − 0.202, p = 0.041). Regression analysis revealed that both inclusive leadership (β = − 0.098, p = 0.049) and psychological safety (β = − 0.091, p = 0.048) significantly predicted lower implicit absenteeism. Furthermore, SEM results confirmed that psychological safety partially mediated the relationship between inclusive leadership and implicit absenteeism (indirect effect β = − 0.010). The model demonstrated an acceptable fit (RMSEA = 0.091; CFI = 1.000; IFI = 1.000; χ² = 9.748, p < 0.001). Conclusion The findings highlight the critical role of inclusive leadership in reducing implicit absenteeism by fostering psychological safety. Promoting inclusive leadership practices and psychologically safe work environments may enhance nurse engagement, reduce presenteeism-related productivity loss, and ultimately improve patient care outcomes. Clinical trial registration Not applicable.
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spelling doaj-art-8947f01e55af47b3b5d97963009a9f9c2025-08-20T03:45:24ZengBMCBMC Nursing1472-69552025-07-0124111110.1186/s12912-025-03464-4Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeismAyman Mohamed El-Ashry0Bashair Mohamed Elsayed Abdo1Mahmoud Abdelwahab Khedr2Mona Metwally El-Sayed3Islam Sameh Abdelhay4Mennat-Allah G. Abou Zeid5Psychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria UniversityDepartment of Nursing Administration, Faculty of Nursing, Damanhour UniversityPsychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria UniversityPsychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria UniversityDepartment of Nursing Administration, Faculty of Nursing, Mansoura UniversityNursing Administration Department, Faculty of Nursing, Ain Shams UniversityAbstract Objective This study aimed to investigate the mediating role of psychological safety in the relationship between inclusive leadership and implicit absenteeism among nurses. Design A descriptive, correlational cross-sectional design was conducted in accordance with the STROBE guidelines. Methods Data were collected from 407 nurses working in two public hospitals in El-Behara Governorate, Egypt, using validated Arabic versions of the Inclusive Leadership Scale, Psychological Safety Scale, and the Stanford Presenteeism Scale (SPS-6). Descriptive statistics, Pearson’s correlations, multiple regression, and structural equation modeling (SEM) were employed to analyze the data using SPSS and AMOS (version 26). Results Inclusive leadership was significantly and negatively associated with implicit absenteeism (r = − 0.207, p = 0.030) and positively associated with psychological safety (r = 0.204, p = 0.036). Psychological safety was also negatively correlated with implicit absenteeism (r = − 0.202, p = 0.041). Regression analysis revealed that both inclusive leadership (β = − 0.098, p = 0.049) and psychological safety (β = − 0.091, p = 0.048) significantly predicted lower implicit absenteeism. Furthermore, SEM results confirmed that psychological safety partially mediated the relationship between inclusive leadership and implicit absenteeism (indirect effect β = − 0.010). The model demonstrated an acceptable fit (RMSEA = 0.091; CFI = 1.000; IFI = 1.000; χ² = 9.748, p < 0.001). Conclusion The findings highlight the critical role of inclusive leadership in reducing implicit absenteeism by fostering psychological safety. Promoting inclusive leadership practices and psychologically safe work environments may enhance nurse engagement, reduce presenteeism-related productivity loss, and ultimately improve patient care outcomes. Clinical trial registration Not applicable.https://doi.org/10.1186/s12912-025-03464-4LeadershipAbsenteeismLatent class analysisPsychological safetyNurses
spellingShingle Ayman Mohamed El-Ashry
Bashair Mohamed Elsayed Abdo
Mahmoud Abdelwahab Khedr
Mona Metwally El-Sayed
Islam Sameh Abdelhay
Mennat-Allah G. Abou Zeid
Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeism
BMC Nursing
Leadership
Absenteeism
Latent class analysis
Psychological safety
Nurses
title Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeism
title_full Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeism
title_fullStr Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeism
title_full_unstemmed Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeism
title_short Mediating effect of psychological safety on the relationship between inclusive leadership and nurses’ absenteeism
title_sort mediating effect of psychological safety on the relationship between inclusive leadership and nurses absenteeism
topic Leadership
Absenteeism
Latent class analysis
Psychological safety
Nurses
url https://doi.org/10.1186/s12912-025-03464-4
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