Influence of toxic and transformational leadership practices on nurses' job satisfaction, job stress, absenteeism and turnover intention: A cross-sectional study

Leodoro J. Labrague*, Chidozie E. Nwafor, Konstantinos Tsaras

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Aim: This study examined the influence of toxic and transformational leadership practices on nurses' job satisfaction, psychological distress, absenteeism and intent to leave the organisation or the nursing profession. Background: Transformational leadership is attributed to favourable nurse consequences; however, the nursing literature is silent regarding the causal association between toxic leadership and nurses' job outcomes. Methods: This is a cross-sectional study involving 770 registered nurses from 15 hospitals in Central Philippines. Data were collected using seven self-report scales during the months of December 2019 to February 2020. Results: The composite scores for the transformational leadership scale and toxic leadership scale were 4.22 and 1.59, respectively. Toxic leadership predicted job satisfaction, absenteeism, psychological distress and intention to leave the profession. Transformational leadership predicted job satisfaction and intent to leave the profession. Conclusion: Results suggest that nurses working with a transformational leader report higher job contentment and lower intent to leave the nursing profession. Nurses who work for a manager exhibiting toxic leadership behaviours demonstrated lower job contentment, higher stress levels, frequent absenteeism and higher intent to leave the nursing profession. Implication for Nursing Management: Nurse retention strategies should include measures to foster transformational leadership and derail toxic leadership practices in nurse managers through evidence-based education, training and professional development.

Original languageEnglish
Pages (from-to)1104-1113
Number of pages10
JournalJournal of Nursing Management
Issue number5
Publication statusPublished - Jul 1 2020


  • job satisfaction
  • job stress
  • nurse
  • toxic leadership
  • transformational leadership
  • turnover intention

ASJC Scopus subject areas

  • Leadership and Management

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