Toxic leadership, conscientious intelligence, and quality of nursing work life among registered nurses: A cross-sectional moderation study

Abstract

Background : Quality of nursing work life is an important indicator of nurses’ professional well-being. Toxic leadership has been associated with poorer nursing outcomes; however, limited evidence exists on how personal ethical resources, such as conscientious intelligence, may shape the relationship between toxic leadership and quality of nursing work life among registered nurses. Aim: We aimed to examine the relationship between toxic leadership and quality of nursing work life among registered nurses and to determine whether conscientious intelligence moderated this relationship. Design: A cross-sectional analytical design was used. Methods: A convenience sample of 274 registered nurses in Egypt completed self-administered questionnaires assessing the study variables. Schmidt’s Toxic Leadership Scale, the Conscientious Intelligence Scale, and the Quality of Nursing Work Life Scale were used. Data were analyzed using descriptive statistics, independent samples t -test, one-way analysis of variance, Pearson’s correlation, and Hayes’ PROCESS Model 1 for moderation analysis. Results Toxic leadership was negatively correlated with quality of nursing work life ( r = −.605, p < .001) and conscientious intelligence ( r = −.334, p < .001) . Conscientious intelligence was positively correlated with quality of nursing work life ( r = .318, p < .001). The moderation model was statistically significant, F (3, 270) = 59.026, p < .001, and explained 39.6% of the variance in quality of nursing work life. The interaction was significant ( B = −0.0065, standard error = 0.0026 , t = −2.538, p = .012) and explained an additional 1.4% of the variance. The negative conditional association between toxic leadership and quality of nursing work life became stronger as conscientious intelligence increased. Conclusion: Greater perceived toxic leadership was associated with poorer quality of nursing work life. Although conscientious intelligence was positively associated with quality of nursing work life at the bivariate level, it did not demonstrate the hypothesized protective moderation. The stronger negative association at higher levels of conscientious intelligence may reflect greater sensitivity to perceived violations of professional and moral values, but this explanation requires further investigation. Implications for Nursing Management: Healthcare organizations should consider prioritizing leadership evaluation, accountability systems, safe reporting mechanisms, and efforts to strengthen ethical climates. Initiatives to strengthen nurses’ conscientious and ethical capacities could be accompanied by organizational efforts to create ethically supportive work environments.