الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 123 |  |  |
| | | from | 123 | | |
Abstract
Humble leadership is considered a critical factor that affects nurses’ behavior and is increasingly known as an essential attribute for leaders to build successful organizations. Also, the nurse leader is only overhead unless getting out the best in his subordinates. Regrettably, many leaders lose sight of this. Power can cause leaders to become excessively preoccupied with outcomes and control. Hence, treat nurses as a means to an end. So, humble leadership practices based on the value of respect, trust, and open communication are vital not only in giving high-quality care, but also in making a healthy work environment. The main is to facilitate nurses feel purposeful, more motivated, respected, empowered, allowing nurses to learn and develop so they can get their best selves to work, feel like to be part of their organization, and become more resilient.
Aim of the study:
In the present research aim was to identify the relationship between head nurses’ humble leadership style and both of insider identity and resilience at workplace, as perceived by nurses.
Setting of the study
The present research was performed at Alexandria Main University hospital in all intensive care units (ICU) (N=15) namely: chest disease, hepatic, diabetes mellitus, burn, systemic lupus erythematosus disease, renal, cardio thorax disease, hematemesis, resuscitation, neurosurgery, children neurosurgery, surgery anesthesia, head and neck, transitional medical unit. Also, critical care units (N=8) namely: the first unit, the second unit, the third
unit, the fourth unit, the fifth unit (medical ICU), the sixth unit (surgical ICU), toxic unit, and emergency anesthesia. Alexandria Main University hospital is considered the largest teaching hospital and has the greatest number of healthcare providers with different categories and qualifications of nursing personnel such as professional, technical and diploma nurses. It receives patients from wide range of governorates in Egypt. It is a multispecialty hospital and provides comprehensive healthcare services such as inpatient, outpatient, intensive care and critical care, emergency, radiological, laboratory and physiotherapy services. Moreover, it provides teaching and clinical training services for medical and nursing students and a setting for wide range of scientific research.
Subjects of the study
The participants in the study included:
All the nurses who could provide direct and indirect nursing care at the above-mentioned units and available at the time of data collection and with more than one year of experience (N=356). They were classified as follow: intensive care units: N=217, and in critical care units: N=139.
Tools:
The researcher applied 3 tools as follows:
Tool (I): Leader Expressed Humility Scale
Owens et al (2013) have developed this tool to assess nurses’ perception of humble leader behavior and it was adopted by the researcher to use in the current research. It consists of 9 items divided into 3 dimensions; willingness to accurately see the self (3 items), appreciating the others’ strengths and contributions (3 items), and teachability (3 items). Nurses’ responses were evaluated on a 5-point Likert scale ranging from (1) = strongly disagree up to (5) = strongly agree. The overall score ranging from (9-45). The score ranges from (9 - 21) indicates low humility, score between (21- 33) reveals moderate humility, and score from (33 - 45) indicates high humility.
Tool (II): Perceived Insider Status Scale
Stamper and masterson (2002) developed this tool to assess the point to which nurses perceive identity (status) as an insider inside a particular organization. It was adopted by the researcher. It consists of one dimension (6items). Nurses’ responses were evaluated on a 5-point Likert scale ranging from (1) = strongly disagree up to (5) = strongly agree. The reversed score was made for all the negative statement. the overall score was ranging from (6 - 30). The Score range from (6 - 14) indicates low perception of insider identity, score between (14 - 22) reveals moderate perception of insider identity, and score from (22 - 30) indicates high perception of insider identity.
Tool (III): Resilience at workplace Scale
Winwood et al (2013) developed this tool to validate nurses’ resilience at workplace. It consists of 17 items divided into 6 dimensions; living authentically (3items), find your calling (3 items), maintaining perspective (2 items), handling stress (4 items), constructing social connections (3 items), and remaining healthy (2 items). Scoring was changed from 7 to 5 points Likert scale for the facility of subjects’ responses. The overall score ranging from (17-85). the Score range from (17 - 39) indicates low resilience, score between (40-62) reveals moderate resilience, and score (63 - 85) indicates high resilience.
In addition, the researcher developed a socio-demographic data sheet of nurses and attached it to the research tools. It was including the following items (age, sex, level of education, type of current unit of work, years of experience in nursing profession, number of working hour/weeks, number of years of experience in the current working unit, marital status, earlier attendance of any training programs on humble leadership and leadership).
Method:
The research protocol was submitted to the Research Ethics Committee of the Faculty of Nursing, Alexandria University for ethical approval.
An official permission to collect the necessary data for the study was obtained from Faculty of Nursing, Alexandria University.
The study tools were translated into Arabic and tested for its face and content validity by five experts in the study’s field from nursing administration department, Faculty of Nursing, Alexandria University. The adjustments were done based on experts’ opinions such as re-wording some questions. The study tools were tested for their reliability using Cronbach’s alpha coefficient test, where leader expressed humility scale (α= 0.88), perceived insider status scale (α= 0.74), resilience at workplace scale (α = 0.85) which indicate good reliability.
A pilot study was carried out on a number of 10 % of nurses (N=36) from critical care units in order to assess and ensure the tools’ clarity, their application, and their viability, to identify potential obstacles and issues during data collection. They weren’t from the study subjects and no adjustments were made.
Data collection
The researcher conducted data collection through hand delivered questionnaires for studying the subjects at their work setting. And after having individualized interviews with each one that lasted for 10 minutes, the researcher explained the research’ aim and the needed instructions were given.
Each subject took from 15-to-20 minutes to fill out the questionnaires. The data collection took 3 months beginning from March 2022 to end of May 2022.
The following were the main results of the study.
1- The results illustrated that more than one half (57.3%) of the studied nurses perceived their leaders had high level of humble leadership style. While, more than one third of the studied nurses (33.1%) perceived their leaders had moderate level of humble leadership style. Also, there were statistical significance positive and strong correlation between overall humble leadership style and its sub-dimensions.
2- There was no statistically significant difference between the mean score of head nurses `humble leadership style and nurses `socio-demographic characteristics except years of experience in the working hospital (p=0.024* F=3.194) and years of experience in the current working unit (p = 0.026* f =3.111).
3- The results clarified that more than half (59.3%) of the studied nurses had high level of perceived insider identity. However, more than one third of the studied nurses (34.8%) had moderate level of perceived insider identity. Also, more than half (59.6%) of the studied nurses had a moderate level of resilience at workplace. However, more than one third of the studied nurses (38.8%) had high-level of resilience at workplace.
4- There was no statistically significant difference between the mean score of nurses` insider identity and nurses `sociodemographic characteristics except years of experience in nursing profession (p = 0.037* F = 2.849) and working hours per week (P=0.037* F=3.342).
5- There was no statistically significant difference between the mean score of nurse’s resilience at workplace and nurses `sociodemographic characteristics.
6- The results displayed a statistically significant regression coefficient value between humble leadership style and its dimensions as an independent variable and perceived insider identity as a dependent variable, by using multivariate linear regression model for which R²= 9% making the model has a significant prediction (F=12.761*; p < 0.001**).
7- The results displayed a statistical significant regression coefficient value between humble leadership style and its dimensions as an independent variable and resilience at workplace as a dependent variable, by using multivariate linear regression model for
which R²= 9% making the model has a significant prediction (F=12.867 ; P<0.001** ).
8- There was high statistically significance weak positive correlation between the overall nurses’ perceptions of humble leadership style and overall nurses `perceived insider identity (p= 0.001** r=0.310). Also, there was high statistically significance weak positive correlation between the overall nurses’ perceptions of humble leadership style and overall nurses` perception of resilience at workplace (p=0.001** r=0.289).
9- There were high statistically significance differences between levels of head nurses humble leadership, levels of perceived insider identity and levels of resilience at workplace (p = 0.000**).
Conclusion
The current study highlighted several important findings. The results illustrated that more than one half of the studied nurses perceived their leaders had high level of humble leadership style. Likewise, more than half of the studied nurses had high level of perceived insider identity, and more than half of them had moderate level of resilience at workplace. Moreover, there were highly statistically significant difference and weak positive correlation between levels of humble leadership, levels of insider identity and levels of resilience at workplace.
Recommendations were given based on the results of the study.
1. Arrangement for a series of workshops on humble leadership style concepts and skills.
2. Establish orientation programs for newly hired nurses to decrease their intention to leave and improve their insider identity, increase information sharing, improve communication of work-related issues with head nurses.
3. Increase information sharing, improved communication of work-related issues with nursing leaders, an effort to get involved in problem-solving for enhancing working conditions to a less stressful work environment and improve resilience.
4. Mentorship programs are recommended to improve nurses’ resilience by improving positive and supportive professional relationships, supporting optimism, emotional insight, life balance, and spirituality.
5. Leaders should demonstrate more humble leadership style by modeling for followers how to perceive faults favorably and exhibit receptivity to comments.
6. Build autonomy in nurses through giving them with more authority and responsibilities and enable nurses to play a key role in establishing their own performance goals to be more competent and resilient.