Yue Gu, Hang Liu, Tingyao Nie, Ying Li, Xiaozhen Sun, Rui Yang, Yanping Qi, Liwen Guo, Liang Tong
The PMH-Scale is a concise, valid, and reliable instrument for screening for positive mental health in clinical environments characterized by high emotional demands, such as nursing. Its application can facilitate prompt monitoring and inform evidence-based interventions.
BACKGROUND: Toxic leadership behaviors by nurse managers may be associated with lower career resilience among nurses. However, it remains unclear whether different regulatory focus profiles exhibit heterogeneous indirect associations in this context.
AIM: To examine the association between toxic leadership behaviors and nurses' career resilience, and to investigate whether different regulatory focus profiles exhibit distinct indirect associations in this relationship.
METHODS: From May to October 2025, a multicenter cross-sectional survey was conducted among 1,210 nurses using the Toxic Leadership Behaviors of Nurse Managers Scale, the Nurse Regulatory Focus Scale, and the Career Resilience Scale. Latent profile analysis identified regulatory focus profiles, and three-step methods were used to examine profile differences and associations while accounting for classification uncertainty. Profile-based path analysis estimated overall and profile-specific statistical indirect associations.
RESULTS: Four regulatory focus profiles were identified: Low-Regulatory (9.8%), Balanced (40.4%), Prevention-Dominant (11.9%), and Dual-High (37.9%). Career resilience was highest in the Dual-High profile and lowest in the Low-Regulatory profile. Higher toxic leadership scores were associated with lower odds of membership in the other three profiles relative to the Low-Regulatory profile. Toxic leadership was negatively associated with career resilience (total: β = -0.388, 95% CI [-0.439, -0.344]; direct: β = -0.280, 95% CI [-0.325, -0.241]), with a negative overall indirect association through regulatory focus profiles (β = -0.108, 95% CI [-0.145, -0.082]). Relative to the Low-Regulatory profile, the relative indirect contribution was negative for the Dual-High profile (β = -0.163, 95% CI [-0.228, -0.116]), positive for the Prevention-Dominant profile (β = 0.065, 95% CI [0.040, 0.100]), and nonsignificant for the Balanced profile.
CONCLUSION: Toxic leadership behaviors were negatively associated with nurses' career resilience, and the profile-specific relative indirect contributions varied across regulatory focus profiles.