Authentic Leadership and Nurses' Innovative Behaviour: A Two-Wave Multicentre Study of Psychological Empowerment and Leader-Member Exchange.

AIM: To examine the association between authentic leadership and nurses' innovative behaviour and to test the parallel mediating roles of psychological empowerment and leader-member exchange. DESIGN: A two-wave, time-lagged, multicentre survey design. METHODS: Clinical nurses from 12 public hospitals across eastern, central and western China participated. A total of 2291 nurses completed the baseline survey, and 1812 completed the follow-up assessment and were included in the final analysis, yielding a retention rate of 79.1%. Authentic leadership, psychological empowerment and leader-member exchange were measured at Time 1, and nurses' innovative behaviour was measured at Time 2. Structural equation modelling and bootstrap analysis were conducted to test the hypothesised mediation model. RESULTS: Authentic leadership was positively associated with psychological empowerment and leader-member exchange. Both mediators were positively associated with nurses' innovative behaviour. The direct association between authentic leadership and innovative behaviour was not significant after the mediators were included. Psychological empowerment demonstrated a stronger mediating effect than leader-member exchange. CONCLUSION: Authentic leadership may support nurses' innovative behaviour primarily by strengthening psychological empowerment, with leader-member exchange providing an additional relational pathway. IMPLICATIONS FOR THE PROFESSION: Nurse managers should develop authentic leadership practices that strengthen nurses' psychological resources and workplace relationships to foster innovation in clinical settings. REPORTING METHOD: This study adhered to STROBE reporting guidelines.