BMC Nurs. 2026 Feb 7. doi: 10.1186/s12912-026-04413-5. Online ahead of print.
ABSTRACT
BACKGROUND: As a critical form of proactive behaviors, taking charge plays a central role in facilitating hospitals’ improvement and development. Although prior research has extensively examined how to encourage nurses to engage in taking charge, the relationship between the concept of “spirit at work” and taking charge remains insufficiently understood. This study was designed to examine the impact of spiritual leadership on the nurses’ taking charge and its internal mechanism.
METHODS: Drawing on the conservation of resources (COR) theory, we developed a moderated mediation model to elucidate how spiritual leadership fosters nurses’ taking charge through spiritual well-being, and how this effect is contingent on nurses’ pay-for-performance perceptions. We conducted a field study in China to test our theoretical model, with data collected from 353 nurses and 88 head nurses across three different time points. Data analysis was run using descriptive statistics and confirmatory factor analyses. And regression analyses were used to examine the hypotheses.
RESULTS: The regression results revealed that spiritual leadership was positively associated with nurses’ taking charge. Spiritual well-being significantly mediated the relationship between spiritual leadership and nurses’ taking charge. Moreover, we observed that the indirect effect of spiritual leadership on taking charge through spiritual well-being was stronger for nurses who perceived higher levels of pay-for-performance than for those with lower perceptions.
CONCLUSIONS: These findings highlight the essential role of spiritual leadership in promoting nurses’ positive psychological states and proactive behaviors. Hospital administrators may consider strengthening head nurses’ spiritual leadership to enhance nurses’ spiritual well-being and their propensity to take charge. Additionally, implementing performance-based compensation practices can cultivate a climate that reinforces distributive fairness and further encourages proactive behavior.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:41654904 | DOI:10.1186/s12912-026-04413-5
