From leadership research to district action: Impact of Ethical Leadership and Organizational Culture on Nursing Personnel's Organizational Commitment: A Cross-Sectional Study

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Introduction Nursing personnel's organizational commitment is a growing global concern, influencing retention in dynamic and high-demand healthcare environments. Ethical leadership and organizational culture both contribute to organizational commitment. Little is known about the interaction between these variables when they coexist, and whether the results vary between secondary and tertiary hospitals. This study aims to investigate the impact of ethical leadership and organizational culture on nursing personnel's organizational commitment in Greece and to examine whether this varies according to nursing institutions’ sizes. Methods A cross-sectional study was conducted, enrolling 724 nursing personnel from two secondary and two tertiary Greek hospitals. Data were collected from January to May of 2023. The tools used were the Ethical Leadership Scale, the Organizational Culture Profile, and the Three-Component Model of Commitment. Descriptive statistics, independent t-test, Spearman and Pearson correlation coefficient, and multivariate linear regression analyses were performed to explore the variables’ relationships. Results Ethical leadership was related to affective (β = 0.38, CI = 0.27-0.49), normative (β = 0.44, CI = 0.33-0.55), and continuance commitment (β = 0.21, CI = 0.09-0.31). The organizational culture factors of supportiveness (β = 0.31, CI = 0.15-0.47), decisiveness (β = 0.30, CI = 0.12-0.47), and team orientation (β = 0.30, CI = 0.13-0.46) were related to affective commitment. Innovation (β = 0.36, CI = 0.23-0.49), emphasis on rewards and growth (β = 0.21, CI =0.07-0.36), focus on results (β = 0.19, CI = 0.04-0.34), and team orientation (β = 0.25, CI = 0.07-0.42) were related to normative commitment. Secondary hospitals had better scores on commitment. Conclusion This study reinforces existing evidence on nursing personnel's organizational commitment being correlated to ethical leadership and organizational culture. Furthermore, it highlights that a smaller hospital size contributes to better outcomes. Nursing personnel's commitment is imperative and achievable through a strong organizational culture with benefits for nurses, patients, and organizations. These findings can guide health policies on hospital management style and nursing personnel leadership development education.

Study methods

A descriptive correlational, cross-sectional study was conducted between January and May 2023 in two secondary hospitals (≤300 beds) and two tertiary hospitals (>300 beds), all located in urban areas of Greece. The secondary hospitals are located in smaller urban areas compared to the tertiary ones. Of the tertiary hospitals, one is public and the other is university-affiliated.

Limitations

Convenience sampling is an obstacle to drawing general conclusions. The majority of the sample is female. Being a cross-sectional study, findings are limited to the time period of the study. Also, nursing personnel's perceptions may differ in other public hospitals, so they cannot be generalized. However, the limitation of generalization does not limit the fact of the correlation between variables and OCom. Future research could examine the correlation of EL with the eight factors of OCul.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Select one recurring district decision. Publish the decision owner, evidence requirements, consultation process and appeal route; test the process on a bounded low-risk decision. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Track decision time, unresolved objections, documented reasons, appeals and access differences. Review whether the process changes who can participate and who carries the burden. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Vasiliki Kourkouni; Petros Galanis; Konstantinos Athanasakis; Michael Igoumenidis. Impact of Ethical Leadership and Organizational Culture on Nursing Personnel's Organizational Commitment: A Cross-Sectional Study. Cureus (2025-06-20). https://doi.org/10.7759/cureus.86440

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.