Nurse Managers' Toxic Leadership Behaviors and Their Influence on Nurses' Quality of Life: A Cross-Sectional Study.

Background: Leadership and organizational climate significantly impact nurses' effectiveness, especially in the high-stress environments typical of healthcare institutions. However, toxic leadership characterized by micromanagement and bias can negatively affect employee morale and diminish service quality. Aim: This study aimed to examine how nurse managers' toxic leadership behaviors influence the quality of life of nurses in Kazakhstan. Methods: This research employed a quantitative, cross-sectional, and correlational design. The study was conducted at the University Medical Center in Astana, Kazakhstan. A convenience sample of 313 nurses participated in the survey, which included a paper questionnaire with three parts: a participant information sheet, the "Toxic Leadership Behaviors of Nurse Managers Scale" (ToxBH-NM), and the "World Health Organization Quality of Life" assessments. The demographic characteristics, toxic leadership behaviors of nurse managers, and quality of life were analyzed descriptively. Multiple regression analyses were used to examine the impact of nurse managers' toxic leadership behaviors on nurses' quality of life. Results: The findings indicated a generally positive nurse managers' leadership behaviors (M = 1.55, SD = 0.83). More than half of the nurses reported an overall quality of life that they described as good (55.3%) and expressed satisfaction with their health (56.2%). Weak to moderate inverse correlations (r = 0.16 to 0.38, p < 0.001) were found between toxic leadership behaviors and the quality of life of nurses. The four regression models were found to be significant, explaining 15.7% (R 2 = 0.192, adjusted R 2 = 0.157), 8.9% (R 2 = 0.127, adjusted R 2 = 0.089), 11.8% (R 2 = 0.155, adjusted R 2 = 0.118), and 16.0% (R 2 = 0.195, adjusted R 2 = 0.160) of the total variance in "physical health" (F 13,299 = 5.47, p < 0.001), "psychological health" (F 13,299 = 3.34, p < 0.001), "social relationships" (F 13,299 = 4.21, p < 0.001), and the "environment domain" (F 13,299 = 5.56, p < 0.001). Conclusion: Experiences of humiliating behavior from nurse managers were linked to a poorer quality of life among nurses. Factors such as marital status, the specific hospital where the nurses worked, and the toxic leadership behaviors of nurse managers significantly affected the nurses' quality of life. Implication for Nursing Management: These findings can serve as a foundation for developing programs that specifically address the toxic leadership behaviors identified in the study, which adversely affect nurses' quality of life.