Abstract Objective Using structural equation models to investigate the influence of managers’ toxic leadership and employee silence on nurse work engagement. Methods This quantitative study used a correlational and cross-sectional design. From 6 December 2023 to 15 January 2024, 1 310 nurses were recruited from 29 public hospitals in Ningxia, China, using the convenience sampling method. Questionnaires were used to collect demographic data and scores for employee silence, work engagement, and exposure to toxic leadership behaviours by nurse managers. Structural equation model was used to analyze the influencing factors and action paths of nurse work engagement. Results Employee silence values were positively correlated with nurse managers’ toxic leadership behaviours (r=0.493, P<0.001), and statistically significantly negatively correlated with work engagement (r=-0.448, P<0.001). Employee silence partially mediated the relationship between toxic leadership and work engagement. Conclusion Toxic leadership behaviours have adverse effects in the form of employee silence and reduced work engagement. Hence, hospitals and nursing managers should take effective measures to reduce such behaviours and encourage nurses to verbalise their concerns, thereby improving their work engagement.
Zheng et al. (Wed,) studied this question.