AIM: This study examines the mechanisms through which transformational leadership enhances nurses' adaptive performance within a conflict-affected environment characterized by chronic uncertainty, escalating demands, and severe resource constraints. It introduces a novel-mediated moderation model in which psychological capital (PsyCap) serves as a mediator and workplace spirituality (WPS) functions as a moderator. BACKGROUND: Adaptive performance is vital in contemporary healthcare, yet its antecedents remain underexplored. While transformational leadership is recognized as a driver of employees' psychological resources, little is known about how these resources translate into adaptive outcomes in nursing. This article represents one of the first empirical studies in nursing and management research to simultaneously test the direct effect of transformational leadership on adaptive performance, the mediating role of PsyCap, and the moderating role of WPS. By positioning WPS as a boundary condition, it demonstrates how spiritual values and meaning at work strengthen the influence of PsyCap on adaptability, marking a theoretical insight with practical significance. METHODS: This study adopted a quantitative cross-sectional design and surveyed registered nurses providing direct patient care in five major public hospitals across the Gaza Strip, Palestine. Data were collected via an online questionnaire using purposive sampling, and structural equation modeling was employed to test a moderated mediation model. RESULTS: The results indicate that transformational leadership is positively associated with nurses' adaptive performance and PsyCap. PsyCap partially mediates the relationship between transformational leadership and adaptive performance. In addition, WPS strengthens the positive association between PsyCap and adaptive performance, supporting the proposed moderated mediation model. CONCLUSIONS: Adaptive performance in healthcare can be enhanced when leadership, psychological resources, and spirituality are aligned. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing leaders should deliberately enact transformational behaviors, systematically cultivate PsyCap, and nurture WPS to build resilient, adaptive nursing teams capable of thriving amid turbulence.
Abukhalifa et al. (Thu,) studied this question.