Toxic Leadership and Nurses' Resilience and Psychological Well-Being: Evidence From Seven Government Hospitals in Saudi Arabia

Background: Nurses’ resilience and psychological well-being are central to sustaining a healthy workforce, yet their relationships with toxic leadership remain poorly characterized in Saudi Arabia. Objective: To examine the associations of toxic leadership with resilience and psychological well-being among Saudi nurses and to compare the relative strength of these relationships. Methods: A cross-sectional correlational study was conducted among 296 Saudi nurses in seven governmental hospitals in Hafr Al-Batin. Toxic leadership, resilience, and psychological well-being were measured using validated instruments. Spearman correlations and bootstrap structural equation models were used. Results: Toxic leadership was negatively correlated with resilience (r=−.601) and psychological well-being (r=−.517), both p<.01. Structural models showed significant negative associations with resilience (β=−.4800, p=.0015, R²=.380; 95% bootstrap CI −.7909 to −.2578) and psychological well-being (β=−.2879, p=.0010, R²=.233; 95% bootstrap CI −.5782 to −.1349). The psychological well-being model showed CFI=.8797, TLI=.8390, IFI=.8616, and RMSEA=.0756. The resilience model showed CFI=.8986, TLI=.8705, IFI=.8895, and RMSEA=.0708. A spirituality item concerning divine help had the highest resilience item mean (4.47/5). Conclusion: Toxic leadership was associated with lower resilience and psychological well-being. The findings provide new Saudi evidence and a culturally relevant indication that spirituality may be an important resilience resource. Longitudinal and multisource studies are needed.