Validation of the Korean version of the toxic leadership behaviors of nurse managers scale: a cross-sectional study

The Toxic Leadership Behaviors of Nurse Managers (ToxBH-NM) Scale was developed to assess toxic leadership specifically in nursing and has demonstrated validity across diverse cultures. A Korean adaptation could enhance understanding of toxic leadership in the Korean nursing context and contribute to improving workplace culture in the country. Therefore, this study aimed to translate and validate the Korean version of the ToxBH-NM Scale. This was a cross-sectional study with a methodological approach. A secondary analysis was performed on data from 311 hospital nurses in South Korea, drawn from 319 nurses who completed the parent study’s survey between November and December 2024. Content and construct validity, including convergent validity, were evaluated. Competing measurement models, including one-factor, original four-factor, and bifactor models, were compared. Cronbach’s α and intraclass correlation coefficients were used to verify reliability. Principal component analysis yielded three components (intemperate–authoritarian, deceptive–abusive, and self-serving–opportunistic behaviors), and the three-factor model with six correlated residuals showed acceptable fit on most indices in confirmatory factor analysis. However, the original four-factor structure fitted slightly better, the factors were very highly correlated (0.87–0.94), and a bifactor model indicated a dominant general factor, supporting the use of the total score. Convergent validity was supported by a strong positive correlation with the Workplace Incivility Scale ( r = 0.79, p < 0.001). Reliability testing showed high internal consistency and good test–retest reliability among 60 participants. The findings provide preliminary support for the reliability and validity of the K-ToxBH-NM Scale. Pending replication in independent and more representative samples, the scale may be useful as a research instrument for assessing toxic leadership among South Korean nurses, with the total score as the primary score.