Engaging leadership and nurses' mental health in German acute care hospitals: the mediating role of job resources.

Authors

Joan Kleine, Dorothea Kohnen, Alessandro Campione, Reinhard Busse

Published in

BMC nursing. Jun 29, 2026. Epub Jun 29, 2026.

Abstract

Nurses in German acute care hospitals face high levels of work-related stress, including symptoms of burnout, depression, and anxiety. This study investigates whether engaging leadership is associated with burnout, depressive, and anxiety symptoms among nurses and whether these associations operate through job resources.
A cross-sectional online survey was conducted among registered nurses working in acute care hospitals participating in the German branch of Magnet4Europe. Data collection took place between September and December 2023. Engaging leadership was measured with a validated twelve-item scale. Job resources included role clarity, skill use, autonomy, performance feedback and opportunities for development. Burnout symptoms were measured using the Burnout Assessment Tool. Depressive and anxiety symptoms were assessed with the PHQ-2 and GAD-2. The preregistered analysis used complete case analysis and structural equation modelling to test direct and indirect associations.
In total, 1,502 nurses from eighteen hospitals were included in the analysis. Engaging leadership was strongly associated with perceived job resources. Job resources were associated with lower burnout, depressive, and anxiety symptoms. Engaging leadership also showed small direct associations with burnout and depressive symptoms, but not with anxiety symptoms. Indirect effects were significant across all three models, suggesting that job resources may be an important mechanism linking engaging leadership to nurses' mental health.
Nurses who experience more engaging leadership also report more job resources and fewer symptoms of mental ill-health. These findings suggest that leadership practices which support meaning, competence, connection and autonomy may strengthen resilience and reduce psychological strain among nursing staff in Germany. Leadership development and resource strengthening may therefore represent important strategies for improving nurses' well-being and retention in German hospital settings.
Not applicable. This cross-sectional secondary analysis was conducted within the Magnet4Europe project, which is registered in the ISRCTN registry (ISRCTN10196901, registered on 10 April 2020).

PMID:
42374393
Bibliographic data and abstract were imported from PubMed on 30 Jun 2026.

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