ArticleBMC health services research2026
Passive-avoidant leadership and psychological distress among Iranian nurses: the mediating role of work-to-family conflict.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe ineffective leadership style of passive-avoidance is consistently linked to detrimental outcomes, particularly in high-stress clinical settings like healthcare. Extensive research demonstrates a link between work-to-family conflict and heightened psychological distress. However, the specific mechanism and sequential pathway through which passive-avoidant leadership translates into psychological distress for nurses, particularly in the cultural context of Iranian healthcare, remains under-explored. This study addresses this gap by formally testing the mediating role of work-to-family conflict.
methodsThis was a cross-sectional, correlational study conducted among 326 official and contractual nurses working in a large hospital in Iran. Data were collected using validated self-report instruments for passive-avoidant leadership, work-to-family conflict, and psychological distress. Structural Equation Modeling (SEM) with the Maximum Likelihood Robust (MLR) method was employed using R software (version 4.5.0) to test the direct and indirect relationships between the variables.
resultsPassive-avoidant leadership was significantly associated with psychological distress, directly and indirectly, through work-to-family conflict. Although the effect size was relatively small, the association observed in this Iranian sample appeared somewhat stronger than that reported in several previous cross-sectional studies.
conclusionsThese finding suggests that healthcare leaders may benefit from training in active supervision and that hospital management should consider organizational strategies that help reduce work-to-family conflict and support nurses' mental health and promote well-being.
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