Evidence map›Paper›PMID 42365461›Full record

ArticleJournal of nursing management2026

Nurses' Experiences of Rebel Nurse Leadership in Psychiatric Care: A Qualitative Interview Study of Positive Deviance.

Sebastian Gabrielsson, Git-Marie Ejneborn Looi, Annika Ahlblom, Ylva Kortekaas Genstrand, Anneli Björkdahl, Jessica Östling, Susanne Berg, Nina Lakso, Mattias Larsson, Johanna Salberg

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sebastian GabrielssonDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.ORCID https://orcid.org/0000-0002-1624-1795
Git-Marie Ejneborn LooiDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.ORCID https://orcid.org/0000-0001-5502-2942
Annika AhlblomDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.ORCID https://orcid.org/0009-0001-7746-1628
Ylva Kortekaas GenstrandDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.
Anneli BjörkdahlDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.
Jessica ÖstlingDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.ORCID https://orcid.org/0009-0001-5703-2682
Susanne BergDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.
Nina LaksoDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.
Mattias LarssonDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.
Johanna SalbergDepartment of Health, Education, and Technology, Luleå University of Technology, Luleå, Sweden, ltu.se.ORCID https://orcid.org/0000-0003-0142-8204

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nurses play a key role in person-centered psychiatric care by supporting patient recovery, fostering independence, and building trusting relationships. However, organizational rules may conflict with nurses' ethical values, leading to moral distress, burnout, and resignation. Drawing on the theory of positive deviance, previous research has identified how nurses may engage in positive rebel leadership, leading and practicing nursing in ways that diverge from prevailing norms, rules, codes of conduct, and workplace strategies. This study explores how such leadership in psychiatric care can support professional standards and improve patient outcomes. The aim was to describe nurses' experiences of rebel nurse leadership in psychiatric care. A qualitative descriptive design was employed, using semistructured individual interviews with 33 nurses experienced in psychiatric care. A qualitative content analysis and meta-synthesis were conducted, with the support of generative artificial intelligence in the synthesis process. The results describe nurses' experiences of rebel nurse leadership in psychiatric care as taking responsibility, guided by professional competence and an internal ethical compass; leading change and challenging hierarchies to enable holistic care that respects patients' rights and dignity; relying on the support of colleagues and management, while facing the risk of exclusion. The study shows how rebel nurse leadership, grounded in professional competence and ethical conviction, might support person-centered and high-quality psychiatric care. The findings illustrate how such leadership emerges in response to organizational norms that constrain nursing practice and frame acts of resistance as expressions of professional responsibility. The study emphasizes the importance of supporting nurses' autonomy to enable improvements in care quality and patient outcomes.

Indexed as

LeadershipNurse AdministratorsNursesPsychiatric NursingAdultAttitude of Health PersonnelFemaleHumansInterviews as TopicMaleMiddle AgedQualitative Researchcontent analysismental health nursingpositive deviancepsychiatric carequalitative studyrebel nurse leadership

Identifiers

PMID42365461
PMCPMC13310386

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.