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The research investigated the relationship between servant leadership (SL) and innovative work behavior (IWB) among nurses in Pakistan. It also formulates and hypothesizes a serial mediation model, integrating trust-in leadership (TL) and knowledge sharing (KS) as mediated variables.
Nurses' IWBs are critical for improving patient healthcare quality. Despite their significance, scant research has examined how leadership styles, especially SL, can trigger such behavior in nursing. The paper seeks to fill this gap by examining how SL can enhance innovation among nurses, while accounting for the mediating variables of TL and KS within the Pakistani healthcare system.
A quantitative, cross-sectional study was conducted, involving 269 nurses from hospitals in Islamabad and Rawalpindi. A time-lagged approach to data collection was used to reduce common method bias. Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) were employed to test the proposed hypothesized relationships using SPSS (version 27) and AMOS (version 23).
The hypotheses revealed a significant impact of the constructs. It was discovered that SL has both direct and indirect positive influences on IWB among nurses through TL and KS. Moreover, the findings support high serial mediation, implying that SL has a positive effect on IWB by first building trust, which then leads to knowledge sharing.
The paper contributes to the literature on servant leadership and innovative work behavior by examining mediating mechanisms within nursing teams in Pakistan. The paper also offers practical implications for nurse managers and hospital administrators on fostering a culture of innovation and trust among nurses.
The findings offer actionable insights for nursing management by demonstrating that adopting a servant leadership style can directly and indirectly enhance nurses' innovative work behaviors. By prioritizing trust-building and fostering a culture of knowledge sharing, nurse managers can stimulate innovation, which is critical for improving patient care quality and overall healthcare outcomes.
Poor oral health is a common but often overlooked concern in palliative care, negatively impacting patients' quality of life. There is limited understanding of how palliative care providers (PCPs) approach oral health promotion in this context. This review synthesises evidence on the knowledge, attitudes and practices of PCPs regarding oral health care and strategies to support them in this area.
Integrative review.
A systematic literature search was undertaken until January 2025 across multiple databases (MEDLINE, CINAHL, Cochrane, ProQuest, EMBASE and Scopus) and grey literature. Inclusion criteria focused on nurses, medical specialists and allied health professionals involved in palliative or end-of-life care, with no publication year restriction.
This review followed Whittemore and Knafl's (2005) framework for integrative reviews. Study quality was assessed using appropriate tools for qualitative and quantitative studies, clinical guidelines and screening tools. A hybrid thematic synthesis approach was used for analysis.
Twenty-five studies were included, mostly of moderate to high quality. Sample sizes ranged from 8 to 1339, with most participants being nurses and nursing assistants, followed by medical professionals. Findings revealed inconsistent knowledge, varied practices and limited prioritisation of oral health care. Barriers included system constraints, limited training and patient-related challenges. Supportive strategies such as guidelines, screening tools and educational interventions were identified.
A significant gap exists in PCP knowledge and practices regarding oral healthcare due to various barriers, with few supportive strategies documented in this field.
There is an urgent need for enhanced education, robust evidence-based guidelines and tailored training for providers to advance and integrate oral health care in palliative care settings.
PRISMA Checklist.
No patient or public contribution.
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