Exploring the role of spiritual leadership among nurse colleagues: an associative analysis of its impact on passion and altruism

Spirituality is an individual and subjective facet of human experience that involves the search for meaning, purpose, and a connection to something beyond oneself, whether through organized religion, personal beliefs, nature, or existential reflections [1, 2]. It serves as a source of inner peace and transcendence, encompassing diverse beliefs and practices [3]. However, challenges in spiritual leadership, passion, and altruism among nurses have been observed both within the research community and globally, raising concerns about their potential impact on the nursing profession. These issues may affect nurses' ability to maintain emotional balance, a positive outlook, and a sense of interconnectedness with others, ultimately influencing their sense of well-being and ethical decision-making [4]. Addressing such challenges is critical, as spirituality in nurses can enhance their overall quality of life, contribute to psychological and emotional well-being, and provide a framework for understanding and navigating the complexities of the human experience, personally and professionally [5].

Spiritual leadership in nursing involves a comprehensive approach beyond conventional managerial duties. It revolves around guiding and motivating individuals in the healthcare setting by incorporating spiritual values, ethical principles, and a sense of purpose into leadership practices. This leadership style recognizes the interdependence of physical, emotional, and spiritual aspects of well-being, underlining the importance of addressing the spiritual needs of both patients and healthcare providers [1]. Spiritual leadership to cultivate nurses’ workplace environment that nurtures empathy, passion, and a profound understanding of the human experience [2]. It acknowledges the inherent worth of each person and fosters a sense of community and interconnectedness among the healthcare team [3].

Nurse leaders may have a sense of purpose in their teams, positively impacting job satisfaction, resilience, and overall welfare. It was documented in several studies that nurses have a moderate level of spiritual leadership [5], ranging from mild to high (6). Furthermore, spiritual leadership improves patient care by acknowledging and honoring patients' spiritual beliefs and values, fostering a more patient-centered and culturally aware healthcare approach. Ultimately, spiritual leadership in nursing plays a crucial role in creating a holistic and empathetic healthcare environment [4].

Spiritual leadership, as a concept, comprises two primary components; the first component focuses on performance and includes three critical subscales: commitment, vision, and productivity [5]. Commitment refers to a leader's dedication to ethical and moral principles, guiding their decision-making and actions. Vision involves articulating and inspiring others with a shared purpose and direction. Productivity reflects the leader's commitment to achieving organizational goals efficiently and effectively [6]. The second component centers around attendance and involves two vital ingredients: belonging and belief. Belonging highlights creating a supportive and inclusive environment where team members feel connected and valued. Belief pertains to fostering a shared belief system that aligns with the organization's values, promoting unity among team members. This comprehensive framework, with its dual components and five specific subscales under each, forms the foundation for nursing spiritual leadership, providing a holistic approach to leadership that goes beyond traditional managerial aspects [7, 8].

Spiritual leadership emphasizes nurses possessing a deep sense of purpose, guided by ethical values and committed to the well-being of patients and the healthcare team. This sense of purpose aligns with a nurse's passion for making a positive impact on the lives of others [3]. Additionally, spiritual leadership emphasizes the importance of empathy and compassion, encouraging nurses to connect with patients holistically and acknowledging their physical, emotional, and spiritual needs. This empathetic approach resonates with a nurse's innate passion for providing patient-centered care beyond clinical procedures. Furthermore, spiritual leaders in nursing foster a collaborative and supportive work environment, recognizing the interconnectedness of the healthcare team. This cooperative spirit aligns with a nurse's passion for teamwork and a shared commitment to improving patient outcomes [9, 10].

Fry [11]. Incorporated spirituality as a long-neglected aspect into leadership theories and ultimately proposed the concept of spiritual leadership, which emphasizes intrinsically motivating oneself and others through the leader’s values, attitudes, and behaviors. Conceptually, spiritual leadership comprises three principal components, vision, hope/faith, and altruistic love, as the leader’s values, attitudes, and behaviors.

Passion in nursing encapsulates an intense and genuine commitment to the profession, reflecting a deep love and enthusiasm for the intricacies of patient care. This enthusiasm is evident in nurses' unwavering dedication to their roles beyond job requirements. A study by Cleveland et al. [12] documented that nurse trustees demonstrate a strong passion for community service. Although survey participation rates vary by state, the respondents contribute to every state and even extend their efforts to some international communities. Passionate nurses exhibit behaviors such as continuous learning, the proactive pursuit of excellence, and a genuine concern for the well-being of their patients [13]. This commitment is reflected in their tireless efforts to stay abreast of medical advancements, provide empathetic and personalized care, and advocate for their patients' rights. Passion for nurses is a driving force that fuels resilience and determination in the face of the challenges inherent in healthcare. Passionate nurses inspire their colleagues, contribute to a positive work culture, and ultimately enhance the overall quality of patient care [14]. In addition, passion is a cornerstone of nursing practice, shaping the profession's character and fortifying the commitment to delivering compassionate and holistic care to those in need. Passion fuels the resilience and determination needed to navigate healthcare's complex and demanding nature. It propels nurses to go above and beyond their duties, fostering a culture of excellence and being altruistic to others [15]. A study by Gkorezis et al. [16] found that nurses have considerable passion.

Furthermore, Vallerand et al. [17] presented his Dualistic Model of Passion, demonstrating its importance and effects. They explained that it is a strong tendency of the individual toward an activity of high value, which the individual loves, spends time and energy on, finds happiness and luxury, and achieves a balanced and purposeful life. According to this model, passion includes two dimensions: the harmonious academic passion that contributes to the continuous happy engagement in academic work and helps to prevent experiences that negatively affect the individual due to psychological conflict and psychological discomfort, and the obsessive passion that controls experiences which negatively affect the individual as a result of psychological conflict and distress.

Altruism within the nursing context entails a selfless and compassionate dedication to the welfare of others, surpassing mere professional obligations, with moderate to high levels among nurses [18]. It manifests through sincere empathy, kindness, and caregiving in nurses' interactions with patients, families, and peers. Altruistic behavior in nursing involves prioritizing others' needs, offering emotional support, and advocating for the patient's best interests [19]. This generous commitment becomes particularly evident during challenging situations, where nurses consistently strive to alleviate suffering and enhance the well-being of those under their care. The importance of altruism for nurses is profound, influencing positive patient outcomes and enriching healthcare experience. Altruistic gestures foster trust and a sense of security in the nurse-patient relationship and contribute to a positive work environment by strengthening teamwork and cultivating a compassionate culture. Ultimately, altruism is an inherent and essential aspect of nursing practice, shaping the profession's character and upholding the ethical principles guiding nurses in delivering comprehensive and patient-centric care [20, 21].

A higher altruism level was associated with a better quality of nursing. In addition, nurses responding to patients' ethical requirements can demonstrate professionalism and let the patient feel more thoroughly cared for [22]. Altruistic care is important in building a strong, trusting relationship that can reduce conflicts. Conversely, when altruistic care decreases, nursing quality also declines, with low nursing satisfaction and a high complaint rate [17].

Several studies have highlighted the importance of spiritual leadership in various contexts. Wang et al. [10] revealed the mediating role of calling in leadership with harmonious passion among managers. Additionally, Abou Zeid et al. [1] showed a strong positive correlation between spiritual leadership and psychological capital among nursing educators. Wu and Lee [3] found that spiritual leadership positively influences work engagement, with spiritual well-being and psychological capital mediating this effect. Other studies, such as that by Birnie [23], have shown that spiritual leadership can increase retention rates and improve the psychological well-being of nurses. These findings underscore the gap in knowledge regarding spiritual leadership among nurse colleagues and its potential association with their passion and altruism.

Table 1 Presents nurses' baseline characteristics; 391 nurses participated in this study. The majority (88%) of the participants were female, (70.8%) were married, and less than half (43.0%) of them had a Bachelor's degree in nursing. More than half (55.5% 57.5%) were practical guides and had less than five years of experience in the same specialty, respectively. Also, (52.2%) of them lived in urban areas and (30.7%) in upper Egypt.

Table 2 Reveals a detailed insight into participants' mean scores and distribution across different levels for the studied variables of spiritual leadership, passion, and altruism. In terms of spiritual leadership, the participants exhibited a mean score of 60.77 ± 13.659, with (50.9%) of them falling into the "high" category, specifically (61.4%) scoring in the "high" category for hope/faith. Moving on to the passion-related variables, the total passion mean score was 68.16 ± 20.527, and the harmonious passion mean score was 34.98 ± 10.46, with 49.9% of them in the "high" category. Also, obsessive passion had a mean score of 33.17 ± 11.12, with (48.8%) percentage in the "high" category. Finally, the total altruism mean score of 29.45 ± 9.095, with (40.2%) of them having high altruism.

Table 3, Demonstrates that (89.5%) of participants have a strong spiritual relationship with God, (84.1%) of them engaged in religious or spiritual practices such as prayer, fasting, or almsgiving, (57.8%) of them hadn't a spiritual teacher or spiritual director guiding them, (64.7%) of them felt that they had a strong connection with nature or are connected to its spirituality, (55.2%) of them did not connect with the self through practices such as meditation or yoga. Furthermore, all participant's spiritual data had significant differences with spiritual leadership, passion, and altruism at (P < 0.05).

Table 4 Results disclose significant and positive correlations between spiritual leadership, passion, and altruism as follows (r = 0.644, P < 0.001), (r = 0.519, P < 0.001), and (r = 0.509, P < 0.001) correspondingly.

Figure 2 and Table 5 illustrate the mediation analysis results of spiritual leadership regarding the relationship between altruism and passion. These findings confirm the positive direct effects between altruism and passion with (B = 0.540, P < 0.0001) and altruism to spiritual leadership (β = 0.780, P < 0.0001), also between spiritual leadership to passion (B = 0.781, P < 0.0001). In addition, these findings clarify the indirect effect path between altruism, spiritual leadership, and passion (B = 0.608, P < 0.0001).

Spiritual leadership is a concept that is often overlooked in the healthcare profession but can profoundly impact how nurses approach their work. Considering the associative analysis of spiritual leadership with passion and altruism in patient care is crucial for nurse colleagues. By tapping into spiritual beliefs and values, nurses can find a more profound sense of purpose and meaning in their work, leading to increased compassion and empathy towards patients and a stronger connection with colleagues and the healthcare team. Incorporating spiritual leadership into nursing practice enhances the ability to provide holistic care and support to those in need. Striving to embody spiritual leadership qualities can create a nurturing and healing environment for both patients and nurses [1]. Therefore, this study aimed to investigate the role of spiritual leadership in the relationship between altruism and passion for work among nurse colleagues.

One of the imperative results of the current study was that the nurse colleagues generally perceive spiritual leadership positively and highly, with a majority falling into the high category for hope or faith, which reflects a strong inclination towards these aspects of spiritual leadership. This could be attributed to the high levels of perceived spiritual leadership among nursing colleagues that align with the core values of nursing, which emphasize holistic, compassionate care. This spiritual approach can enhance resilience in nurses by offering meaning and inner strength to navigate the profession's challenges.

Analogous with the foregoing findings, a recent study done by Abouzaid [27], reported that the total levels of spiritual leadership among nurse leaders were high. As well, Ali et al. [28], revealed that nursing managers’ spiritual leadership levels were high on the level of meaning/calling, vision, and hope/faith dimensions, while the largest percentage of participants who scored an individual subscale as “low level” was for the “altruistic love” subscale. Conversely, the previous findings were in disagreement with a study conducted by Abou Zeid et al. [1], which revealed that nursing educators perceived their spiritual leadership behaviors at a moderate level.

One important factor that is connected to the quality of work-life is a passion for one's job. It promotes flow at work, which seems to be good for nurse colleagues' mental health and guards against burnout [29]. In terms of the overall mean score and the levels of passion among nurse colleagues, more than half exhibited a high level of passion. The highest mean score was associated with harmonious passion, linked to positive outcomes such as improved well-being and effective coping strategies. The intense nurse colleagues’ passion fosters dedication, energy, and a sense of purpose. The findings indicate that colleagues have a healthy, harmonious passion for their work.

This is not surprising, considering the difficult working conditions that nurse colleagues face, such as an underappreciated and unsupportive work environment, having little time for professional development, and juggling a demanding workload. This can be explained by the fact that nurse colleagues have a sense of belonging and a strong commitment to do their work, without hesitation, even if they are overworked or in danger [30]. Their acceptance of their mission and ethical commitment allowed them to play a crucial role in promoting their work with passion. In the same track, a study carried out by Li et al. [31], clarified a positive association between leaders’ and workers’ passion at work; a leader’s work passion was transferred to employees via emotional contagion. Leaders may act as role models in fostering passion at work. On the contrary, Luo et al. [32], revealed that nurse colleagues expressed that they didn’t have passion for work.

As for the total mean score of altruism; the study findings indicated a highly positive perception of altruistic behaviors. Interestingly, participants appear to be more evenly distributed across the "High," "Low," and "Moderate" categories for altruism. This suggested a varied engagement in altruistic acts among the participants. The possible explanation for these findings might be due to that the nurse colleagues are familiar that altruism is a cornerstone of the nursing profession. They select to track a nursing profession since they are altruistically oriented, wish to work and comfort others, or consider nursing a significant vocation; often, it is the first and merely educational choice. Conversely, the previous findings were in disagreement with those of a study conducted by Chen et al. [19], who indicated that altruism has been decreasing over time. In this regard, Bhuvana & and Pavithra [22] revealed that altruism has been decreasing among health professionals.

One of the conspicuous results of the current study is that notably, spiritual leadership had a statistically significant positive correlation with passion and altruism among nurse colleagues. This suggests that higher levels of spiritual leadership are associated with increased passion, as well as heightened altruistic tendencies among nursing colleagues. This may be explained by the fact that one promising strategy for fostering a positive work environment is spiritual leadership; spiritual leaders help their followers develop a strong calling by fostering a clear and inspiring vision, bolstering their beliefs, and showing compassion for others, work-based spiritual leadership initiatives yield excellent results. In this regard, a healthier workplace and an atmosphere where people can express themselves freely and be passionate are the results of spiritual leaders' empathy and regard for their staff, their attention to both positive and negative feedback during interactions with them, and their best efforts to meet their needs [33, 34].

The results of the current study revealed that altruism is one of the most significant attributes of spiritual leadership in nursing. Few studies have been carried out concerning the interrelation between passion, leadership, and spirituality. Anane [35] is one of the few researchers who has studied the relationship between spiritual leadership and extrinsic passion and found that spiritual leadership (altruism and membership) is effective with the combination of extrinsic passion on organizational commitment.

The eventual goal of the existing work was to investigate the role of spiritual leadership in the relationship between altruism and passion for work among nurse colleagues. Moving to the mediation analysis results, the results verified that spiritual leadership has both direct and indirect effects on nurses' passion and altruism. Spiritual leadership directly impacts passion, and passion, in turn, mediates the relationship between spiritual leadership and altruism.

These indirect effects provide important insights into the interplay between these variables. The findings suggest that spiritual leadership has a profound influence on cultivating altruism and passion among nurse colleagues. Spiritual leadership inspires nurse colleagues to go beyond their professional duties and extend genuine compassion and empathy. It fosters a supportive, nurturing work environment where nurse colleagues are motivated to collaborate and uplift one another. Spiritual leadership ignites a collective passion for providing holistic, compassionate care, creating a sense of unity and shared purpose. It also instills resilience and inner strength, enabling followers to navigate challenges with grace. Overall, the influence of spiritual leadership helps establish a culture of altruism and passion, ultimately enhancing the quality of patient care. Research studies suggested that spiritual leadership values can stimulate and inspire employees to increase loyalty, altruistic behaviors, passion, and active participation, ultimately enhancing employee commitment to the organization [11, 36, 37].

Our study represents a novel attempt to examine spiritual leadership as a mediating factor between altruism and passion. Without the least suspicion, this existing study is notable for equally theoretical and clinical implications because it sheds light on the significance and necessity of taking spiritual leadership into account as a factor contributing to nurse colleagues' tendency towards passion for work and altruistic behaviors. Emphasizing the mediating role provides novel implications in nursing [38‐40]. Understanding the incentives of nurse colleagues' propensity towards altruism and passion is essential to intensify them. Subsequently, it has significant favorable outcomes on their physical, psychosocial, and emotional well-being, and in turn is linked to the quality of work life, since one of the professional principles that best represents the quality of work is altruism, which is characterized by a concern for the well-being of others and a readiness to prioritize and make sacrifices for their needs. The results of this study may guide decision-makers to create plans for enhancing spiritual leadership among nursing colleagues through training, education, and policy development.

In deduction, the current study results verified that nurse colleagues had high levels of perceived spiritual leadership, passion, and altruism. The results revealed noteworthy positive correlations between spiritual leadership, passion, and altruism. Furthermore, mediation analysis highlighted that spiritual leadership could be mediating the effect of altruism on the passion level. This study delivers valued insights into the crucial role of spiritual leadership in augmenting nurse colleagues’ altruistic tendencies and passion. Our research confirms the prominence of cultivating and implementing spiritual leadership in nursing educational institutions. Besides, educational institutions should take into consideration the most effective leaders who promote workplace spirituality, which eventually, in return, enhances the altruism, passion, and work engagement of nurse colleagues.