Introduction
Today, the concept of well-being has evolved from a biomedical model, representative of merely the absence of disease, to a social model that also encompasses social and environmental impacts [
1]. Organizational well-being, which denotes the happiness of individuals within an organization [
2], refers to the state in which an individual in organizational life leads a pleasant and valuable life on the organization’s structural or environmental dimensions (emotional, efficient, self-reflective) and personal dimensions (physical, mental, social, and spiritual) levels of the organization [
3]. Considering the role of organizational well-being in increasing the satisfaction and happiness of organization members, enhancing morale, and work motivation, and therefore positively affecting organizational growth [
4], it is important to consider the organizational well-being of its members.
Nurses, who make up approximately half of hospital healthcare personnel, are indispensable in determining hospital productivity by playing critical roles in delivering patient-centered care, performing evidence-based practices, engaging in interdisciplinary team activities, improving the quality of nursing, and leading infection control [
5]. The higher the level of organizational well-being among nurses within a nursing organization, the healthier they are physically and emotionally [
6], and the better performance they achieve [
7]. Nurses with high levels of organizational well-being are not only satisfied with their work and positively impact patient safety [
8,
9], but also enhance the efficiency of the healthcare system through their positive impact on nursing performance [
10]. In summary, enhancing nurses’ organizational well-being is crucial as it improves work performance and nursing quality, positively impacting hospital productivity and quality patient care [
11].
Factors affecting organizational well-being include individual and organizational factors [
2,
12], nurses’ working conditions [
8,
13], the work environment [
14,
15], and the social environment within the hospital [
16]. Organizational well-being emerges from complex interactions between personal, job-related, and organizational characteristics. Positive psychological capital, a personal characteristic influencing organizational well-being, is regarded as an inherent positive psychological attribute with significant developmental potential among the concepts of static organizational behavior [
17,
18]. This concept encompasses self-efficacy, hope, optimism, and resilience [
17], where these four psychological traits intricately interact to produce a synergistic effect [
19]. Positive psychological capital not only reduces job-related negative attitudes and behaviors, but also promotes desirable attitudes, behaviors, and performance, thereby contributing to organizational growth [
19‐
21]. It is positively correlated with organizational well-being [
13] and can be developed, managed, and enhanced through learning or training, making it a viable target for future intervention strategies [
22,
23].
Shared leadership, an organizational characteristic that affects organizational well-being, involves team-level leadership shared among members [
24] and refers to collective leadership in which leadership influence is not expressed from a formal single person but is accepted and expressed informally by team members as a distributed influence [
25]. This distributes leadership roles among team members and influences one another to achieve organizational goals [
24]. Shared leadership not only effectively resolves conflicts and fosters harmony within the team, but also enhances team decision-making and task efficiency [
26]. Additionally, it is an important factor that contributes to a happier workplace by improving interpersonal relationships within the organization, therefore increasing organizational well-being [
27]. Particularly, in environments where task complexity is increasing and customer expectations for quality and speed of service are rising, shared leadership is effective in generating high performance [
28]. Therefore, hospitals managing high-severity conditions that require complex tasks and high-quality nursing services should focus on shared leadership, a factor influencing organizational well-being.
Nursing organizations differ from typical organizations because they provide medical services in collaboration with other professions through 24-hour shift work. Particularly, nurses in hospitals specializing in treating severe diseases experience high levels of stress owing to the complexity of medical procedures and the life-critical nature of their tasks [
29]. Continuous exposure to stressors in clinical settings can adversely affect nurses’ mental and physical well-being [
30], leading to negative outcomes for both patients and the organization [
31]. Therefore, there is a pressing need to focus on organizational well-being, which pertains to the well-being of individuals within the organization, specifically nurses. However, despite the differences in work conditions, organizational characteristics, and the work environment of nursing organizations, as well as the individual differences among nurses, to the best of our knowledge, studies on organizational well-being conducted within nursing organizations are scant. Additionally, previous studies on the leadership of nurses related to well-being in the workplace focused on nursing managers [
32], and most of these studies confirmed the improvement of nurses’ well-being through specific interventions [
33] rather than individual competencies for nurses.
Against this backdrop, this study aims to assess the levels of positive psychological capital, shared leadership, and organizational well-being among nurses. It also seeks to elucidate the relationships among these variables, thereby proposing effective strategies for enhancing organizational well-being. Therefore, given the limited research on exploring the levels and relationships of these variables specifically among nurses, a descriptive survey design was chosen to accurately capture and describe the current state of positive psychological capital, shared leadership, and organizational well-being. This design is well-suited for providing foundational insights and establishing a basis for future in-depth qualitative research.
Methods
Study design, setting, and participants
We employed a descriptive survey research design. Participants were recruited through non-probability sampling and included nurses who had worked for over a year at hospitals in Korea, designated to provide highly specialized treatment for patients with severe conditions. Participant recruitment announcements were posted on two community websites frequently used by Korean nurses for professional networking and career-related discussions. Only those who voluntarily agreed to participate in the study were recruited. The sample size was determined using G*Power version 3.1.9.7 based on 10 predictors by applying a significance level 0.05, a power (1-β) 0.90, and an effect size 0.15, based on previous studies [
13]. Although the ideal sample size for multiple regression analysis was calculated to be 147, considering potential dropout rates, responses from 177 participants were finally analyzed.
Instruments
We used self-report questionnaires as the research instruments to evaluate general characteristics such as gender, age, marital status, and educational attainment, as well as job-related characteristics including nurses’ working department, job schedule type, total clinical experience, and annual income.
Organizational well-being was evaluated using a tool developed by Kim and Sung [
3]. This tool comprises a 27-item scale, which is divided into environmental and personal dimensions. The environmental dimension is further divided into six sub-dimensions namely: interpersonal relationships within the organization (3 items), welfare benefits (2 items), job satisfaction (2 items), organizational climate (5 items), organizational commitment (4 items), and learning opportunities (3 items). The personal dimension is subdivided into the sense of fulfillment in life (2 items) and leisure in life (6 items). Each item was rated on a 5-point scale, ranging from 1 (not at all) to 5 (very much so), where higher scores indicate greater organizational well-being. The internal consistency reliability of the original scale reported Cronbach’s α = 0.90 [
3]. In our study, Cronbach’s ⍺ = 0.92.
Positive psychological capital (PsyCap) was evaluated using the Psychological Capital Questionnaire (PCQ) developed by Luthans, Youssef, and Avolio [
18] and adapted by Lee and Choi [
34]. The 24-item PCQ comprises four dimensions—hope, efficacy, resilience, and optimism (HERO), each containing 6 items. Each item is rated on a 6-point Likert scale from 1 (totally disagree) to 6 (totally agree), with higher scores indicating greater positive psychological capital. Items 3, 8, and 19 were reverse-scored. The internal consistency reliability of the original scale reported Cronbach’s α = 0.89 [
18], whereas in the Korean version, Cronbach’s α = 0.93 [
34]. In our study, Cronbach’s α = 0.92.
The Shared Leadership was assessed using a 25-item scale developed by Hiller et al. [
25], and adapted by Bang [
35]. This scale comprises four dimensions namely, planning and organizing (6 items), problem-solving (7 items), support and consideration (6 items), and development and mentoring (6 items). Each item was rated on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree), where higher scores indicate greater shared leadership. The internal consistency reliability of the Korean version scale reported Cronbach’s α = 0.95 [
35]. In our study, Cronbach’s α = 0.96.
The content validity of the entire tool was reviewed by two experts with nursing knowledge, and then pilot tests were conducted to verify the appropriateness and relevance of the adapted tool. Four nurses with clinical expertise further reviewed and evaluated the appropriateness of each question. They independently assessed the tool’s clarity, relevance, and inclusiveness, with particular emphasis on its applicability in the clinical field. The results of the pilot test confirmed that nurses in the clinical field had no difficulty using the tool; hence, it was used in our study.
Data collection
Data Collection was conducted from July 1 to August 31, 2023, using an online survey to collect data. The survey process began by explaining the research purpose and objectives to the administrators of two online nursing community websites to obtain their consent before posting a recruitment notice. Clear and detailed information regarding the study’s purpose, participation criteria, privacy, anonymity, confidentiality, and withdrawal options was provided to potential participants before they joined the study, ensuring that participation was entirely voluntary and based on informed consent. To minimize potential bias, participants were required to log in using a unique ID, and each ID was limited to a single submission, preventing duplicate responses. Additionally, anonymity and confidentiality were strictly maintained throughout the process, encouraging honest and pressure-free participation.
Ethical considerations
The study was conducted after receiving approval from the Pusan National University Institutional Review Board (IRB No: PNU IRB/2023_76_HR). Enrollment was limited to those who voluntarily agreed to participate. To ensure ethical considerations, study participants were given detailed explanations of the study’s purpose, privacy protection, anonymity, and withdrawal options. All data were collected using a secure survey platform, encrypted, and stored on a password-protected computer. IP addresses were not collected to ensure anonymity, and all data was securely destroyed after the study’s completion.
Data analyses
The data were analyzed using the SPSS version 29.0. The general and job-related characteristics of the participants were examined through frequencies, percentages, means, and standard deviations. The levels of positive psychological capital, shared leadership, and organizational well-being were assessed using means and standard deviations. Differences in these variables in relation to participants’ characteristics were analyzed using t-tests and ANOVA, with post-hoc testing conducted using the Scheffe test. Correlations between variables were evaluated using the Pearson correlation coefficient, and hierarchical regression analysis was used to identify the factors influencing participants’ organizational well-being.
Discussion
Our study aims to determine the impact of nurses’ positive psychological capital and shared leadership on organizational well-being, and to propose strategies for personnel and organizational management to enhance nurses’ organizational well-being. The main findings indicate that both positive psychological capital and shared leadership significantly influence organizational well-being, with the former having a more pronounced effect than the latter.
In our study, the mean organizational well-being score of participants was 3.32 out of 5. The scores for the environmental dimension were lower than those for the personal dimension, with the lowest scores in the “organizational climate” sub-dimension. Similarly, Della et al. [
16] found that nurses’ organizational well-being is strongly influenced by the social environment, including relationships with managers and colleagues. Our results align with their findings, highlighting the importance of the social and structural aspects of organizations. However, the particularly low score in “organizational climate” suggests that current organizational structures may not sufficiently support nurses’ well-being. Organizational climate, which reflects members’ perceptions of the organization [
36], involves interpersonal relationships and cohesion between managers and colleagues [
3]. This indicates a need for targeted interventions to improve communication and collaboration. Activities such as team-building exercises, regular feedback sessions, and leadership training can enhance the organizational climate, ultimately promoting nurses’ well-being.
Organizational well-being differed significantly by gender, marital status, and clinical experience in our results. Female nurses had lower organizational well-being scores than male nurses. Well-being is closely linked to stress coping styles, with rational coping styles associated with higher well-being and emotional coping styles with lower well-being [
37]. Graves et al. [
38] found that women experience higher stress levels than men and often use emotion-centered approaches to cope with stress. This supports our findings, suggesting that female nurses’ higher stress levels and emotional coping strategies may negatively impact their organizational well-being. Interventions to promote rational coping strategies could help improve their well-being. Unmarried nurses scored lower in organizational well-being than their married counterparts. Godifay et al. [
39] reported that married individuals experience less work stress, and Dong et al. [
31] highlighted that social support, including family support, significantly reduces stress levels. Given that stress and well-being are closely linked, the lower organizational well-being scores of unmarried nurses in our study may be partly attributed to their reduced access to family support. These findings suggest the potential value of providing additional social support for unmarried nurses, such as through peer support programs, to mitigate stress and enhance their well-being. Clinical experience showed an inverse relationship with organizational well-being after the initial years of practice. Nurses with 1 to 3 years of experience had higher well-being than those with 3 to 5 years of experience. This may be due to less accumulated emotional fatigue in the earlier stages of their careers. Previous studies suggest that prolonged clinical experience increases stress and emotional fatigue, reducing adaptability to stress [
40,
41]. Nursing managers should promote stress reduction activities for experienced nurses and provide reasonable stress coping strategies. These findings highlight the importance of tailored interventions. While prior studies emphasize the role of social and family support [
31,
39], our results show that addressing stress levels based on gender, marital status, and clinical experience can significantly improve nurses’ organizational well-being. Tailored programs that combine stress management techniques and social support could be particularly effective.
The mean score for positive psychological capital among participants in our study was 4.12 out of 6, higher than the 3.77 reported in a study of 243 nurses in Pakistan [
42]. Our findings also showed that positive psychological capital significantly varies by educational attainment, consistent with results from a Saudi Arabian study involving 500 nurses [
43]. While 92.1% of participants in our study had a bachelor’s degree or higher, only 36% did in the Pakistani study. However, the lower score in the Pakistani study may also reflect cultural norms, workplace stress, or differences in healthcare systems beyond educational factors. Further research is needed to explore the combined effects of education and other contextual variables, such as ethnic and cultural characteristics, on positive psychological capital.
We confirm that positive psychological capital is a crucial factor affecting organizational well-being, consistent with previous research indicating a correlation between clinical nurses’ organizational well-being and their positive psychological capital [
13]. Positive psychological capital helps reduce negative attitudes and behaviors related to job performance while enhancing positive attitudes, behaviors, and performance [
19‐
21], fostering positive changes within the organization [
44]. Given that positive psychological capital can be enhanced through learning and training [
22,
23], increasing organizational well-being through the education and development of nursing staff’s positive psychological capital is a feasible strategy. Additionally, mindfulness meditation has been shown to improve adaptation and coping capabilities against negative emotions and stress, boosting positive psychological capital [
45]. Loving-kindness meditation has also been effective in developing positive emotions and improving stress mediation abilities and social support [
46]. Ultimately, to improve the organizational well-being of nurses, nursing managers should post information about mindfulness and loving–kindness meditation programs that can increase positive psychological capital and encourage nurses to practically implement them. Moreover, periodic evaluations are needed to ensure that these efforts actually contribute to the improvement of organizational well-being.
The mean score for shared leadership among the study participants was 3.64 out of 5, closely aligning with the 3.62 score observed among nurses at general hospitals in Korea [
47]. We found that problem-solving was the lowest-scoring dimension of shared leadership. Problem-solving involves the nursing team’s ability to anticipate issues before they occur, and collaboratively analyze and address them once they arise [
25]. Furthermore, problem-solving skills are enhanced through better practice of self-directed learning and critical thinking [
48]. Nursing managers should consider ways to foster shared leadership of nurses by periodically providing self-directed learning via online lectures and workshops to share critical thinking and improve problem-solving skills.
Shared leadership was identified as a significant factor influencing organizational well-being in our study. It helps resolve communication issues among organizational members, reduces team conflicts [
49], and improves overall team performance [
50] and effectiveness [
51,
52]. Inceoglu [
53] highlighted that shared leadership enhances the psychological well-being of organizational members, while Kim, Chang, & Kim [
27] emphasized its role in promoting workplace happiness, thereby boosting organizational well-being. Our findings align with these studies, supporting the idea that shared leadership positively impacts both individual and organizational outcomes. Previous research has shown that group activities fostering a sense of community can strengthen shared leadership by encouraging behavioral changes and group cohesion [
54]. We believe that the implementation of tailored group activities for nurses could further maximize the benefits of shared leadership, particularly in healthcare settings where collaboration is critical. For instance, structured peer support programs and team-building activities could mitigate internal conflicts, improve communication, and enhance a sense of belonging among team members. In conclusion, nursing managers should prioritize the development of group activities and peer support programs tailored to nursing teams’ needs. Such strategies could foster group cohesion and shared goals, ultimately enhancing organizational well-being. It is also important to evaluate the effectiveness of these interventions systematically to ensure their impact on improving well-being in nursing organizations.
Additionally, positive psychological capital and shared leadership have a significant positive effect on organizational well-being and can contribute to its improvement through their interaction. These two factors tend to increase together; as one factor rises, the other also tends to rise. This mutually reinforcing relationship suggests that both individual psychological strengths and collaborative leadership dynamics work in tandem to enhance organizational well-being. Positive psychological capital has also shown a mediating effect in the relationship between shared leadership and organizational commitment, while shared leadership positively influences positive psychological capital [
55]. Thus, fostering shared leadership can promote a positive psychological state, which may enhance organizational commitment and further strengthen positive psychological capital.
Study limitations and recommendations
Our study has several limitations. While we examined how positive psychological capital (as an individual factor), and shared leadership (as an organizational factor), influence organizational well-being, previous research suggests that positive psychological capital can be significantly shaped by organizational culture [
56]. Additionally, leadership style is closely tied to the broader organizational environment [
57], highlighting the importance of a supportive organizational culture. Our study did not include organizational culture as a variable; therefore future research could further explore the relationships between organizational culture, positive psychological capital, and shared leadership, with a focus on building a culture centered on stability, trust, and open communication to support and strengthen these factors.
Furthermore, this study was conducted by non-probability sampling of nurses from hospitals designated to provide highly specialized care to patients with severe disease in South Korea, limiting the generalizability of our findings to different nursing environments and cultural contexts. Future studies should examine these factors across diverse healthcare settings and cultural backgrounds to provide a more comprehensive understanding of positive psychological capital and shared leadership in various nursing contexts. Such research could help identify universally effective strategies and those that may require adaptation to specific cultural or organizational environments. Despite these limitations, our study holds several key contributions. First, it provides insights into how positive psychological capital (as an individual factor), and shared leadership (as an organizational factor), interact to influence organizational well-being. This dual focus underscores the need for both individual and organizational approaches to enhance well-being within nursing environments.
Another significant contribution of this study is the practical application of positive psychological capital and shared leadership in nursing practice. By identifying these factors as critical influences on organizational well-being, this study provides a foundation for developing targeted interventions that can be integrated into nursing environments. Such interventions could support stress resilience, foster collaborative leadership, and ultimately enhance the well-being of healthcare staff, contributing to improved patient care and job satisfaction among nurses.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.