J Korean Clin Nurs Res.  2019 Dec;25(3):314-322. 10.22650/JKCNR.2019.25.3.314.

The Structural Equation Model of Organizational Culture, Authentic Leadership, Self-Esteem, and Bullying in Nurses at Critical Care Units

  • 1Team Leader, Department of Nursing, Seoul National University Hospital, Korea.
  • 2RN, Department of Nursing, Asan Medical Center, Korea. hj8035@naver.com
  • 3Team Manager, Department of Nursing, Severance Hospital, Korea.
  • 4Unit Manager, Department of Nursing, Asan Medical Center, Korea.
  • 5Professor, Department of Nursing, Dong-A University, Korea.


The purpose of this study were to identify the influential factors of bullying of intensive care nurses and to suggest a final structural model based on identified relationships between nursing organizational culture, authentic leadership, self-esteem, and bullying in the workplace.
Data were collected from 221 nurses at intensive care units in eight general hospitals using structured questionnaires and analyzed by structural equation modeling.
In this study, the average of bullying in the workplace was 1.34±0.40, nursing organizational culture was 3.31±0.47, self-esteem was 2.79±0.44, and authentic leadership was 3.61±0.60. The factors affecting nursing organizational culture were authentic leadership (β=.54, p<.001) and self-esteem (β=.24, p=.002) that had direct positive effects on the nursing organizational culture. The nursing organizational culture had also a direct effect on reducing workplace bullying (β=−.45, p<.001). Authentic leadership (β=−.24, p=.004) and self-esteem (β=−.11, p=.004) had indirect effects on workplace bullying, which was mediated by the nursing organizational culture.
To understand and reduce workplace bullying, evaluating a nursing organizational culture should be preceded. Based on the finding of this study, an intervention for increasing authentic leadership and self-esteem of nurses can positively help to create the nursing organizational culture and then reduce workplace bullying.


Organizational Culture; Leadership; Self-Esteem; Bullying
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