Ambidextrous Leadership and Presenteeism Among Clinical Nurses: A Moderated Mediation Model of Self‐Efficacy and Leader–Member Exchange
- 1School of Nursing Guangdong Pharmaceutical University Guangzhou Guangdong China gdpu.edu.cn
- 2Guangzhou Municipal Health Commission Guangzhou Guangdong China
Abstract
Aim: This study aimed to examine the pathways linking ambidextrous leadership (AL) to nurses’ presenteeism, with a particular focus on the mediating role of self‐efficacy and the moderating role of leader–member exchange (LMX) in this process.
Background: Presenteeism among clinical nurses remains persistently high and is associated with reduced individual productivity and with risks to patient safety. Previous research has examined associations between the leadership style and attendance behavior; however, AL—the flexible combination of exploratory and exploitative behaviors—has received limited empirical attention in this context. Examining this pathway may inform nursing management practice.
Methods: A cross‐sectional, descriptive, and correlational design was adopted. Data were collected from 394 clinical nurses recruited through convenience sampling at three tertiary hospitals in Guangzhou. In addition to correlational analyses, regression models were constructed to examine the mediating and moderating pathways among these variables.
Results: AL was negatively associated with nurses’ presenteeism and positively associated with self‐efficacy; higher self‐efficacy was, in turn, associated with lower presenteeism. Mediation analysis indicated that self‐efficacy partially accounted for the association between AL and presenteeism, with the indirect pathway representing 33.3% of the total effect. In addition, LMX moderated the first stage of this pathway: the positive association between AL and self‐efficacy was stronger among nurses reporting higher LMX.
Conclusion: The findings support the hypothesized moderated mediation model, in which self‐efficacy partially mediates the association between AL and nurses’ presenteeism, and in which LMX conditions the first stage of that pathway. Because the design was cross‐sectional, these associations are correlational and cannot establish causal direction. The findings suggest that structural measures such as reasonable scheduling, sick‐leave protection, workload adjustment, and occupational health support remain the primary responsibility of nursing management and that managerial attention to relational quality and to nurses’ self‐efficacy beliefs may complement, but cannot replace, them.
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BibTeX
@article{zhou2026ambidextrous,
title = {{Ambidextrous Leadership and Presenteeism Among Clinical Nurses: A Moderated Mediation Model of Self‐Efficacy and Leader–Member Exchange}},
author = {Xiuran Zhou and Shifang Zou and Hui Peng and Ying Yu and Xiaoying Yan},
journal = {Journal of Nursing Management},
year = {2026},
month = oct,
doi = {10.1155/jonm/5209573},
url = {https://doi.org/10.1155/jonm/5209573},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Ambidextrous Leadership and Presenteeism Among Clinical Nurses: A Moderated Mediation Model of Self‐Efficacy and Leader–Member Exchange
AU - Xiuran Zhou
AU - Shifang Zou
AU - Hui Peng
AU - Ying Yu
AU - Xiaoying Yan
PY - 2026
DA - 2026/10/28
JO - Journal of Nursing Management
DO - 10.1155/jonm/5209573
UR - https://doi.org/10.1155/jonm/5209573
AB - Aim: This study aimed to examine the pathways linking ambidextrous leadership (AL) to nurses’ presenteeism, with a particular focus on the mediating role of self‐efficacy and the moderating role of leader–member exchange (LMX) in this process. Background: Presenteeism among clinical nurses remains persistently high and is associated with reduced individual productivity and with risks to patient safety. Previous research has examined associations between the leadership style and attendance behavior; however, AL—the flexible combination of exploratory and exploitative behaviors—has received limited empirical attention in this context. Examining this pathway may inform nursing management practice. Methods: A cross‐sectional, descriptive, and correlational design was adopted. Data were collected from 394 clinical nurses recruited through convenience sampling at three tertiary hospitals in Guangzhou. In addition to correlational analyses, regression models were constructed to examine the mediating and moderating pathways among these variables. Results: AL was negatively associated with nurses’ presenteeism and positively associated with self‐efficacy; higher self‐efficacy was, in turn, associated with lower presenteeism. Mediation analysis indicated that self‐efficacy partially accounted for the association between AL and presenteeism, with the indirect pathway representing 33.3% of the total effect. In addition, LMX moderated the first stage of this pathway: the positive association between AL and self‐efficacy was stronger among nurses reporting higher LMX. Conclusion: The findings support the hypothesized moderated mediation model, in which self‐efficacy partially mediates the association between AL and nurses’ presenteeism, and in which LMX conditions the first stage of that pathway. Because the design was cross‐sectional, these associations are correlational and cannot establish causal direction. The findings suggest that structural measures such as reasonable scheduling, sick‐leave protection, workload adjustment, and occupational health support remain the primary responsibility of nursing management and that managerial attention to relational quality and to nurses’ self‐efficacy beliefs may complement, but cannot replace, them.
SN - 0966-0429
SN - 1365-2834
ER -