الفهرس 
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Abstract
Recent fraud scandals have put ethical leadership behavior high on the priority list of
organizations as ethical problems that break down the trust and reputation of both leaders
and organizations. Ethical leadership behaviors are critical to leaders‟ credibility and have
meaningful influence on the attitudes and ethical conduct of nurses and ultimately on
organizational performance. Also, Ethical leadership behavior is fostered through a
favorable ethical climate that provide ethical framework for nurses in the organization.
Ethical leadership behavior is necessary for creating an ethical climate and is key to
obliging staff nurses to decrease or prevent anti-social behavior and gaining better results.
Aim of study:
The aim of this study is to investigate the relationship between nurses’ perception of
ethical leadership and anti-social behavior through ethical climate as a mediating factor at
Alexandria Main University Hospital.
Setting:
This study was conducted in Medical, Surgical Inpatient Care Units and its
specialties with bed capacity 1370 beds and Critical Care Units with 147 beds capacity at
Alexandria Main University Hospital. Medical Inpatient Care Units and its specialties
include 25 units, Surgical Inpatient Care Units and its specialties include 17 units Critical
Care Units include 13 units.
Subjects:
Non-probability, Consecutive sampling of the study subjects were included in this
study (n=355) who were working in the previously selected setting with experience more
than 6 month and were available during time of data collection and distributed as follow 92
nurses in Medical Inpatient Care Units, 121 nurses in Surgical Inpatient Care Units and
142 nurses in Critical Care Units.
Tools:
Three tools were used in this study.
Tool (I): Ethical Leadership Work Questionnaire (ELW)
This tool was developed by Brown et al. (2005) and validated by Karianne et
al.(2011) (11,13) .It was adopted by the researcher to measure ethical leadership behavior of
first line nurse managers as perceived by nurses. It consisted of 36 items classified into
seven dimensions namely: people orientation (7 items) fairness (6 items), power sharing (6
items), concern of sustainability (3 items), ethical guidance (7 items), role clarification (3
items) and integrity (4 items) .The response was measured on a 5-point likert scale ranging
from (1) strongly disagree to (5) strongly agree. The reversed score was applied for
negative statements (9 items). The overall score level range from (36 to 180). Lower level
of ethical leadership behavior range from (36 -84), moderate level of ethical leadership
range from (85-132) and higher level of ethical leadership range from (133 -180).
Tool (II): Ethical work climate questionnaire:
It was developed by Victor and Cullen (2008) were used to measure the ethical work
climate as perceived by nurses (,23). It consisted of 36 items that are classified into nine
dimensions: self-interest, efficiency, personal morality, organizational profit, friendship,
organizational rules and procedures, team interest, laws and professional codes and social
responsibility. Each dimension composed of 4 items. The response was measured on 6
point likert scale ranged from (0) completely false to (5) completely true. The reversed
score was applied for negative statements (5 items). The overall score level ranging from
(0 to180). Lower scoring of ethical work climate range from (0 - 60), moderate scoring of
ethical work climate range from (61-120) and higher scoring of ethical work climate range
from (121-180). The higher scoring indicates more positive perception of nurses about
their ethical work climate.
Tool (III): Anti-social behavior at work tool:
Tool was developed by DeVellis (1991) it composed of 28 items and updated by
Robinson & Bennett (2000) to 18 items to assess anti-social behavior of nurses. It was
adopted by the researcher (178, 33). This tool classified into two major dimensions; antisocial
behavior against the organization (12 items) such as falsifying receipts and dragging
out work to get overtime and anti-social behavior against individuals (6 items) such as
playing mean pranks on coworkers and say something hurtful to someone at work . The
response was measured on 5 point likert scale range from (1) never to (5) always. The
overall score level range from (18 to 90). Lower scoring of anti-social behavior level range
from (18 - 42), moderate scoring range from (43 -66) and higher scoring of anti-social
behavior level range from (67-90). The lower total score of anti-social behavior items of
nurses indicate the highest nurses‟ social behavior and vice versa.
In addition, nurses’ demographic data sheet that was developed by the researcher to
collect data for nurses include age, gender, marital status, presence of children, level of
education, working units, years of experience in nursing career and years of experience in
current working units .
Methods
1- An official permission was obtained from the Faculty of Nursing and the hospital
administrators at Alexandria Main University Hospital to collect the necessary data.
2- Tool I, III translated into Arabic, and tested for their face validity by five experts from
Faculty of Nursing, Alexandria University.
3- Tool I, II, and III were tested for their reliability by using statistical test to measure the
internal consistency using Cronbach‟s alpha Correlation Coefficient test. The result of
three tools revealed that they were reliable with value of r = 0.886 for ethical
leadership work questionnaire, r = 0.924 for anti-social behavior at work and for ethical
work climate r= 0.950.
4- Pilot study was carried out on 10 % of nurses (n=36) rather than the study subjects
5- Data were collected for this study by the researcher .Data collection took a period of
two month starting from 10/10/2018 to 10/12/2018.
6- Ethical considerations were assured.
Result of the study showed that:
The present study revealed that more than half of studied nurses (58%) perceived
moderate mean percent score of overall ethical leadership behavior (60.18±15.99)
represented in its all dimensions.
Also, this study indicated that more than half of studied nurses (53.5%) perceived
moderate mean percent score of overall ethical work climate (64.16± 14.39)
represented in its all dimensions.
On another hand, more than half of studied nurses (61.4%) perceived low mean
percent score of overall anti-social behavior at work (30.03±28.57) represented in its
two dimensions.
These were statistically significant moderate positive correlation between ethical
leadership behavior and ethical work climate. While, there were statistically
significant low negative correlation between ethical leadership behavior and antisocial
behavior. Also, there was significant low negative correlation between ethical
work climate and anti-social behavior.
There was a statistical significant positive relationship was found between ethical
leadership and ethical climate; as increase in ethical leadership by one standardized
point score associated with increase in ethical climate by (0.243) standardized point
score.
On other hand, there was statistical significant negative relationship between ethical
climate and anti-social behavior ; as increase in ethical climate by one standardized
point score associated with decrease in anti-social behavior by (5.367) standardized
point score.
Also, there was statistical significant negative relationship between ethical leadership
and anti-social behavior ; as increase in ethical leadership by one standardized point
score associated with decrease in anti-social behavior by (0.029) standardized point
score. So, ethical climate is considered partial meditated factor has indirect effect on
anti-social behavior.
The findings of this study lead to the following recommendation:
A: Recommendations for Top Level Management to enhance Ethical
Leadership Behavior and Ethical Work climate:
Provide training programs for all administrative levels related to:
D. Ethical leadership behavior including people orientation, power sharing,
fairness, integrity, transparency, ethical guidance, role clarification and
interpersonal skills for leaders to be considered as role models for nurses.
E. Leadership skills, including how to deal with different personalities, behaviors
and to be updated with advanced researches in management and their areas of
specialties.
F. Ethical work climate including importance of ethics, standards and nursing
code of ethics, friendship, organization rules and procedure, characteristics of
ethical work climate and ways to improve it.
Provide opportunities for nurses to participate in ethical decision making and
problem solving through attending units meeting and listen to their ideas and
concern in order to promote positive team work and enhance feeling of
responsibility.
Put system for rewarding and supporting nurses who behave ethically and serving
as ethical role models..
B: Recommendations toward First -Line Nurse Managers:
Create equitable work environment for all nurses through maintaining an open,
clear communication with all nurses about the ethical behavior, ethical dilemma and
identifying methods for matching organizational goals and objectives with their
needs, to gain their participation and commitment for goals attainment as well as the
acceptance of individual differences to motivate nurses for working hard. Therefore,
encouraging self-reporting about any incident or defect in their work, which in turn
build no blame culture in hospital and inform nurses about it.
Build autonomy in nursing staff through providing them with more authorities,
responsibilities and permit nurses to play a key role in setting their own
performance goals.
C: Recommendations toward Nurses for Enhancing Social Behavior
Enhance social activities through conducting birthday parties, field trip, exchanging
gifts, offering more support and attention for nurses through sending congratulation
card in case of success and identifying nurse‟s needs and try to satisfy them in order
to improve their work performance, productivity and increase nurses‟ sense of
belonging and obligation to reduce their anti-social behavior.
Encourage staff nurses‟ innovation, new ideas and critical thinking. Therefore, create a
competition between nurses for selecting the best nurse who perform social behavior
and social intelligence during the working and motivating them through putting their
names and pictures on hospital board as well as giving them certificate or non-minatory
incentives to be role model for other nurses as well as other health care providers.
The following are suggestions for further studies in this area should be
done:
Anti-social behavior in the eyes of nurses: The role of organizational support and
effectiveness.
Comparative study to identify factors the effect on occurrence of anti-social behavior
between staff nurses in governmental and private hospitals.
Relationship between ethical leadership, happiness at work and sense of energy with
organizational citizenship behavior.
Relationship between clinical educator behavior, anti-social behavior of students and
their impact on students „performance.