Caring for the caregiver during COVID-19 outbreak: Does inclusive leadership improve psychological safety and curb psychological distress? A cross-sectional study

Fuqiang Zhao, Fawad Ahmed*, Naveed Ahmad Faraz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

100 Citations (Scopus)


Background: Public health emergencies and epidemics shatter the assumptions of the world as a safe place. Healthcare workers are at the forefront of such pressures resulting from a persistent threat to their safety and well being. It is therefore important to study such mechanisms that can influence and predict the psychological distress of nurses Objectives: While there is an increasing number of studies on positive outcomes of leadership styles, their influence on curbing unwanted adverse outcomes is scarce. This study aims to observe the influence of an inclusive leadership style on psychological distress while assessing the mediating role of psychological safety. It uses the theoretical lens of job demands-resources theory and the theory of shattered assumptions to develop and test hypotheses. Design: Cross-Sectional Study with Temporal Separation Settings and Participants: The researchers recruited 451 on-duty registered nurses from 5 hospitals providing patient care during the highly infectious phase of COVID-19 in January 2020 in Wuhan city, the epicentre of the outbreak in China Methods: After obtaining permission from hospital administration, data were collected through an online questionnaire survey in three stages with temporal separation to avoid common method bias. Partial least square structural equation modelling was used to analyze data. The study controlled for effects of age, gender, experience, working hours and education. Results: Hypothesized relationships proved significant. Inclusive leadership has an inverse relationship with psychological distress with a strong path-coefficient. Psychological safety mediates the relationship between inclusive leadership and psychological distress while explaining 28.6% variance. Multi-group analysis results indicate no significant differences between respondents based on these control variables Conclusions: Recurring or prolonged experiences of stress and anxiety at the workplace, without a mechanism to counter such effects, can culminate into psychological distress. Inclusive leadership style can serve as such a mechanism to curb psychological distress for healthcare workers by creating a psychologically safe environment.

Original languageEnglish
Article number103725
JournalInternational Journal of Nursing Studies
Publication statusPublished - Oct 2020
Externally publishedYes


  • COVID-19
  • Inclusive leadership
  • Job demands resources theory
  • Psychological distress
  • Psychological safety
  • Public health emergencies

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