{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:57:36Z","timestamp":1790578656609,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":269,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007614","name":"Al Jouf University","doi-asserted-by":"publisher","award":["DGSSR-2025-01-01585"],"award-info":[{"award-number":["DGSSR-2025-01-01585"]}],"id":[{"id":"10.13039\/501100007614","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Co\u2010created leadership may improve nurses\u2019 work environments, but evidence on candidate pathways in hierarchical settings is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate processes, outcomes and exploratory change pathways associated with a participatory supportive leadership programme in Saudi hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a five\u2010hospital participatory action research evaluation with an uncontrolled three\u2010wave cohort (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009200), mixed\u2010effects outcome models, exploratory bootstrap product\u2010of\u2010coefficients analyses, nine interaction tests with Benjamini\u2013Hochberg false\u2010discovery\u2010rate control and longitudinal qualitative data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Retention was 86.0%. Practice Environment Scale of the Nursing Work Index scores improved (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.36), while personal and work\u2010related burnout and turnover intention decreased and job satisfaction increased; client\u2010related burnout did not change significantly. Thirteen of 20 unadjusted change\u2010pathway intervals excluded zero. Four interactions were nominally significant, but none survived false\u2010discovery\u2010rate correction. Complete\u2010case analyses preserved the significance classification for 10 of 11 outcomes; staffing\/resource adequacy attenuated (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038 to 0.054). Qualitative themes contextualised, but did not confirm, quantitative patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The programme was associated with favourable relational and participatory changes, but the uncontrolled design precludes causal or mediation claims.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Management<\/jats:title>\n                    <jats:p>Managers can use structured co\u2010creation to support nurse voice and psychological safety while pairing local leadership action with staffing policy and readiness\u2010sensitive implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/7257178","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:40:22Z","timestamp":1790577622000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Co\u2010Creating Supportive Leadership and Nurse Work Environments: A Mixed\u2010Methods Participatory Action Research Study in Saudi Arabia"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8491-8190","authenticated-orcid":false,"given":"Majed Mowanes","family":"Alruwaili","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"key":"e_1_2_17_1_2","doi-asserted-by":"publisher","DOI":"10.1080\/00185868.2025.2524814"},{"key":"e_1_2_17_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0326519"},{"key":"e_1_2_17_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/23779608251374232"},{"key":"e_1_2_17_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-026-35681-5"},{"key":"e_1_2_17_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.70093"},{"key":"e_1_2_17_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13070779"},{"key":"e_1_2_17_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02395-w"},{"key":"e_1_2_17_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mnl.2025.102478"},{"key":"e_1_2_17_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2026.04.031"},{"key":"e_1_2_17_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/23779608261468455"},{"key":"e_1_2_17_11_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-060722-024251"},{"key":"e_1_2_17_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/08933189231187883"},{"key":"e_1_2_17_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtumed.2024.04.007"},{"key":"e_1_2_17_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/su16083277"},{"key":"e_1_2_17_15_2","first-page":"A8.1","volume-title":"18-4E6X Enhancing Nursing Work Environment: Organizational and Psychosocial Interventions Evaluation","author":"Bernal A. F.","year":"2024"},{"key":"e_1_2_17_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/14783363.2024.2404438"},{"key":"e_1_2_17_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep14040222"},{"key":"e_1_2_17_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-18332-z"},{"key":"e_1_2_17_19_2","doi-asserted-by":"publisher","DOI":"10.1155\/jonm\/2653041"},{"key":"e_1_2_17_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mnl.2025.102554"},{"key":"e_1_2_17_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-025-03869-1"},{"key":"e_1_2_17_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.70170"},{"key":"e_1_2_17_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-025-03059-z"},{"key":"e_1_2_17_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.1876"},{"key":"e_1_2_17_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/09697330261465881"},{"key":"e_1_2_17_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.12726"},{"key":"e_1_2_17_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-025-02514-4"},{"key":"e_1_2_17_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemep.2022.100833"},{"key":"e_1_2_17_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2026.07.027"},{"key":"e_1_2_17_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2021.104791"},{"key":"e_1_2_17_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/15480518241246026"},{"key":"e_1_2_17_32_2","doi-asserted-by":"publisher","DOI":"10.5465\/amp.2012.0088"},{"key":"e_1_2_17_33_2","volume-title":"Men and Women of the Corporation","author":"Kanter R. M.","year":"1993"},{"key":"e_1_2_17_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0001848191041003003"},{"key":"e_1_2_17_35_2","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2007.007074"},{"key":"e_1_2_17_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_17_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/0011000010376416"},{"key":"e_1_2_17_38_2","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"e_1_2_17_39_2","doi-asserted-by":"publisher","DOI":"10.1002\/nur.10032"},{"key":"e_1_2_17_40_2","doi-asserted-by":"publisher","DOI":"10.1891\/1061-3749.27.2.234"},{"key":"e_1_2_17_41_2","doi-asserted-by":"publisher","DOI":"10.1080\/02678370500297720"},{"key":"e_1_2_17_42_2","doi-asserted-by":"publisher","DOI":"10.4102\/sajhrm.v11i1.507"},{"key":"e_1_2_17_43_2","volume-title":"Manual for the Minnesota Satisfaction Questionnaire","author":"Weiss D. J.","year":"1967"},{"key":"e_1_2_17_44_2","doi-asserted-by":"publisher","DOI":"10.2307\/2666999"},{"key":"e_1_2_17_45_2","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.83.6.853"},{"key":"e_1_2_17_46_2","doi-asserted-by":"publisher","DOI":"10.5465\/256727"},{"key":"e_1_2_17_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199108000-00004"},{"key":"e_1_2_17_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-9-7"},{"key":"e_1_2_17_49_2","first-page":"127","article-title":"Dimensions of National Culture and Effective Leadership Patterns: Hofstede Revisited","volume":"3","author":"Dorfman P. W.","year":"1988","journal-title":"Advances in International Comparative Management"},{"key":"e_1_2_17_50_2","doi-asserted-by":"crossref","first-page":"6626","DOI":"10.1007\/978-94-007-0753-5_3470","volume-title":"Encyclopedia of Quality of Life and Well-Being Research","author":"Clarke V.","year":"2014"},{"key":"e_1_2_17_51_2","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917733847"},{"key":"e_1_2_17_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2020.02.005"},{"key":"e_1_2_17_53_2","doi-asserted-by":"publisher","DOI":"10.3233\/EFI-2004-22201"},{"key":"e_1_2_17_54_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-67"}],"container-title":["Journal of Nursing Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/7257178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jonm\/7257178","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jonm\/7257178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:40:24Z","timestamp":1790577624000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jonm\/7257178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":54,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jonm\/7257178"],"URL":"https:\/\/doi.org\/10.1155\/jonm\/7257178","archive":["Portico"],"relation":{},"ISSN":["0966-0429","1365-2834"],"issn-type":[{"value":"0966-0429","type":"print"},{"value":"1365-2834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"7257178"}}