Impact of Leadership Style on Professional Ethics and Moral Courage of Perioperative Nurses: A Cross‐Sectional Study in Southern Iran

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Aim This study aimed to investigate the association between leadership styles and professional ethics and moral courage among perioperative nurses in southern Iran. Background Operating rooms are high‐pressure environments where leadership behaviors and ethical decision‐making are critical for safe surgical care. Methods A cross‐sectional study was conducted with 251 perioperative nurses in Shiraz hospitals (June–August 2024). Standardized instruments were used: the Multifactor Leadership Questionnaire (MLQ), the Cadozier Professional Ethics Questionnaire, and the Sekerka Moral Courage Scale. Data were analyzed using Spearman’s correlation and robust multiple regression (bootstrapping) due to non‐normal data distribution. Results Active leadership styles demonstrated strong positive correlations with both professional ethics ( r = 0.852) and moral courage ( r = 0.868). Robust multiple regression analysis confirmed that transformational leadership was the primary positive predictor of both outcomes ( β PE = 0.754; β MC = 0.824). Transactional leadership was also a significant predictor of professional ethics ( β PE = 0.197) but not of moral courage ( p = 0.330). The models explained a substantial portion of the variance for professional ethics (adjusted R 2 = 0.842) and moral courage (adjusted R 2 = 0.704). Conclusion Active leadership is significantly associated with enhanced professional ethics and moral courage in perioperative nurses. Fostering transformational and transactional leadership is therefore recommended to improve the ethical climate in high‐pressure clinical settings.

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