Workplace Upward Networking Between Affective Leadership and Voice Behavior

BACKGROUND: Psychological safety, leadership support, and organizational climate frequently limit the primary nurses' voice behavior. Nurses then tend to remain silent when assessing the possible risks associated with vocalizing concerns (voice behavior). Research predominantly confirms a top-down structure between leadership and voice behavior from clinical nurses, with less research on the mechanism of upward management. This study aimed to validate the mediating role of workplace upward networking between affective leadership and the voice behaviors of clinical nurses. METHODS: This study was a cross-sectional survey, using purposeful sampling to select 639 nurses from all primary hospitals in Hangzhou. Measurement tools included the demographic information questionnaire, affective leadership scale, voice behavior scale, and workplace upward networking scale. RESULTS: The relationship between affective leadership and voice behavior mediated by upward networking in the workplace was confirmed. Affective leadership affected workplace upward networking, with an explained variation of 37%. Affective leadership and workplace upward networking affected voice behavior, with an explained variation of 61%. CONCLUSIONS: This study provides support for a nursing management model in primary care, emphasizing the cultivation of affective leadership behaviors and style and the enhancement of upward management strategies to foster clinical nurses voicing concerns to management about safety issues or ideas for innovation.