The Ethical Leadership Scale (ELS): Italian adaptation and exploration of the nomological network in a health care setting

Aim: To validate the Ethical Leadership Scale by Brown, Treviño and Harrison (2005) in Italian language, and assess, in health care setting, whether ethical leadership is related to leader–member exchange and also job satisfaction, work engagement, cynicism and organisational service climate. Background: Ethics is a key component in health care professions, and leaders have to encourage ethical behaviour. Unfortunately, no instrument is currently validated in Italy and the associations between this construct and the proposed measures have been understudied. Methods: A cross-sectional study was conducted in a large organisation offering health care services. All employees were invited to fill an online survey. The answers of 637 respondents, working in 48 centres for elderly and disabled people, were examined with exploratory and confirmatory factor analyses and aggregated at the centre level to test the association among the examined measures. Results: The 10 items on the ethical leadership scale load on a single factor, negatively related to cynicism and positively related to the other examined variables. Conclusion: The proposed scale is a reliable tool to assess the ethical leadership of Italian health care managers and nurse leaders. Implications for Nursing Management: The scale allows to assess and monitor ethical leadership in health care workplaces. Supporting ethical leadership may stimulate employees' work attitudes and promote organisational service climate.