The current global nursing shortage has been concerning, particularly for nursing managers. According to the latest data from the National Health and Medical Commission of China, there were 5.018 million nurses in China. There were 3.56 registered nurses per 1,000 population and a medical-to-nursing ratio of 1:1.17 at the end of 2021. There is a million-level gap in the number of nurses in China. Especially in recent years, the continuous outbreak of the new crown pneumonia epidemic has highlighted the problems of nurses’ job burnout, willingness to leave, and psychological exhaustion etc. Hence, it is imperative to maximize limited nursing human resources to ensure that nursing quality remains high in China (Central People's Government of the People's Republic of China, 2022). Based on the literature review, the study is based on Bakker’s job requirement-resource model (JDR). The model assumes that the level of work engagement depends on the balance of work requirements and work resources. Job demands require the individual to make constant physical, mental, cognitive, and emotional efforts to complete various aspects of the work, which may cause adverse physical or psychological stress. Work resources can offset the adverse effects of job requirements, effectively stimulate employees’ work motivation, improve their work engagement level, and produce positive work results (Bakker and Demerouti 2007). With the development of positive psychology, nursing researchers have focused on developing psychological nursing resources, such as psychological empowerment, psychological capital, self-efficacy, work engagement, etc.(Lin et al., 2020) in China. Work engagement has been proven to improve job satisfaction (Waltz et al., 2020), retention (Gustafsson et al., 2021), and nurses’ work ability (Tomietto et al., 2019), which significantly influences nursing outcomes. Meanwhile, evidence has shown that authentic leadership (Lisbona et al., 2021) and transformational leadership (Wu and Lee, 2020; Schaufeli, 2021) are important factors that influence nurse work engagement. However, destructive behaviors are ignored by most nursing managers, such as abusive supervision. Abusive supervision could negatively influence individual work attitudes, behaviors and work outcomes (Qian et al., 2015; Özkan, 2021). However, few studies have examined the relationship between abusive supervision and work engagement among nurses in China. Furthermore, the literature also indicates that the intrinsic motivational process of work engagement is explained by self-efficacy (Wallin et al., 2021), but few studies have attempted to determine the specific mechanism underlying this process in China. Therefore, this study aimed to explore the relationships between abusive supervision, self-efficacy, and work engagement; we also sought to determine the mechanisms that might explain the links between these three variables in China.

Abusive supervision refers to subordinates’ perceptions of the extent to which supervisors engage in the sustained display of hostile verbal and nonverbal behaviors, excluding physical contact (Finlay et al., 2020). Behavioral descriptions of abusive supervision include the silent treatment, impoliteness, aggressive eye contact, angry tantrums, explosive outbursts (e.g., yelling at someone for disagreeing), intimidation (e.g., threats of job loss), and derogatory words, as well as ridiculing or humiliating someone in front of others (DeMarce et al., 2021). Some studies have linked abusive supervision to organization attitudes, behaviors, and work outcomes, indicating that abusive supervision has some deleterious consequences as follows. Baig and Riaz (2021) have reported that abusive supervision is positively associated with stress and emotional exhaustion. Other scholars have also found that abused subordinates may experience anxiety (Huang et al., 2019), and insomnia (Sannes et al., 2021). A statistically significant negative correlation between abusive supervision and organizational citizenship behavior (OCB) has been observed by Baig and Riaz (2021). When subordinates have the perception of being abused, they might refuse to help coworkers, exhibit negative attitudes that affect their ability to finish their work, and even reduce their chances of receiving earned rewards (Estes, 2013). Some researchers have also sought to explore abuse in the nurse supervisor-subordinate relationship. In Estes (2013) study, 46.6% of the nurses investigated reported experiencing abusive supervision, and 36.6% even thought that their performance was negatively influenced by abusive supervision. Sharif Nia et al. (2021) have suggested that the increasing occurrence of abusive supervision can be harmful for individuals and organizations, including decreased job satisfaction and increased adverse events.

Work engagement is defined as “a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption in the activity”(Waltz et al., 2020). In recent years, most studies have confirmed that work engagement can significantly predict positive outcomes. Particularly in healthcare settings, work engagement is becoming an important resource to enhance nursing recruitment and retention (Gustafsson et al., 2021), increase commitment (Lin et al., 2020), and advance performance (Eguchi et al., 2020). Therefore, exploring determinants of nurses’ work engagement has great significance. In terms of the links between leadership level and nursing work engagement, Tillott et al. (2013) have claimed that management factors were relatively important to others in influencing work engagement. García-Sierra and Fernández-Castro (2018) empirically demonstrated that transformational leadership is positively related to work engagement but that organizational justice mediated their relationship, meaning that managers’ leadership significantly predicts nurses’ perception of justice and, eventually, influences work engagement. In addition, a statistically significant positive correlation between abusive supervision and work burnout was found by Carlson et al. (2012). Scholars have hypothesized that work engagement is the opposite of burnout (Koranne et al., 2022). Work burnout and work engagement are opposites along two distinct bipolar dimensions. Hence, nurses who are exhausted are less likely to engage in their work.

Self-efficacy refers to “people’s judgments of their capabilities to organize and execute the courses of action required to attain designated types of performances” (Bandura, 1986). As a type of important personal resource, self-efficacy has been demonstrated as having vital and precursor influences on positive consequences. Tsai et al. (2014) have suggested that nurses with high self-efficacy had higher professional commitment and invested more effort into their jobs. Enhanced self-efficacy can help to improve the quality of nursing care and increase nursing performance (Eller et al., 2018; Kim et al., 2021). Wallin et al. (2021) have also claimed that self-efficacy, as the main personal resource, explains intrinsic motivational processes, such as work engagement. Accordingly, we consider that the higher a nurse’s self-efficacy, the more likely the nurses engage in the nursing professional practice autonomously. According to social cognitive theory, vicarious experiences and verbal persuasion, as a contextual resource, strongly influence individual self-efficacy (Bandura, 1986). Salanova et al. (2011) have claimed that managers can effectively increase self-efficacy among nurses through role modeling and verbal encouragement. However, if the managers tend to demonstrate abusive supervision, open verbal communication and bi-directional feedback will be destroyed. Hence, we believe that abusive supervision can negatively predict self-efficacy. In addition, as stated earlier, abusive supervision can cause stress, emotional exhaustion, burnout, and depression, and then decrease the motivation to engage in the job (Baig and Riaz, 2021). In the process, self-efficacy can efficiently regulate the predicament to achieve a desired balance between work attitude and behavior. For these reasons, we believe that abusive supervision will influence nurses’ work engagement by mediating self-efficacy.

The results showed that the average score of abusive management was 1.55 ± 0.71. The item with the highest score was that my leader would criticize subordinates in front of everyone, indicating that nurses pay more attention to the head nurse’s verbal evaluation and feedback on themselves. When the head nurses educate their subordinates, they usually ignore the inner feelings of the nurses. The results showed that the self-efficacy score of nurses was 4.97 ± 0.70. The item with the highest score was that when encountering difficulties at work, nurses were willing to try to solve the problem, and showed good confidence in their ability to deal with work problems. The results show that nurses have strong self-belief and are more confident in their professional skills when faced with complex and numerous nursing work. The average score of nurses’ work engagement was 5.01 ± 1.26, which was at an upper-middle level, similar to the findings of Wang et al. (2012). It shows that nurses are more active in performing nursing work. Among the three dimensions of work engagement, the average score of dedication is the highest, and the average score of vitality is the lowest (Table 2). The level of work engagement of Chinese nurses is lower than that of Europe and the United States (Jin et al. 2022), which suggests that effective measures should be taken, especially in terms of improving work vitality. Improving the work engagement level of nurses is an urgent problem that needs to be addressed by managers in China.

Our study aimed to explore the relationships between abusive supervision, self-efficacy and work engagement, and to extend the knowledge of the mechanisms through which abusive supervision predicts nurses’ work engagement. Our results were similar to the findings of Sharif Nia et al. (2021), likely because most Chinese nursing managers (i.e., charge nurses) are females. Influenced by traditional culture, Chinese females are characterized by subtle emotion and sensibility. When resolving their relationships with sub-nurses, they are more likely to be convergent in abuse and, in turn, to emotionally encourage nurses. However, given that abusive supervision is steadily increasing and has detrimental effects on individuals and organizations (Sharif Nia et al., 2021), attention directed toward this issue should be continuously increased. In addition, self-efficacy and work engagement scores are consistent with previous nursing studies conducted by Eller et al. (2018) and Kim et al. (2021), respectively, indicating considerable similarities.

The findings demonstrate several theoretical and practical implications. First, as shown in hypothesis 1, the perceived abusive supervision by nurses negatively predicts work engagement. This finding is supported by the JDR (Estes, 2013) (i.e., abusive supervision replaces job recourse, such as supervisor support and positive feedback, and, in turn, increases nurses’ burden in job demand, which eventually has a detrimental effect on work engagement). For example, when nurses perceived they are suffering from abuse, for instance, being told that they have stupid ideas and are incompetent, they can be disturbed by the lack of manager support and encouragement. Then, the nurses’ work enthusiasm is greatly reduced. Our findings also align with those of Carlson et al.(Carlson et al., 2012), who demonstrated that abusive supervision contributes to work burnout and, in turn, decreases work engagement level.

Second, our research confirmed the motivational process of work engagement based on Bandura’s social cognitive theory (i.e., hypothesis 2 (Bandura, 1986). The theory indicates that the individual’s attitudes and behaviors are predicted by efficacy expectations. Higher levels of self-efficacy and confidence align with a stronger intrinsic motivation. The results are consistent with those of Eller et al. (2018), who identified that high self-efficacy can help nurses enhance considerable work engagement, thereby improving extra-role performance in Western countries. Therefore, we deeply believe that to achieve nursing job goals, nurses with high level self-efficacy are more likely to undertake the task actively, make unremitting endeavors, and devote themselves to their jobs.

Third, as hypothesis 3 predicted, we argued that the more abusive the behaviors conducted by nursing supervisors, the lower self-efficacy is experienced by nurses. According to Bandura (1986) suggestion, the process of individual’s behavior motivation (i.e., self-efficacy) was dependent on both accepting others’ verbal persuasion and observing behavioral models. In China, the charge nurse, as the first-line manager in the ward, serves as the backbone, guiding the nursing activities and serving as a role modeling for nurses. When nurse managers continuously behave in an abusive manner, such as criticizing nurses or denying nurse’s abilities, the nurses are likely to experience depression and self-doubt, and then they lack of confidence in their jobs and eventually present with decreased self-efficacy. Worse still, this abusive leadership style, as a salient example, can cause individuals to mirror that behavior and treat other team members with aggression and hostility (Huang et al., 2019).

Finally, the most compelling finding of our research is the mediating role that self-efficacy plays between abusive supervision and work engagement (hypothesis 4).

This result lends support to the notion that when nursing managers present abusive behaviors, nurses will experience less self-efficacy in their jobs, which then decreases their work engagement. The results are similar with Wallin et al. (2021) which pointed out that nurses’ self-efficacy plays a mediating role between leadership behavior and work engagement. Zhang and Li (2015) pointed out that nurses’ work effort depends to a certain extent on leader factors, and work motivation (such as self-efficacy) is a powerful contributing factor for them to achieve work goals. At the same time, the Chinese researcher also emphasized that nurses with higher self-efficacy had more self-confidence, they were more proactive in dealing with stressful events, focused on their work with more enthusiasm, and their level of work engagement will be higher (Li, 2021). These studies explain the mediating process of self-efficacy as a motivational variable. Therefore, the study indicated that abusive management as a harmful leadership behavior will make nurses continue to be confused and questioned about their own abilities, thereby blocking their intrinsic motivation process, resulting in powerlessness and frustration, and ultimately affecting their work vigor, focus, and dedication. This suggests that in the process of management, head nurses should not only pay attention to restraining their abusive leadership behaviors, but also learn to use relevant theories to stimulate nurses’ self-efficacy, so as to better stimulate the inner potential of nurses and obtain a high level of work engagement team in China.

The findings of our study confirm a statistically significant structural association between abusive supervision, self-efficacy, and work engagement among Chinese nurses. The findings further indicate that abusive supervision negatively predicted work engagement, and self-efficacy emerged as an important mediating factor. This finding implies that preventing and controlling abusive leadership behaviors, while comprehensively improving nurses’ self-efficacy level, might have vital significance in contributing to work engagement. If hospital managers take positive actions to select, train, and monitor nursing supervisors and strive to build a healthy, polite, and respectful work environment that pays attention to encourage nurses’ confidence in their abilities, they can achieve more work engagement and increase the loyalty of nurses to their organizations.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

This study and the gathering of data were approved by the Harbin Medical University Institutional Review Board. All participants provided written informed consent prior to participating in this study.

NS and LyL: conception, design, analysis, and data interpretation, drafting the manuscript, revising the manuscript, and its final approval. QlZ and XfL: acquisition of data, project administration, manuscript revisions, and its final approval. XfL and SpZ: formal analysis, manuscript revision, and final approval. LyL and HhH: conception, manuscript revision, and final approval. NS: conception, design, funding acquisition, project administration, manuscript revision, and final approval. All authors contributed to the article and approved the submitted version.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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