Development of the attitude scale of nurse managers towards employees showing cynicism

This study was conducted using a qualitative (in-depth individual interview method) and quantitative (methodological method) design, with the aim of deeply exploring nurse managers' perceptions of employees exhibiting cynical behavior and developing a scale to measure their attitudes toward such employees. The study was conducted in two phases. In the qualitative phase, 25 nurse managers participated, while the methodological phase included 468 nurse managers. Data for the qualitative phase were collected from 25 nurse managers through individual in-depth interviews using a "Semi-Structured Interview Form." In the second phase, the methodological stage, data were collected from 468 nurse managers using the draft version of the "Nurse Managers' Attitudes Toward Employees Exhibiting Cynical Behavior Scale," which was developed based on the findings of the first phase. The qualitative data were manually analyzed using the content analysis method, whereas the quantitative data were analyzed using SPSS 26.0 and LISREL 8.7 software.Findings from the qualitative phase regarding nurse managers' perspectives on employees displaying cynical behavior were categorized under two main themes: negative attitudes and behaviors toward the institution, and the approach of the institution/manager. Negative attitudes and behaviors were examined under three sub-themes: types of negative attitudes and behaviors, causes of negative attitudes and behaviors, and reflections of these attitudes and behaviors. The institution/manager's approach was assessed under two sub-themes: approaches to preventing negative attitudes and behaviors, and imposing sanctions against them. A 54-item draft scale was created based on the qualitative data and then reviewed by experts. Following expert review, 2 items were removed, resulting in a 52-item draft scale with a content validity index of 0.90. Exploratory factor analysis was conducted, yielding a 15-item structure. Confirmatory factor analysis was subsequently performed, and the model fit indices were found to be within acceptable and good fit ranges: Chi-square/df (CMIN/df) = 2.14, CFI = 0.99, NNFI = 0.98, NFI = 0.98, IFI = 0.99, GFI = 0.98, SRMR = 0.073, RMSEA = 0.049. The reliability of the scale over time was tested using the test-retest method with 30 participants, and no significant difference was found between the two measurements (p > 0.05). The total Cronbach's Alpha value of the scale was found to be 0.829. The sub-dimensions had the following values: "working conditions" = 0.646, "communication and relationships" = 0.861, "managerial support" = 0.757, and "employee characteristics" = 0.849. In addition, statistically significant relationships were found between the total scale and its sub-dimensions (p < 0.01). As a result of the study, it is considered that nurse managers' initial attempts to prevent negative attitudes and behaviors in employees displaying cynicism would significantly benefit the individual, the team, service recipients, and the institution. Furthermore, in cases where such behaviors persist, taking necessary legal actions would be crucial in preventing more serious consequences. The developed scale is also expected to be useful in evaluating nurse managers' approaches toward employees exhibiting negative attitudes and behaviors (i.e., cynical behavior). Keywors: Nurse, Nurse Manager, Cynicism, Organizational Cynicism