Authentic Leadership Questionnaire applied to Brazilian nurses: evidence of validity

Rev. Latino-Am. Enfermagem 2022;30:e3546 DOI: 10.1590/1518-8345.5868.3546 www.eerp.usp.br/rlae Original Article Authentic Leadership Questionnaire applied to Brazilian nurses: evidence of validity* Vanessa Gomes Maziero1,2 https://orcid.org/0000-0002-0359-8365 Highlights: (1) The validation of an authentic leadership Fernanda Ludmilla Rossi Rocha1 questionnaire is innovative in the country. (2) Authentic https://orcid.org/0000-0002-0911-3728 leadership is a model still little used in the Brazilian scenario. Juliana Alvares Duarte Bonini Campos3 (3) The validated scales will allow the assessment of nurses’ https://orcid.org/0000-0001-7123-5585 authentic leadership. Bruna Moreno Dias1 https://orcid.org/0000-0002-7346-4848 Objective: to establish the psychometric properties of the Authentic Alexandre Pazetto Balsanelli4 Leadership Questionnaire (ALQ) applied to Brazilian nurses. Method: https://orcid.org/0000-0003-3757-1061 cross-sectional observational study with a non-probabilistic sample. Carmen Silvia Gabriel1,5 The psychometric properties of the RATER and SELF versions of https://orcid.org/0000-0003-2666-2849 the ALQ were calculated using confirmatory factor analysis with the Andrea Bernardes1,5 WLSMV robust estimation method. The following indices were used https://orcid.org/0000-0002-9861-2050 to assess the goodness-of-fit of the model: chi-square by degrees of freedom (χ2/df), Tucker-Lewis Index (TLI), Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Squared Residual (SRMR). Data reliability was analyzed using the ordinal coefficient alpha and composite reliability. Results: 181 nurses participated of the study (female gender: 80.1%; mean age of 34.6 years; working time of less than * Paper extracted from doctoral dissertation “Analysis of five years: 76.3%). The complete ALQ RATER and ALQ SELF models the validity of the Authentic Leadership Questionnaire”, did not present an adequate fit. Therefore, the refined models presented to Universidade de São Paulo, Escola de presented a better fit to the sample data (ALQ RATER: χ2/df=2.77; Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating 1 Centre for Nursing Research Development, Ribeirão Preto, CFI=0.97; TLI=0.97; RMSEA=0.10; SRMR=0.05; ALQ SELF: χ2/ SP, Brazil. df=2.74; CFI=0.94; TLI=0.92; RMSEA=0.10; SRMR=0.08). In the Universidade de São Paulo, Escola de Enfermagem de ALQ RATER model, items 1, 7 and 13 were excluded. Due to the high Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing correlation between the factors Relational Transparency and Moral Research Development, Ribeirão Preto, SP, Brazil. 2 3 4 Perspective, a three-factor model based on the combination of the Empresa Brasileira de Serviços Hospitalares, Campo Grande, MS, Brazil. factors mentioned above was proposed. In the ALQ SELF model, Universidade Estadual Paulista, Faculdade de Ciências items 2, 5, 9 and 10 were excluded. Likewise, a three-factor model Farmacêuticas, Araraquara, SP, Brazil. based on the combination of two factors, now called Self-Awareness Universidade Federal de São Paulo, Escola Paulista de Balance, was proposed. Conclusion: the data obtained with the Enfermagem, São Paulo, SP, Brazil. 5 Scholarship holder at the Conselho Nacional de Authentic Leadership Questionnaire with Brazilian nurses were valid Desenvolvimento Científico e Tecnológico (CNPq), Brazil. and reliable. Descriptors: Leadership; Organization and Administration; Health Services; Nursing, Team; Validation Study; Psychometrics. How to cite this article Maziero VG, Rocha FLR, Campos JADB, Dias BM, Balsanelli AP, Gabriel CS, Bernardes A. Authentic Leadership Questionnaire applied to Brazilian nurses: evidence of validity. Rev. Latino-Am. Enfermagem. 2022;30:e3546. [Access ]; Available in: month day year . https://doi.org/10.1590/1518-8345.5868.3546 URL 2 Rev. Latino-Am. Enfermagem 2022;30:e3546. ALQ were carried out for its use in various countries, such Introduction as Spain(7), France(8) and Pakistan(9-10). The concept of “authenticity” is related to positive Criticism of the original 2008 study(6) pointed out psychology and has its roots in Greek philosophy. It has that the researchers did not report the use of modification first been applied in the fields of sociology and education(1), indices related to the tests or the adjustment of models. but, in 2003, the construct gained greater prominence in In this sense, the authors encouraged other researchers the area of management and leadership, and authentic to carry out new studies to explain and detail the analyzed leaders began to be defined as those who are aware of performed(11). how they think and behave and are perceived by others Recent research reported that the four factors as aware of their own values, moral perspectives and that make up the ALQ (Self-awareness; Relational knowledge and of the strengths of others(1). Transparency; Balanced Processing; and Moral Perspective) Authenticity requires trust, optimism, resilience explain the composition of Authentic Leadership(11). and high moral character and is related to being true to It is important to emphasize that so far this yourself. The theoretical model of Authentic Leadership is instrument has not been validated in Portuguese nor for characterized by transparency in relationships, sharing of Brazilian people, and its psychometric properties have information and feelings, organizational commitment, and not been evaluated in a sample of nurses working in a satisfaction in performance through conduct consistent hospital environment. However, as it one of the most with a system of personal values and convictions. Authentic Leadership can result in greater motivation to engage in leadership roles as it creates a healthy work environment and promotes leadership self-efficacy(2). Furthermore, a study suggests that Authentic Leadership is associated with the quality of customer service(3). The American Association of Critical-Care Nurses considers authentic leadership as the main leadership model and claims that it is capable of creating and sustaining healthy work environments in critical care settings(4). Based on the assumptions of this model, those who are led can find greater meaning in the activities performed and greater commitment to work, creating used instruments to asses leadership style(10), the cultural adaptation of the ALQ to Brazilian Portuguese and its evaluation by leaders working in the health area are urgent matters. This may help to design strategies that can contribute to a more effective leadership through fair and authentic management and transformative leadership. Based on the above, this study was carried out with the objective of establishing the preliminary psychometric properties (validity of the internal structure) of the Authentic Leadership Questionnaire (ALQ) applied to Brazilian nurses. Method an environment that supports both leaders and their subordinates. Study design The theory that supports Authentic Leadership is based on four pillars: Self-awareness (leaders’ willingness to constantly analyze their strengths and opportunities for improvement); Relational Transparency (leaders’ ability to remain consistent with their values in the relationship with This is a cross-sectional observational study with a non-probabilistic sample, carried out in two general hospitals located in the Center-West Region of Brazil. Population and sample subordinates); Balanced Processing (unbiased decision making) and Internalized Moral Perspective (leaders’ values are consistent with their moral conduct) . (5) The first institution (Hospital A) is a public teaching hospital with 210 inpatient beds in different specialties Aiming to assess the authenticity of leaders, and approximately 1,600 professionals, of which 230 are evaluating their ethical, moral, behavioral and nurses. The second institution (Hospital B) is a private, organizational characteristics, in 2007, the original non-profit entity, under municipal management, with versions of the Authentic Leadership Questionnaire 671 beds and more than 3,600 professionals, of whom – ALQ (6) were created and tested in two independent 260 are nurses(12). samples from the United States and China. The US sample The target population of this study was composed of consisted of employees of a high-tech industry, while nurses working in these institutions. The inclusion criteria the Chinese sample was composed of employees of a were nurses with an active bond with the institutions, large state-owned enterprise. The ALQ was published in and a total of 300 nurses were considered eligible. English in two different versions: the RATER scale, aimed The minimum sample size for the factor analysis was at assessing the leadership exercised by the respondents’ calculated considering five to 10 subjects per parameter leader; and the SELF scale, to assess the participant’s own of the factor model(13). As the ALQ (SELF and RATER) has leadership profile. Subsequently, validation studies of the 38 parameters (16 items, 16 errors and 6 correlations www.eerp.usp.br/rlae Maziero VG, Rocha FLR, Campos JADB, Dias BM, Balsanelli AP, Gabriel CS, Bernardes A. between factors), the minimum sample size estimated Psychometric sensitivity was estimated using summary ranges between 190 and 380 participants. Nurses were (mean, median and standard deviation) and shape approached individually at their workplace and invited to measures (asymmetry and kurtosis) of the distribution participate in the study. On that occasion, the two versions of the responses to the items and was considered adequate of the ALQ were delivered in printed form and then when the absolute values of asymmetry and kurtosis were collected after five days. In this way, the participant was less than three and seven, respectively(14-15). able to respond to the instrument with attention, at their The factorial validity was tested by means of own time and space, reducing the risk of interruptions Confirmatory Factor Analysis (CFA) using the robust and/or exposure and embarrassment. Of the 300 eligible estimation method of mean- and variance-adjusted nurses, 250 received the printed instruments and 50 were weighted least squares (WLSMV). The following indices not located due to vacation, absence, relocation, among others. Of the 250 instruments delivered to nurses, only 200 were returned. Data was collected from December 2017 to March 2018. Instruments were used to assess the goodness-of-fit to the sample data: chi-square by degrees of freedom (χ2 /df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Squared Residual (SRMR). The following values were considered adequate: χ2/ df ≤ 2.0; CFI and TLI ≥ 0.90; and RMSEA ≤ 0.10(16- A questionnaire composed of demographic and occupational questions was elaborated to characterize the sample. The questionnaire included: gender (female or male), degree (undergraduate, specialization/residence, master’s/doctorate), work sector (Administration/ . In addition, factor loadings (λ) were evaluated and 17) considered adequate if ≥ 0.50. The modification indices calculated using the method of Lagrange multipliers (LM) were inspected to see if LM>11(13,15). Convergent validity was evaluated by Average Management, Clinic/Surgical Unit, Maternal-Infant Care, Variance Extracted (AVE) and considered adequate if AVE Emergency Medical Care, Coronary Care Unit, Adult ≥ 0.50(18). The method used to assess the validity of the Inpatient Unit, Intensive Care Unit, among others), discriminant construct was the one was the one proposed shift (morning, afternoon, evening, full-time), time of in 1981(18), which considered that if AVEi and AVEj ≥ ρij2, professional experience (in years) and time working in the existence of discriminant validity can be confirmed. the hospital (in years). The reliability of the factors was evaluated using the The measurement instrument used was the Authentic ordinal coefficient alpha (α) and the Composite Reliability Leadership Questionnaire - ALQ, which was applied to all (CR). Values of α and CR greater than 0.70 were considered participants in its two versions with different purposes: indicators of reliability(15,18). the RATER scale was used to assess the leadership of the After the factor adjustment of the ALQ RATER and respondents’ leader and the SELF scale was used to assess SELF scales, a second-order hierarchical model (SOHM) the leadership profile of the respondents’ themselves. was proposed in order to verify the contribution of each Each version (SELF and RATER) has 16 items factor to the general construct of leadership. distributed in four factors: Relational Transparency (RT The programs MPLUS v.8.3 (Muthén and Muthén, – items 1 to 5); Moral Perspective (MP – items 6 to 9); 2019, Los Angeles) and R (R Core Team, 2016) with the Balanced Processing (BP – items 10 to 12); and Self- packages “lavaan”(19) and “semTools”(20) were used to awareness (SA – items 13 to 16). The responses are on a perform the analyses. five-point Likert scale (0: Rarely/never, 1: Occasionally, 2: Sometimes, 3: Often and 4: Very often, almost always)(6). Ethical aspects The authorization to use the ALQ was granted The ethical precepts on the guidelines and standards directly by Mind Garden, Inc., the company responsible for research involving human beings contained in Resolution for licensing the questionnaire, representing Dr. Bruce No. 466 of the National Health Council of December 12, J. Avolio. 2012 were followed. The study was approved by the Research Ethics Committee of the Nursing School of the Psychometric properties of the ALQ - evaluation of University of São Paulo (CAAE: 67343717100005393). the internal structure The psychometric sensitivity of the items, the factorial, Results convergent, and discriminant construct validity, and the Of the 300 eligible nurses, 200 responded to the reliability of the instrument for the sample (internal questionnaire (adherence rate=66.7%) but 19 were structure) were estimated. excluded due to inconsistent responses, resulting in www.eerp.usp.br/rlae 3 4 Rev. Latino-Am. Enfermagem 2022;30:e3546. a sample of 181 participants. Among these, 63.5% (n=115) worked in hospital A and most were female (145; 80.1%). The mean age was 34.6 years old (standard Characteristic No % Work Sector deviation=6.7) and most participants had a specialization Intensive care unit 41 22.7 or residency degree (138; 76.2%), had worked in hospitals Other 41 22.7 for less than five years (138; 76.2%) and had more than Adult Inpatient Unit 29 16.0 five years of professional experience (123; 67.3%). The Maternal-infant Care 23 12.7 Clinic/Surgical Unit 20 11.0 Coronary Care Unit 12 6.6 Table 1 - Demographic and occupational characteristics of Emergency Medical Care 9 5.0 nurses (n=181). Campo Grande, MS, Brazil, 2018 Administration/Management 6 3.3 Morning 58 32.0 demographic and occupational characteristics of nurses is presented in Table 1. Characteristic No % Gender Work shift Female 145 80.1 Night 57 31.5 Male 34 18.8 Afternoon 42 23.2 Did not answer 2 1.1 Full-time 23 12.7 Did not answer 1 0.6 Age group Professional experience 20 to 29 years 47 26.0 30 to 39 years 92 50.8 Less than 1 year 13 7.2 40 to 49 years 37 20.4 1 to 5 years 45 24.9 50 years or older 3 1.7 5 to 10 years 52 28.7 Did not answer 2 1.1 10 to 20 years 56 30.9 Over 20 years 14 7.7 Did not answer 1 0.6 Highest degree Undergraduate 21 11.6 Specialization/residency 138 76.2 Master’s/PhD 21 11.6 Less than 1 year 30 16.6 Did not answer 1 0.6 1 to 5 years 108 59.7 5 to 10 years 13 7.2 Over 10 years 30 16.6 Institution Hospital A 115 63.5 Hospital B 66 36.5 Regarding the analysis of the psychometric properties Time working in the Hospital refined models of the ALQ RATER are shown in Figure 1. of the ALQ for the sample, the CFA of the complete and www.eerp.usp.br/rlae Maziero VG, Rocha FLR, Campos JADB, Dias BM, Balsanelli AP, Gabriel CS, Bernardes A. Figure 1 – Confirmatory Factor Analysis of the complete (A) and refined (B) ALQ RATER models (n=181). Ribeirão Preto, SP, Brazil, 2021 The complete model (A) of the ALQ RATER did not validity of the ALQ RATER scale factors was adequate present an adequate fit to the sample data (χ /df=4.42; (VEM=0.50-0.78). However, the discriminant validity of CFI=0.94; TLI=0.92; RMSEA=0.14; SRMR=0.08). the instrument’s factors was not confirmed (r2=0.60- Items 1 and 7 showed low factor loadings and item 1.00) due to the strong correlations between them. As 13 showed a high correlation with the instrument’s for reliability, acceptable values of ordinal α (0.74-0.91) BP factor (LM=40.51-61.09); therefore, these items and CR (0.69-0.88) were found. 2 were removed. The refined model (B) showed the In order to assess the contribution of factors to the best fit to the sample data (χ /df=2.78; CFI=0.98; concept of leadership, a second-order hierarchical model TLI=0.97; RMSEA=0.10; SRMR=0.05). The convergent (SOHM) was proposed for the ALQ RATER (Figure 2). 2 www.eerp.usp.br/rlae 5 6 Rev. Latino-Am. Enfermagem 2022;30:e3546. Figure 2 – Confirmatory Factor Analysis of the ALQ RATER second-order hierarchical model (n=181). Ribeirão Preto, SP, Brazil, 2021 The SOHM of the ALQ RATER presented an adequate fit to the sample data (χ2/df=2.89; CFI=0.97; TLI=0.97; RMSEA=0.10), adequate factor loadings (λ=0.63-0.94) and high contribution of factors to the leadership construct (β=0.86-1.00; p<0.001). Nevertheless, based on the observation of the high correlation between the factors RT and MP factors (Figure 1), a three-factor model was proposed for the ALQ RATER (Figure 3), with the original factors BP and SA and a third factor combining the RT and MP factors (called Relational and Moral - RM), composed of items RT2, RT3, RT4, RT5, MP6, MP8, and MP9. The model presented an adequate fit to the sample data (χ2/df=2.77; CFI=0.97; TLI=0.97; RMSEA=0.10; SRMR=0.05). www.eerp.usp.br/rlae Maziero VG, Rocha FLR, Campos JADB, Dias BM, Balsanelli AP, Gabriel CS, Bernardes A. Figure 3 – Confirmatory Factor Analysis of the ALQ RATER three-factor model (n=181). Ribeirão Preto, SP, Brazil, 2021 This three-factor model presented factor loadings However, during the adjustment, it was found λ ≥0.65, strong correlations between factors (r=0.81- that the BP factor would be composed only of items 0.93), and adequate convergent validity (AVE=0.52-0.78). 11 and 12. Therefore, a three-factor model adjusted The discriminant validity between the factors was not to the sample and combining the BP and SA factors confirmed (r2 =0.66-0.86) and adequate ordinal α (0.850.91) and CR (0.83-0.88) values were found. As for the ALQ SELF, the complete four-factor model did not fit the sample data (χ2/df=3.85; CFI=0.84; TLI=0.81; RMSEA=0.13; SRMR=0.11). Most items had low factor was proposed. This three-factor model contained the factors RT, MP and the combination of BP and SA (called Self-Awareness Balance - SAB), composed of items BP11, BP12, SA13, SA14, SA15 and SA16. The loadings, and items 9 and 10 were correlated with other model presented an adequate fit to the sample data factors in the instrument (LM=48.15-61.22). There were (χ 2/df=2.74; CFI=0.94; TLI=0.92; RMSEA=0.10; moderate correlations between most factors (r=0.48-0.68) SRMR=0.08). The CFAs of the full model (four-factor) and strong correlations between the BP and SA factors and of the refined model (three-factor) of the ALQ SELF (r=0.97). are shown in Figure 4. www.eerp.usp.br/rlae 7 8 Rev. Latino-Am. Enfermagem 2022;30:e3546. Figure 4 – Confirmatory Factor Analysis of the complete four-factor (A) and refined three-factor (B) ALQ SELF models (n=181). Ribeirão Preto, SP, Brazil, 2021 The convergent (AVE=0.48-0.57) and discriminant leader that can cultivate and promote values, so that (r =0.10-0.25) validity of the factors of the ALQ SELF they can make fair decisions based on high ethical refined were confirmed. Regarding the reliability of standards(6,22). Thus, the Relational and Moral factors are the items, adequate values were found (α=0.71-0.88; associated with transparency and ethics, which must go CR=0.67-0.84). Due to the moderate correlations between hand in hand. Corroborating the above, a study carried the factors, an ALQ SELF SOHM was not proposed for out in Belgium shows that the authentic leadership and the sample. behavioral integrity of the leader are related to follower 2 performance and organizational commitment, and that Discussion this relationship is maintained by controlling the ethical In the ALQ RATER scale, the high correlation between the factors Relational Transparency and Moral Perspective made it possible to combine these factors. This is justified by the direct relationship between their theoretical concepts, since showing the true self to others (relational transparency) is an essential characteristic of those who behave according to their personal values organizational culture(24), correlating the factors Relational Transparency and Moral Perspective. The exclusion of items 1 and 7 of the new Relational and Moral factor and item 13 of the Self-Awareness factor is considered acceptable from a theoretical point of view, since the remaining items are capable of expressing the concepts of relational transparency (leaders show (moral perspective). In addition, it is known that people themselves as they are), moral perspective (leaders tend to perceive and evaluate transparency based on demonstrate values and ethical conduct) and self- their own structures, values, emotions and cognitive awareness (leaders are aware of their strengths and , and that relational transparency requires weaknesses)(7,21). Furthermore, the items are not always genuineness and transparency of leaders to gain the trust correlated with a single factor, as there is some degree of of their followers association with conceptually related factors(25). In Spain, limitations (21) (22) , propagate their thoughts and seek harmony in the group(9). the ALQ was applied to a sample of 623 workers from It is important to emphasize that it is necessary to public and private organizations from different sectors invest in strengthening interpersonal relationships between and, as in Brazil, there was a need to exclude three leaders and team members, so that communication can items(7). be more assertive and self-confidence can be developed The second-order hierarchical model proposed in the team(23). Similarly, moral perspective requires a for the ALQ RATER showed that the factors Relational www.eerp.usp.br/rlae Maziero VG, Rocha FLR, Campos JADB, Dias BM, Balsanelli AP, Gabriel CS, Bernardes A. Transparency, Moral Perspective and Balanced Processing In this investigation, the second-order hierarchical were the ones that most contributed to the elaboration model was only possible for the RATER scale, which of the leadership construct with Brazilian nurses. This showed a strong correlation between the factors. This result differs from those of study carried out with 1861 result corroborates the study by the creators of the employees from organizations of various sectors and ALQ(6), which highlights that the four factors (Relational sizes, which found that the dimension with the greatest Transparency, Moral Perspective, Balanced Processing explanatory power for the leader’s assessment was Self- and Self-Awareness) are not independent and that the awareness, followed by Balanced Processing(26). In this leadership construct, a single second-order factor, can sample, which compared 1019 Brazilian employees to 842 explain this dependence. Portuguese employees, the theoretical explanation for this The review of the validation by the authors of the fact was that leaders’ self-knowledge and relationship with original version of the ALQ(11), in line with the original 2008 subordinates are essential for an authentic leadership(26). article(6) reinforced the importance of the four theoretical As in the RATER scale, the exclusion of items 2, 5, components of the Authentic Leadership model. However, 9 and 10 can be theoretically justified, as it does not the authors encourage the development of other model compromise the concepts of the different factors, since validation studies(11). the remaining items can contemplate the definition of Thus, the proposed ALQ validation analysis may each one of the factors. It is also important to highlight contribute to expanding the knowledge of professionals that it is possible for the factors to overlap(25), as occurred and researchers in the areas of nursing and hospital between Balanced Processing and Self-Awareness, which management, as the study presents the cultural adaptation showed perfect correlation. For this reason, a single factor of the ALQ to Brazilian Portuguese(31) as well as evidence was proposed (Balance and Self-Awareness). This can be related to the validity of the instrument’s internal structure justified using the theoretical framework of the instrument when applied to nurses working in Brazilian hospitals. itself, considering that in order to make a coherent The limitations of this study refer to the use of a decision it is necessary to analyze it beforehand (balanced non-probabilistic sample and to the sample size, aspects processing) and to be aware of one’s own weaknesses and that prevent the generalization of the results. However, strengths (self-awareness). Balanced processing refers to it is worth noting that the SELF and RATER versions of the leaders’ ability to carefully analyze a situation before the ALQ were considered valid and reliable instruments making decisions, while also being able to accept other to be applied to the population of nurses, which will points of view, even if they are different from their own . certainly contribute to the improvement of investigations Similarly, self-awareness refers to the deep perception of on authentic leadership in Brazilian healthcare settings. (1) their values and beliefs and to how they behave and are perceived by others(1,27). It is also worth noting that the creator of the instrument himself suggests that it is not reasonable to conceptualize the four factors of the ALQ as assessing entirely separate and distinct constructs(6). Given the above, the psychometric evaluation of the ALQ indicated the validity of the internal structure of the three-factor models of the RATER and SELF versions. In contrast, in Pakistan(9), New Zealand(28), Spain(7), Belgium(24),, Portugal(29) and Turkey(30), the validity of the four-factor model was confirmed(7). Regarding the differences in the adjustment of the two versions (SELF and RATER), when participants assess themselves as leaders, they are able to perceive balanced processing, being able, in their opinion, to make unbiased decisions; the same occurs with self-awareness, as individuals believe they understand the impact they can have on people(5). However, the participants present difficulties in understanding the importance of relational Conclusion The SELF and RATER scales of the Authentic Leadership Questionnaire (ALQ) applied to a sample of Brazilian nurses allowed the collection of valid and reliable information, which made it possible to assess the authentic leadership of these professionals. However, for the ALQ to be used, it was necessary to make adaptations in the instrument’s internal structure. The SELF and RATER scales can be used independently and can be applied to Brazilian nurses working in hospital settings. The application of the scale may provide evidence related to the authenticity of the nurse leader and their influence in hospital organizations, opening space for reflection, discussion and future use of this tool for tracking and monitoring characteristics related to authentic leadership in this context. 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Adaptação cultural do Authentic Leadership Questionnaire (ALQ) para o contexto da enfermagem brasileira [Thesis]. Ribeirão Preto: Escola de Enfermagem de Ribeirão Preto; 2018 [cited 2021 Nov 23]. Available from: http://doi.org/10.11606/T.22.2018. tde-03072018-154029 Authors’ contribution Study concept and design: Vanessa Gomes Maziero, Andrea Bernardes. Obtaining data: Vanessa Gomes Maziero. Data analysis and interpretation: Vanessa Gomes Maziero, Fernanda Ludmilla Rossi Rocha, Juliana Alvares Duarte Bonini Campos, Bruna Moreno Dias, Alexandre Pazetto Balsanelli, Carmen Silvia Gabriel, Andrea Bernardes. Statistical analysis: Fernanda Ludmilla Rossi Rocha, Juliana Alvares Duarte Bonini Campos. Drafting the manuscript: Vanessa Gomes Maziero, Fernanda Ludmilla Rossi Rocha, Juliana Alvares Duarte Bonini Campos, Bruna Moreno Dias, Alexandre Pazetto Balsanelli, Carmen Silvia Gabriel, Andrea Bernardes. Critical review of the manuscript as to its relevant intellectual content: Vanessa Gomes Maziero, Fernanda Ludmilla Rossi Rocha, Juliana Alvares Duarte Bonini Campos, Bruna Moreno Dias, Alexandre Pazetto Balsanelli, Carmen Silvia Gabriel, Andrea Bernardes. Others (Final approval): Received: Nov 23rd 2021 Accepted: Mar 10th 2022 Associate Editor: Ricardo Alexandre Arcêncio Corresponding author: Andrea Bernardes E-mail: andreab@eerp.usp.br https://orcid.org/0000-0002-9861-2050 www.eerp.usp.br/rlae Copyright © 2022 Revista Latino-Americana de Enfermagem This is an Open Access article distributed under the terms of the Creative Commons (CC BY). This license lets others distribute, remix, tweak, and build upon your work, even commercially, as long as they credit you for the original creation. This is the most accommodating of licenses offered. Recommended for maximum dissemination and use of licensed materials.