Toxic leadership and quality of work life: the moderating role of nurses’ agility

BACKGROUND: Toxic leadership undermines morale, job satisfaction, and retention among nurses. While previous studies have established its detrimental effects, the moderating role of nurses' agility-a capacity for adaptation and resilience-remains underexplored, especially in the Egyptian healthcare context. OBJECTIVE: This study examines the direct impact of toxic leadership on nurses' quality of work life and explores whether nurses' agility can mitigate these negative effects. DESIGN AND METHODS: A cross-sectional, correlational design was used involving 265 full-time nurses across three hospitals in the Beni-Suef governorate, Egypt. Data collection instruments included the Toxic Leadership Scale, the Work-Related Quality of Life Scale, and the Workforce Agility Scale. Statistical analyses involved Pearson's correlation, multiple linear regression, and moderation analysis via Hayes' PROCESS macro. RESULTS: Toxic leadership had a statistically significant negative impact on nurses' quality of work life (r = -0.503, p < 0.001). Conversely, agility was positively associated with both toxic leadership (r = 0.159) and quality of work life (r = 0.425). Moderation analysis showed that nurses' agility significantly buffered the negative effect of toxic leadership on quality of work life (β = 0.0049, p < 0.05). CONCLUSION: Toxic leadership erodes nurses' quality of work life, but nurses with high agility experience less deterioration in work satisfaction and well-being. This suggests that agility operates as a protective factor. IMPLICATIONS FOR NURSING & POLICY: Healthcare institutions must address toxic leadership through leadership development programs and should proactively enhance nurses' agility through training in adaptability, stress management, and situational problem-solving. This dual strategy can improve nurse retention and ultimately, patient care outcomes. PATIENT OR PUBLIC CONTRIBUTION: Not applicable. CLINICAL TRIAL NUMBER: Not applicable.