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arxiv: 2606.29056 · v1 · pith:PUE7AXAMnew · submitted 2026-06-27 · 💰 econ.GN · q-fin.EC

Green Transformational Leadership and Sustainable Nursing Practices: Evidence from the Healthcare Sector

Thabit Atobishi , Saeed Nosratabadi This is my paper

Pith reviewed 2026-06-30 08:15 UTC · model grok-4.3

classification 💰 econ.GN q-fin.EC
keywords green transformational leadershipsustainable clinical behaviorsethical climategreen psychological climateperceived organizational hypocrisyhealthcarenursessustainability
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The pith

Green transformational leadership and ethical climate promote sustainable clinical behaviors in nurses through green psychological climate, though perceived organizational hypocrisy reduces these effects.

A machine-rendered reading of the paper's core claim, the machinery that carries it, and where it could break.

The paper investigates the role of green transformational leadership and ethical climate in encouraging sustainable practices among nurses in hospitals. It shows that these elements positively influence sustainable clinical behaviors, with green psychological climate serving as a partial mediator. Perceived organizational hypocrisy acts as a moderator that weakens the positive relationships. Data from 760 nurses in Jordan support a model that accounts for over a third of the variance in such behaviors. A reader would care because the healthcare sector is a significant source of emissions, and changing staff behaviors offers a direct way to address that.

Core claim

Green transformational leadership and ethical climate positively predict sustainable clinical behaviors among registered nurses. Green psychological climate partially mediates both relationships. Perceived organizational hypocrisy significantly weakens the positive effects of green transformational leadership and ethical climate on sustainable behaviors. The model explains 35.7% of the variance in sustainable clinical behaviors.

What carries the argument

Structural equation model testing the effects of green transformational leadership and ethical climate on sustainable clinical behaviors, mediated by green psychological climate and moderated by perceived organizational hypocrisy.

If this is right

  • Healthcare organizations should develop green transformational leadership to encourage sustainable behaviors.
  • Building an ethical climate supports environmental sustainability in clinical settings.
  • Addressing perceived organizational hypocrisy is essential to realize the benefits of leadership and climate efforts.
  • Green psychological climate is an important pathway for these influences.
  • Such approaches can contribute to reducing the environmental footprint of healthcare.

Where Pith is reading between the lines

These are editorial extensions of the paper, not claims the author makes directly.

  • The moderation effect suggests that authenticity in organizational sustainability claims is crucial for employee engagement.
  • These relationships may generalize to other professions within healthcare or similar service industries.
  • Interventions aimed at aligning words and actions on green issues could amplify the impact of leadership training.
  • Future studies might explore how these factors interact with actual emission reduction metrics rather than self-reported behaviors.

Load-bearing premise

Survey responses from nurses at one point in time can establish the causal direction from leadership and climate to behaviors without being distorted by how people answer questions or by behaviors shaping perceptions.

What would settle it

Finding that changes in leadership style or reductions in perceived hypocrisy over time do not lead to increases in sustainable clinical behaviors would challenge the causal claims.

Figures

Figures reproduced from arXiv: 2606.29056 by Saeed Nosratabadi, Thabit Atobishi.

Figure 3
Figure 3. Figure 3: Moderating effect of Competitive Pressure on the relationship between Organizational Readiness and AI-Enabled Exploration. Blue dots represent the High Pressure group; red dots represent the Low Pressure group. 4.5. Robustness and Sensitivity Analyses To further establish the methodological rigor of the findings, we conducted five ad￾ditional analyses. First, we replicated the structural model using covari… view at source ↗
read the original abstract

The healthcare sector contributes approximately 4.4% of global greenhouse gas emissions, yet research on the organizational determinants of sustainable behaviors among healthcare workers remains limited. This study examines how green transformational leadership and ethical climate influence sustainable clinical behaviors among registered nurses, with green psychological climate as a mediator and perceived organizational hypocrisy as a moderator. Data were collected from 760 nurses across 11 public and private hospitals in Jordan using a cross-sectional survey design. Structural equation modeling with bootstrapping was employed to test the hypothesized relationships. The results revealed that both green transformational leadership and ethical climate positively predicted sustainable clinical behaviors. Green psychological climate partially mediated both relationships. Perceived organizational hypocrisy significantly weakened the positive effects of green transformational leadership and ethical climate on sustainable behaviors. The model explained 35.7% of the variance in sustainable clinical behaviors. These findings highlight that fostering sustainability in healthcare requires not only supportive leadership and ethical organizational environments but also authenticity and consistency between stated values and actual practices. The study extends green transformational leadership theory to healthcare settings, integrates ethical climate research with environmental sustainability, and introduces perceived organizational hypocrisy as a critical boundary condition. Practical implications for healthcare administrators seeking to reduce their environmental footprint are discussed.

Editorial analysis

A structured set of objections, weighed in public.

Desk editor's note, referee report, simulated authors' rebuttal, and a circularity audit. Tearing a paper down is the easy half of reading it; the pith above is the substance, this is the friction.

Referee Report

2 major / 2 minor

Summary. The paper claims that green transformational leadership and ethical climate positively predict sustainable clinical behaviors among 760 Jordanian nurses, with green psychological climate partially mediating both relationships and perceived organizational hypocrisy weakening the effects; a cross-sectional SEM with bootstrapping on single-source survey data explains 35.7% of variance in the outcome.

Significance. If the directional and mediational claims were identified, the work would usefully extend green transformational leadership theory into healthcare settings, integrate ethical climate with sustainability research, and introduce perceived organizational hypocrisy as a boundary condition in a sector responsible for 4.4% of global GHG emissions. The sample size and bootstrapping approach provide a reasonable empirical base for correlational patterns.

major comments (2)
  1. [Abstract and Methods] Abstract and Methods section: The cross-sectional, single-wave, single-source survey design is used to support claims that green transformational leadership and ethical climate 'positively predicted' sustainable clinical behaviors and that green psychological climate 'partially mediated' the paths. No longitudinal, multi-source, or instrumental-variable identification strategy is described, so the reported directional and mediation effects cannot be distinguished from associations, common-method variance, or reverse causation.
  2. [Results] Results section: The headline finding that the model explains 35.7% of variance in sustainable clinical behaviors is obtained from the same fitted SEM parameters used to estimate the paths; without reported model-fit statistics (CFI, RMSEA, SRMR), measurement-model diagnostics (loadings, AVE, discriminant validity), or explicit common-method-bias tests, it is impossible to assess whether the mediation and moderation results are artifacts of measurement issues.
minor comments (2)
  1. [Abstract] The abstract states the sample was drawn from 11 hospitals but provides no information on response rate, hospital-level clustering, or whether multilevel modeling was considered.
  2. [Methods] Notation for the interaction terms representing the hypocrisy moderation is not defined in the abstract or early methods description.

Simulated Author's Rebuttal

2 responses · 0 unresolved

We thank the referee for the detailed and constructive feedback. We address each major comment below, indicating where revisions will be made to the manuscript.

read point-by-point responses

  1. Referee: [Abstract and Methods] Abstract and Methods section: The cross-sectional, single-wave, single-source survey design is used to support claims that green transformational leadership and ethical climate 'positively predicted' sustainable clinical behaviors and that green psychological climate 'partially mediated' the paths. No longitudinal, multi-source, or instrumental-variable identification strategy is described, so the reported directional and mediation effects cannot be distinguished from associations, common-method variance, or reverse causation.

    Authors: We agree that the single-wave, single-source cross-sectional design limits the ability to establish causal direction or rule out reverse causation and common-method variance. The terms 'predicted' and 'mediated' in the abstract and results follow common usage in SEM-based organizational research but can overstate the strength of evidence. We will revise the abstract, introduction, results, and discussion to replace these with more precise language such as 'were positively associated with' and 'partially accounted for the relationships between,' and we will add an explicit limitations paragraph discussing the design constraints and the correlational nature of the findings. revision: partial

  2. Referee: [Results] Results section: The headline finding that the model explains 35.7% of variance in sustainable clinical behaviors is obtained from the same fitted SEM parameters used to estimate the paths; without reported model-fit statistics (CFI, RMSEA, SRMR), measurement-model diagnostics (loadings, AVE, discriminant validity), or explicit common-method-bias tests, it is impossible to assess whether the mediation and moderation results are artifacts of measurement issues.

    Authors: We will add the requested information to the revised Results section, including overall model fit indices (CFI, RMSEA, SRMR), measurement-model details (standardized loadings, AVE, composite reliability), discriminant validity assessment (Fornell-Larcker criterion and HTMT ratios), and common-method bias diagnostics (Harman's single-factor test and a full collinearity assessment). These statistics were computed during analysis but were not reported in the initial submission. revision: yes

Circularity Check

1 steps flagged

SEM path coefficients fitted to single-wave survey data presented as directional predictions, partial mediation, and moderation

specific steps
  1. fitted input called prediction [Abstract]
    "The results revealed that both green transformational leadership and ethical climate positively predicted sustainable clinical behaviors. Green psychological climate partially mediated both relationships. Perceived organizational hypocrisy significantly weakened the positive effects of green transformational leadership and ethical climate on sustainable behaviors. The model explained 35.7% of the variance in sustainable clinical behaviors."

    The verbs 'predicted', 'partially mediated', and 'significantly weakened' denote the estimated direct and indirect path coefficients obtained by maximum-likelihood fitting of the hypothesized SEM to the identical survey responses; these statistics are therefore tautological with the model that was estimated on the input data.

full rationale

The paper's headline results consist of reporting the sign, significance, and partial mediation of paths estimated by fitting a structural equation model to the same 760-respondent cross-sectional dataset. These quantities are defined by construction as the fitted parameters and derived indirect effects; the 35.7% variance explained is likewise the in-sample R². No out-of-sample prediction, longitudinal identification, or parameter-free test is supplied, so the claimed 'predictions' and mediation reduce directly to the fitted inputs.

Axiom & Free-Parameter Ledger

1 free parameters · 2 axioms · 0 invented entities

Central claim rests on fitted SEM parameters from self-report survey data plus standard domain assumptions about construct validity and causal inference from cross-sectional designs; no free parameters or invented entities are explicitly introduced beyond the model.

free parameters (1)
  • SEM path coefficients and interaction terms
    Estimated from the 760-respondent dataset to test mediation and moderation.
axioms (2)
  • domain assumption Survey items validly and reliably measure the latent constructs of interest
    Invoked by applying SEM to self-reported data without reported validation metrics.
  • domain assumption Cross-sectional associations support the hypothesized directional and mediated relationships
    Standard assumption in such organizational studies but not independently verified.

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discussion (0)

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