Editorial summary. This is our text summary of an article published by bmc-nursing. Charts, figures, and the author’s full voice are at the original — read it there .
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Editorial verdict
Methodologically limited but contextually grounded — the correlation findings are statistically significant but the paper reports the direction of the nepotism–justice link inconsistently, but single-site convenience sampling in one Egyptian hospital severely restricts generalizability; treat the directional findings as exploratory, not conclusive.
Executive summary
This descriptive correlational study examines the relationships between paternalistic leadership (PL), nepotism practices, and nurses' perceptions of organizational justice (OJ) within an Egyptian public hospital context. The authors argue that paternalistic leadership — characterized by benevolence, moral authority, and authoritarianism — positively influences perceptions of fairness, while nepotism exerts a negative influence. Conducted at Samanoud Central Hospital, Egypt, the study recruited 267 staff nurses via convenience sampling using three validated questionnaires: the Paternalistic Leadership Questionnaire (Cheng et al., 2004), the Nepotism Questionnaire (Arasli et al., 2006), and the Organizational Justice Questionnaire (Karriker & Williams, 2009). Results revealed a statistically significant positive correlation between total paternalistic leadership and organizational justice (r = 0.549, p < 0.001) and a significant negative correlation between nepotism and organizational justice (r = −0.337, p < 0.001). More than half (56.9%) perceived a moderate level of paternalistic leadership; fewer than half perceived moderate levels of nepotism (42.7%) and organizational justice (45.7%). The study concludes that the moral and benevolent dimensions of paternalistic leadership can foster fairer organizational environments, while nepotism systematically erodes perceptions of justice. Contextual factors, including Egypt's collectivist culture, are acknowledged as influential in shaping these dynamics.
Key insights
- 1A statistically significant positive correlation (r = 0.549) was found between paternalistic leadership and organizational justice among nurses, with benevolent and moral leadership dimensions showing the strongest associations (r = 0.833 and r = 0.841 respectively with total PL).
- 2Nepotism practices were negatively correlated with overall organizational justice (r = −0.337), although the paper's correlation table reports positive correlations between nepotism and the distributive (r = 0.560), procedural (r = 0.551) and interpersonal (r = 0.464) dimensions, an inconsistency the paper does not resolve.
- 3Authoritarian leadership, a sub-dimension of paternalistic leadership, was negatively correlated with procedural justice (r = −0.218) and total organizational justice (r = −0.212), suggesting that not all components of paternalistic leadership uniformly enhance fairness perceptions.
Practical takeaways
- The study recommends transparency and merit-based decision-making in hiring, promotion, and performance evaluation to reduce nepotism and strengthen justice perceptions among nursing staff; this is the authors' recommendation, not a measured association.
- The study identifies gender as significantly associated with nurses' perceptions of paternalistic leadership, nepotism, and organizational justice, age with paternalistic leadership and organizational justice, and educational level with organizational justice only, indicating that workforce composition may interact with leadership effectiveness in healthcare settings.
Frameworks mentioned
Social Exchange Theory
Theoretical framework used to explain how workers assess workplace interactions through reciprocal exchange, and how nepotism disrupts reciprocity norms, influencing perceptions of distributive and procedural justice.
Equity Theory
Used to explain how employees compare their input-to-outcome ratios with peers, particularly in contexts where familial ties influence organizational decisions under paternalistic leadership.
References
- Cheng et al. (2004).Paternalistic Leadership Questionnaire.
- Arasli, Bavik, & Ekiz (2006).Nepotism Questionnaire.
- Karriker & Williams (2009).Organizational Justice Questionnaire.
- Brislin (1970).Translation and back-translation methodology.
Source & Provenance
bmc-nursing
Hend Sabry Saad Habaza, Heba Rabea Hagras, Hanan Elsaid Elsabahy, Manal Saleh Moustafa Saleh, Hamad Ghaleb Dailah, Ahmed Hendy, Hussain Ali Shobaili
October 30, 2025
Research Study
Middle East
Original source metadata is preserved. AI analysis is generated separately.
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