Abstract
AIM: To provide a comprehensive understanding of how nurse managers' leadership styles affect staff engagement and to identify key themes that influence engagement from both statistical and experiential perspectives within a multicultural healthcare context. DESIGN: Explanatory sequential mixed-methods design, with integration occurring across the design, methods and reporting stages using the Pillar Integration Process. METHODS: The study was conducted in four public hospitals in western Saudi Arabia. Quantitative data were collected from 278 registered nurses using the validated Multifactor Leadership Questionnaire (MLQ-5X) and Utrecht Work Engagement Scale (UWES-9). Thirteen nurses participated in follow-up semi-structured interviews. The study adhered to the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines. RESULTS: Four integrated themes emerged: relational leadership, recognition and reward, impact of neglectful leadership and cultural competence in leadership. Saudi and non-Saudi nurses perceived leadership differently, influenced by cultural norms. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.