Abstract
BACKGROUND: Head nurses are frontline leaders who directly shape nurses’ work environments, staff well-being, and patient outcomes. Previous studies suggest that inclusive leadership behaviours of head nurse exert a positive influence on nursing practice. Yet, little is known about the factors of head nurses’ use of inclusive leadership in daily practice. The purpose of this study was to explore the factors influencing head nurses’ implementation of inclusive leadership from the perspectives of multiple stakeholders, using a qualitative descriptive approach guided by the diffusion of innovation theory. METHODS: A qualitative descriptive study was adopted. Semi-structured interviews were conducted between October 2024 and March 2025 from stakeholders of inclusive leadership which included 7 chief nursing officers, 8 head nurses, and 10 nurses. Thematic analysis was applied to analyze the data. The participants were recruited via purposive and snowball sampling methods. RESULTS: 12 themes related to head nurses’ implementation of inclusive leadership were identified through thematic analysis, collectively forming the core framework for understanding this leadership practice. Based on the Diffusion of Innovation theory, these themes were classified into 5 major constructs: relative advantage, compatibility, complexity, trialability, and observability. CONCLUSION: There are certain factors that promote and hinder the implementation of inclusive leadership by head nurses. Future research should explore the potential of inclusive leadership in nursing management and ensure its alignment with clinical practice. CLINICAL TRIAL NUMBER: Not applicable.