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Leader’s integrity and employee silence in healthcare organizations

Hakan Erkutlu (Faculty of Economics and Administrative Sciences, Nevsehir Haci Bektas Veli Universitesi, Nevsehir, Turkey)
Jamel Chafra (Department of Tourism and Hotel Management School of Applied Technology and Management, Bilkent Universitesi, Ankara, Turkey)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 24 August 2018

Issue publication date: 12 July 2019




Drawing on the social exchange theory, the purpose of this paper is to examine the relationship between a leader’s behavioral integrity and employee acquiescent silence. Specifically, the authors take a relational approach by introducing employee’s relational identification as the mediator. The moderating role of employee political skill, in the relationship between behavioral integrity and employee acquiescent silence, is also considered.


The data of this study encompass 913 front-line nurses from 13 university hospitals in Turkey. Hierarchical multiple regression analysis was conducted to test the proposed model.


The results of this study support the negative effect of behavioral integrity on employee’s acquiescent silence, as well as the mediating effect of employee’s relational identification. Moreover, when the level of employee political skill is low, the relationship between behavioral integrity and acquiescent silence is strong, whereas the effect is weak when the level of political skill is high.

Practical implications

The findings of this study suggest that healthcare administrators’ words and deeds should be consistent while interacting with their subordinates, as it leads to positive interpersonal relationship, which, in turn, lowers employee silence. Moreover, healthcare administrators should pay more attention to the buffering role of employee political skill for those subordinates with low relational identification and higher workplace silence.


This study contributes to the literature on workplace silence by revealing the relational mechanism between behavioral integrity and employee silence. This paper also offers a practical assistance to employees in the healthcare industry and their administrators interested in building trust and high-quality manager–employee relationship, as well as lowering workplace silence.



Erkutlu, H. and Chafra, J. (2019), "Leader’s integrity and employee silence in healthcare organizations", Leadership in Health Services, Vol. 32 No. 3, pp. 419-434.



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Copyright © 2018, Emerald Publishing Limited

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