Determinants of Nurse Managers' Servant Leadership: A Systematic Review

Abstract

This systematic literature review synthesizes evidence on factors that may predispose, develop, enable, reinforce, or constrain servant leadership among nurse managers. The evidence base comprises 49 English-language publications issued within the predefined eligibility window, identified through a PRISMA-informed search of bibliographic databases, publisher platforms, Google Scholar, and supplementary citation sources. Because the corpus includes direct nursing studies as well as adjacent healthcare leadership and professional-preparation evidence, conclusions are strongest for nurse-manager samples and more tentative when transferred from related settings. Thematic narrative synthesis and frequency mapping produced four interdependent domains: personal moral-service orientation, relational leadership capability, developmental preparation, and organizational-contextual conditions. Organizational support was the most frequently represented factor, followed by service values, cultural context, empowerment practice, and relational trust; emotional intelligence, leader humility, and formal leadership training received comparatively limited attention. The synthesis indicates that servant leadership is neither a fixed trait nor a training outcome in isolation. Its enactment depends on the interaction of ethical service motives, relational competence, development opportunities, psychological safety, manageable demands, and institutional reinforcement. The review offers an integrated determinant framework while distinguishing literature coverage from causal evidence and identifying priorities for longitudinal, multilevel, comparative, and intervention research.