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ORIGINAL ARTICLE
How is an unethical leadership born in critical care teams? Stress coping strategies analysis
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1
Powiślańska Academy of Applied Sciences, Kwidzyn Poland
 
2
University Clinical Hospital, Poznan, Poland
 
 
Submission date: 2025-04-07
 
 
Final revision date: 2025-07-14
 
 
Acceptance date: 2025-08-09
 
 
Online publication date: 2026-09-18
 
 
Corresponding author
Marcin Muża   

Powiślańska Szkoła Wyższa, Kwidzyn, Poland
 
 
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Leadership is directly connected with proper communication, interpersonal collaboration, as well as noticing and resolving problems. Therefore, not only are knowledge and abilities important but also non-technical skills are crucial. Current data suggest that physicians and paramedics differ in their critical care team management patterns. Doctors tend to act unethically more often than do paramedics.

Aim of the research:
The aim of this study was to find differences in stress coping strategies among team leaders, which could be responsible for unethical leadership patterns (understood as rushing others, shouting, or cursing).

Material and methods:
The survey was addressed to physicians and paramedics (who claimed to be leaders in their critical care teams). It consisted of the authors’ self-designed questionnaire concerning non-technical aspects of leadership and the Mini-COPE questionnaire. A total of 75 replies were obtained.

Results and conclusions:
The highest scores (for both groups) were obtained in the ‘Active coping’ and ‘Planning’ subscales (which are elements of ‘active strategy group’) as well as ‘Acceptance’. Results in ‘Denial’, ‘Substance use’, ‘Turning into religion’, and ‘Discontinuation of action’ subscales were generally low among both professions. Active coping strategies correlate with more ethical and composed leadership. Physicians present emotional discharge and blaming oneself more often than paramedics do. The higher the level of active coping, the more ethical and composed the leadership. Emotional discharge and blaming oneself (higher level among physicians) may explain the differences in their leadership patterns. Unethical behaviour of team leaders could be their stress reduction strategy.
REFERENCES (29)
1.
Ignacio J, Dolmans D, Scherpbier A, Rethans JJ, Chan S, Liaw SY. Stress and anxiety management strategies in health professions’ simulation training: a review of the literature. BMJ Simul Technol Enhanc Learn. 2016; 2: 42-46.
 
2.
Bleetman A, Sanusi S, Dale T, Brace S. Human factors and error prevention in emergency medicine. Emerg Med J. 2012; 29: 389-393.
 
3.
Harvey A, Bandiera G, Nathens AB, LeBlanc VR. Impact of stress on resident performance in simulated trauma scenarios. J Trauma Acute Care Surg. 2012; 72: 497-503.
 
4.
Maresca G, Corallo F, Catanese G, Formica C, Lo Buono V. Coping strategies of healthcare professionals with burnout syndrome: a systematic review. Medicina. 2022; 58(2): 327.
 
5.
Muża M, Kalemba A, Kapłan C, Plata H, Bornio E. The effect of verbal pressure on students’ performance during simulated emergency situation – a randomized pilot study. J Public Health Emerg. 2023; 7: 25.
 
6.
Ahmad I, Gao Y, Hali SM. A review of ethical leadership and other ethics- related leadership theories. Eur Sci J. 2017; 13(29): 10.
 
7.
Muża M, Bornio E, Plata H. Different views on emergency team management according to Polish medical professionals. J Public Health Emerg. 2024; 8: 24.
 
8.
Juczyński Z, Ogińska-Bulik N. Narzędzie pomiaru stresu i radzenia sobie ze stresem. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego, Warszawa 2012.
 
9.
Weinstein N, Brown K, Ryan R. A multi-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. J Res Personal. 2009; 43: 374-385.
 
10.
Carroll L. Active Coping. In: Encyclopedia of Behavioral Medicine. Gellman MD (ed.). Springer, Cham 2020.
 
11.
Baluwa MA, Lazaro M, Mhango L, Msiska G. Stress and coping strategies among malawian undergraduate nursing students. Adv Med Educ Pract. 2021; 12: 547-556.
 
12.
Ogińska-Bulik N, Kobylarczyk M. Relation between resiliency and post-traumatic growth in a group of paramedics: the mediating role of coping strategies. Int J Occup Med Environ Health. 2015; 28(4): 707-719.
 
13.
Wojcieszek A, Nawalana A, Majda A. Intensity of the stress and coping strategies in the group of the Małopolska officers from the State Fire Service. Nurs Probl. 2017; 25(1): 49-55.
 
14.
Woszczyk S, Domagalska J, Żelazko A, Nowak P. Stres i sposoby radzenia sobie z nim przez policjantów i strażaków. Bezpieczeństwo Pracy Nauka i Praktyka. 2016; 10: 11-15.
 
15.
Katinić M, Puljak L, Čivljak M. Emotional intelligence and degree of education of healthcare professionals in emergency medicine. Psychiatr Danub. 2022; 34 (Suppl 10): 24-33.
 
16.
Fteiha M, Awwad N. Emotional intelligence and its relationship with stress coping style. Health Psychol Open. 2020; 7(2): 2055102920970416.
 
17.
Díaz-Tamayo AM, Escobar-Morantes JR, García-Perdomo HA. Coping strategies for exposure to trauma situations in first responders: a systematic review. Prehosp Disaster Med. 2022; 37(6): 810-818.
 
18.
Rathert C, Fleming DA. Hospital ethical climate and teamwork in acute care: the moderating role of leaders. Health Care Manage Rev. 2008; 33(4): 323-331.
 
19.
Li G, Li L, Xie L, Lopez OS. The effects of ethical leadership on creativity: a conservation of resources perspective. Curr Psychol. 2024; 43: 1-11.
 
20.
Mayo AT, Williams Woolley A. Teamwork in health care: maximizing collective intelligence via inclusive collaboration and open communication. AMA J Ethics. 2016; 18(9): 933-940.
 
21.
Si X, Xue H, Song X, Liu X, Zhang F. The relationship between ethical leadership and nurse well-being: the mediating role of workplace mindfulness. J Adv Nurs. 2023; 79: 4008-4021.
 
22.
Cakir MS, Wardman JK, Trautrims A. Ethical leadership supports safety voice by increasing risk perception and reducing ethical ambiguity: evidence from the COVID-19 pandemic. Risk Analysis. 2023; 43: 1902-1916.
 
23.
Ali Awad NH, Al-Anwer Ashour HM. Crisis, ethical leadership and moral courage: ethical climate during COVID-19. Nurs Ethics. 2022; 29(6): 1441-1456.
 
24.
Keselman D, Saxe-Braithwaite M. Authentic and ethical leadership during a crisis. Healthc Manage Forum. 2021; 34(3): 154-157.
 
25.
Carne B, Kennedy M, Gray T. Review article: Crisis resource management in emergency medicine. Emerg Med Australas. 2012; 24(1): 7-13..
 
26.
Bleetman A, Sanusi S, Dale T, Brace S. Human factors and error prevention in emergency medicine. Emerg Med J. 2012; 29(5): 389-393.
 
27.
Greiner AM, Kaldjian LC. Rethinking medical oaths using the Physician Charter and ethical virtues. Med Educ. 2018; 52(8): 826-837.
 
28.
Hajar R. The physician’s oath: historical perspectives. Heart Views. 2017; 18(4): 154-159.
 
29.
Zhan T, Yao Y. [A preliminary study of Dao gao yao huang shi shu (Oath of Praying for the King of Medicine), a Chinese version of Hippocratic Oath]. Zhonghua Yi Shi Za Zhi. 2018; 48(6): 342-345. Chinese.
 
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