Entrepreneurial Leadership and Sustainable Development Behavior: A Moderation–Mediation Model of Sustainable Leadership and Team Psychological Safety

Abstract

Introduction: Nursing leadership is pivotal for sustainable healthcare, yet the interplay of entrepreneurial leadership (EL), sustainable leadership (SL), team psychological safety (TPS), and sustainable development behavior (SDB) remained underexplored, particularly in resource-constrained hierarchical contexts such as Egyptian nursing. Objectives: This study investigated how EL promoted SDB by examining the mediating role of TPS and the moderating effect of SL based on job demands-resources and social cognitive theories, in alignment with the United Nations Sustainable Development Goals (SDGs). Methods: A quantitative cross-sectional design was employed, utilizing data collected from an administered survey. A convenience sample of 318 nurses from different university hospitals participated in the study. Descriptive statistics and inferential techniques, such as Pearson’s correlation, multiple regression, and moderation-mediation analyses, were used to analyze the data. Results: Nurses exhibited strong positive associations among EL, SL, TPS, and SDB, collectively accounting for substantial variance in sustainable behaviors. TPS partially mediated the EL-SDB pathway, explaining a meaningful portion of the effect, while SL significantly moderated this relationship, amplifying EL’s influence under high sustainable leadership conditions. Conclusions: By integrating entrepreneurial innovation with ethical sustainability and psychological safety, this model addresses critical gaps in the impact of relational leadership on workforce behavior, team resilience, and patient-centered outcomes in global health systems. Practically, nurse training programs should emphasize EL-SL synergies and TPS cultivation to embed SDG-aligned practices, such as eco-friendly care protocols and interdisciplinary collaboration.