Search Advanced

AIMS Public Health

2026, Volume 13, Issue 2: 573-588. doi: 10.3934/publichealth.2026030
Previous Article Next Article
Research article

Association between workplace gaslighting, mental health and work life in nurses: a cross-sectional study in Greece

  • 1.
    Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
  • 2.
    Department of Nursing, University of Thessaly, Larissa, Greece
  • 3.
    Faculty of Nursing, University of West Attica, Athens, Greece
  • 4.
    Andreas Syggros Hospital of Cutaneous and Venereal Diseases, Athens, Greece
  • Published: 11 May 2026
  • Background 

    Workplace gaslighting is an alarming issue. However, the negative consequences of workplace gaslighting in nurses are unknown. In this context, our aim was to examine the association between workplace gaslighting and nurses' mental health and work life.

    Methods 

    We conducted an online cross-sectional study in Greece during December 2024. We employed a convenience sample of nurses. We used the Gaslighting at Work Scale (GWS) to measure levels of workplace gaslighting among our nurses. We used the Patient Health Questionnaire-4, the Quiet Quitting Scale, and the Utrecht Work Engagement Scale-3 to measure anxiety-like symptoms, depressive-like symptoms, quiet quitting, and work engagement, respectively.

    Results 

    The study population included 369 nurses with a mean age of 37.86 years. We found a positive association between workplace gaslighting, anxiety-like symptoms, and depressive-like symptoms in our nurses. After adjustment for confounders, we found a positive association between GWS scores and anxiety-like symptoms (adjusted b = 0.758, 95% CI = 0.606 to 0.909, p < 0.001), and depressive-like symptoms (adjusted b = 0.720, 95% CI = 0.555 to 0.885, p < 0.001). Moreover, our multivariable models showed a positive association between GWS scores and quiet quitting (adjusted b = 0.258, 95% CI = 0.186 to 0.330, p < 0.001). Also, we found a negative association between GWS scores and work engagement (adjusted b = −0.353, 95% CI = −0.512 to −0.195, p < 0.001).

    Conclusions 

    Our findings suggest that nurses who experience higher levels of gaslighting from their supervisors have more anxiety-like symptoms and depressive-like symptoms. Moreover, workplace gaslighting is associated with quiet quitting and work engagement. However, considering the cross-sectional nature of our study and the study limitations, further research should be conducted to extract more valid results.

    Citation: Aglaia Katsiroumpa, Ioannis Moisoglou, Olympia Konstantakopoulou, Parisis Gallos, Maria Rekleiti, Petros Galanis. Association between workplace gaslighting, mental health and work life in nurses: a cross-sectional study in Greece[J]. AIMS Public Health, 2026, 13(2): 573-588. doi: 10.3934/publichealth.2026030

    Related Papers:

  • Background 

    Workplace gaslighting is an alarming issue. However, the negative consequences of workplace gaslighting in nurses are unknown. In this context, our aim was to examine the association between workplace gaslighting and nurses' mental health and work life.

    Methods 

    We conducted an online cross-sectional study in Greece during December 2024. We employed a convenience sample of nurses. We used the Gaslighting at Work Scale (GWS) to measure levels of workplace gaslighting among our nurses. We used the Patient Health Questionnaire-4, the Quiet Quitting Scale, and the Utrecht Work Engagement Scale-3 to measure anxiety-like symptoms, depressive-like symptoms, quiet quitting, and work engagement, respectively.

    Results 

    The study population included 369 nurses with a mean age of 37.86 years. We found a positive association between workplace gaslighting, anxiety-like symptoms, and depressive-like symptoms in our nurses. After adjustment for confounders, we found a positive association between GWS scores and anxiety-like symptoms (adjusted b = 0.758, 95% CI = 0.606 to 0.909, p < 0.001), and depressive-like symptoms (adjusted b = 0.720, 95% CI = 0.555 to 0.885, p < 0.001). Moreover, our multivariable models showed a positive association between GWS scores and quiet quitting (adjusted b = 0.258, 95% CI = 0.186 to 0.330, p < 0.001). Also, we found a negative association between GWS scores and work engagement (adjusted b = −0.353, 95% CI = −0.512 to −0.195, p < 0.001).

    Conclusions 

    Our findings suggest that nurses who experience higher levels of gaslighting from their supervisors have more anxiety-like symptoms and depressive-like symptoms. Moreover, workplace gaslighting is associated with quiet quitting and work engagement. However, considering the cross-sectional nature of our study and the study limitations, further research should be conducted to extract more valid results.


    Abbreviations

    ANOVA

    analysis of variance

         CI

    confidence interval

         GWS

    Gaslighting at Work Scale

         PHQ-4

    Patient Health Questionnaire-4

         QQS

    Quiet Quitting Scale

         SD

    standard deviation

         STROBE

    Strengthening the Reporting of Observational Studies in Epidemiology

         UWES-3

    Utrecht Work Engagement Scale-3
    加载中


    Ethics approval and consent to participate


    We conducted our study in accordance with the Declaration of Helsinki [52]. Moreover, the Ethics Committee of the Faculty of Nursing, National and Kapodistrian University of Athens, approved our study protocol (approval number: 15, December 9, 2024). We collected our data on an anonymous and voluntary basis. We informed participants about the aim and the design of our study, and they gave their informed consent.

    Availability of data and materials


    The original data presented in the study are openly available in FigShare at https://doi.org/10.6084/m9.figshare.28868615.v1.

    Authors' contributions


    AK, Pe. G, and IM conceptualized the study and designed the work. AK, Pe. G, IM, OK, Pa. G, and MR contributed to the acquisition of the data. Pe. G, OK, and Pa. G participated in the analysis of the data and software handling. AK, IM, and Pe. G drafted the work and substantively revised it. All authors have read and agreed to the submitted version of the manuscript. All authors have agreed both to be personally accountable for their own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

    Conflict of interest


    Petros Galanis is an editorial board member for AIMS Public Health. Petros Galanis and Ioannis Moisoglou are the guest editors for a special issue of AIMS Public Health, and they were not involved in the editorial review or the decision to publish this article. All authors declare no conflicts of interest in this paper.

    [1] Stern R The gaslight effect: How to spot and survive the hidden manipulation others use to control your life, Harmony (2018).
    [2] Britannica | Gaslighting | Definition, Origins, & Fact. [cited 2025 February 27]. Available from: https://www.britannica.com/topic/gaslighting
    [3] Klein W, Li S, Wood S (2023) A qualitative analysis of gaslighting in romantic relationships. Pers Relatsh 30: 1316-1340. https://doi.org/10.1111/pere.12510
    [4] Bui THT, Nguyen TNN, Hoang MA, et al. (2026) Exploring gaslighting experience and authenticity in romantic relationships among Vietnamese young adults. Int J Adv Counselling 48: 8. https://doi.org/10.1007/s10447-025-09619-x
    [5] March E, Kay CS, Dinić BM, et al. (2025) “It's all in your head”: Personality traits and gaslighting tactics in intimate relationships. J Fam Viol 40: 259-268. https://doi.org/10.1007/s10896-023-00582-y
    [6] Fraser S (2021) The toxic power dynamics of gaslighting in medicine. Can Fam Physician 67: 367-368. https://doi.org/10.46747/cfp.6705367
    [7] Donati Law, PLLCCan I Sue My Employer for Gaslighting? (2023). [cited 2025 February 27]. Available from: https://www.donatilaw.com/blog2/2023/august/is-gaslighting-illegal-at-work-/
    [8] Scholkmann F, May CA (2023) COVID-19, post-acute COVID-19 syndrome (PACS, “long COVID”) and post-COVID-19 vaccination syndrome (PCVS, “post-COVIDvac-syndrome”): Similarities and differences. Pathol Res Pract 246: 154497. https://doi.org/10.1016/j.prp.2023.154497
    [9] Gillie G, Bokek-Cohen Y (2025) Gaslighting of Inpatients—A threat to nursing care and a violation of relational autonomy. Nurs Ethics 32: 2257-2269. https://doi.org/10.1177/09697330251331194
    [10] Fink-Samnick E (2025) Medical gaslighting's universal truth. Prof Case Manag 30: 111-115. https://doi.org/10.1097/NCM.0000000000000796
    [11] Moisoglou I, Katsiroumpa A, Katsapi A, et al. (2025) Poor nurses' work environment increases quiet quitting and reduces work engagement: a cross-sectional study in Greece. Nurs Rep 15: 19. https://doi.org/10.3390/nursrep15010019
    [12] De Luca R, Bonanno M, Maggio MG, et al. (2024) Compassion fatigue in a cohort of south italian nurses and hospital-based clinical social workers following COVID-19: A cross-sectional survey. J Clin Med 13: 4200. https://doi.org/10.3390/jcm13144200
    [13] López-López IM, Gómez-Urquiza JL, Cañadas GR, et al. (2019) Prevalence of burnout in mental health nurses and related factors: a systematic review and meta-analysis. Int J Mental Health Nurs 28: 1035-1044. https://doi.org/10.1111/inm.12606
    [14] Zabin LM, Zaitoun RSA, Sweity EM, et al. (2023) The relationship between job stress and patient safety culture among nurses: a systematic review. BMC Nurs 22: 39. https://doi.org/10.1186/s12912-023-01198-9
    [15] Lessi L, De Barbieri I, Danielis M (2025) Addressing nursing resignation: insights from qualitative studies on nurses leaving healthcare organisations and the profession. J Adv Nurs 81: 2290-2315. https://doi.org/10.1111/jan.16546
    [16] Pitfield C, Shahriyarmolki K, Livingston G (2011) A systematic review of stress in staff caring for people with dementia living in 24-hour care settings. Int Psychogeriatr 23: 4-9. https://doi.org/10.1017/S1041610210000542
    [17] Galanis P, Vraka I, Fragkou D, et al. (2021) Nurses' burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis. J Adv Nurs 77: 3286-3302. https://doi.org/10.1111/jan.14839
    [18] Marshman C, Hansen A, Munro I (2022) Compassion fatigue in mental health nurses: A systematic review. Psychiatric Ment Health Nurs 29: 529-543. https://doi.org/10.1111/jpm.12812
    [19] Haji Matarsat HM, Rahman HA, Abdul-Mumin K (2021) Work-family conflict, health status and job satisfaction among nurses. Br J Nurs 30: 54-58. https://doi.org/10.12968/bjon.2021.30.1.54
    [20] Ghahramani S, Kasraei H, Hayati R, et al. (2023) Health care workers' mental health in the face of COVID-19: a systematic review and meta-analysis. Int J Psychiatry Clin Pract 27: 208-217. https://doi.org/10.1080/13651501.2022.2101927
    [21] Sweet PL (2019) The sociology of gaslighting. Am Sociol Rev 84: 851-875. https://doi.org/10.1177/0003122419874843
    [22] Moisoglou I, Katsiroumpa A, Konstantakopoulou O, et al. (2025) Workplace gaslighting is associated with nurses' job burnout and turnover intention in Greece. Healthcare 13: 1574. https://doi.org/10.3390/healthcare13131574
    [23] El-Sayed AAI, Alsenany SA, Atta MHR, et al. (2025) Navigating toxicity: investigating the interplay between workplace gaslighting, workaholism, and agility among nurses. Nurs Inq 32: e12697. https://doi.org/10.1111/nin.12697
    [24] Atta MHR, Waheed Elzohairy N, Abd Elaleem AEDMH, et al. (2024) Comprehending the disruptive influence of workplace gaslighting behaviours and mobbing on nurses' career entrenchment: A multi-centre inquiry. J Adv Nurs 81: 1815-1828. https://doi.org/10.1111/jan.16368
    [25] Moisoglou I, Katsiroumpa A, Papathanasiou IV, et al. (2026) Association between workplace gaslighting and perceived quality of care, patient safety and quiet quitting: a cross-sectional study among nurses in Greece. Healthcare 14: 450. https://doi.org/10.3390/healthcare14040450
    [26] Lipman-Blumen J (2006) The Allure of Toxic Leaders: Why We Follow Destructive Bosses and Corrupt Politicians--And How We Can Survive Them. Cary: Oxford University Press USA – OSO.
    [27] Padilla A, Hogan R, Kaiser RB (2007) The toxic triangle: Destructive leaders, susceptible followers, and conducive environments. Leadersh Q 18: 176-194. https://doi.org/10.1016/j.leaqua.2007.03.001
    [28] Kiazad K, Restubog SLD, Zagenczyk TJ, et al. (2010) In pursuit of power: The role of authoritarian leadership in the relationship between supervisors' Machiavellianism and subordinates' perceptions of abusive supervisory behavior. J Res Pers 44: 512-519. https://doi.org/10.1016/j.jrp.2010.06.004
    [29] Akinyele AI, Chen Z (2025) Dark clouds of leadership: causes and consequences of toxic leadership. Int Stud Manag Organ 55: 476-503. https://doi.org/10.1080/00208825.2024.2442185
    [30] Sarsenbay Z, Murat A, Kamzayeva T, et al. (2025) Nurse managers' toxic leadership behaviors and their influence on nurses' quality of life: a cross-sectional study. J Nurs Manag 2025: 6862124. https://doi.org/10.1155/jonm/6862124
    [31] Labrague LJ (2024) Linking toxic leadership with work satisfaction and psychological distress in emergency nurses: the mediating role of work-family conflict. J Emerg Nurs 50: 670-678. https://doi.org/10.1016/j.jen.2023.11.008
    [32] Celebi Cakiroglu O, Tuncer Unver G (2024) Toxic leadership, mental well-being and work engagement among nurses: a scale adaptation study and structural equation model approach. J Health Organ Manag 38: 49-69. https://doi.org/10.1108/JHOM-10-2022-0291
    [33] Koç O, Şahin H, Öngel G, et al. (2022) Examining nurses' vengeful behaviors: the effects of toxic leadership and psychological well-being. Behav Sci (Basel) 12: 452. https://doi.org/10.3390/bs12110452
    [34] Ofei AMA, Paarima Y, Barnes T, et al. (2022) Toxic leadership behaviour of nurse managers on perceived job satisfaction and productivity of nursing workforce in sub-Saharan Ghana: A multi-centre cross-sectional study. J Nursing Management 30: 2733-2742. https://doi.org/10.1111/jonm.13741
    [35] Alsadaan N, Alqahtani M (2024) Toxic leadership in emergency nurses: assessing abusive supervision and its team-level impacts on conflict management and organizational commitment. J Nurs Manag 2024: 1-11. https://doi.org/10.1155/2024/4271602
    [36] Hossny EK, Alotaibi HS, Mahmoud AM, et al. (2023) Influence of nurses' perception of organizational climate and toxic leadership behaviors on intent to stay: A descriptive comparative study. Int J Nurs Stud Adv 5: 100147. https://doi.org/10.1016/j.ijnsa.2023.100147
    [37] Tsapnidou E, Moudatsou M, Katharakis G, et al. (2025) The impact of toxic leadership on nurse retention: a scoping review. Healthcare 13: 2341. https://doi.org/10.3390/healthcare13182341
    [38] Türkmen Keskin S, Özduyan Kiliç M (2024) Investigation of the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions. J Adv Nurs 80: 1859-1867. https://doi.org/10.1111/jan.15951
    [39] Mrayyan MT (2026) Effects of nursing leaders' toxic leadership on nurses' workplace satisfaction, job engagement, and turnover intention: an online cross-sectional study. J Adv Nurs 82: 522-539. https://doi.org/10.1111/jan.16923
    [40] Tawfik AF, El-Ashry AM, Atalla ADG, et al. (2025) Toxic leadership and quality of work life: the moderating role of nurses' agility. BMC Nurs 24: 1172. https://doi.org/10.1186/s12912-025-03776-5
    [41] Labrague LJ (2024) Toxic leadership and its relationship with outcomes on the nursing workforce and patient safety: a systematic review. Leadersh Health Serv (Bradf Engl) 37: 192-214. https://doi.org/10.1108/LHS-06-2023-0047
    [42] Labrague LJ (2021) Influence of nurse managers' toxic leadership behaviours on nurse-reported adverse events and quality of care. J Nurs Manag 29: 855-863. https://doi.org/10.1111/jonm.13228
    [43] Farghaly Abdelaliem SM, Abou Zeid MAG (2023) The relationship between toxic leadership and organizational performance: the mediating effect of nurses' silence. BMC Nurs 22: 4. https://doi.org/10.1186/s12912-022-01167-8
    [44] Von Elm E, Altman DG, Egger M, et al. (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61: 344-349. https://doi.org/10.1016/j.jclinepi.2007.11.008
    [45] Katsiroumpa A, Moisoglou I, Konstantakopoulou O, et al. (2025) The gaslighting at work scale: Development and initial validation. J Workplace Behav Health 2025: 1-23. https://doi.org/10.1080/15555240.2025.2539157
    [46] Kroenke K, Spitzer RL, Williams JBW, et al. (2009) An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics 50: 613-621. https://doi.org/10.1176/appi.psy.50.6.613
    [47] Karekla M, Pilipenko N, Feldman J (2012) Patient Health Questionnaire: Greek language validation and subscale factor structure. Compr Psychiatry 53: 1217-1226. https://doi.org/10.1016/j.comppsych.2012.05.008
    [48] Galanis P, Katsiroumpa A, Vraka I, et al. (2023) The quiet quitting scale: Development and initial validation. AIMS Public Health 10: 828-848. https://doi.org/10.3934/publichealth.2023055
    [49] Galanis P, Moisoglou I, Katsiroumpa A, et al. (2024) Association between workplace bullying, job stress, and professional quality of life in nurses: a systematic review and meta-analysis. Healthcare 12: 623. https://doi.org/10.3390/healthcare12060623
    [50] Schaufeli WB, Shimazu A, Hakanen J, et al. (2019) An ultra-short measure for work engagement: The UWES-3 validation across five countries. Eur J Psychol Assess 35: 577-591. https://doi.org/10.1027/1015-5759/a000430
    [51] Katsiroumpa A, Moisoglou I, Kalogeropoulou M, et al. (2024) Utrecht work engagement scale (3 items version): translation and validation in Greek. Int J Caring Sci 17: 1342-1349. https://doi.org/10.31219/osf.io/8dx3s
    [52] World Medical Association.World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA (2013) 310: 2191-2194. https://doi.org/10.1001/jama.2013.281053
    [53] Galvão RKH, Araújo MCU (2009) Variable Selection. Comprehensive Chemometrics . Elsevier 233-283. https://doi.org/10.1016/B978-044452701-1.00075-2
    [54] Qin N, Yao Z, Guo M (2023) The role of bidirectional associations between depression, anxiety, and emotional exhaustion on turnover intention among nurses: a multicenter cross-sectional study in China. BMC Nurs 22: 350. https://doi.org/10.1186/s12912-023-01516-1
    [55] Yuan Z, Wang J, Feng F, et al. (2023) The levels and related factors of mental workload among nurses: A systematic review and meta-analysis. Int J Nurs Pract 29: e13148. https://doi.org/10.1111/ijn.13148
    [56] Xie W, Chen L, Feng F, et al. (2021) The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis. Int J Nurs Stud 120: 103973. https://doi.org/10.1016/j.ijnurstu.2021.103973
    [57] Galanis P, Moisoglou I, Katsiroumpa A, et al. (2024) Impact of workplace bullying on quiet quitting in nurses: the mediating effect of coping strategies. Healthcare 12: 797. https://doi.org/10.3390/healthcare12070797
    [58] Modaresnezhad M, Andrews MC, Mesmer-Magnus J, et al. (2021) Anxiety, job satisfaction, supervisor support and turnover intentions of mid-career nurses: A structural equation model analysis. J Nurs Manag 29: 931-942. https://doi.org/10.1111/jonm.13229
    [59] Galanis P, Katsiroumpa A, Vraka I, et al. (2024) Nurses quietly quit their job more often than other healthcare workers: An alarming issue for healthcare services. Int Nurs Rev 71: 850-859. https://doi.org/10.1111/inr.12931
    [60] Fernandopulle N (2021) To what extent does hierarchical leadership affect health care outcomes?. Med J Islam Republ Iran 35: 117. https://doi.org/10.47176/mjiri.35.117
    [61] Moisoglou I, Katsiroumpa A, Konstantakopoulou O, et al. (2025) Workplace gaslighting: implications for employees' mental health and work life in Greece. Healthcare 13: 3255. https://doi.org/10.3390/healthcare13243255
    [62] Vanalli M, Cesare M, Cocchieri A, et al. (2023) Natural language processing and string metric-assisted assessment of semantic heterogeneity method for capturing and standardizing unstructured nursing activities in a hospital setting: a retrospective study. Ann Ig 35: 3-20. https://doi.org/10.7416/ai.2022.2517
  • Reader Comments
  • © 2026 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索
AIMS Public Health
2.7 5.3

Metrics

Article views(230) PDF downloads(34) Cited by(0)

Preview PDF
Download XML
Export Citation
Article outline

Figures and Tables

Tables(4)

Other Articles By Authors

Related pages

Tools

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog