Journal of Modern Medical

Introduction
Competent, committed and motivated employees are the main key to providing quality services in organizations. Organizations and managers should know that human capital is the most valuable asset of the organization. Today, one of the challenges facing organizations is pessimism. Cynicism is the tendency to consider self-interests as the main motivator and do not believe in the purity of intentions, human virtue and altruism. This negative attitude has infiltrated many organizations and is the main reason for many unfavorable and negative organizational consequences and one of the problematic issues in the organization.
Another factor is organizational silence, which refers to employees’ refusal to comment on organizational and management problems [22], and it occurs when supervisors or leaders misbehave with their coworkers [24]. Organizational silence does not only mean not speaking, but also means not writing and not listening to each other [26]. In recent years, much attention has been drawn to the dark or destructive side of leadership. The increase in repetition of destructive behaviors of leaders and the important effects of these behaviors on individual and organizational outcomes in the workplace is the most important reason for paying attention to the dark side of leadership [17]. 
Therefore, the present study aims to investigate the effect of narcissistic leadership style on employee cynicism with the mediating role of employee silence and workplace gossip.

Methods
This is a descriptive cross-sectional study. The study population consists of the headquarters staff of Dr. Gharazi Hospital in Isfahan, Iran (n=150). Using Cochran’s formula, the sample size was determined 108, and samples were selected by a simple random sampling method. To collect data, the narcissism scale by Hochwarter & Thompson (2012) [44, 46], the employee silence scale by Tangirala and Ramanujam (2008) [47], the organizational cynicism scale by Dean et al. (2009) [48], and the workplace gossip scale by Kuo et al. (2015) [49] were used. To analyze the data, descriptive statistics (Mean±standard deviation) and structural equation modeling (SEM) method were used in SPSS software, version 25 and SmartPLS software, version 4.

Results
Participants included 103 (95.4%) men and 5 (4.6%) women. Eight people (7.4%) had a high school diploma, 58 (53.7%) had a associate or bachelor’s degree, and 42 (38.9%) had a master’s degree or higher. Nine people (8.3%) were less than 30 years old, 39 (36.1%) aged 30-40 years, 37 (34.3%) aged 40-50 years, and 23 (21.3%) aged over 50 years. In the current research, according to the hypotheses, the model is presented in the significant mode (Figure 1) and the standard mode (Figure 2).



The first hypothesis in the present study was that narcissistic leadership has an effect on employee cynicism with the mediating role of employee silence. The results showed that the t value was 4.445 (outside the range [−1.96, 1.96]) and the standardized path coefficient was 0.147 (P<0.001). Therefore, the first hypothesis was confirmed.



The second hypothesis was that narcissistic leadership style has an effect on employee cynicism with the mediating role of workplace gossip. The results showed that the t value was 3.950 (outside the range [−1.96, 1.96]) and the standardized path coefficient was 0.135 (P<0.001). Therefore, the second hypothesis was also confirmed.
The third hypothesis was that narcissistic leadership style has an effect on workplace gossip. The results showed that the t value was 8.362 (outside the range [−1.96, 1.96]) and the standardized path coefficient was 0.534 (P=0.001). Therefore, the third hypothesis was also confirmed.

Conclusion
The leadership style in an organization is effective on the performance of that organization. Paying attention to the leadership style is important for the quantitative and qualitative improvement of the organization. Based on the results of the present study, narcissistic leadership style in a hospital can affect employee cynicism with the mediating role of employee silence and workplace gossip. The effects of employee silence and workplace gossip on employee cynicism are also positive and significant. Therefore, it is recommended to use qualitative methods to examine the barriers to effective leadership in the hospitals in Iran, especially teaching hospitals. This study had some limitations such as the use of a self-report for collecting information and the short duration of study due to the high workload and working conditions in the hospitals.

Ethical Considerations

Compliance with ethical guidelines
This study was approved by the Ethics Committee of Payame Noor University, Natanz Branch (Code: IR.REC.PNU.1401.77070). 

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors' contributions
Supervision of research implementation, and Data analysis: Farshid Aslani; Research execution: Atefeh Heshmatzadeh; Writing an article and submitting an article: Farshid Aslani, Atefeh Heshmatzadeh, and Marziyeh Malekieh.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
We hereby express our thanks and appreciation to the directorate, management and all the staff of Shahid Gharehi Hospital.




 

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