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Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review
Abstract
Background:
Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments.
Methods:
The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers.
Results:
A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes.
Conclusions:
The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to enhance nursing job satisfaction, retention, work environment factors and individual productivity within healthcare settings.
... Healthcare managers demonstrate various leadership styles aiming at contributing to their organizations. Classic (situational/let them do) and contemporary leadership (operational/transformational) styles are common samples (Cummings et al. 2018). In this context, this study aimed to reveal the relationship between nurses' perceived leadership behaviours and hospital safety culture and the factors affecting them. ...
... Healthcare managers also demonstrate various leadership styles aiming at contributing to their organizations. Classic (situational/let them do) and contemporary leadership (operational/transformational) styles are common samples (Cummings et al. 2018;Sfantou et al. 2017). However, not every manager can show temporary leadership styles. ...
... Task-oriented leaders are concerned with the quality of service and focus on achieving goals and ensuring employees achieve their goals. Studies have found that task-oriented leadership supports structure, coordination, clarification of roles and monitoring of operations (Cummings et al. 2018). Managers who shows task-oriented leadership style can improve patient safety because they constantly follows up the process of work activities and makes an effort for productive performance. ...
Background
Work environments that support patient safety initiatives are important for quality service and patient outcomes. The relationship between the leadership behaviours of nurse managers and safety culture, which has the potential to support these initiatives, constitutes one of the most important knowledge gaps.
Objectives
The study aimed to determine the relationship between nurses' perceived leadership behaviours and hospital safety culture and the factors affecting them.
Design
We tested the theoretical model using structural equation modelling with the AMOS 21 program.
Methods
The research was conducted with 134 nurses in two public hospitals in the south of Türkiye. Data were collected between October and December 2021 using the Leadership Behaviour Questionnaire and the Patient Safety Culture Hospital Questionnaire. Descriptive statistical analysis used to evaluate the data of the study. Structural equation modelling analysis and confirmatory factor analysis performed to test the research hypotheses.
Results
The study found that non‐punitive attitudes towards the mistakes had a full mediating effect on overall perception of safety interaction with employee‐oriented leadership and high‐level hospital interventions (β = −0.510, 95% CI −1.006/−0.076), and change had partly mediating effect on overall perception of safety interaction with change‐oriented leadership (β = −0.510, 95% CI −1.043/−0.053).
Conclusions
It is clear that if nurse managers are to improve the staff's patient safety culture, they should develop change‐oriented leadership skills by identifying adverse events and risks and motivating staff to learn from errors without taking punitive measures. In this context, healthcare organizations should evaluate the leadership qualities of managers. Managers at all levels can make plans to develop leadership behaviours that will play a facilitating role in improving patient safety.
... Flexible and contemporary leadership models, such as resonant and authentic, contribute to worker and patient satisfaction (Cummings et al. 2018) and to health system performance by improving quality and efficiency through supporting positive perceptions of the safety climate (Wong, Cummings, and Ducharme 2013;Dirik and Seren Intepeler 2017). Authentic leadership refers to leaders with deep self-awareness of their beliefs, behaviours and values that enhance effective outcomes in healthcare organisations (Avolio et al. 2004;Sfantou et al. 2017;Cummings et al. 2018) and increase positive perceptions of safety climate (Dirik and Seren Intepeler 2017;Cummings et al. 2018;Mrayyan et al. 2023). ...
... Flexible and contemporary leadership models, such as resonant and authentic, contribute to worker and patient satisfaction (Cummings et al. 2018) and to health system performance by improving quality and efficiency through supporting positive perceptions of the safety climate (Wong, Cummings, and Ducharme 2013;Dirik and Seren Intepeler 2017). Authentic leadership refers to leaders with deep self-awareness of their beliefs, behaviours and values that enhance effective outcomes in healthcare organisations (Avolio et al. 2004;Sfantou et al. 2017;Cummings et al. 2018) and increase positive perceptions of safety climate (Dirik and Seren Intepeler 2017;Cummings et al. 2018;Mrayyan et al. 2023). Safety climates refer to the shared perception of workplace policies, processes, procedures and practices that shape how safety is prioritised and addressed within the workplace in an organisation (Zohar 2011). ...
... Flexible and contemporary leadership models, such as resonant and authentic, contribute to worker and patient satisfaction (Cummings et al. 2018) and to health system performance by improving quality and efficiency through supporting positive perceptions of the safety climate (Wong, Cummings, and Ducharme 2013;Dirik and Seren Intepeler 2017). Authentic leadership refers to leaders with deep self-awareness of their beliefs, behaviours and values that enhance effective outcomes in healthcare organisations (Avolio et al. 2004;Sfantou et al. 2017;Cummings et al. 2018) and increase positive perceptions of safety climate (Dirik and Seren Intepeler 2017;Cummings et al. 2018;Mrayyan et al. 2023). Safety climates refer to the shared perception of workplace policies, processes, procedures and practices that shape how safety is prioritised and addressed within the workplace in an organisation (Zohar 2011). ...
Aim
To analyse the relationship between authentic nursing leadership and safety climates across hospital settings during the COVID‐19 pandemic.
Background
Authentic nursing leadership shapes the safety climate by fostering positive perceptions of workplace policies, processes, procedures and practices that influence how safety is prioritised and addressed within an organisation.
Design
A cross‐sectional study.
Methods
Our study was conducted from December 2021 to December 2022 in six Brazilian hospitals. Participants were nursing staff working in General Medicine Units, Intensive Care Units (ICU) and Emergency Departments (ED) who provided care to patients with COVID‐19. The Authentic Leadership Questionnaire and the Safety Attitudes Questionnaire were used to measure nursing staff perceptions of authentic leadership and safety climates. Data were analysed using descriptive and inferential statistics.
Results
391 nursing staff across six hospitals participated. Self‐awareness significantly enhanced perceptions of the safety climates. Additionally, being a Registered Nurse and working in the ICU were positively associated with achieving safe climates in the working environment. In contrast, working in EDs was significantly negatively related to safety climates.
Conclusions
The COVID‐19 pandemic underscored a lack of authentic nursing leadership and unsafe climates. Therefore, it is critical to implement educational strategies that foster authentic leadership, particularly focusing on self‐awareness, to promote more positive safety climates. Ensuring that leadership and safety climates are relationship‐focused is critical to enhancing patient outcomes.
Implications for the Profession and/or Patient Care
Nursing staff's perceptions of authentic leadership and safety climates are important in making more informed decisions about patient management.
Impact
Since self‐awareness increases positive perceptions of safety climates, nursing staff should exercise it to guide their actions in facing future health crises.
Reporting Method
STROBE guidelines.
Patient or Public Contribution
Higher self‐awareness in relationships with others is a predictor of safety climates and can lead to enhanced patient outcomes.
... With a global shortage within the nursing workforce [1], and reports of a strained work situation in hospitals worldwide [2], there is a need for a further understanding of nursing staffs' work life experiences to enable improved working conditions, staff well-being, and the quality of care. The first-line managers (FLMs) are in a key position to influence the work life experiences of nursing staff through their management and leadership [3][4][5]. With their ability to give staff access to necessary prerequisites to perform their work [6,7], they are also in a key position to improve the quality of the care [8,9]. ...
... Research in nursing has also presented evidence regarding the influence of leadership on the quality of care [34] and the well-being of nursing staff [3]. Statistically significant relationships between leadership and the quality of care assessed by both the nursing staff [29] and the patients [35] has been found in previous research. ...
... Positively significant relationships have Lundin et al. BMC Health Services Research (2024) 24:1491 been shown with leadership styles characterized as being relational oriented [3]. Negatively significant relationships have been found when hospital nursing staff have reported the leadership behavior of their managers to be, as defined by Labrague, toxic [36,37]. ...
Background
Leadership and access to structural empowerment are known to influence the work life experiences of staff and quality of care. Knowledge about relationships between specific factors of structural empowerment, leadership and management, staff well-being and quality of care at both an individual and unit level is scarce.
Aim
To study the relationship between staff-rated access to empowering structures, leadership and management performance, well-being, and quality of care in hospital settings measured at the individual level and aggregated at the unit level.
Methods
A cross-sectional correlative design was applied. Questionnaire data from 331 randomized hospital nursing staff working at 38 units in 25 hospitals in Sweden were analyzed using bivariate correlations and general estimation equation (GEE) models.
Results
Results from the bivariate analysis of relationships confirmed earlier research. In the GEE models, some unexpected results were found and differences between the individual and unit levels. Adding management and leadership as independent factors in the second model showed few relationships of significance to the outcome variables.
Conclusion
Results confirm the importance of staff access to empowering structures in relation to well-being and quality of care. Differences and similarities were shown when studying these relationships at both the individual and unit level. The findings feature implications for hospital management to promote staff access to empowering structures. The findings provide information on how these structures relate to the individual and the unit; information that could be useful when planning or implementing strategies with the aim to promote staff well-being and care quality. The non-significant results for leadership and management in relation to staff outcomes in the GEE-models, raise questions for further research where a shift from individual to organizational focused performances within the field of leadership is implied.
... Hence, to prevent employee ill-health in home-care work, it is crucial to examine the existence of modifiable or promotable work environmental factors that can buffer potential detrimental effects of emotional dissonance on mental health. Leadership, defined as the process whereby an individual influences a group of individuals to achieve a common goal (16), is one factor that is considered amenable to strategic interventions and frequently studied as a factor potentially affecting employees' health (17,18). According to the job demands-resources model, high quality leadership is a vital resource in the work environment that can assist employees in coping with stressors (19). ...
... In the literature examining how leadership impacts employees' health and well-being, two main approaches emerge: one emphasizing task-oriented aspects of leadership and the other focusing on relation-oriented dimensions of leadership (16). To achieve the common goal, task-oriented leaders focus on the task to be accomplished by the followers, whereas relationoriented leaders focus on the quality of the relationship with followers. ...
... To achieve the common goal, task-oriented leaders focus on the task to be accomplished by the followers, whereas relationoriented leaders focus on the quality of the relationship with followers. In a systematic review of nursing studies, the authors concluded that leadership focused on task completion alone is not sufficient to achieve optimal outcomes for the nursing workforce, but a focus on relational leadership is needed to achieve healthy work environments (16). ...
Objectives:
Evidence suggests that emotional dissonance, the imbalance between true feelings and those displayed to meet work standards, heightens the risk of mental distress. In nursing occupations, exerting such emotional effort is a part of the job role. Drawing from the job demands-resources model, high-quality leadership is a resource that may assist employees in coping with stressors. We examined whether quality of leadership mitigated the potential adverse impact of emotional dissonance on mental health.
Methods:
In 2019, 1426 home-care workers from 130 organizational units were surveyed, with follow-ups after 8 and 14 months. Prospective associations between emotional dissonance (the Frankfurt Emotion Work Scales) and mental distress (Hopkins Symptom Checklist, HSCL-5), including interactions between emotional dissonance and leadership behaviors (Nordic Questionnaire for Psychological and Social Factors at Work), were determined using lagged linear mixed models.
Results:
Emotional dissonance was positively associated with mental distress (adjusted P<0.05), whereas supportive, empowering, and fair leadership were negatively associated with mental distress (adjusted P<0.05). All three investigated sources of leadership behaviors moderated the direct association between emotional dissonance and mental distress (adjusted P<0.05). Emotional dissonance and mental distress were reciprocally related; an increase in either will heighten the level of the other. Leadership behaviors did not moderate the reversed association between emotional dissonance and mental distress (adjusted P>0.05).
Conclusions:
Supportive, empowering, and fair leadership buffers the association of emotional dissonance on mental distress. Strategic interventions that enhance the quality of leadership may help prevent mental distress among employees in professions with emotionally demanding tasks.
... Effective leaders guide health care organizations through complex challenges, drive innovation, and promote a culture of patient safety and quality improvement (Sfantou et al., 2017). Leaders in health care influence various aspects of organizational performance, including staff morale, patient satisfaction, and clinical outcomes (Cummings et al., 2018). Health care leaders are also tasked with navigating regulatory environments, managing resource constraints, and fostering interdisciplinary collaboration to optimize patient care delivery (Cummings et al., 2018). ...
... Leaders in health care influence various aspects of organizational performance, including staff morale, patient satisfaction, and clinical outcomes (Cummings et al., 2018). Health care leaders are also tasked with navigating regulatory environments, managing resource constraints, and fostering interdisciplinary collaboration to optimize patient care delivery (Cummings et al., 2018). Effective health care leadership is essential for driving organizational change, promoting evidence-based practice, and advancing health equity and access to care (Cummings et al., 2018). ...
... Health care leaders are also tasked with navigating regulatory environments, managing resource constraints, and fostering interdisciplinary collaboration to optimize patient care delivery (Cummings et al., 2018). Effective health care leadership is essential for driving organizational change, promoting evidence-based practice, and advancing health equity and access to care (Cummings et al., 2018). By inspiring vision, cultivating a culture of continuous learning, and empowering frontline staff, health care leaders can accomplish improvements in care delivery that ultimately benefit patients and communities. ...
In health care settings, employee engagement and burnout vary widely. Little is known, however, about how leadership actions may influence this variation. This study identified leadership behaviors that may increase employee engagement and decrease staff burnout in the Veterans Health Administration (VHA). Applying a positive deviance approach to examine organizational survey data across the entire administration, we first statistically identified VHA sites that, based on employee feedback, showed the greatest improvement in engagement or burnout from 2021 to 2022. We then interviewed these sites’ directors (N = 15) or primary care service chiefs (N = 13) about how they achieved this. Findings indicate commonalities across these leaders’ best practices. Interviewees emphasized creating community, making providers feel valued, including staff to assess and optimize organizational efficiency, and strategically communicating to obtain feedback and share updates. These findings highlight skills and attention foci of health care leaders relevant to increasing engagement and decreasing burnout.
... More specifcally, turnover intention refers to the conscious and deliberate desire to leave an entity [9], such as a healthcare organization or a profession. Among work organization factors of interest, transformational leadership which refers to particular behaviors and practices engaged in by leaders that improve overall performance and outcomes [10] has been shown to play a key role in nurses' turnover intention [11,12]. Tese behaviors promote work engagement as they create the conditions required for the appropriation of job resources conducive to positive and adaptative responses, including greater commitment and less turnover intention [13]. ...
... Although research in the nursing context has focused more on leadership behaviors of the immediate supervisor, which have been associated with favorable motivational outcomes for nurses (e.g., [12,14,15]), top management's behaviors also likely play an important role in nurses' turnover intention. Top management refers to the upper management team within an organization that sets and directs the strategies and policies and makes strategic decisions [16]. ...
... As the decisions of top management pertain, for example, to patient care, resource allocation, infrastructure development, adoption of medical devices, implementation of software and technology, and the formulation of policies and procedures, they play a key role in the day-to-day operations of departments, teams, and units and thus in the work life of nurses. Although we recognize that proximal leaders (e.g., middle or front-line supervisors) are essential in shaping nurses' experience and bringing policies to life, top management appears to play a pivotal leadership role in achieving and maintaining successful changes at every level of the organization [12]. As a frst attempt to consider top management leadership, we take the frst step to examine the potential motivational pathways by which their behaviors predict nurses' work engagement and turnover intention. ...
Aims: This study examines the contribution of top management’s transformational leadership behaviors on two targets of nurses’ turnover intention (organization and occupation) by focusing on the indirect (through vigor and dedication) and conditional indirect associations (involving autonomous motivation as a moderator).
Background: Although the issue of nurse turnover has received growing scientific attention, the research is currently silent about the specific targets of turnover intention and more importantly, the potential pathways through which top management’s transformational leadership behaviors relate to each target.
Method: Cross-sectional data from a sample of 426 French–Canadian nurses and structural equation modeling were used to test the proposed model.
Results: Top management’s transformational leadership behaviors distinctly predicted organizational and occupational turnover intention through specific nurses’ states of engagement. While perceived transformational leadership positively predicted vigor, its indirect associations (via dedication) with organizational and occupational turnover intention depend on nurses’ level of autonomous motivation at work.
Conclusion: In times of nurse shortage, the present findings provide insights into how and when top management’s transformational leadership behaviors relate to nurses’ organizational and occupational turnover intention.
Implications for Nursing Management: Healthcare organizations are advised to foster top management transformational leadership behaviors and autonomous motivation to sustain the nursing workforce.
... Despite their importance, the performance and well-being of nurses are often compromised by low job satisfaction and reduced organizational commitment (Feather, 2009). Leadership within healthcare settings has been identified as a critical factor in addressing these challenges (Cummings et al., 2010). Effective leadership not only enhances job satisfaction but also improves organizational commitment, thereby positively influencing healthcare outcomes (Mosadegh Rad & Yarmohammadian, 2006). ...
... Moreover, the mediating role of job satisfaction in the relationship between leadership styles and organizational commitment among nurses in Ethiopian public hospitals is underexplored. Existing studies focus on healthcare systems with more resources and different cultural dynamics, making it crucial to explore how leadership functions in resource-constrained settings like Tigray (Cummings et al., 2010;Ahmad et al., 2013). This study fills this research gap by using a Structural Equation Modeling (SEM) approach to assess the relationships between leadership styles, job satisfaction, and organizational commitment in the public hospitals of Tigray, Ethiopia. ...
... Transformational leadership is characterized by four dimensions: idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration (Avolio et al., 2009). Erstwhile research indicates that transformational leadership is more effective in motivating employees, fostering job satisfaction, and improving organizational commitment (Cummings et al., 2010). Job satisfaction, in particular, serves as a mediator in these relationships, as employees who feel satisfied with their leadership are more likely to remain committed to their organization (Feather, 2009). ...
This study delves into the complex dynamics between leadership styles and organizational commitment, emphasizing the mediating influence of job satisfaction among nursing professionals in public hospitals across the Tigray region of Ethiopia. Utilizing a robust cross-sectional research design, data was collected from 568 head and staff nurses through a structured survey instrument. The analytical approach involved a comprehensive application of both SPSS 20 for regression analysis and AMOS for structural equation modeling (SEM), offering a nuanced understanding of both direct and indirect relationships between leadership behaviors and organizational outcomes. Results indicate that transformational leadership exerts a profound positive influence on both job satisfaction and organizational commitment, while transactional leadership, although beneficial, demonstrates a comparatively scrawnier impact. The pivotal role of job satisfaction as a mediator underscores the necessity for healthcare institutions to cultivate an environment conducive to the professional and emotional well-being of their nursing staff, which in turn fortifies their commitment to organizational goals and improves patient care outcomes. The study’s findings suggest the urgent need for targeted leadership development initiatives, particularly those aimed at enhancing transformational leadership competencies and empowering women leaders within the healthcare system. Additionally, ongoing leadership training is recommended to equip nursing supervisors with the skills necessary to foster job satisfaction and, consequently, elevate organizational commitment.
... Questa analisi dimostra la correlazione tra una leadership efficace i e processi organizzativi efficaci, identificando la leadership infermieristica come principale fattore nello sviluppo della sostenibilità organizzativa. Un ulteriore studio (Smama'h et al., 2023) ha indicato la necessità di approfondire i diversi stili di leadership, in quanto, leadership diverse riflettono capacità diverse dei manager, i quali hanno un ruolo essenziale nel favorire ambienti di lavoro sicuri e sostenibili e prestazioni ottimali del personale (Chandra & Priyono, 2015;Cooper et al., 2002;Cummings et al., 2018;Pawirosumarto et al., 2017;Sugiharjo et al., 2023). Uno stile di leadership efficace e personalizzato consente di ottenere una qualità e sicurezza delle cure erogate più alta (Batubara et al., 2021;Kiwanuka et al., 2021;Sfantou et al., 2017). ...
... Ma è importante non includere in questo ragionamento etico ed ispirato alla sostenibilità il responsabile della filiera infermieristica, ovvero il dirigente infermieristico. Infatti studi precedenti dimostrano la centralità della leadership infermieristica per il raggiungimento di esiti importanti come la soddisfazione del paziente, il turnover infermieristico (Wang et al., 2022); la motivazione dei dipendenti ad essere autonomi nel processo decisionale, creare un ambiente di lavoro favorevole al fine di massimizzare la produttività e ridurre al minimo i costi; qualità e sicurezza delle cure erogate (Cooper et al., 2002); (Cummings et al., 2018); (Sugiharjo et al., 2023) Se però vari sono stati gli stili di leadrship indagati dalla letteratura, poco si sa in merito allo stile etico e sostenibile. È noto che questi esiti possono essere utili per sviluppare politiche volte a migliorare la motivazione e la qualità della vita degli infermieri e la qualità dell'assistenza. ...
BACKGROUND:La leadership infermieristica riveste un ruolo essenziale nel raggiungimento degli obiettivi dell'Agenda 2030 dell'ONU, basata sui 17 SDGs. Infatti vi è sovrapposizione tra gli SDG e i principi etici infermieristici. Tra le responsabilità dei leader infermieristici rientra garantire l'applicazione dei principi etici nell'assistenza infermieristica e creare un ambiente di lavoro con elevati standard etici. Pertanto, i manager infermieristici influenzano i valori, gli atteggiamenti e i comportamenti di un'organizzazione. OBIETTIVI:Esplorare il ruolo della leadership infermieristica in un contesto etico e sostenibile METODO:Nel periodo tra marzo e giugno 2024, è stata condotta una revisione della letteratura analizzando la letteratura disponibile attraverso la banca dati PubMed. RISULTATI:I risultati indicano che la leadership in infermieristica è di fondamentale importanza. È in grado di influenzare la soddisfazione del paziente, il carico di lavoro infermieristico e il turnover. Nonostante il dovere ontologico alla figura stessa del manager infermieristico, è ancora celata la correlazione tra la leadership infermieristica ed esiti etici e sostenibili. La causa appare risiedere nella scarsa formazione al tema specifico della classe dirigente. CONCLUSIONE:Molti studi hanno analizzato il tema degli SDG in relazione ai professionisti infermieri. È importante includere in questo ragionamento etico ed ispirato alla sostenibilità il responsabile della filiera infermieristica: il dirigente infermieristico. Quindi sarebbe opportuno considerare l’etica e la sostenibilità un elemento identitario del management infermieristico e revisionare il sistema formativo ed organizzativo per rendere indissolubile questa relazione.
... Selain itu, Klein dan McDonald (2019) mengidentifikasi berbagai tantangan operasional yang dihadapi rumah sakit, termasuk peningkatan permintaan layanan kesehatan, perubahan demografi, dan perkembangan teknologi medis. Cummings et al. (2020) menyoroti bagaimana kepemimpinan yang efektif dapat meningkatkan efisiensi dan efektivitas pelayanan. Untuk mengatasi tantangan ini, laporan WHO (2021) merekomendasikan strategi untuk meningkatkan akses dan kualitas layanan kesehatan, terutama di daerah terpencil dengan keterbatasan sumber daya. ...
... Namun penelitian tersebut tidak didukung oleh Widati (2020), dan Muchtadin (2023) menyatakan bahwa resiliensi tidak berpengaruh terhadap kepuasan kerja. Cummings et al. (2020) mendefinisikan Gaya kepemimpinan adalah cara di mana seorang pemimpin menavigasi interaksi dan hubungan dengan anggota tim mereka. Ini mencerminkan pendekatan individu dalam mengarahkan, membimbing, dan menginspirasi karyawan untuk mencapai tujuan organisasi.. Dalam arti lain bahwa karyawan akan puas jika memiliki pimpinan yang ramah, dapat menghargai bawahan, memotivasi bawahan, dan membangun kepercayaan dengan bawahan. ...
The purpose of this study This study aims to test and analyze the effect of resilience, leadership style, communication, and work motivation on employee job satisfaction. leadership, communication, and work motivation on employee job satisfaction at An Ni'mah General Hospital Wangon, Banyumas Regency. at An Ni'mah General Hospital Wangon, Banyumas Regency. This type of research is quantitative-survey research. The population in this study were employees of An Ni'mah Wangon Hospital, Banyumas Regency, totaling 280 employees. totaling 280 employees. The sample was taken using the Roscoe formula which amounted to 105 employees at An Ni'mah Wangon General Hospital, Banyumas Regency. Technique sampling technique in this study using Simple Random Sampling (SRS) technique. The research instrument used a questionnaire. Analysis techniques in this study This study uses Smart Partial Least Square (Smart-PLS) 3.0 statistical analysis. used for validity test, reliability test and hypothesis testing. Results This study proves that leadership style and work motivation affect employee job satisfaction at An Ni'mah General Hospital. while resilience and communication have no effect on job satisfaction of An Ni'mah General Hospital employees of An Ni'mah General Hospital.
... Despite over a decade of research into the antecedents of healthy and productive work environments, high turnover rates, absenteeism, dissatisfaction, and compassion fatigue remain prevalent (Marshman et al., 2022). Positive leadership within healthcare institutions has been identified as conducive to nurses' well-being and maintaining a healthy workforce (Cummings et al., 2018;Niinihuhta & Haggman-Laitila, 2022). ...
... This type of selfreflective activity intentionally guides the individual to link and label SBNH-L values to their own practice, deepening their awareness of the SBNH-L approach. Such targeted nursing leadership development initiatives develop nurses' ability to face the challenges of a taxed healthcare system (Cummings et al., 2018). Additionally, the 8-item version can offer organizations an opportunity to do a quick environmental scan of their leadership and track it over time. ...
Introduction: The healthcare system is currently facing significant human resource challenges. Strengths-Based Nursing and Healthcare Leadership (SBNH-L), a unique, value-driven leadership approach, holds great potential in creating healthy workplaces in healthcare. Objective: To develop and validate a scale to measure SBNH-L. Methods: The development and validation of the SBNH-L scale followed a rigorous process including 3 stages: 1) Item generation, 2) Scale development, and 3) Construct validation. For construct validation, a quantitative psychometric design, with two cross-sectional samples, was used (the first sample in February 2021, n = 194 North American healthcare managers and the second sample in April 2022, n = 357 Canadian healthcare workers). Results: The scale showed good psychometric properties (notably, Cronbach’s alphas ranged from .73 to .96) as well as evidence of construct validity; data showed satisfactory fit with the hypothesized 8-factor structure (χ2 = 747.43, df = 224, p<.001), and one-factor long (χ2 = 811.87, df = 252, p <.001) and short versions (χ2 = 97.70, df = 20, p <.001). The scale predicted organizational support (r =.40, p < .01) and work satisfaction of workers (r = .51, p < .01), two key outcomes, beyond other common leadership approaches. Discussion and Conclusion: The SBNH-L Scale is theoretically and structurally strong: the principal component analysis and the confirmatory factorial analyses results aligned with SBNH-L theory and the SBNH-L Scale demonstrated high internal consistency. The scale provides a unique way to tap into the protective potential of SBNH-L and can be used for evaluative and formative purposes of healthcare leaders and their organizations.
... However, recent research indicates that professional nursing governance structures, which empower nursing leadership, are often overlooked in strategic decision-making during such crises [4]. Most nursing leadership literature focuses on individual attributes such as style, traits, and skills [5][6][7], which contrasts with the growing emphasis on leadership as a collective, relational, and ongoing process [8]. ...
... However, following the practice [22] and relational [23] turn, relationships have received increased attention in nursing leadership and governance research [13,24]. Despite this shift, the literature still primarily focuses on interpersonal relationships [13], relational skills [25], and leadership styles [5]. According to Uhl-Bien [14], such approaches to relations are entitative, focus on individual agency, and consider agents involved as "independent, discrete entities" [14]. ...
Aim(s): To understand how nurses experience their positioning amidst hospital crises.
Background: Nursing leadership literature is predominantly focused on the skills and competencies of nurses and less on the relations in practice with nurses. Nurses are often valued for bedside care but are overlooked in strategic decision-making during crises. Foundational research emphasizes the need for nurses’ equal participation in interprofessional healthcare practices and governance.
Methods: We conducted a qualitative interpretive interview and focus group study, amidst the COVID-19 crisis. We interviewed 64 chairs of nurse councils and deepened our understanding of our initial findings in four focus groups with 34 participants.
Results: Nurses differ widely on (a) what is important to them in crisis management, (b) how they can contribute to crisis management, and (c) how they value their involvement or lack of it. Furthermore, we uncovered three relational leadership struggles for nurses concerning (1) navigating, (2) positioning, and (3) collaborating, in crisis management structures.
Conclusion: The ailing positioning and representation of nurses in crisis management result from their limited participation in strategic decision-making, and the lack of intervention on this by board members, physicians, and managers.
Implications for Nursing Management: This study highlights the need for agents such as board members, managers, physicians, and nurses themselves to create clear frameworks and policies that define nurses’ roles in crisis situations, emphasizing the importance of addressing power dynamics and enhancing communication and collaboration in hospital settings. Effective crisis management requires involving nurses from the start, providing regular training, and promoting a more equal approach to teamwork. Understanding relational leadership and its impact during crises can empower nurses and improve overall hospital crisis response.
... However, their performance is shaped by both internal and external factors, including leadership quality, reward systems, and facility availability. Cummings et al. (2018) assert that strong leadership provides motivation and direction, while well-structured reward systems contribute to increased morale and job satisfaction. Conversely, ineffective leadership and inadequate compensation structures often result in disengagement and reduced performance (Laschinger & Fida, 2014). ...
RSUD Bahteramas Kendari, as a referral hospital, plays an essential role in providing health services. This study aims to analyze the strengths, weaknesses, opportunities, and threats related to the role of leadership, rewards, and facilities on the performance of nursing staff in 2024 and strategies for optimizing service satisfaction. This study used a qualitative descriptive method. The 20 respondents were selected using the snowball sampling technique. Data collection through interviews, observation, and documentation was analyzed using SWOT to identify internal and external factors. The results showed strengths in effective leadership (score 2,11), competitive reward systems, and modern health facilities. Weaknesses include a lack of leadership training (score 1,90) and compensation transparency, which needs to be improved. Externally, opportunities include adopting new technology and cooperation with educational institutions (score 1,37). Threats include competition from other hospitals and government policy pressure (score 1,44). The resulting strategy is quadrant II of the diversification strategy, which utilizes opportunities to overcome weaknesses. Optimizing leadership training, increasing rewards transparency, taking advantage of technological possibilities, and promoting educational cooperation are recommended to improve nurse performance and service satisfaction
... Nurse managers play a central role in addressing workplace integration needs as they are responsible for overseeing the operation of individual wards, and for providing direct supervision and support for nurses directly involved in patient care [19][20][21]. Cummings et al. [22] conducted a systematic review and reported a strong link between leadership and management behaviours and various nurse outcomes, such as productivity and effectiveness, as well as job satisfaction and retention. Evidence suggests that nursing leadership behaviours influence nurses' ability to contribute to organizational goals [23]. ...
Background
Healthcare systems globally are confronted with a shortage of nurses. Various strategies to address this have been applied, including active recruitment of internationally qualified nurses. Nurse managers may have a central role in supporting workplace integration. This study aimed to explore how domestically qualified nurses and internationally qualified nurses viewed the role of nursing management and its impact on workplace integration.
Method
Semi-structured interviews with 21 domestically and 14 internationally qualified nurses were conducted. Nurses were selected using purposive sampling. Snowball sampling was applied to reach a sufficient sample size. Interviews were pseudonymized and transcribed. Transcripts were coded according to Qualitative Content Analysis with data structured into themes and subthemes.
Results
Five key themes related to impact of nursing management on workplace integration were identified: (a) Appropriate Placement, (b) Recruitment Process, (c) Leadership Support, (d) Workforce Shortage, and (e) Additional Burden/ Increased Workload. Active support by nursing leadership and the opportunity for shared-decision making was seen as a key factor. Increased workload, additional time and resources requirements associated with orientation of internationally qualified nurses and pressures from staff shortages were highlighted as hindrances. Inappropriate placement of internationally qualified nurses was perceived as key hindrance that could be addressed by nursing management. An imbalanced ratio between domestically and internationally qualified nurses was perceived as challenging by domestically qualified nurses.
Conclusion
Integration of internationally qualified nurses to clinical practice brings several challenges that may be positively impacted by nursing management through appropriate placement of internationally qualified nurses, supportive nurse managers and adequate preparation of domestically qualified nurse mentors/preceptor.
Implications for practice
Nurse managers should ensure that internationally qualified nurses’ work experience matches local clinical unit vacancies before hiring them. Peer support is a supportive factor for internationally qualified nurses. Nurse managers should find a balanced ratio between internationally and domestically qualified nurses in the roster. Introducing mentors or preceptors at ward level may be a strategy decrease work-related stress in both nursing groups.
Registration number
The study has been prospectively registered (27 June 2019) at the German Clinical Trial Register (DRKS00017465).
... It is positively correlated with willingness to share knowledge, the higher the perceived organizational support, the higher the sense of belonging to the organization and the stronger the willingness to share knowledge [24]. A systematic review reported 13 outcomes affected by leadership, the most common including organizational climate and organizational support [25]. One study found that ambidextrous leadership can positively predict students' perceived organizational support and intrinsic motivation, serve as an important antecedent variable of perceived organizational support [26]. ...
Background
Knowledge sharing behavior of nurse specialists can cultivate nurses’ core abilities, improve the quality of healthcare system services, and enhance people’s well-being. Ambidextrous leadership can increase the level of knowledge sharing behavior, but the exact mechanism in nurse specialists remain unclear. This study investigated the relationship between ambidextrous leadership and knowledge sharing behavior among nurse specialists, with a specific focus on the mediation roles played by perceived organizational support and organizational commitment.
Methods
An anonymous cross-sectional survey with a convenience sampling among nurse specialists was conducted in Anhui Province, east China from July to September 2024. Sociodemographic information questionnaire, Multifactor Leadership Questionnaire, Perceived Organizational Support Scale, Chinese Employees Organizational Commitment Scale and Knowledge Sharing Behavior Scale were used to collect data. SPSS23.0 and AMOS 26.0 were used for statistical analysis.
Results
A total of 298 nurse specialists participated in this study. The average score of nurse specialists’ knowledge sharing behavior was 55.00(10.65). Knowledge sharing behavior was positively correlated with ambidextrous leadership (r = 0.562, p<0.01), perceived organizational support (r = 0.575, p<0.01), and organizational commitment (r = 0.413, p<0.01). The total effect (β = 0.635) of ambidextrous leadership on knowledge sharing behavior consisted of a direct effect (β = 0.320) as well as an indirect effect (β = 0.315) mediated through perceived organizational support and organizational commitment. Perceived organizational support and organizational commitment have a chain-mediated effect (β = 0.056) between ambidextrous leadership and knowledge sharing behavior among nurse specialists, bootstrap 95% confidence interval (0.018,0.131), which represented 8.8% of the total effect.
Conclusions
This study confirms that ambidextrous leadership has a significant positive predictive effect on knowledge sharing behavior. Ambidextrous leadership was first associated with an increase in perceived organizational support, followed by a sequential ascend of organizational commitment, which associated with an improvement in knowledge sharing behavior among nurse specialists at last. Hospital managers can increase the levels of knowledge sharing behavior among nurse specialists by improving ambidextrous leadership, perceived organizational support and organizational commitment.
... To provide employees with sufcient work resources for balancing work demands, caring about their health, and encouraging them to develop a healthy lifestyle are crucial [10]. However, some leadership styles are task-centered (e.g., discordant, instrumental, and managerial), which concentrate on completing tasks to achieve high nursing quality but generally reduce nurses' job satisfaction [11]. Passive avoidance and free-ranging leadership styles also increase nurses' working stress and expected turnover rate due to their attitude of avoiding responsibility and participation [4,12]. ...
Background: With increasing burnout and turnover rates among nurses, health leadership can effectively improve the health and well-being of both leaders and staff. However, in the nursing field, the definition and mechanisms of health leadership remain unclear and require further research.
Aim: The main objective of this study was to define the concept of health leadership in nursing, construct a nursing model program, and promote the formation of normative nursing health leadership theories and strategies.
Evaluation: We searched the PubMed, CINAHL, Embase, Web of Science, PsycINFO, and Scopus databases. The following themes were extracted from the included articles: the concept, assessment tools for health leadership, influencing factors, intervention measures, and health effects.
Key Issues: A systematic search of the relevant databases yielded 3161 initial search results. Thirty-two studies were eligible for inclusion. Research shows that the concepts and measurement tools of health leadership are rarely applied in the field of nursing. Health leadership is influenced by personal factors (e.g., leadership qualities such as care, support, courage, patience, tolerance for uncertainty, persuasion skills, work ethic, pressure, experience, effort–reward imbalance, etc.; specific knowledge; self-awareness; psychological capital; leadership style; motivation; consideration; and a commitment to health issues) and organizational factors (e.g., work environment, attention to subordinates, job expectations, and relationship transparency). Several studies have demonstrated that interventions, such as personal development planning, leadership training, face-to-face communication, self-directed learning, and reflection, are effective in promoting healthy leadership styles and improving the well-being of leaders and employees.
Conclusions: We constructed a health leadership model as a reference for the development of relevant measurement tools and intervention strategies for the nursing field.
Implications for Nursing Management: Nursing leaders should focus on their health and that of their subordinates, develop and implement health leadership, and aim for improvement in employees’ well-being and nursing quality.
... Numerous nursing leadership models and theories have evolved in recent years. Traditional leadership research emphasizes transformational and transactional leadership as supportive for nurses aiming to alter daily practices [15]. This approach assumes that a single leader influences or directs others. ...
Background
The contemporary healthcare system is inherently complex, necessitating organizational and ward-level changes to address challenges. Continuous adaptations in daily practices are essential to meet unexpected patient needs. These dynamic changes require resilience from healthcare staff, including nurses. This paper explores how nurses show leadership in response to changes within a complex work environment that demands resilience in their daily practices.
Methods
An empirical qualitative study was employed. Non-participatory observations were conducted in February and March 2022 (n = 60 h), providing thick descriptions of nurses working across various shifts. Subsequently, two semi-structured group interviews were held: the first with nurses only and the second with multidisciplinary healthcare professionals. The interview transcripts and thick descriptions were analyzed using thematic analysis. Descriptive statistics were used to summarize participant characteristics.
Results
Responding to a changing work environment requires resilience from nurses who exhibit leadership showing four distinct behaviors: proactive, patient-centered care; investigative problem-solving; reflective learning; and profession-based approaches.
Conclusion
Collaboration is a key factor in resilient nurse leadership, both among nurses, and in interaction with patients, other healthcare professionals, and management. This research highlights how nurses’ considerations, beliefs, and interactions, make their leadership behavior visible in a context that demands situated, structural, and social resilience.
... Healthcare professionals work in high-pressure environments, requiring them to make critical decisions under time constraints, all while managing the emotional toll of constant exposure to human suffering (Harrison et al., 2015). Moreover, the diverse backgrounds and specializations of healthcare teams demand leadership that not only fosters collaboration but also leverages this diversity to enhance overall team performance (Cummings et al., 2018). Given these challenges, the role of leadership in shaping the work experience of healthcare professionals is crucial, influencing not only employee performance but also the quality of care provided to patients (Buchan, 2019). ...
This study investigates the relationship between leadership styles
Reviewed: October 12, 2024
and employee performance within hospitals in the Effutu
Accepted: October 17, 2024
Municipality, Ghana. Targeting nurses, healthcare administrators,
Published: October 29, 2024
allied health professionals, and domestic staff from four
purposefully selected hospitals, a sample size of 384 participants
Keywords:
was determined using the Cochran formula. A stratified random
Organizational Leadership
sampling technique ensured a proportional representation of the
Leadership Styles
distinct subgroups. A final usable sample of 300 participants was
Healthcare Management
achieved after thorough data checking and screening. Data were
Hospitals
collected using a questionnaire developed from established
Employee Outcomes
leadership constructs, exhibiting high reliability with a Cronbach's
Employees Performance
Alpha of 0.87. Descriptive and inferential statistical analyses were
conducted using SPSS version 25.0, including multiple linear
regression to assess the impact of various leadership styles on
employee performance. The findings indicate that all examined
leadership styles—transactional, bureaucratic, autocratic,
© 2024 The Author(s)
transformational, democratic, participative, and laissez-faire—had
significant positive effects on employee performance. These
results challenge the notion of a single "best" leadership style,
suggesting that the effectiveness of leadership approaches is
context-dependent. The study's limitations include its
geographical scope, with recommendations for future research to
explore contextual factors, long-term effects, and cross-cultural
comparisons to enhance the understanding of leadership impacts
in diverse healthcare settings.
... Furthermore, leadership and management are viewed as distinct but complementary activities: leadership focuses on human and relational aspects, while management involves facilitating, organizing, and planning the conditions that enable successful leadership (Alvesson & Spicer, 2012;Vevatne et al., 2020. Previous studies have highlighted the influence of nurse leaders on the nursing work environment, particularly the significant relationship between nursing leaders' leadership style and nurses' health, job satisfaction, and well-being (Cummings et al., 2018;Kohnen et al., 2024;Niinihuhta & Häggman-Laitila, 2022). Collaboration between nurses and nurse leaders is essential for fostering a HPWE (Jiménez et al., 2017;Mabona et al., 2022;Wei et al., 2018). ...
Purpose
The purpose of this meta-ethnography is to integrate and synthesize nurses’ and nurse leaders’ perspectives on a health-promoting work environment to enhance understanding of its essential aspects.
Methods
A meta-ethnographic approach developed by Noblit and Hare was conducted.
Findings
Line of argument synthesis led to the development of an overarching tree metaphor: “cultivating a flourishing environmental tree rooted in values, held stable by leadership, and nurtured by safe working conditions.” This metaphor illustrates that a health-promoting work environment is imbued with three interdependent aspects: 1) core values as the roots of the tree, including respect, recognition, community, and engagement 2) value-conscious leadership as the trunk of the tree, meaning a leader who is conscious of their power position and responsibilities and 3) safe working conditions as fertile soil for the tree, comprising the physical and administrative dimensions of the work environment.
Conclusions
Collaboration between nurses and leaders is crucial for cultivating a health-promoting work environment. However, nurse leaders, due to their influential positions, have the responsibility to facilitate this environment. Consequently, leaders need to receive adequate resources and support from their superiors to foster an environment that enhances nurses’ health and job satisfaction.
... Transformational leadership, characterized by inspiring and motivating teams toward achieving higher performance, has consistently been associated with positive outcomes such as improved staff morale, reduced burnout, and enhanced patient satisfaction (Boamah et al., 2018). Conversely, laissez-faire leadership, which involves minimal supervision and decision-making, often correlates with lower team cohesion and reduced care quality (Cummings et al., 2018). These variations highlight the need for a systematic examination of how leadership styles influence healthcare outcomes. ...
Nursing leadership plays a crucial role in shaping healthcare quality, directly impacting patient outcomes, staff satisfaction, and organizational performance. This systematic review explores the relationship between various nursing leadership styles and healthcare quality metrics, including patient safety, clinical outcomes, and team dynamics. By synthesizing findings from recent studies, the review identifies transformational and servant leadership as the most effective styles for fostering positive healthcare outcomes. It also highlights challenges, such as limited leadership training and organizational barriers, and offers actionable recommendations for integrating leadership development into nursing education and practice. These insights aim to guide healthcare organizations in adopting evidence-based leadership models to enhance overall care quality.
... Poor work organization was associated with employee dissatisfaction during work, which contributed to feelings of frustration and helplessness [27][28][29], which was also shown by the results of our research. ...
Nursing employees often encounter various stressors during their professional activities, which reduce their work efficiency and can affect their mental health. The aim of this study was to investigate the correlation between job stress and the quality of workplace. The study found that, on average, nurses feel constant pressure (M = 1.33, SD = 0.77), that they have psychological problems due to work (M = 0.73, SD = 0.62), which are most closely related to information support, electronic rather than paper documentation (r = 0.347***, p < 0.001). The strongest correlation was between poor work organization and intention to quit the job (r = −0.378***, p < 0.001). The results show that psychological problems are significantly associated with lack of support (β = 0.138, p = 0.006). Factors that significantly affect the occurrence of stress among nursing employees are the organization of work, and the competences and skills of health management for working with nursing employees. The chapter addresses why it is important that nursing management and policymakers develop strategies to ensure adequate numbers of competent staff and establish a supportive management system.
... In addition, although the average working hours per week showed low expected influence on the whole network, the bridging centrality results indicated that negative effects of long working hours are still contagious and trigger depressive symptoms. The medium working hours per week in this study is 40 h, which aligns with the required working hours regulated by the labor law of China, and less than average working hours (48 h) of critical care nurses in Colombia, Argentina, Peru and Brazil [86]. Nevertheless, qualitative study implied that nurses often had to extend their work time without compensation [17], which may exacerbate work-related complaints. ...
Background:
Critical care nurses are vulnerable to depression, which not only lead to poor well-being and increased turnover intention, but also affect their working performances and organizational productivity as well. Work related factors are important drivers of depressive symptoms. However, the non-liner and multi-directional relationships between job demands-resources and depressive symptoms in critical care nurses has not been adequately analyzed. Understanding these relationships would be helpful for reducing depression, increasing nurses' well-being and retain healthcare forces.
Methods:
This was a cross-sectional study using baseline data from the Nurses' mental health study (NMHS), a prospective cohort study on nurses from 67 tertiary hospitals in 31 province-level administrative regions in China. Only clinical nurses working in the ICU were included (n = 13,745). Data were collected using online questionnaires, and analyzed using network analysis and structural equation model. Job demands (average working hours per week, average number of night shifts per month, paperwork burden and work-life balance), job resources (supervisor support, co-worker support, leader justice, organizational climate satisfaction, work meaning, and career prospect), personal resource (resilience) and depressive symptoms were main variables in the networks, while demographic data and social health (social-emotional support and loneliness) were covariates.
Results:
The prevalence of severe, moderately severe, moderate, mild, and none or minimum depressive symptoms in critical care nurses of this study were 1.21, 3.42, 9.76, 42.88, and 42.07% respectively. In the final network, 132 of 210 possible edges (62.8%) were not zero. "Fatigue" had the highest expected influence, followed by "Motor", and "Appetite". Meanwhile, in terms of job demands-resources and personal resources, the node with the highest expected influence was "Supervisor support", followed by "Work meaning" and "Co-worker support". Three bridge variables were identified: "Resilience-adaptation", "Average working hours per week", and "Co-worker support". The final structural equation model basically supported the results of network analysis with an acceptable model-fit (GFI = 0.918, AGFI = 0.896, PCFI = 0.789, PNFI = 0.788, NFI = 0.909, IFI = 0.911, CFI = 0.911, SRMR = 0.040, and RMSEA = 0.064).
Conclusions:
There was a rather strong interconnectedness between depressive symptoms and job demands-resources. Fatigue, motor, and appetite were core depressive symptoms of critical care nurses. Close attention to those symptoms could help recognize depression in critical care nurses. Supervisor support, work meaning, and co-worker support played vital roles as job resources in reducing depression, while negative impact of long average working hours per week were more contagious. Resilience, as personal resources, could help mediate the associations between job demands-resources and depression. In clinical practice, it's recommended for nursing managers to (1) encourage critical care nurses to find their "meaning in work", (2) implement resilience enhancing programs for nurse, (3) build and maintain meaningful relationships with nurses and support them in daily work, and (4) create a harmonious and dedicated working environment where co-workers are willing to help and support each other. Improvements in those modifiable aspects could help reduce risk and prevent exacerbations of depressive symptoms in critical care nurses.
... Es por ello que, la triangulación de fuentes indicó que los líderes que son capaces de priorizar el bienestar laboral, generalmente tienden a fomentar una cultura organizacional que valora a los empleados como individuos, todo ello con el fin de promover un entorno que minimiza el agotamiento profesional y el estrés crónico. (44,45,46) Teniendo en cuenta lo antes descrito, estudios como los de Matthews et al. (46) y Cummings et al. (47) han demostrado que los estilos de liderazgo transformacional a la par que auténtico están relacionados con niveles mucho más altos de bienestar entre los empleados, lo que se traduce en un riesgo mucho menor de rotación. A su vez, se reflejó en el análisis que, estos líderes tienden a establecer una comunicación abierta y empática, reconociendo en su esfera aquellas necesidades individuales del personal, así como brindar el apoyo para superar desafíos tanto profesionales como personales. ...
Staff turnover represents a critical challenge in the health and management sciences, impacting team stability, quality of care, and organizational costs. This article explores the relationship between leadership styles and staff retention through a narrative review of the literature published between 2018 and 2022 in the Scopus database. The analysis focused on 21 documents selected under criteria of pertinence, relevance, and academic quality. Through a semi-systematic methodology, thematic patterns and key theoretical perspectives were identified that underline how leadership can mitigate factors associated with staff turnover. The results showed that leadership styles play a crucial role in creating a positive work environment, where well-being, trust, and inclusion are priority categories. These approaches promote job satisfaction, reduce stress, and strengthen employee engagement, which contributes to minimizing the intention to leave. The importance of adapting strategies to generational expectations was also highlighted, particularly in relation to work flexibility, professional development and individual recognition. It is concluded that the implementation of adaptive and people-centred leadership styles, together with comprehensive organisational policies, is essential to meet the challenges of staff turnover in the health sector
... It is characterized by supervisors who demonstrate their true selves, maintain transparency and integrity, and actively adapt to change [29]. This is a popular leadership approach in healthcare and is believed to help construct a satisfying work environment through the establishment of healthy professional bonds and effective dialogical processes, and ultimately affect their well-being at work [29][30][31]. Prior research on authentic leadership in healthcare has primarily focused on nurses. Given the increasingly dynamic interactions between various components in the health system faced by physicians, this study extends previous research to examine the impact of authentic leadership on physicians' job satisfaction and burnout. ...
Background
This study aims to investigate the direct associations among perceived doctor-patient relationship, authentic leadership, organizational climate, and job burnout, as well as the indirect pathways through job satisfaction, with the aim of offering potential preventive strategies at the organizational level.
Methods
A total of 399 physicians from six tertiary hospitals in Anhui Province were enrolled by purposive sampling method. Structural equation modeling was performed to examine the proposed model.
Results
The average score of the participants' job burnout was 35.22 (SD: 12.14), and the burnout rate was found to be 55.7%. Perceived doctor-patient relationship, organizational climate directly influenced job burnout. Perceived doctor-patient relationship, authentic leadership and organizational climate also indirectly influenced burnout through job satisfaction.
Conclusions
The present study underscores the significant influence of the perceived doctor-patient relationship, authentic leadership and organizational climate in mitigating burnout, and further reveals that job satisfaction serves to alleviate burnout. It is crucial to emphasize the importance of both internal and external psychosocial and organizational environmental factors. Additionally, the study highlights the pivotal role of job satisfaction in influencing physician burnout.
... Estos datos reclaman un liderazgo que promueva entornos profesionales de la práctica enfermera saludables. En cuanto a esto, autores como Cummings et al. (2018) y Wong et al. (2013) resaltan la relación que el liderazgo de enfermería tiene con la satisfacción de las enfermeras y la reducción de su nivel de estrés. ...
La enfermería, como profesión vocacional, se define por un profundo compromiso hacia el bienestar de los pacientes, impulsado por principios éticos y humanos. Sin embargo, en los actuales entornos sanitarios, las demandas organizacionales pueden entrar en conflicto con los valores internos que guían la profesión, como la atención centrada en la persona y la construcción de relaciones auténticas con los pacientes. Esta tensión entre la vocación profesional y las condiciones del entorno de la práctica puede generar una desconexión que afecta tanto al bienestar de las enfermeras como a la calidad de la atención que proporcionan. Factores como la falta de tiempo, la sobrecarga de trabajo y la elevada “ratio” enfermera-paciente, dificultan que las enfermeras ejerzan plenamente su vocación, lo que contribuye al aumento del malestar moral y el agotamiento. Un equilibrio adecuado entre los bienes internos de la profesión y las demandas del entorno de la práctica que valore la vocación de los profesionales y favorezca la autonomía, la colaboración interdisciplinaria y una cultura de cuidado puede mitigar el agotamiento y promover el compromiso de las enfermeras. Para ello es esencial que las organizaciones de salud adapten sus estructuras organizacionales a las características de la identidad profesional de las enfermeras, garantizando que puedan cumplir con sus fines internos.
... It has been argued that the primary intent of destructive leaders is to disguise their lack of competence or avoid taking responsibility and making decisions (Milosevic, Maric, and Lončar 2020). Whatever the type, destructive leadership has been found to predict poor productivity, job dissatisfaction and an increased intention to leave the nursing profession amongst employees (Alilyyani, Wong, and Cummings 2018;Cummings et al. 2018;Labrague 2021;Ofei et al. 2023). ...
Aim
To describe how nursing staff assess their superiors' destructive leadership and nurse leaders' structural empowerment. A further aim is to examine the associations between destructive leadership and staff outcomes and how nurse leaders' structural empowerment moderates these associations.
Design
A cross‐sectional study.
Methods
The data were collected during November 2022–April 2023. Nursing staff assessed their work well‐being, commitment, decision‐making and career advancement. Destructive leadership was evaluated using the Employment Precariousness Scale and some additional questions. Nurse leaders' structural empowerment was assessed using the Conditions For Work Effectiveness Questionnaire‐II. The data were analysed using statistical methods including linear regression.
Results
Nursing staff (n = 381) assessed destructive leadership as rare, but it negatively associated with their commitment, decision‐making, career advancement and work well‐being. Nurse leaders' (n = 97) structural empowerment had a positive association with nursing staff outcomes. The interaction between destructive leadership and nurse leaders' structural empowerment positively affected the work well‐being and commitment of nursing staff. The models explained 32% of nurses' work well‐being and 19% of their commitment.
Conclusion
Destructive leadership undermines nursing staff outcomes. Structural empowerment of nurse leaders should be enhanced to protect against destructive leadership and other protective factors should be explored in the future to identify and prevent destructive leadership.
Implications for the Profession
Organisations should provide nurse leaders with appropriate resources and support to enhance their empowerment and opportunities to improve their leadership skills and expertise and should develop ways of identifying destructive leadership patterns and policies to resolve situations in which destructive leadership occurs.
Impact
A work environment that empowers nurse leaders may reduce the effect of destructive leadership on staff well‐being, commitment, decision‐making and career advancement. The significance of protective factors against destructive leadership should be explored using more robust methods in future research.
Reporting Method
A STROBE checklist.
Patient or Public Contribution
None.
... In congruent with these results, previous study (Cummings et al., 2018) that transformational leadership behaviors enhanced satisfaction, effectiveness, and improved extra effort from staff. However, Cummings et al. (2018) reported that transactional leader behaviors resulted in reduced satisfaction and effectiveness and productivity among nurses that counteract the results in this study. ...
... The effectiveness of government work is also related to law enforcement against tax violations. When the law enforcement system runs well and fairly, the public will realize that tax non-compliance has serious consequences (Asbari et al., 2020;Cummings et al., 2018). It can motivate citizens to comply with their tax obligation, as they realize that violations will be dealt with strictly. ...
Phenomenon/Issue: Local government and village head leadership play an important role in increasing public awareness of paying taxes, but work effectiveness as a mediating variable has not been widely explored. Purpose: This research aims to analyze the influence of government policy and village head leadership on public awareness of paying taxes, with work effectiveness as a mediating variable. Novelty: This research adds work effectiveness variables as mediators to deepen understanding of how government policy and village head leadership can influence people's awareness of paying taxes. Research Methods: Quantitative research using a survey approach was carried out in Karangrejo Village, Karangrejo District, Magetan Regency. Data was collected through questionnaires filled out by respondents who were residents of Karangrejo Village. Results: The results of the study show that government policy and village head leadership have a significant effect on people's awareness of paying taxes. Work effectiveness was found as a mediating variable that strengthens this influence. Research Contributions: This research provides insight into the importance of transparent government policies and responsive village head leadership to increase work effectiveness and public awareness in paying taxes, which will ultimately have a positive impact on increasing local tax revenues
... Transformative leadership has the potential to increase employee happiness more than indifferent or uninterested leadership. According to professionals, leadership that is solely concerned with employee output and ignores the opinions of its followers will not be successful in obtaining the best performance from its workforce (Cummings 2010). ...
The ability of an organisation to adapt to constant change determines its long-term viability. Organisations that understand the value of excellent leadership in organisational performance will see growth and sustainable profitability. This research focused on the automotive industry in Isipingo, Durban, KwaZulu-Natal, South Africa. To thrive and remain competitive, the automotive sector must adapt to changing conditions, be efficient, and respond rapidly to external forces. Managers are frequently challenged with balancing the frustrations of different interest groups within the sector; becoming skilled and successful leaders; and steering the organisation in the appropriate direction. The emotional competency of employees is a valuable resource designated as emotional capital. The purpose of this study was to investigate whether the emotions of leadership influence employee performance in this Industry Therefore, the research question entailed, what is the role of leaders' emotions? Analysis of extant literature was related to aspects that impact leaders’ emotional capability. The main variables included emotional capital, leadership, emotions, and employee performance. This study was based on a quantitative approach. Primary data was collected through a survey which was analysed using Spearman’s rho correlation. The results highlighted how a leader's emotions affect employees and demonstrated a substantial association between employee performance and the leader's overall emotional state. It was determined that a leader's emotions can have both beneficial and negative effects on employee performance. The recommendations offered useful advice on how to choose tactics that would yield appropriate results for the organisation to be sustainable.
... Nowadays, the academic community mostly adopts Cummings et al.'s (2018) definition of work engagement, which they believe is a positive, fulfilling, more lasting, and universal emotional cognitive state, manifested through three dimensions: vitality, dedication, and focus. Previous studies have shown that high work engagement, as a positive work attitude, can lead to improvements and enhancements in employee performance (Noesgaard & Jørgensen, 2024). ...
Drawing on the theory of transactional leadership, this study investigates the potential impact of transactional leadership on work performance through the mediating role of work engagement. A survey was conducted among 157 employees from a manufacturing enterprise in China, revealing that transactional leadership significantly and positively influences both work performance and work engagement. Moreover, work engagement fully mediates the relationship between transactional leadership and work performance. This study offers practical management strategies for enterprise leaders, emphasising task-oriented approaches, goal-setting, and motivating employees to invest greater effort through work promotions, material incentives, and other methods, ultimately fostering improved work performance.
... Healthcare professionals work in high-pressure environments, requiring them to make critical decisions under time constraints, all while managing the emotional toll of constant exposure to human suffering (Harrison et al., 2015). Moreover, the diverse backgrounds and specializations of healthcare teams demand leadership that not only fosters collaboration but also leverages this diversity to enhance overall team performance (Cummings et al., 2018). Given these challenges, the role of leadership in shaping the work experience of healthcare professionals is crucial, influencing not only employee performance but also the quality of care provided to patients (Buchan, 2019). ...
This study investigates the relationship between leadership styles and employee performance within hospitals in the Effutu Municipality, Ghana. Targeting nurses, healthcare administrators, allied health professionals, and domestic staff from four purposefully selected hospitals, a sample size of 384 participants was determined using the Cochran formula. A stratified random sampling technique ensured a proportional representation of the distinct subgroups. A final usable sample of 300 participants was achieved after thorough data checking and screening. Data were collected using a questionnaire developed from established leadership constructs, exhibiting high reliability with a Cronbach's Alpha of 0.87. Descriptive and inferential statistical analyses were conducted using SPSS version 25.0, including multiple linear regression to assess the impact of various leadership styles on employee performance. The findings indicate that all examined leadership styles—transactional, bureaucratic, autocratic, transformational, democratic, participative, and laissez-faire—had significant positive effects on employee performance. These results challenge the notion of a single "best" leadership style, suggesting that the effectiveness of leadership approaches is context-dependent. The study's limitations include its geographical scope, with recommendations for future research to explore contextual factors, long-term effects, and cross-cultural comparisons to enhance the understanding of leadership impacts in diverse healthcare settings.
Leadership development in nursing is a cornerstone for improving healthcare delivery and fostering professional growth. As the demands of modern healthcare evolve, cultivating leadership among medical nurses has become critical. This article explores the transition from trainees to mentors, emphasizing the systematic development of leadership skills in the next generation of nursing professionals. Drawing on global perspectives, the study examines challenges, opportunities, and effective strategies for embedding leadership training in nursing education and practice. The article highlights the importance of early identification of potential nurse leaders, structured mentorship programs, and a supportive organizational culture. Key competencies such as communication, emotional intelligence, and decision-making are identified as foundational for successful leadership. The role of clinical exposure, experiential learning, and interprofessional collaboration in shaping leadership capacity is also discussed. Through case studies and evidence-based practices, the article provides insights into the impact of strong nursing leadership on patient outcomes, team dynamics, and healthcare systems. Examples from both developed and developing nations underscore the universal need for robust leadership development frameworks. Addressing barriers such as resource constraints, gender bias, and burnout, the article offers actionable recommendations to bridge the gap between education and practice. It emphasizes the necessity of policies that prioritize leadership training, incentives for leadership roles, and international collaborations to standardize approaches.
Background: Leadership is crucial in nursing as it influences decision-making autonomy and work performance. Studies have shown that leadership styles affect nursing outcomes and patient care, but there is limited understanding of how these styles affect nurses' autonomy and performance.Study Aim:This study aims to evaluate the role of leadership styles in fostering work performance and autonomy in nurses’ decision-making at Northern Region Hospitals.Methodology:This study used a descriptive exploratory design. The data was collected using a cross-sectional survey. Convenience sampling, with a sample size of 102, was used to recruit participants. The instruments used were the Multi-Factor Leadership Questionnaire−Adapted Version questionnaires, the Individual Work Performance Questionnaire, and the Autonomy Scale.Results: The study found a linear relationship between transformational leadership style and nurse work performance and autonomy. Transformational leaders foster support, collaboration, and empowerment, enhancing nurses' autonomy in clinical decision-making. Healthcare organizations should prioritize developing transformational leadership among nurse managers to improve job satisfaction, patient care outcomes, and effective nursing management strategies.Conclusion: The study found a linear relationship between transformational leadership style and nurse work performance and autonomy. Transformational leaders foster support, collaboration, and empowerment, enhancing nurses' autonomy in clinical decision-making. Healthcare organizations should prioritize developing transformational leadership among nurse managers to improve job satisfaction, patient care outcomes, and effective nursing management strategies.
Organizational citizenship behavior, which represents employees’ discretionary efforts, is essential for a company’s success. Previous research has identified a link between organizational citizenship behavior and transformational leadership. Additionally, transformational leadership has been associated with effective corporate governance. Empirical studies have further revealed that organizational citizenship behavior is influenced by good corporate governance (GCG). This study investigates the relationship between transformational leadership, GCG, and organizational citizenship behavior, both directly and indirectly. A quantitative method was employed, with data collected through a survey. The study’s population included 103 executives from Badan Amil Zakat Nasional (BAZNAS) in Yogyakarta and Central Java, with a response rate of 48.5%. Data analysis was conducted using SEM-PLS 3.0. The results show a favorable and significant synergistic relationship between transformational leadership, GCG, and organizational citizenship behavior.
Aim
To synthesize the previous findings of nurses’ self‐leadership in hospital settings.
Background
Self‐leadership is a process of comprehensive self‐influence. People direct themselves toward optimal performance with self‐motivation and take responsibility for their actions. Self‐leadership has been found to have a connection with the experience of meaningfulness of work, commitment, and job satisfaction.
Methods
The scoping review was conducted by following the PRISMA‐ScR reporting checklist. PubMed, CINAHL, Scopus, and PsycINFO databases were searched, and 1831 articles were identified and screened. Multiple study designs were included while specific inclusion and exclusion criteria regarding population, concept, and context were addressed. Narrative data synthesis was conducted.
Findings
The search identified a total of 13 relevant studies published between 2013 and 2023. Four themes were found to describe nurses’ self‐leadership: Self‐leadership is nurses' internal skill that increases with experience ( n = 8); self‐leadership improves nurses' work performance ( n = 8); self‐leadership supports work well‐being ( n = 5); and self‐leadership thrives in favorable nursing work environments ( n = 6).
Conclusion
Self‐leadership has a positive connection to nurses’ work performance and well‐being. Nursing students should be introduced to self‐leadership skill development in their nursing education programs, and nurses should be offered continuing education opportunities to develop self‐leadership skills throughout their careers. Further studies are necessary to fill the information gap about explaining self‐leadership in the context of professional nursing and offering recommendations for how to strengthen nurses’ self‐leadership skills.
Implications for nursing education, practice, and policy
Self‐leadership encourages nurses to work proactively to improve patient care and enhance work environments. Self‐leadership includes behaviors that can be encouraged through each developmental stage of a nurse's career. Faculty, nurse leaders, and organizational structures play an important role in identifying self‐leadership behaviors and supporting their positive development.
Background: The impact of redeployment on staff was not widely recognised before the COVID-19 pandemic. The redeployment of critical care nurses is frequently employed in healthcare organisations as a last-minute staffing management approach without proper infrastructure.
Studiesexploringthefeelingsandexperiencesofredeployedcriticalcarenursesinthismanneraresparse. The aim of this study was to develop an understanding of the experiences of critical carers during their redeployment to cover shifts in the general direction. Study Design: This study adopted a qualitative research design to explore critical nurses experiences of redeployment. Ten critical nurses attending a postgraduate critical care course in one university were recruited between January and April 2019. Data were collected using a focus group, which was thematically analysed. Results: Three themes were identified: 'challenges in transitioning towards settings’, ‘concerns regarding patient safety and satisfaction', and ‘insufficient infrastructure and support'. Participantsexpressedconcernsaboutpatientandstaffsafetyduring redeployment,describingfeelingsofanxietyandundervaluation. Conclusions: The study illuminates the intricate challenges experienced by redeployed critical care nurses, highlighting the crucial need for comprehensive support, targeted training, and strategic planning to safeguard patientscare and nurseswell-being during periods of staff shortages in healthcare settings. These findings emphasise the importance of proactive measures in fostering a resilient and adaptable healthcare workforce. This is a small study involving only one focus group of 10 critical care nurses, which may limit the transferability of the findings. As a result, the findings may not fully reflect the experiences of critical carers from other sites.
Employee commitment is a vital determinant of organizational success, affecting productivity, retention, and overall performance. In the current competitive business landscape, organizations strive to improve commitment levels through the implementation of effective leadership styles. However, transformational and transactional leadership styles have garnered considerable attention among the various leadership paradigms due to their unique methods of motivating and managing employees. Thus, the purpose of this study is to examine how job satisfaction affects the relationship between transformational and transactional leadership styles and employee commitment among quantity surveyors in private consulting firms in Nigeria.The study used quantitative methods to collect cross-sectional data from 127 practicing quantity surveying firms (QSFs) in Abuja. A total of 76 valid questionnaires were returned out of a sample of 127. This is a response rate of almost 60%, and the study's hypotheses were tested using Partia
Background: Strong leadership and good nursing actions are needed in order to treat sepsis in intensive care units (ICUs). A serious illness, sepsis requires fast and coordinated treatment to raise patient outcomes. Methods: This study methodically examines the body of knowledge already in publication on how nurses control sepsis in ICUs. Many databases were searched comprehensively in order to find research on nursing practices, leadership styles, and their effects on patient outcomes and sepsis control. Results: The quality of care in sepsis treatment is evidently much influenced by nurse leadership. Particularly transformative and real leadership styles help to increase team cooperation, communication, and adherence to therapeutic recommendations by means of their influence. Furthermore, proven to lower fatality rates and raise patient satisfaction is the use of standardized procedures for sepsis treatment along with continuous education and training for the nursing team. Conclusion: The leadership and clinical abilities of nurses are essential in the management of sepsis in ICUs. Strong nursing leadership taken in concert with other disciplines improves the quality of treatment given to septic patients. Future studies should concentrate on creating and assessing leadership development initiatives for nurses to maximize sepsis control in critical care environments.
The perioperative setting is one of the most demanding areas in healthcare, requiring precise coordination for optimal patient outcomes. However, this environment is susceptible to disruptions from microaggressions and burnout, which can negatively impact communication, collaboration, teamwork, and care quality. These issues can create a toxic work culture, heighten patient anxiety, and lead to poorer patient outcomes. Pediatric surgical nurses face heightened burnout due to emotional overload, increasing workloads, and lack of managerial support. Leadership plays a critical role in addressing these challenges by fostering an inclusive and supportive workplace. Leadership styles must include an authentic commitment to equity, belonging, and representation is essential to improving nurse well-being, job satisfaction, and patient outcomes. Leaders must engage with staff through open dialogue, implement strategies such as education and stress reduction programs, and promote a work-life balance to combat burnout and microaggressions. However, barriers such as limited resources, resistance to change, and generational differences may impede progress. Overcoming these obstacles requires a multifaceted approach, including comprehensive education, stakeholder engagement, and phased adaptation. By leveraging technology and tailoring strategies to suit various generational needs, nurse leaders can foster an environment that supports professional satisfaction, reduces burnout, and promotes excellence in pediatric surgical care.
Background
Workplace conflicts, especially in hospital environments, pose significant challenges to both staff productivity and well-being. The complex nature of healthcare environments, combined with diverse team dynamics, makes effective conflict management crucial. Previous studies suggest that structured educational interventions can help mitigate conflicts and foster better working conditions.
Objective
This study aims to evaluate the effectiveness of educational interventions, specifically in conflict management and emotional intelligence training, on reducing workplace conflicts and improving coping strategies among hospital nurses.
Methods
The study involved four stages: (1) Problem identification through interviews and literature review, (2) Use of demographic data and conflict assessment tools including the Dobrin Job Conflict, Jehn's Interpersonal Conflict, and Putnam & Wilson's Conflict Management Strategies Questionnaire, (3) Conducting workshops focused on conflict resolution and emotional intelligence, and (4) Assessing the intervention's impact through paired t-tests and statistical analyses.
Results
The intervention significantly reduced relational, task-related, and procedural conflicts. Following the workshops, the use of non-confrontation and control strategies decreased, while problem-solving strategies became more prevalent. Correlation analysis indicated that demographic factors such as age and work experience significantly influenced the results.
Conclusion
Educational interventions, particularly in emotional intelligence, proved effective in reducing conflicts and improving conflict management strategies. This highlights the importance of continuous training programs aimed at enhancing workplace relations and productivity in hospital settings.
Administration, the activity of running an organization, establishment or a business, is very important not only in the smooth running of the activities, but also in the attainment of set goals and objectives. However, for effective administration to take place, the administrator's use of language (spoken, written and paralanguage) will have impact (positive or negative) on the day-today running of the establishment. It has been established that language, a principal means by which human beings communicate, is an essential tool in leadership. Communication is not just a transmission of information but involves connection and inspiration. The language use builds connection between the speaker and the hearer/listener. Thus, language is somewhat linked to leadership style as both play an important role in promoting peace and cordiality in an establishment or organization. This paper investigated the usefulness of language in administration using Adeleke University, Ede, as a case study. The study is guided by three research questions to drive home the objectives of the study. The objectives are to investigate the significance of language use in leadership positions, examine how leadership styles facilitate effective administration, and establish the effects of non-verbal cues on the performance of leaders. A total of two hundred respondents, both academic and administrative staff of the University, formed the respondents to a structured questionnaire designed by the researchers. Obtained data was analyzed using descriptive and inferential statistics with insights from Transformational Leadership Theory.
Amaç –Bu çalışmanın amacı, sağlık kurumları çalışanlarının deneyimledikleri ve inşa ettikleri örgüt kültürünün betimlenmesidir. Sağlık kurumlarında örgütsel kültür deneyimlerine ilişkin yeni bakış açılarının kazandırılması ve kavrayışın derinleştirilmesi amaçlanmıştır.Yöntem –Sağlık kurumlarında çalışanların ve yöneticilerin deneyimledikleri örgüt kültürünün nasıl betimleneceği bu araştırmanın problemini ifade etmektedir. Etnografi deseninin benimsendiği araştırmada, bir sağlık kurumunda aynı yöneticiye bağlı olarak çalışan 9 hemşire ile yüz yüze yarı yapılandırılmış mülakatlar gerçekleştirilmiştir. Araştırmada, amaçlı örnekleme yöntemlerinden ölçüt ve kartopu örnekleme stratejileri kullanılmıştır. Çalışmada incelenen kavramlar ile ilgili temaların ve grubun betimlenmesine dayanan genel bir kültürel yorum yapma amacıyla veriler emik ve etik bir yaklaşımla analiz edilmiştir. Araştırmada etnografik içerik analizi yapılmıştır ve verilerin görselleştirilerek sunulmasında Maxqda 2022 Analitycs Pro kullanılmıştır.Bulgular –Çalışmanın bulguları “artifaktlar”, “varsayımlar”, “normlar” ve “kahraman: lider” temalarıyla sunulmuştur. Kelime bulunu analizine göre katılımcıların en çok “hasta” ve “biz” kelimelerini kullandıkları görülmüştür. Tartışma –Çalışma sonucunda, örgüt kültürünün temel inşacısı olarak birim yöneticisinin söylem ve davranışlarının çalışanların deneyimlerinde çok etkili olduğu görülmüştür. Örgütte kullanılan dil, varsayımlar ve normlar katılımcılar tarafından benimsemiştir. Kurumdaki hiyerarşi kültürü, güç mesafesi katılımcıların söylem ve deneyimlerinde açığa çıkmıştır. Bu çalışmada, hemşirelerin örgüt kültürü deneyimleriyle ilgili ortaya çıkan sonuçların ilgili alan yazını genişleteceği düşünülmektedir. Sağlık kurumlarında örgüt kültürünün geliştirilmesine yönelik daha fazla çalışmaya ve politikaya ihtiyaç duyulduğu düşünülmektedir.
Purpose
The purpose of this paper is to describe first-line managers’ (FLMs’) experiences and reflections on structural conditions for management practice within hospital settings using Kanter’s theory of structural empowerment.
Design/methodology/approach
A qualitative deductive approach with a descriptive design was used. Interviews were conducted with 11 FLMs in charge of medical or surgical hospital units spread across Sweden. Data were analyzed using a directed content analysis, based on Kanter’s theory of structural empowerment, encompassing such as access to necessary and sufficient resources, information, support and opportunities to learn and develop.
Findings
Findings of this study from the FLMs’ descriptions and reflections shed light on the impact of power dynamics on the structural conditions for management practice. The availability of nursing staff was a fundamental resource in the FLMs’ work performance, ensuring delivery of care to patients and a sound work environment for staff. Additionally, the other structural elements outlined in Kanter’s theory were evident in the findings, as the FLMs wished for structured information flow, identified potential and challenged opportunities for development and emphasized the importance of receiving support from people with a genuine understanding of their work situation.
Originality/value
The results of this study contribute to the understanding of FLMs’ structural conditions for management practice in hospital settings. The paper’s originality stems from the use of a deductive approach, providing a structured lens with the potential to inform future research and practice in the field of health-care management.
Introduction
Leadership development is of the utmost importance as the Army Medical Department prepares for future conflicts. All Army Medical Department leaders, including nurses, need to be prepared to lead in a high-tempo, complex environment. Nurse leader effectiveness is paramount to military readiness as well as for recruitment and retention within the Army Nurse Corps (ANC). Both Army talent management and Defense Health Agency documents recognize the importance of Emotional Intelligence principles for successful leadership. Resonant Leadership (RL) is informed by Emotional Intelligence principles and is well-studied within nursing literature. Additionally, the body of evidence examining RL demonstrates a positive impact on the nurse work environment. The purpose of this concept analysis is to define RL within the context of Army nursing, to clarify how this concept relates to Army leadership doctrine, and to propose innovative application(s) of RL within the ANC.
Methods
Rodgers’ evolutionary concept analysis method was used to define the attributes, antecedents, and consequences of RL. The concept elements were then cross-referenced with published Army leadership doctrine, applying RL to the context of Army nursing.
Results
The outcome of this analysis defines RL as a way of being, with attributes including strong, trusting relationships, the leader being in tune with followers, and mutual optimism. Antecedents of RL in Army nursing center on individual leader behavior and include emotional intelligence, technical/management skills and intellect, and acting on follower worries/concerns. Consequences of RL for Army nursing impact followers/staff and include improved job satisfaction, empowerment, and decreased burnout/emotional exhaustion.
Discussion
The defining characteristics of RL complement the competencies and attributes outlined in Army leadership doctrine. Additionally, the outcomes of RL positively influence the nursing work environment. There has been extensive research on the effect of RL within the civilian nursing workforce. However, to date, no studies have researched RL Army nursing. Leaders within the ANC can apply this analysis to their own leadership practice and integrate RL into leadership development education. Policy decisions within the ANC should promote RL to support positive nursing workforce outcomes including improved satisfaction and retention.
Conclusion
Resonant Leadership bridges the gap between frontline nursing leadership development, the Army leadership model, and the DHA’s Joint Professional Practice Model for nurses. By focusing on developing resonance, Army nurse leaders can simultaneously demonstrate many of the attributes and competencies the Army describes within its leadership doctrine. Although further research is needed to determine the prevalence of RL within Army nursing, RL has applicability to practice and military education. RL is one tool at the disposal of ANC senior to leaders to promote healthy work environments while preparing competent leaders for the complexities of future combat operations.
Aim
To identify and synthesise the qualitative evidence that is available regarding reducing the turnover of hospital nurses from their own perspectives.
Design
A qualitative systematic review using the meta‐aggregation design.
Data Sources
Qualitative studies either in English or in Chinese, dating from 2018 to 2023, were obtained from eight databases, including CINAHL, PubMed, Web of Science, Embase, Ovid, and Chinese National Knowledge Infrastructure (CNKI), Wanfang Database and the China Biomedical Database.
Methods
Studies were screened using pre‐determined inclusion and exclusion criteria. Quality assessment was done using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines.
Results
Sixteen papers were included that explored nurses' perspectives on enhancing their retention or reducing staff turnover. We developed three synthesised findings and 12 categories from 64 identified findings, including (1) individual adjustment strategy: professional pride, self‐growth and psychological adjustment; (2) social support strategy: constructive workplace relationships, balancing work life and recognition of nursing and (3) organisational change strategy: embracing management and leadership, promote nursing professionalisation, workload management and support, flexible work patterns and opportunities, supporting personal career development and competitive salary.
Conclusion
This review provides an in‐depth and meaningful understanding of nurses' own perceptions and suggestions for enhancing nursing turnover, which will call for a wide range of measures targeting the individual, social and organisational levels.
Implications for Nursing Management
This study contributes important knowledge to help improve hospital nurse's turnover, which can provide evidence to support nurse managers, other stakeholders and policymakers in correspondingly developing effective measures to address nurse turnover.
Patient or Public Contribution
There was no direct contribution from patient or caregiver to this study because the data of this study originated from published papers.
Purpose:
Leadership was a critical component in managing the Covid-19 pandemic. A scoping review of clinical leadership investigates the leadership styles employed by clinicians during times of unprecedented crisis, with the Covid-19 pandemic as a focus.
Design/methodology/approach:
The scoping review was designed based on a five-stage approach proposed by Arksey and O'Malley (2005). Three key databases were searched: Scopus, Cumulative Index for Nursing and Allied Health Literature (CINAHL), and ProQuest Healthcare Administration between 2020 and 2022.
Findings:
Of the 23 papers included in the review, the majority were based on developed countries. Seven leadership approaches were found to be useful in times of crises, with compassionate leadership being particularly effective. Seven key themes relating to the pandemic were also identified.
Research limitations/implications:
This review is limited by the search strategy employed and the possibility some publications could have been missed. However, it is clear from the results that there is limited research on healthcare leadership outside of the acute setting and in developing countries. These are important areas of further research that need to be pursued to inform our learning for other times of unprecedented crisis.
Originality/value:
Various leadership styles were employed during the pandemic, but compassionate leadership, which fosters a collaborative, caring and kind environment, becomes a necessity when faced with uncertainty and adversity. This review identifies key factors that leaders need to manage during the pandemic. Practically, it sheds light on leadership strategies that may be employed in future unprecedented crises.
The authors examine the source, nature, and direction of work and family conflict. Confirmatory factor analysis of a 22-item scale suggested the appropriateness of distinguishing between strain-based and time-based conflict and between family interfering with work (FIW) and work interfering with family (WIF). Six-month longitudinal survey data (N = 236) suggested that strain-based FIW is a precursor to both stress and turnover intentions. Strain-based WIF emerged as an outcome of stress.
The authors reviewed more than 70 studies concerning employees' general belief that their work organization values their contribution and cares about their well-being (perceived organizational support; POS). A meta-analysis indicated that 3 major categories of beneficial treatment received by employees (i.e., fairness, supervisor support, and organizational rewards and favorable job conditions) were associated with POS. POS, in turn, was related to outcomes favorable to employees (e.g., job satisfaction, positive mood) and the organization (e.g., affective commitment, performance, and lessened withdrawal behavior). These relationships depended on processes assumed by organizational support theory: employees' belief that the organization's actions were discretionary, feeling of obligation to aid the organization, fulfillment of socioemotional needs, and performance-reward expectancies.
In 3 studies, the authors demonstrated that individuals are motivated by role models who encourage strategies that fit their regulatory concerns: Promotion-focused individuals, who favor a strategy of pursuing desirable outcomes, are most inspired by positive role models, who highlight strategies for achieving success; prevention-focused individuals, who favor a strategy of avoiding undesirable outcomes, are most motivated by negative role models, who highlight strategies for avoiding failure. In Studies 1 and 2, the authors primed promotion and prevention goals and then examined the impact of role models on motivation. Participants' academic motivation was increased by goal-congruent role models but decreased by goal-incongruent role models. In Study 3, participants were more likely to generate real-life role models that matched their chronic goals.
Objective:
To evaluate the effect of transformational and transactional leadership styles of head nurses on the job satisfaction of staff nurses in critical care units (CCU) of a tertiary care hospital.
Study design:
Cross-sectional study.
Place and duration of study:
Critical care units at Aseer Central Hospital (ACH), Abha, Saudi Arabia, from July to December 2012.
Methodology:
The multifactor leadership questionnaire (MLQ-5X) and job satisfaction survey with demographics were used. Staff nurses (N=89) reporting to 8 nurse leaders responded as per the requirements of MLQ-5X and also filled the job satisfaction survey. ANOVA, correlation coefficient (Pearson r) and multiple linear regression were used for analyses.
Results:
All nurse leaders demonstrated a combination of transactional (TA) and transformational (TF) style of leadership. Nurses working under leaders with a TF style demonstrated significantly (p < 0.05) higher job satisfaction. The operating conditions were related negatively to the style of leadership. Pay, fringe benefits and nature of work were not related to the style of leadership. The nurses were moderately satisfied with their work and 23% of the variation in nurses' job satisfaction could be explained by the head nurses 6 leadership facets with positive effect of professional support, intellectual motivation, management by correction and their laissez faire style.
Conclusion:
The study emphasized the importance of TF style of head nurses for increasing staff nurses' job satisfaction. It is suggested that nurse leaders should be trained in TF style of leadership and provided more support and training for effective management of CCU.
Background:
The geographical maldistribution of the health workforce is a persisting global issue linked to inequitable access to health services and poorer health outcomes for rural and remote populations. In the Northern Territory (NT), anecdotal reports suggest that the primary care workforce in remote Aboriginal communities is characterised by high turnover, low stability and high use of temporary staffing; however, there is a lack of reliable information to guide workforce policy improvements. This study quantifies current turnover and retention in remote NT communities and investigates correlations between turnover and retention metrics and health service/community characteristics.
Methods:
This study used the NT Department of Health 2013-2015 payroll and financial datasets for resident health workforce in 53 remote primary care clinics. Main outcome measures include annual turnover rates, annual stability rates, 12-month survival probabilities and median survival.
Results:
At any time point, the clinics had a median of 2.0 nurses, 0.6 Aboriginal health practitioners (AHPs), 2.2 other employees and 0.4 additional agency-employed nurses. Mean annual turnover rates for nurses and AHPs combined were extremely high, irrespective of whether turnover was defined as no longer working in any remote clinic (66%) or no longer working at a specific remote clinic (128%). Stability rates were low, and only 20% of nurses and AHPs remain working at a specific remote clinic 12 months after commencing. Half left within 4 months. Nurse and AHP turnover correlated with other workforce measures. However, there was little correlation between most workforce metrics and health service characteristics.
Conclusions:
NT Government-funded remote clinics are small, experience very high staff turnover and make considerable use of agency nurses. These staffing patterns, also found in remote settings elsewhere in Australia and globally, not only incur higher direct costs for service provision-and therefore may compromise long-term sustainability-but also are almost certainly contributing to sub-optimal continuity of care, compromised health outcomes and poorer levels of staff safety. To address these deficiencies, it is imperative that investments in implementing, adequately resourcing and evaluating staffing models which stabilise the remote primary care workforce occur as a matter of priority.
Given the lack of active nurses in industrialized countries throughout the world, in combination with demographic changes, it is of utmost importance to protect nurses’ well-being and to prevent psychological distress, because of their strong association with premature occupational leave. The aim of this study was to investigate the effects of quality of leadership and social support at work on well-being and psychological distress of nurses and to determine whether nurses’ overcommitment mediates the relationship between the abovementioned determinants and the outcomes. A cross-sectional survey design was used to gather our data. This study utilized part of the database of the Nurses’ Early Exit Study. A total of 34,771 nurses (covering all nurse qualifications) working in hospitals, nursing homes, and home-care institutions in 8 European countries filled out a questionnaire (response rate = 51.4%). For all model variables (job satisfaction, satisfaction with salary, positive affectivity, personal burnout, negative affectivity, quality of leadership, social support from immediate supervisor, social support from near colleagues, and overcommitment), psychometrically sound, that is, valid and reliable measures were used. Outcomes from testing a structural equation mediation model indicated that, respectively, positive and negative influences of leadership quality and social support from supervisor and colleagues on nurses’ well-being and psychological distress are partially mediated, that is, reduced, by nurses’ overcommitment. Social work environment is highly important in relation to nurses’ well-being and psychological distress.
[Background] Recent studies have revealed that nursing staff turnover remains a major problem in emerging economies. In particular, nursing staff turnover in Malaysia remains high due to a lack of job satisfaction. Despite a shortage of healthcare staff, the Malaysian government plans to create 181 000 new healthcare jobs by 2020 through the Economic Transformation Programme (ETP). This study investigated the causal relationships among perceived transformational leadership, empowerment, and job satisfaction among nurses and medical assistants in two selected large private and public hospitals in Malaysia. This study also explored the mediating effect of empowerment between transformational leadership and job satisfaction.
[Methods] This study used a survey to collect data from 200 nursing staff, i.e., nurses and medical assistants, employed by a large private hospital and a public hospital in Malaysia. Respondents were asked to answer 5-point Likert scale questions regarding transformational leadership, employee empowerment, and job satisfaction. Partial least squares-structural equation modeling (PLS-SEM) was used to analyze the measurement models and to estimate parameters in a path model. Statistical analysis was performed to examine whether empowerment mediated the relationship between transformational leadership and job satisfaction.
[Results] This analysis showed that empowerment mediated the effect of transformational leadership on the job satisfaction in nursing staff. Employee empowerment not only is indispensable for enhancing job satisfaction but also mediates the relationship between transformational leadership and job satisfaction among nursing staff.
[Conclusions] The results of this research contribute to the literature on job satisfaction in healthcare industries by enhancing the understanding of the influences of empowerment and transformational leadership on job satisfaction among nursing staff. This study offers important policy insight for healthcare managers who seek to increase job satisfaction among their nursing staff.
Full article (PDF) available at http://rdcu.be/m9FI
Objectives
To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care.
Design
Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models.
Setting
Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland.
Participants
Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals.
Main outcome measures
Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction.
Results
Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80<OR<0.93), after adjusting for patient and hospital factors. Each 10 percentage point reduction in the proportion of professional nurses is associated with an 11% increase in the odds of death. In our hospital sample, there were an average of six caregivers for every 25 patients, four of whom were professional nurses. Substituting one nurse assistant for a professional nurse for every 25 patients is associated with a 21% increase in the odds of dying.
Conclusions
A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages.
Background:
Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses.
Objective:
The aim of this study is to evaluate the influence of nurse manager leadership style factors on staff nurse work engagement.
Methods:
Using a descriptive correlational research design, 441 staff nurses working in 3 acute care hospitals were surveyed. Survey instruments included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form.
Results:
Transactional and transformational leadership styles in nurse managers positively influenced staff nurse work engagement. Passive-avoidant leadership style in nurse managers negatively influenced staff nurse work engagement.
Conclusions:
Nurse managers who provide support and communication through transformational and transactional leadership styles can have a positive impact on staff nurse work engagement and ultimately improve organizational outcomes.
Background:
The nurse leadership of a hospital is identified as the single most important aspect of the practice environment that impacts nurse outcomes. When nurses are satisfied with their jobs, they tend to remain with their employers and become more productive in their workplaces.
Objectives:
This study aimed to investigate the relationship between leadership, job satisfaction and intentions to leave among registered nurses (RNs) working in hospitals in the North West and Free State provinces of South Africa.
Methods:
A cross-sectional survey design was adopted. The population (N = 680) with the sample (n = 204) included RNs in medical-surgical units in both private and public hospitals in the two provinces. Data were collected using the RN4CAST questionnaire.
Results:
RNs were satisfied with the items pertaining to leadership except for praise and recognition (55.7%). They also indicated high levels of overall job satisfaction (70.5%) but were dissatisfied with wages (50%), study leave (40.9%) and opportunities for advancement (40.1%). Furthermore, 46.1% of the RNs intended to leave their current hospitals. The results indicated a relationship between leadership and job satisfaction (r = 0.47; p = 0.00) and between intention to leave and job satisfaction (d = 0.50).
Conclusion:
The nurse managers played a significant role influencing RN's level of job satisfaction, while job satisfaction was highly correlated with intention to leave. The nurse leadership can improve job satisfaction by giving praise and recognition to the RNs for jobs well done, and RNs should be afforded the opportunity to advance their careers through further studies.
Background:
The current challenges facing healthcare systems, in relation to the shortage of health professionals, necessitates mangers and leaders to learn from different leadership styles and staff empowerment strategies, so as to create a work environment that encourages nursing staff commitment to patients and their organization. This study intends to measure the effects of nurses' overall perception of the leadership style of their managers, and psychological empowerment on their organizational commitment in acute care units, in National Guard Health Affairs, Riyadh City, Saudi Arabia.
Methods:
This was a cross-sectional survey, where the data was obtained from nurses at King Abdulaziz Medical City. Hard copy questionnaires were distributed to 350 randomly selected nurses. Three hundred and thirty two (332) were completed, representing a response rate of 95 %. Three validated survey instruments were used to obtain the data: (1) The Multifactor Leadership Questionnaire (MLQ), formulated by Bass and Avolio (1997), (2) The Psychological Empowerment Scale developed by Spreitzer (1995) and (3) The Three-Component Model of Employee Commitment developed by Meyer and Allen (1997). A theoretical model that conceptually links leadership, empowerment, and organizational commitment was used. The SPSS program version 19 was employed to perform descriptive and inferential statistics including correlation and stepwise multiple regression analysis.
Results:
Overall most nurses perceived their immediate nursing managers as not displaying the ideal level of transformational leadership (TFL) behaviors. Nurses' commitment appeared to be negatively correlated with TFL style and perceived psychological empowerment. However, commitment was positively correlated with the Transactional Leadership (TAL) style. Analysis, also, showed that commitment is significantly associated with the nurse's nationality by region: North American (P = 0.001) and Arab (p = 0.027). The other important predictors of commitment include TAL (P = 0.027), Laissez-faire Leadership (LFL (P = 0.012), and autonomy (P = 0.016). The linear combination of these predictors explained 20 % of the variability of the nurses' commitment.
Conclusion:
The study findings suggest that leadership styles and employee empowerment could play an instrumental role in promoting organizational commitment of nurses working in acute health care settings, at least in the Saudi Arabian context.
Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job. It is defined by the three dimensions of exhaustion, cynicism, and professional inefficacy. As a reliably identifiable job stress syndrome, burnout clearly places the individual stress experience within a larger organizational context of people's relation to their work. Burnout impairs both personal and social functioning. This decline in the quality of work and in both physical and psychological health can be costly—not just for the individual worker, but for everyone affected by that person. Interventions to alleviate burnout and to promote its opposite, engagement with work can occur at both organizational and personal levels. The social focus of burnout, the solid research basis concerning the syndrome, and its specific ties to the work domain make a distinct and valuable contribution to people's health and well-being.
Past research has shown that abusive supervision is linked to negative outcomes for employees, chiefly employees' counterproductive work behaviors directed at organizations. This study examined the relationships between two types of ineffective supervision (abusive supervision and authoritarian leadership style) and employees' distal negative outcomes (e.g., exhaustion, physical symptoms, job dissatisfaction, intention to quit, and poor job performance) in a sample of 232 nurses and 24 supervisors. In addition, this study examined how emotional reactions (anxiety and depression) mediated the negative relationships between ineffective leadership and employees' distal outcomes. The results suggested that both types of ineffective leadership were related to similar negative employee outcomes, and anxiety and depression mediated these relationships. The conclusions from this study contribute to the ineffective leadership literature through connecting previous findings on abusive supervision with those of authoritarian leadership style. Organizations can utilize these results to raise awareness among supervisors about the implications their behaviors in the workplace have on employees' welfare and on organizational effectiveness. (PsycINFO Database Record
Background and aims:
Effective delegation improves job satisfaction, responsibility, productivity and development. The ageing population demands more nurses in long-term-care hospitals. Delegation and leadership promote cooperation among nursing staff. However, little research describes nursing delegation and leadership style. We investigated the relationship between registered nurses' delegation confidence and leadership in Korean long-term-care hospitals.
Methods:
Our descriptive correlational design sampled 199 registered nurses from 13 long-term-care hospitals in Korea. Instruments were the Confidence and Intent to Delegate Scale and Multifactor Leadership Questionnaire.
Results:
Confidence in delegation significantly aligned with current-unit clinical experience, length of total clinical-nursing experience, delegation-training experience and leadership. Transformational leadership was the most statistically significant factor influencing delegation confidence.
Implications for nursing management:
When effective delegation integrates with efficient leadership, staff can deliver optimal care to long-term-care patients.
Emotional intelligence (EI) is one of the most widely discussed topics in current psychology. Although first mentioned in the professional literature nearly two decades ago, in the past five years it has received extensive media attention. The term "emotional intelligence" refers to the ability to identify, express, and understand emotions; to assimilate emotions into thought; and to regulate both positive and negative emotions in oneself and others. Yet despite the flourishing research programs and broad popular interest, scientific evidence for a clearly identified construct of EI is sparse. It remains to be seen whether there is anything to EI that researchers in the fields of personality, intelligence, and applied psychology do not already know.
This book offers a comprehensive critical review of EI. It examines current thinking on the nature, components, determinants, and consequences of EI, and evaluates the state of the art in EI theory, research, assessment, and applications. It highlights the extent to which empirical evidence supports EI as a valid construct and debunks some of the more extravagant claims that appear in the popular media. Finally, it examines the potential use of EI to guide practical interventions in various clinical, occupational, and educational settings.
Bradford Books imprint
Background:
Leaders are essential in every organization to achieve patient safety and healthy work environments. Authentic leadership is a relational leadership style purported to promote healthy work environments that influence staff performance and organizational outcomes. Given recent growth in authentic leadership research in healthcare and the importance of new knowledge to inform leadership development, there is an obligation to determine what is known about the antecedents and outcomes of authentic leadership in healthcare settings and clarify mechanisms by which authentic leadership affects healthcare staff and patient outcomes.
Objectives:
The aim of this systematic review was to examine the antecedents, mediators and outcomes associated with authentic leadership in healthcare.
Design:
Systematic review.
Data sources:
The search strategy included 11 electronic databases: ABI Inform Dateline, Academic Search Complete, Cochrane Database of Systematic Reviews, PubMed, CINAHL, Embase, ERIC, PsycINFO, Scopus, Web of Science, and ProQuest Dissertations & Theses. The search was conducted in January 2017. Published English-only quantitative research that examined the antecedents, mediators and outcomes of authentic leadership practices of leaders in healthcare settings was included.
Review methods:
Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were analyzed through descriptive and narrative syntheses. Content analysis was used to group antecedents, outcomes and mediators into categories which were then compared to authentic leadership theory.
Results:
1036 titles and abstracts were screened yielding 136 manuscripts for full-text review which resulted in 21 included studies reported in 38 manuscripts. Significant associations between authentic leadership and 43 outcomes were grouped into two major themes: healthcare staff outcomes with 5 subthemes (personal psychological states, satisfaction with work, work environment factors, health & well-being, and performance) and patient outcomes. There were 23 mediators between authentic leadership and 35 different outcomes in the included studies and one antecedent of authentic leadership.
Conclusions:
Findings of this review provide support for authentic leadership theory and suggest need for additional testing in future studies using longitudinal and interventional designs in more varied healthcare settings with diverse and interprofessional healthcare samples. Knowledge generated through this systematic review provides a more comprehensive understanding of authentic leadership, which can be used to educate future leaders and has the potential to improve leadership development strategies and positive outcomes in healthcare workplaces.
This book explores the various features of work environments that affect nurses' experiences of their work, their interactions with co-workers and patients, and ultimately health care quality and patient outcomes. Using a broad and comprehensive approach, the authors identify the most extensively researched and best-understood concepts in the field and presents a critical and up-to-date review of the evidence regarding causes and effects of work environment features. It then presents evidence regarding organizational interventions aimed at broad ranges of clinical practices and outcomes, such as team-based interventions and management practices to improve practice climate.
The ideas, approaches, and evidence are presented by a team of researchers and experienced practitioner/leaders; taken together, they form a state-of-the-science toolkit. Unique features of this book include a systematic presentation of best practices in nursing and healthcare leadership, along with the conceptual grounding and empirical support for these approaches, and extensive demonstrations of how these practices, many of which originated in North America, apply to European contexts.
Health care systems depend on viable health professional workforces. Nurse workforce projections for Australia indicate that by 2030 the demand for nurses will exceed supply. Retaining nurses is an ongoing problem both in Australia and globally. This study investigates nurse self-concept, practice environment and resilience, and how these three factors influence the retention of early career registered nurses (ECRNs). ECRNs are defined as RNs in the first 5 years of practice post-graduation. The researchers used a cross-sectional design for the study. Survey responses were elicited from 161 ECRNs in one Australian hospital and health service using four survey instruments: The Nurse Self-Concept Questionnaire, the Practice Environment Scale of the Nursing Work Index, the Connor–Davidson Resilience Scale and the Nurse Retention Index. Study findings demonstrate correlations between ECRN retention intentions and nurse self-concept, practice environment and resilience. The significance of these factors at different points during the first five years of practice emphasises the need for judicious and well-timed use of strategies to positively influence nurse retention. Longitudinal research investigating the significance of influencing factors over time would further contribute to our understanding of ECRN retention intentions.
Aim:
This study analysed nurses' perceptions of authentic leadership and safety climate and examined the contribution of authentic leadership to the safety climate.
Background:
It has been suggested and emphasised that authentic leadership should be used as a guidance to ensure quality care and the safety of patients and health-care personnel.
Methods:
This predictive study was conducted with 350 nurses in three Turkish hospitals. The data were collected using the Authentic Leadership Questionnaire and the Safety Climate Survey and analysed using hierarchical regression analysis.
Results:
The mean authentic leadership perception and the safety climate scores of the nurses were 2.92 and 3.50, respectively. The percentage of problematic responses was found to be less than 10% for only four safety climate items. Hierarchical regression analysis revealed that authentic leadership significantly predicted the safety climate.
Conclusions:
Procedural and political improvements are required in terms of the safety climate in institutions, where the study was conducted, and authentic leadership increases positive perceptions of safety climate.
Recommendations for nursing management:
Exhibiting the characteristics of authentic leadership, or improving them and reflecting them on to personnel can enhance the safety climate. Planning information sharing meetings to raise the personnel's awareness of safety climate and systemic improvements can contribute to creating safe care climates.
Being largely considered a human right, healthcare needs leaders who are able to make choices and to set directions. Following the recommendations expressed by Gilmartin and D'Aunno's review and roadmap compiled in 2008, today, it is important to acknowledge researchers' contributions to outline this landscape. The realist review of 77 publications answered questions such as “what works, for whom, and in which circumstances” highlighting: the effectiveness and acceptance of transformational and collaborative approaches; professionalism, expertise, and good task delegation within operational teams; distributed leadership, relationships, and social responsibility at a systemic level. The relevancy and need of leadership development programs, framed within a wider strategy, emerged. Nonetheless, gaps still exist and require further investigation: particular needs in public vs. private contexts; professionals' and women's differentiating characters; generational gaps; associations between leadership and recruitment HR practices research; how (and if) leaders (should) influence the organizational culture and values; and developing countries specific challenges. Also, a greater proportion of relevant findings should be drawn by empirical and more rigorous studies. Finally, a major attention could be paid to interactions happening at the team, organizational, and systemic level among different leaders and among leaders, followers and external actors.
Recent research has shown that hospital restructuring that included staff layoff has adversely affected the role, health and well-being of nurses who remained employed. Further research found that nurses working in environments that reflected resonant (emotionally intelligent) leadership reported the least negative effects to their healt and well-being following hospital restructuring. What remained unclear was the mechanism by which this mitigation occurred. The purpose of this paper is to explore additional findings from this leadership research and discuss one explanation unique to the academic literature for the mitigation variable--the investment of relational energy by resonant nursing leadership to build relationships with nurses and manage emotion in the workplace.
The Maslact Burnout Inventory (MBI) is a copyrighted instrument that must be obtained directly from the publisher, Mindgarden, Inc. For details about how to obtain the MBI and its Manual, please visit the Mindgarden website using the link shown below.
MINDGARDEN WEBSITE FOR MBI: http://www.mindgarden.com/117-maslach-burnout-inventory?utm_source=MBI+and+AWS+Customers&utm_campaign=0a742675a1-MBI_Manual_Fourth_Edition_Release8_23_2017&utm_medium=email&utm_term=0_1118b1ac54-0a742675a1-43999273
Please note that the company offers special pricing for students, making it very affordable. For details about how to obtain permission to use the MBI for your research as a student, please visit the Mind Garden website using the link shown below.
MINDGARDEN WEBSITE FOR MBI, use by students: http://www.mindgarden.com/content/14-researcher-student
If you have any questions, you can contact Mindgarden directly by visiting this website: https://www.mindgarden.com/contact-us
This study investigates the influence of a firm’s internal climate for innovation on the relationship between public R&D support and the innovation behaviour of the firm. We hypothesise that, if there is a positive relationship between public R&D support and a firm’s innovation activities, this phenomenon is more likely to be observed in firms with an internal climate that promotes innovation, rather than in firms with a restrictive one. Based on a sample of 135 manufacturing firms in Singapore, we discover the significant moderating effect of a firm’s internal climate for innovation on the impact of public R&D support on several measures of a firm’s innovation input, output and collaboration behaviour. We identify two distinct dimensions of internal climate for innovation (organisational policies and individual attitudes), which exhibit different moderating effects.
Despite increasing attention on the topic of empowerment, our under-standing of the construct and its underlying processes remains limited. This article addresses these shortcomings by providing an analytical treatment of the construct and by integrating the diverse approaches to empowerment found in both the management and psychology literatures. In addition, the authors identify certain antecedent conditions of powerlessness and practices that have been hypothesized to empower subordinates.
Purpose
The purpose of this paper is to examine the role of transformational leadership (TL) in developing social identity and its subsequent impact on team climate, intention to leave, burnout and quality of patient care among nurses.
Design/methodology/approach
Data for this cross-sectional study were collected from a sample of 201 registered nurses in Australia through questionnaires. Structural equation modelling was used to test the hypotheses.
Findings
Results illustrate that social identification appears to be the psychological mechanism through which TL impacts important employee outcomes, including perceived quality of patient care.
Practical implications
This study provides valuable insights into understanding the critical role of human resource management (HRM) practice and policy in healthcare environments. Findings from this study indicate that human resource managers can assist nurse unit managers to deliver their HRM roles effectively when adequate support and relevant HRM infrastructures are put in place.
Originality/value
This research considers the role of first-line nurse managers in healthcare organisations. It provides evidence-based knowledge about the type of leadership style required to achieve desirable employee outcomes and the essential HRM opportunities to facilitate this.
AimThe aim of this study was to propose a theoretical model and apply it to examine the structural relationships among nurse characteristics, leadership characteristics, safety climate, emotional labour and intention to stay for hospital nurses. Background
Global nursing shortages negatively affect the quality of care. The shortages can be reduced by retaining nurses. Few studies have independently examined the relationships among leadership, safety climate, emotional labour and nurses' intention to stay; more comprehensive theoretical foundations for examining nurses' intention to stay and its related factors are lacking. DesignCross-sectional. MethodsA purposive sample of 414 full-time nurses was recruited from two regional hospitals in Taiwan. A structured questionnaire was used to collect data from November 2013-June 2014. Structural equationmodelling was employed to test the theoretical models of the relationships among the constructs. ResultsOur data supported the theoretical model. Intention to stay was positively correlated with age and the safety climate, whereas working hours per week and emotional labour were negatively correlated. The nursing position and transformational leadership indirectly affected intention to stay; this effect was mediated separately by emotional labour and the safety climate. Conclusion
Our data supported the model fit. Our findings provide practical implications for healthcare organizations and administrators to increase nurses' intent to stay. Strategies including a safer climate, appropriate working hours and lower emotional labour can directly increase nurses' intent to stay. Transformational leadership did not directly influence nurses' intention to stay; however, it reduced emotional labour, thereby increasing intention to stay.
Aims and objectives:
To explore the association between workplace bullying and workplace environment factors among nurses in Japan.
Background:
Workplace bullying among nurses is increasing globally and occurs more frequently than among other professions. However, there is little information on the impact of workplace environment factors on nurse bullying in Japan.
Design:
A cross-sectional survey using a self-administered questionnaire.
Methods:
Participants were 1152 nurses recruited at seminars or training courses outside of their workplaces in Tokyo. Workplace bullying was measured using the Negative Acts Questionnaire-Revised. Participants were considered to have been 'bullied' if they reported experiencing at least one negative act on a daily or weekly basis. Workplace environment factors were measured using the Practice Environment Scale of the Nursing Work Index, which comprises five domains: nurse participation in hospital affairs; nursing foundations for quality of care; nurse manager ability, leadership and support of nurses; staffing and resource adequacy; and collegial nurse-physician relationships.
Results:
A total of 898 (78·0%) questionnaires were returned, of which 825 (71·6%) were analysed. Altogether, 153 (18·5%) nurses were considered 'bullied.' The three most frequent negative acts reported as occurring on a weekly or daily basis were 'someone withholding information which affects your performance' (6·7%), 'being exposed to an unmanageable workload' (4·4%) and 'being shouted at or being the target of spontaneous anger (or rage)' (3·6%). Logistic regression analysis indicated that 'bullied' were associated with low scores on two work environment domains: nurse manager ability, leadership and support of nurses and staffing and resource adequacy.
Conclusions:
Effective nurse manager leadership and support as well as appropriate staffing management may positively influence workplace bullying among nurses in Japan. Authentic leadership styles and allowing nurses to easily request days off might also be important.
Relevance to clinical practice:
Nurse managers' leadership may influence nurses' workplace bullying.
Accumulating evidence finds servant leadership is related to critical employee and organizational criteria, but only a limited amount of studies link servant leaders to both internal and external stakeholder outcomes. Moreover, there remains a great deal to learn regarding the conditions under which this influence is enhanced or diminished. We address these limitations in the literature by testing a multilevel model that hypothesizes servant leadership is related to nurse behavior and satisfaction as well as patient satisfaction. Further, drawing upon contingency theory, we test a contextual moderator, organizational structure, as a potential enhancer of the relationships between servant leadership and these outcomes. Using a sample of 1485 staff nurses and 105 nurse managers at nine hospitals, we demonstrated that servant leadership is directly related to more nurse helping and creative behavior, and it is related to patient satisfaction through nurse job satisfaction. Also, organizational structure acted as a moderator to enhance the influence of servant leadership on creative behavior as well as patient satisfaction through nurse job satisfaction. Limitations and future research directions are discussed.
Aim:
To determine if nurse managers' leadership style is related to Japanese staff nurses' affective commitment to their hospital.
Background:
In Western countries, nurse managers' transformational leadership style has been found to increase staff nurses' affective commitment to their hospital. However, there are few studies examining this relationship in the context of acute care hospitals in Japan.
Methods:
Staff nurses completed measures of their nurse managers' perceived leadership style and factors related to their own affective commitment. The association between affective commitment and perception of leadership style was assessed with multiple logistic regression.
Results:
Of 736 questionnaires distributed, 579 (78.9%) were returned, and data from 396 (53.8%) fully completed questionnaires were analysed. The intellectual stimulation aspect of transformational leadership positively increased staff nurses' affective commitment (odds ratio: 2.23). Nurse managers' transactional and laissez-faire leadership styles were not related to affective commitment among staff nurses.
Conclusions:
The intellectual stimulation aspect of transformational leadership may increase the retention of staff nurses through enhanced affective commitment.
Implications for nursing management:
To increase staff nurses' affective commitment to their hospital, we suggest that hospital administrators equip nurse managers with intellectual stimulation skills.
Objective:
This study examined the impact of shared governance (SG) on the professional nursing practice environment of a small community hospital over time.
Background:
Shared governance has been shown to empower nurses in direct patient care to make decisions about their practice and improve job satisfaction. No research has been found that examined the progression of SG over time in a small community hospital.
Methods:
Questionnaires pertaining to the professional practice environment, perception of nursing leadership, nurse empowerment, nurse satisfaction, risk of practice errors, and comfort with evidence-based practice were administered to all nurses employed at a 149-bed community hospital in central North Carolina for 5 consecutive years.
Results:
Results showed that nursing leadership and SG explained 90% of the variance in the nursing professional practice environment. This relationship held true for 5 years. All variables showed continued improvement for 4 years, until year 5 when the organization experienced disruptive change. Even during this year, the results did not return to baseline.
Conclusions:
In order to improve the professional practice environment of nurses, hospitals should focus on strong nursing leadership and a sound SG infrastructure.
While authentic leadership (AL) has seen a dramatic increase in scholarly attention over the last decade, its contribution relative to more established leadership constructs merits investigation. We employ meta-analytic techniques to compare AL and transformational leadership theories using 100 independent samples and 25,452 individuals. The findings reveal that (1) the relationship between authentic and transformational leadership is large in magnitude, suggesting construct redundancy (ρ = .72); (2) neither AL nor transformational leadership add noticeable incremental validity beyond the other construct; (3) AL has a lower relative weight than transformational leadership for the outcomes of follower satisfaction, follower satisfaction with the leader, task performance, and leader effectiveness; and (4) AL demonstrates dominance over transformational leadership when predicting group or organization performance and organizational citizenship behaviors. We recommend future research examine AL at the component level and its relationships with related ethical constructs to potentially differentiate it from transformational leadership.
Psychological capital: Investing and developing positive organizational behavior Several years ago, a growing number of psychologists became concerned that the field had overemphasized the negative at the sacrifice of the positive. In seeking the illusive solutions of healing mental illness and dysfunctional behavior, both academic and practicing psychologists had almost completely ignored strengths and developing and helping healthy, productive people reach even higher levels of functioning. The field had largely ignored the elements that contribute to flourishing, instead focusing on what made individuals fail. The jump start for a more positive psychology came in 1998 when then president of the American Psychological Association Martin Seligman challenged the field to better understand what was right with people instead of solely concentrating on what was wrong with people (Seligman and Csikszentmihalyi, 2000; Sheldon and King, 2001). Indeed, what Seligman was calling for was a more balanced approach to studying what constituted the ...
It is important to uncover new approaches to attracting and retaining newly qualified nurses in Canada to address the growing nursing workforce shortage. Authentic leadership theory proposes mechanisms that allow managers to create positive and supportive environments that facilitate new graduate nurses’ transition into practice and subsequently improve nurses’ and organizational outcomes. The purpose of this study was to test a theoretical model linking authentic leadership to new graduate nurses’ job satisfaction through its effect on supportive professional practice environments. A secondary analysis of data (n = 93) from a larger study by Laschinger et al. (2013) was conducted. Mediation multiple regression analysis was performed to determine the influence of authentic leadership and supportive professional practice environments on new graduate nurses’ job satisfaction. Measures of the Authentic Leadership Questionnaire (ALQ), the Revised Nursing Worklife Index (NWI-R) and the North Carolina Center for Nursing – Survey of Newly Licensed Nurses (NCCN-SNLN) were used. A supportive professional practice environment partially mediated the relationship between authentic leadership and new graduate nurses’ job satisfaction. The findings suggest that managers who demonstrate authentic leadership create supportive professional practice environments and are more likely to enhance new graduate nurses’ job satisfaction.
The creation of innovative retention strategies will be a major focus for nursing administration as a shortage of nurses recurs and turnover of staff becomes a problem. A recent study provides information on which to formulate retention strategies. The findings suggest that retention strategies, to be effective, need to be targeted specifically to particular conditions of the nursing staff, e.g., educational preparation and the clinical service on which staff are functioning. The authors outline their research findings and the innovative strategies that have been constructed.
Aim:
The study examined whether three resources, that is, compassion, transformational leadership and work ethic feasibility, buffer against the negative effects of emotional labour on work engagement.
Background:
Emotional labour is a common job stressor among nurses, but little is known about whether certain personal and work resources buffer against it in relation to work engagement. Revealing buffers of emotional labour would help organizations to design tailored interventions.
Design:
Cross-sectional online survey conducted in 2014.
Methods:
Participants were 3466 Finnish nurses. Hypotheses were tested via hierarchical moderated regression analyses.
Results:
Higher emotional labour related to lower engagement. Two interaction effects were found. First, work ethic feasibility buffered against emotional labour: the nurses who perceived work ethic feasibility as high in a situation of high emotional labour, scored higher on engagement compared with those nurses who in this stress situation perceived work ethic feasibility to be low. Second, high compassion was detrimental to engagement in the presence of high emotional labour. Transformational leadership did not act as a buffer but showed a positive relationship with engagement.
Conclusion:
Work ethic feasibility (being able to work according to high ethical standards) is an important resource in nursing as it protects an employee against the negative effects of emotional labour and as it also directly promotes engagement. However, compassion may not always be beneficial in nursing, especially if co-occurring with high job stress. Transformational leadership has potential to improve engagement in nursing although it may not operate as a stress buffer.
