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PubMed1997

The relation between leadership style and empowerment on job satisfaction of nurses.

OBJECTIVE: The authors explore the relation between leadership style and empowerment and its effect on job satisfaction among the nursing staff of a regional medical center. BACKGROUND: Several empirical studies on transformational leadership-found that transformational leadership behaviors were positively related to work team success and leadership effectiveness. Transformational leadership processes have also been suggested to enhance followers' work-oriented values and shape the self-efficacies of followers. Employee empowerment may be influenced by the perception that the organization cares about its employees' well-being and that their work is valued. Empowering nurses may increase job satisfaction and improve patient care. Leadership style and empowerment influence job satisfaction among workers. METHODS: All nursing department staff were invited to complete a self-report questionnaire with no identifying information. Leadership style was measured using Bass's Multifactor Leadership Questionnaire, empowerment was measured with items from Spreitzer's Psychological Empowerment instrument, and job satisfaction was measured by Warr, Cook, and Wall's job satisfaction questionnaire. RESULTS: Both transformational and transactional leadership were positively related to job satisfaction, as was empowerment. Differences in the contributions of empowerment and leadership style in predicting job satisfaction for licensed and unlicensed workers was evident. CONCLUSION: Designing interventions that allow for the relative influence of leadership style as well as empowerment on varying classifications of nursing personnel may be a more effective strategy and have a greater effect on staff attitudes and behaviors.

Decision Making, Organizational↗

PubMedDate not supplied

Leadership styles across hierarchical levels in nursing departments.

BACKGROUND: Some researchers have reported on the cascading effect of transformational leadership across hierarchical levels. One study examined this effect in nursing, but it was limited to a single hospital. OBJECTIVES: To examine the cascading effect of leadership styles across hierarchical levels in a sample of nursing departments and to investigate the effect of hierarchical level on the relationships between leadership styles and various work outcomes. METHODS: Based on a sample of eight hospitals, the cascading effect was tested using correlation analysis. The main sources of variation among leadership scores were determined with analyses of variance (ANOVA), and the interaction effect of hierarchical level and leadership styles on criterion variables was tested with moderated regression analysis. RESULTS: No support was found for a cascading effect of leadership across hierarchical levels. Rather, the variation of leadership scores was explained primarily by the organizational context. Transformational leadership had a stronger impact on criterion variables than transactional leadership. Interaction effects between leadership styles and hierarchical level were observed only for perceived unit effectiveness. CONCLUSIONS: The hospital's structure and culture are major determinants of leadership styles.

Adult↗

PubMedDate not supplied

Leadership from an international perspective.

Leadership development can be considered from its science, which addresses business skills, and it can be considered from the art of leadership, which addresses the management of relationships. There is also the third frame of the "leader within." In this frame, art and science are blended, melded, and matured into the unique shape of each individual's expression of leadership behavior. This third perspective also addresses the cultural diversity of leadership. It permits a comparison of the American leadership experience with the evolving leadership development in Central and Eastern Europe (CEE). The framework used to discuss cultural diversity of leadership development is the Center for Nursing Leadership's Dimensions of Leadership. These dimensions are a set of values, beliefs, and behaviors that look at leadership beyond the traditional skill sets. The dimensions include (1) holding the truth; (2) quest for adventure toward knowing; (3) appreciation of ambiguity; (4) holding multiple perspectives without judgment; (5) discovery of potential; (6) nurturing the emotional and intellectual self; (7) keeping commitments to oneself; and (9) diversity as a vehicle to wholeness. These dimensions explore emerging leadership shifts occuring in nurse leaders in CEE. When the CEE and American experience are compared using these dimensions, nurse leaders have far more in common, despite the cultural differences.

Cross-Cultural Comparison↗

PubMed2005

Examining leadership through critical feminist readings.

PURPOSE: This paper seeks to explore a critique of the limitations of mainstream leadership research and publications and offers a critical management analysis through drawing on a feminist reading of leadership in organizations. DESIGN/METHODOLOGY/APPROACH: There has recently been witnessed a growing interest in the promotion of effective leadership within both organizational studies literature and organisational policy as the route to ensuring employee commitment and enhanced organisational performance and the achievement of ever demanding goals and targets. This turn to leadership is represented in both an upsurge of research studies and a proliferation in the promotion of leadership as the organisational panacea. An analysis of the literature on leadership was undertaken, giving due consideration to mainstream and more critical accounts in relation to illustrations drawn from the UK National Health Service (NHS). FINDINGS: This paper explores mainstream literature on leadership and finds it wanting, in terms of its failure to deliver a common understanding of the concept, in its generally uncritical accounts, and its inability to expose the androcentric nature of the core assumptions within hegemonic discourses of leadership. Drawing on critical feminist readings in relation to the UK NHS, a more critical account of leadership is presented. PRACTICAL IMPLICATIONS: Greater awareness is required for the adoption of culturally sensitive and locally-based approaches that take account of individuals' experiences, identities and power relations and that allows for the presence of a range of masculine and feminine workplace behaviours. ORIGINALITY/VALUE: This paper provides an overview of the dominant themes within the literature on leadership as they relate to the UK NHS, and presents a feminist critique of the more subtle ways in which notions of leadership in organisations fail to consider their potential for bias.

Feminism↗

PubMed2007

Psychometric properties of the Multifactor Leadership Questionnaire among nurses.

AIM: This paper reports a study investigating the psychometric properties of the Multifactor Leadership Questionnaire among nurses. BACKGROUND: Although the Multifactor Leadership Questionnaire is one of the most widely used instruments to measure the multifactor leadership theory in organizational sciences, inconsistent research findings have been reported for its psychometric properties. Little is known about these properties. METHOD: Data were gathered by postal questionnaires in 2001-2002 with nurses working in different healthcare organizations in Finland. A follow-up study was performed 1-year later. The sample consisted of 601 nurses and nurse leaders, and the follow-up study had 78 respondents. The internal consistency of the Multifactor Leadership Questionnaire was explored using Cronbach's alpha coefficient and item-analysis, and the test-retest reliability using Pearson product moment correlation coefficient and intra-class correlation coefficient (single measure intra-class correlation coefficient). The factor structure was studied using exploratory and confirmatory factor analyses. RESULTS: The internal consistencies of the leadership subscales were satisfactory. The Multifactor Leadership Questionnaire was fairly stable measured at the 1-year interval. Although the data fail to support the full nine-factor model, a reduced set of items from the Multifactor Leadership Questionnaire appears to show evidence of the three- and six-factor structures. Exploratory factor analysis showed evidence for the three-factor structure consisting of three distinctive, yet partly related leadership subscales. Confirmatory factor analysis showed evidence for the six-factor structure. CONCLUSION: The psychometric data suggest that a modified version of the Multifactor Leadership Questionnaire is a highly suitable instrument to measure multidimensional nursing leadership. Validity and reliability were supported. The results can be used in studies applying the Multifactor Leadership Questionnaire.

Adult↗

PubMed2005

An evaluation of the leadership attitudes of managers in Turkish Armed Forces' hospitals.

BACKGROUND: As in any other institution, the success of hospitals, which use approximately one-half of all resources in the health sector, depends on moving human resources toward the institution's goals. Ensuring that the workers are used intentionally for specific, predetermined goals, and that the workers are motivated toward achieving these institutional goals are the responsibilities of the managers. OBJECTIVE: In this study, the leadership attitudes of the higher rank executive officers in Turkish Armed Forces' military hospitals were evaluated. METHODS: The managerial grid developed by Blake and Mouton was used to evaluate the leadership attitudes of the officers. A total of 172 questionnaires was sent out to managers, but only 142 (82.6%) were returned completed. RESULTS: The study results show that the managers substantially preferred team leadership styles in terms of leadership philosophy, planning, and evaluation functions, but preferred task-oriented leadership and mid-way leadership styles in terms of execution. Also, it was found that 72% of all managers practiced team leadership in terms of the overall leadership manner. CONCLUSIONS: It seems as if the type of leadership participants preferred was team leadership, and the least was passive leadership. From this finding, we suggest that the managers in Turkish Armed Forces' hospitals are not only interested in their work and goals, but also in the interests of their workers as human beings.

Adult↗

PubMed2006

Management training of physician executives, their leadership style, and care management performance: an empirical study.

OBJECTIVE: To examine associations between management training of physician executives and their leadership styles, as well as effectiveness in achieving disease management goals. STUDY DESIGN: Cross-sectional national survey. METHODS: Executive directors of community health centers (269 respondents; response rate = 40.9%) were surveyed regarding their perceptions of the medical director's leadership, and for quantitative information on the center's achievement of clinical (mostly disease management) goals. The dependent variables were the medical director's scores (as perceived by the executive director) on transformational, transactional, and laissez-faire leadership, effectiveness, satisfaction with the leader, and subordinate extra effort, using an adapted Multifactor Leadership Questionnaire (43 items; 5-point Likert scale). The independent variable was the medical director's management training status. RESULTS: Compared with medical directors with < 30 days of inservice training, medical directors with an MHA, MPH, or MBA, or > or =30 days of in-service training, had 0.32, 0.35, 0.30, 0.36, and 0.37 higher scores on transformational leadership, transactional leadership, rated effectiveness, satisfaction, and subordinate extra effort, respectively, and 0.31 lower score on laissez-faire leadership (all P < .001). Medical directors without management degrees but with > or =30 days of in-service training had 0.34, 0.36, 0.50, and 0.47 higher scores on transformational leadership, transactional leadership, rated effectiveness, and satisfaction with the leader (all P < .02). Our data previously had demonstrated that medical directors' transformational leadership significantly influences achievement of disease management goals. CONCLUSION: Training may enable physician executives to develop leadership styles that are effective in influencing clinical providers' adoption of disease management guidelines under managed care.

Adult↗

PubMed1989

Situational theory of leadership.

The situational theory of leadership and the LEAD instruments for determining leadership style are explained, and the application of the situational leadership theory to the process of planning for and implementing organizational change is described. Early studies of leadership style identified two basic leadership styles: the task-oriented autocratic style and the relationship-oriented democratic style. Subsequent research found that most leaders exhibited one of four combinations of task and relationship behaviors. The situational leadership theory holds that the difference between the effectiveness and ineffectiveness of the four leadership styles is the appropriateness of the leader's behavior to the particular situation in which it is used. The task maturity of the individual or group being led must also be accounted for; follower readiness is defined in terms of the capacity to set high but attainable goals, willingness or ability to accept responsibility, and possession of the necessary education or experience for a specific task. A person's leadership style, range, and adaptability can be determined from the LEADSelf and LEADOther questionnaires. By applying the principles of the situational leadership theory and adapting their managerial styles to specific tasks and levels of follower maturity, the authors were successful in implementing 24-hour pharmacokinetic dosing services provided by staff pharmacists with little previous experience in clinical services. The situational leadership model enables a leader to identify a task, set goals, determine the task maturity of the individual or group, select an appropriate leadership style, and modify the style as change occurs. Pharmacy managers can use this model when implementing clinical pharmacy services.

Behavior↗

PubMed1995

[Nursing leadership in perspective].

South Africa is currently in the process of political change, which places great demands on all service sectors. To meet these demands effectively, will require dynamic leadership on all levels of service industries. The nursing profession in South Africa has produced several significant leaders, of whom Sister Henriëtta Stockdale and Professor Charlotte Searle are prime examples. However, research reports indicate that the profession is currently undergoing a crisis with regard to nursing service management. It is assumed that the nursing profession of South Africa is experiencing a leadership crisis. It seems as if there are not sufficient new leaders to replace those who retire from the profession--which means that leadership development is inadequate in the profession. Only a few South African research projects have been undertaken with regard to leadership in the nursing profession. However, the process of leadership practice in nursing has never been researched in South Africa. In this paper a provisional model is presented for leadership practice in nursing, which is developed and based on a Judeo-Christian-philosophical approach. The dimensions and assumptions of nursing leadership practice will be discussed, whereafter the dynamics of nursing leadership will be highlighted. Finally the process of leadership will be described by suggesting four leadership actions, each with its own principles, prerequisites and assumptions. It is recommended that this provisional model be exposed to reliability and validity control measures, to develop a final model for nursing leadership.

Health Services Needs and Demand↗

PubMed2005

Dietetics students perceive themselves as leaders and report they demonstrate leadership in a variety of contexts.

A leadership survey was designed and administered to undergraduate dietetics students (n=283) at eight universities to examine leadership actions reported most frequently, the context of these leadership actions, and students' reported perceptions of themselves as leaders. The majority of students perceive themselves as leaders in all context areas. The leadership practice, "Enabling Others to Act," was the most frequently reported. There were no significant differences in leadership behaviors based on college classification status and supervisory experience. Leadership behaviors were more prevalent in students who had previous leadership course-work, were older, or who had previous leadership experience. Dietetics students perceive they demonstrate leadership and do so in a variety of contexts, most frequently in class. Therefore, classroom activities may help strengthen leadership abilities of future dietetics professionals.

Adult↗

PubMed2000

Leadership and the UK health service.

This paper explores future leadership requirements for health services in the context of relevant leadership theory and the changing environment for health services in the UK. The output of leadership research is both prolific and confusing and its applicability to health services management uncertain especially in the context of constraints on the strategic managerial behaviour and choices of public service managers. The introduction of general management to the UK NHS in the 1980s, followed by an internal market for health care in 1990 should have provided the opportunity for managers to work differently and to create personal space for leadership. However, it is not known whether sustainable , new ways of leadership working have emerged although it is reasonable to hypothesis from studies elsewhere that a number of contextual and behavioural leadership models are likely to be found in the NHS. Although management researchers have explored networking and referred to the impact of the external environment of leadership, insufficient importance has been attached to-date to the impact of future trends in health services on the leadership of change in the health sector. The paper argues that in future health services leadership will require much more than traditional networking with other organizations and groups and will need to focus on developing and securing external agreement to an agenda for positive change turning the apparent constraints of the external environment, determined primarily by government policies,into opportunities. In other words, the demands of external or contextual leadership will increase forcing a stronger focus on having to achieve change through others.

Health Services Needs and Demand↗

PubMed2004

Transformational and transactional leadership: a meta-analytic test of their relative validity.

This study provided a comprehensive examination of the full range of transformational, transactional, and laissez-faire leadership. Results (based on 626 correlations from 87 sources) revealed an overall validity of .44 for transformational leadership, and this validity generalized over longitudinal and multisource designs. Contingent reward (.39) and laissez-faire (-.37) leadership had the next highest overall relations; management by exception (active and passive) was inconsistently related to the criteria. Surprisingly, there were several criteria for which contingent reward leadership had stronger relations than did transformational leadership. Furthermore, transformational leadership was strongly correlated with contingent reward (.80) and laissez-faire (-.65) leadership. Transformational and contingent reward leadership generally predicted criteria controlling for the other leadership dimensions, although transformational leadership failed to predict leader job performance.

Humans↗

PubMed1993

Leadership in the nursing unit: relationships with nurses' well-being.

The head nurse occupies an important position in the nursing unit. Concerning leadership style, a distinction is traditionally made between consideration and initiating structure. Sometimes a third style is distinguished as well, namely 'production-orientated' leadership. In a study of 561 nurses from 16 general hospitals in The Netherlands, the influence of two leadership styles upon the reactions of nurses (job satisfaction, experienced meaningfulness, health complaints and absenteeism) to their work situations was examined, namely the styles of social (i.e. consideration) and instrumental leadership (a combination of the styles initiating structure and production-orientated). The separate effects of the two styles were studied, as well as the connection between combinations of leadership styles and reactions. The results indicate that social leadership contributes positively to nurses' reactions to their job. Instrumental leadership, on the other hand, leads to health complaints. From the analyses of combinations of leadership styles it appears that nurses are most satisfied if the head nurse pays much attention to both dimensions of leadership. For health complaints, a tendency in this direction is also found. Finally, it becomes clear that nurses with a great need for autonomy prefer a different type of leadership from nurses with little need for autonomy.

Absenteeism↗

PubMed1999

Nursing leadership: influencing and shaping health policy and nursing practice.

The leadership discourse in the United Kingdom has to date been concerned with professional issues and as a result has focused upon developing nurses and nursing. This paper reports on the findings of a research study which examined the broader socio-political factors impacting upon nursing leadership. The study forms an integral part of the Royal College of Nursing's leadership programme. The principal aim of the research was to examine critically contemporary nursing leadership within the context of health policy. An ethnographic approach was used. Informal semi-structured interviews were undertaken with a purposive sample of 24 leaders who were recognized for their effectiveness in leading nursing. Data were analysed for themes. The main themes are presented and discussed here. The findings of the study question the political success which the internally focused nature of leadership has had for the profession. Nursing and therefore nursing leadership is shaped dramatically by the impact of politics and policy. The research discovered that in recognition of this, contemporary nursing leadership has both an internal and an external focus. That is, effective nursing leadership currently is a vehicle through which both nursing practice and health policy can be influenced and shaped. The research also identified the profile of the effective nurse leader, together with the processes through which leaders interpret and translate between the macro issues of policy and the micro issues of practice. In addition, an understanding of what nursing leadership is, has been proposed. Appropriate recommendations for the future of nursing and nursing leadership are outlined.

Anthropology, Cultural↗

PubMedDate not supplied

Developing BSN leaders for the future: the Fuld Leadership Initiative for Nursing Education (LINE).

The Helene Fuld Leadership Initiative in Nursing Education (LINE) program was designed to enhance beginning leadership competencies of baccalaureate nursing students. Given the increasing need for strong and effective leadership throughout the health care system, and the demands new graduates encounter as they move into practice, the LINE program is built on the premise that leadership skills must be instilled at the undergraduate level. The program achieves its goal through an intensive 5-day institute focused on assessing and developing the leadership competencies of nurse educators and their clinical partners to enable them to be effective agents of curriculum change in their home institutions. The institute also assists participants to redesign their baccalaureate nursing (BSN) curricula to ensure that students learn to: (1) work effectively within and across complex, integrated organizational and institutional boundaries; (2) think and act from the perspective of a system; and (3) communicate, negotiate, lead, and facilitate change within health care organizations. D. Goleman's (1998) framework of emotional intelligence, which addresses both personal competence (managing oneself) and social competence (handling one's relationships with others) provides the framework for operationalizing leadership in the BSN curriculum. To date, 26 BSN programs and their clinical partners have participated in the LINE program, which has the potential to influence the beginning leadership development of more than 2,400 BSN students. Program outcomes reveal that education-practice collaboration, professional networking, individual leadership development of nurse educators and their clinical partners as change agents, and the integration of leadership experiences at all levels of the BSN curriculum are important in developing beginning leadership competencies in BSN students.

Communication↗

PubMed2005

Nurse executive transformational leadership and organizational commitment.

OBJECTIVE: To investigate the relationship between nurse executive leadership and organizational commitment among nurses in acute care hospitals. BACKGROUND: A key challenge for organizations is to maximize the contributions of all workers by cultivating their commitment. Nurse leaders are in a position to influence organizational commitment among nurses. METHODS: The theoretical constructs underlying this study are the transformational leadership theory and the Etzioni's organizational theory. A cross-sectional, field survey of nurse executives, nurse managers, and staff nurses was conducted to assess nurse executive transformational and transactional leadership and their relationship to organizational commitment. Hypotheses were tested using correlational analysis, and univariate statistics were used to describe the sample. RESULTS: An inverse relationship between nurse executive transformational and transactional leadership and alienative (highly negative) organizational commitment was statistically significant. A positive association was demonstrated between nurse executive leadership and nurse manager leadership. CONCLUSIONS: This study supports the effect of nurse executive leadership on nurse manager leadership and on organizational commitment among nurses despite role distance. To the extent that transformational leadership is present, alienative organizational commitment is reduced. This relationship shows the importance of nurse executive leadership in organizational involvement among nurses in the dynamic context of contemporary hospital settings.

Adult↗

PubMed2004

A behavior genetic investigation of the relationship between leadership and personality.

Phenotypic research on leadership style has long considered the importance of individual differences in personality when identifying the behaviors associated with good leaders. Although leadership and many personality traits have been separately shown to be heritable, these constructs have not been examined with genetically informative data to identify common sources of heritability in the two domains. A logical extension to current research, therefore, is to examine the extent to which factors of personality are predictive of leadership dimensions and the extent to which unique genetic contributions to the relationship between personality and leadership style may be identified. Adult twin pairs (183 MZ and 64 same-sex DZ) completed the Multifactor Leadership Questionnaire (MLQ) and the Personality Research Form (PRF). Univariate analyses indicated that both leadership factors (transformational and transactional leadership) and all five of the "Big Five" factors (openness, conscientiousness, extraversion, disagreeableness, and neuroticism) were best fit by genetic models. Multivariate genetic analyses suggest that transformational leadership shows a statistically significant positive genetic correlation with conscientiousness, extraversion, and openness to experience. Transactional leadership shows a significant negative genetic correlation with conscientiousness and extraversion, and a significant positive genetic correlation with disagreeableness. These results underscore the importance of conscientiousness and extraversion in predicting leadership style, and illustrate important differences between transformational and transactional leaders.

Adult↗

PubMed2006

Leadership and professionalism curriculum in the Gross Anatomy course.

INTRODUCTION: Today's physicians must demonstrate both professionalism and leadership skills in order to succeed in largely team-based healthcare environments. The purpose of this study was to determine if professionalism attributes, leadership style, and leadership style adaptability are associated with academic performance among first-year students early in their medical curriculum. MATERIALS AND METHODS: Students were divided into 4-member dissection groups for the duration of the Gross and Developmental Anatomy course. Leadership responsibility was randomly assigned to a team member on a rotating basis every 5 weeks. After each 5-week block, student performance was measured by written and practical examinations, and each student assessed their leader's or their own professionalism attributes and leadership style using validated survey instruments. RESULTS: Most students demonstrated either a "selling" only (57%) or "participating" only (30%) leadership style with low to moderate leadership adaptability. "Participating" and "delegating" leadership styles have the highest average group written exam scores (89.4%, P <0.008). "Telling" only or "selling" only leaders have the lowest average group exam scores (83.5%, P <0.001). "Selling" and "participating" leaders have significantly lower average group practical exam scores than other styles (81.5%, P <0.007). Positive associations were observed between the written and practical examination scores and the leader's integrity (P = 0.003, P = 0.002) and responsibility (P <0.001, P = 0.037). CONCLUSIONS: This study demonstrates that various situational leadership styles and aspects of professionalism are associated with written and practical examination scores in the Gross and Developmental Anatomy course. Furthermore, it demonstrates that first-year medical students are in need of leadership skill development.

Anatomy, Cross-Sectional↗