The Association of Leadership Styles and Nurses’ Well-being”
Nursing Leader and Management
Project NLM 643
Munayfah Oudah Aldhafeeri
Supervisor
Dr. Fatma Mansour
1444H
Acknowledgement for Master Project
Praise is to Allah all mighty, and prayers and peace be upon the prophet Muhammad and his family and companions, and those who followed him in his goodness until the Day of Judgment.
First, I thank Allah Almighty for His grace, as He made it possible for me to accomplish this work. Then, I am deeply grateful to Hafar Al-Batin University for providing me with all of the resources and support that have played a crucial role in the success of this project.
I would also like to thank my advisor Dr. Fatma Mansor, for helping me with the graduation project by providing valuable feedback and suggestions. Her insight and guidance were instrumental in helping me to shape my project and write this research.
I would also like to give special thanks to all nurses who participate for their time and consent to answer my questionnaire.
I am thankful to my friends and family for their love and support during this process. Without their encouragement and motivation, I would not have been able to complete this journey.
Table of Contents
Statement of the Research Problem.. 3
Background of The Research Problem.. 4
The Significance of The Study. 6
- Study Design: 11
- Material and Methods/Methodology: 11
- Study Setting:. 12
- Study Population:. 13
- Sample Size and Sampling Technique:. 13
- Data Collection Technique. 13
- Data Collection Tools. 13
- Main Variables and Measures. 19
- Data Management and Processing. 19
- Ethical Consideration:. 20
Definition of Terms
- Transformational leadership:
This is a leadership style that motivates and inspires nurses and helps them achieve effective patient care and promote standards of care
- Transactional leadership:
This is a leadership style that develops relationships between nurse leaders and nurses. This leadership style entails using performance indicators to evaluate and give feedback on the performance of the nursing staff.
- Laissez-faire leadership:
This is a management approach in which the team leader leaves the group members to function and make decisions independently without interference or guidance. This leadership style encourages independence and ingenuity, especially when teammates are knowledgeable and competent and need more guidance to complete their duties.
- Nurse well-being:
This is the emotional, physical, and mental state of nurses and their leaders in the workplace. It is characterized by satisfaction, health, and professional development of nurses.
- Patient Care:
This involves providing support and care to patients and promoting health care to patients, which involves interventions and recommendations that promote evidence-based programs.
- Nursing standards of care:
This involves principles that promote expected and effective patient care in nursing practices.
Abstract
BACKGROUND: Research on the influence of leadership styles on nurses’ well-being and the organizational environment is a central part of this paper. AIM: Three leadership styles — transformational, transactional, and laissez-faire — were used to assess their impact on nurses’ well-being. METHOD: Data were collected through online questionnaires from 174 nurses from Saudi Arabia. RESULTS: Regression and correlation tests indicated that transformational and transactional styles led to increased well-being and positive behaviors, whereas laissez-faire style was more associated with decreased well-being and negative behaviors. DISCUSSION: The findings matched the published evidence well and provided insights into the organizational environment leaders should strive for. CONCLUSION: The findings can be used to fine-tune nursing organizational environments that promote transformational and transactional leadership.
Keywords: transformational leadership, transactional leadership, Laissez-faire leadership, well-being, organizational culture, leadership behavior
Chapter One
1.1 Introduction
Any nurse’s leadership styles determine their nursing well-being and substantially impact their lives and health. Leadership is an essential element in the nursing field since it determines the patient outcomes, staff morale, resource allocation, and professional development of nurses. Nursing leadership faces challenges that include staff shortages, workplace conflicts, the evolution of healthcare policies and regulations, and balancing administrative tasks and patient care. These challenges can be minimized by adopting effective leadership that impacts the quality of patient care by improving patient outcomes, creating a positive working environment, adapting to new healthcare trends and policies, and encouraging professional growth. (Sarver et al., 2019&Wei et al., 2020).
Describe nursing leadership as the potential of nurses to guide and direct healthcare professionals to ensure they deliver patient-centered quality services. The nurse’s role is ensuring patients receive safe and effective services. Nursing leadership is characterized by communicating effectively, thinking critically, solving problems, and having interpersonal skills. Patient care is a critical sector that requires nurse leaders to be well-informed with the latest healthcare trends and policy information to ensure patients are cared for. (Kelly & Hearld, 2020).
Nursing leadership is classified into different categories that determine how nurses interact with patients and how they make their decisions. The nursing leadership styles are classified into transformational, laissez-faire, and transactional. Transformational leadership is a key in inspiring and motivating nurses to deliver quality patient services. This leadership trait challenges nurses to be creative thinkers who support new ideas and approaches that improve patient care. Transformational nurse leaders give development opportunities to their staff to ensure they pursue their academic excellence, which translates to improved patient outcomes. Transformational leadership builds a working team characterized by teamwork, collaboration, and open communication. This results in an improved patient outcome characterized by high standards of care and evidence-based medical results.(Alilyyani et al., 2022; Alsaqqa, 2023).
Laissez-faire is a leadership style whereby leaders allow team members to work and make decisions independently without interference or guidance. This brings autonomy and creativity since team members can interact to discuss issues related to nursing care. Employees feel motivated and engaged in their roles since they can discuss issues that affect them. This leadership style works best where team members are experienced and knowledgeable and require minimal direction while performing their duties. (Specchia et al., 2021; Arikan, 2020), (Alzahrani, 2019).
Transactional nursing leadership requires employers to establish clear expectations from employees and rewards the employees with the highest outcomes. This leadership helps nurses maintain good conduct that enables them to meet the requirement of health standards, which improves the standards of care. The role of transactional leadership in nursing constituents of monitoring performance, whereby nurses’ staff performance is evaluated using performance metrics, and feedback is provided. Transactional leaders reward their staff members with recognition by offering promotions, rewards, and other incentives that can persuade and motivate them. This challenges employees to work better to achieve the expected standards that facilitate effective patient care. (Passakonjaras & Hartijasti, 2020), (Richards, 2020),(Sabbah et al., 2020).
Well-being is the emotional, physical, and mental state of nurses and their leaders in the workplace. The satisfaction, health, and professional development of nurses characterize it. The leadership style used in nursing affects the well-being of nurses in different ways. For example, exemplary leadership in healthcare systems promotes staff satisfaction and maintains standards of care that influence patient care in health institutions. Effective nurse leaders in healthcare systems create a conducive work culture by motivating employees, acting as role models, and setting safety measures. This impacts the well-being of nurses in different ways, including communication, work balance, professional development, and autonomy in decision-making well-being for nurses. Effective leadership styles determine the well-being of nurses and how nurses perform their duties. (Ahmed et al., 2021).
1.2 Statement of the Research Problem
Nursing well-being is hampered by poor nursing leadership, lack of teamwork, interference in decision-making, lack of autonomy, and failure to reward talented employees. Poor leadership also affects good conduct, hindering nurses from meeting health standards.
1.3 Background of the Research Problem
The problem that nurses face that affects their well-being is poor leadership. The key components of poor leadership are a need for more support, teamwork, resources, autonomy, decision-making, and failure to reward hardworking nurses. The obstacles create an un-conducive environment that does not promote standards of care. The problem is clearly articulated by an escalation of challenges that nurses undergo, which affect the nurse’s well-being like emotional, work-balance, psychological, or professional well-being. To address the research problem, the study intends to explore the nurse leadership styles like transformational, transactional, and laissez-faire leadership and their effect on nurse well-being.
1.7 The Significance of the Study
The significance of the study will clearly articulate how the study will determine the association between leadership styles and nurses’ well-being. The research intends to fill the gap in nurse leaders’ effects on nurses’ well-being.Such gaps in nursing systems include inadequate resources, experience poor communication, lack of motivation, and low professional growth. The study will fill this gap by exploring the association between transformational, transactional, and laissez-faire leadership and nurses’ well-being. By addressing the challenges that nurses undergo, the study will address how to improve the nurse’s well-being and enhance patient care by adopting practical implications such as evidence-based programs and recommendations.
1.4 Aim of the Study
Thestudy aims to:
- Explorethe association between leadership style and nurse well-being in order to minimize the gap between nurse leadership and the obstacles nurses undergo that affect their well-being.
- Explore and address the nurse leadership problem by assessing the effect of laissez-faire, transformational, and transactional leadership on nurse well-being.
1.5Research Questions
- What is the effect of transactional leadership on nurses’ well-being?
- What are the challenges faced by nurses in relation to leadership styles?
- What nursing interventions can promote effective nursing leadership?
1.8Research Hypothesis
The hypothesis for the research proposal states that.
Null hypothesis (H0): There is no association between leadership styles and nurses’ well-being.
Alternative Hypothesis (Ha): There is an association between leadership styles and nurses’ well-being.
1.9Research Objectives
The research objectives describe what the project intends to accomplish and provide a guideline on how the research will accomplish its aim.
General Objective
The general objective describes the purpose the research intends to address. The overall goal guides the hypothesis and research in the study. The general objective of the research is to explore the relationship between different leadership styles and nurses’ well-being.
Specific Objectives
Specific instructions are measurable goals that define the aim of the research by providing a guideline and intended purpose.
Specific objective is: To assess the impact of nursing leadership styles onthe quality of nurses’ life at work.
Chapter Two
2.1 Literature Review
Leadership is a multifaceted process that involves setting objectives, motivating others to take action, and encouraging others to reach shared goals. Workers, administrators, and achieving organizational objectives are all closely related to leadership. Leadership style refers to how a leader sets direction, inspires followers, and carries out plans. When managing the staff nurses in healthcare facilities, nurse leaders employ a variety of leadership styles. These leadership styles include transformational, transactional, and laissez-faire leadership. These leadership styles determine the well-being, performance, and standards of patient care in health systems. (Almarwany et al., 2021)
According to Gashaye et al. (2023), these styles include autocratic, democratic, bureaucratic, situational, charismatic, visionary, coaching, laissez-faire, transactional, and transformational. A practical nursing leadership style can lessen nurses’ challenges, like workplace conflicts, staff shortages, and balancing administrative responsibilities and patient care. This literature review determines how leadership philosophies and nursing staff satisfaction relate.
Numerous studies have examined the effect of various leadership philosophies on nursing staff satisfaction. The three leadership philosophies frequently connected to nursing are transformational, laissez-faire, and transactional leadership. Transformational leadership has been determined to be the most successful for encouraging nursing staff well-being. Transformational leaders motivate and inspire nurses to deliver excellent patient care. They promote innovative ideas, support creative thinking, and provide staff development possibilities that improve patient results. With the help of open communication, collaboration, and cooperation, transformational leadership develops exceptional levels of care and fact-based medical outcomes.(Sabbah et al., 2020), (Gashaye et al. 2023).
Different management philosophies, such as transformational, transactional, and laissez-faire leadership, were identified by Ferreira et al. in 2022. They discovered that transformational leadership positively impacted institutional, professional, and patient outcomes. This approach was linked to better staff morale, patient satisfaction, and lower turnover rates. Additionally, transformational leaders were more likely to support employee growth and foster a supportive workplace culture, directly impacting patient care. Contrarily, the study discovered that laissez-faire leadership had a detrimental effect on organizational, professional, and patient results. This type of leadership was linked to low employee motivation, poor job fulfillment, and higher rates of burnout. Laissez-faire leaders, according to Ferreira et al. (2022), were frequently absent or passive, which resulted in inadequate communication and inefficient decision-making.
Laissez-faire leadership is a management approach in which the team leader leaves the group members to function and make decisions independently without interference or guidance. This leadership style encourages independence and ingenuity, especially when teammates are knowledgeable and competent and require little guidance to complete their duties. However, nurses who work for laissez-faire leaders may experience anxiety, exhaustion, and a lack of job satisfaction due to this type of management. Poor leadership is associated with nurses’ well-being. The study also discovered a link between lax leadership, patient satisfaction, and the standard of care provided.(Alzahrani, 2019), (Almarwany et al., 2021).
The transformational leadership style has gained prominence in nursing. This leadership approach is distinguished by leaders who can inspire and motivate their followers toward achieving exceptional outcomes. Empirical research has demonstrated a significant correlation between transformational leadership and the overall well-being of nurses. Leaders who adopt a transformational style tend to encourage the development of a collective vision, facilitate transparent communication, and offer guidance and assistance to their subordinates. These practices have been found to impact the job satisfaction and engagement of nurses positively. The leaders above empower nurses to assume responsibility for their practice, resulting in enhanced patient care and outcomes.(Tourangeau et al., 2020) ,(Cummings et al. , 2018),
The application of transactional leadership, which emphasizes the establishment of unambiguous expectations and the provision of incentives and commendations, has a bearing on the welfare of nurses. According to recent studies conducted by Cummings et al. (2018) and Alrobai, (2020), nurses who operate under the guidance of transactional leaders that offer constructive feedback, incentives, and avenues for advancement tend to exhibit greater job satisfaction, motivation, and career growth. Implementing this leadership approach facilitates the perception of equity and acknowledgment among nursing staff, cultivating a constructive professional milieu.
The efficacy of leadership styles may be influenced by varying healthcare settings and cultural contexts. As per Cummings et al. (2018), leadership styles that emphasize participation and collaboration may be more efficacious in cultures that prioritize group harmony and cooperation, such as collectivist cultures. Moreover, contextual variables, such as the volume of work, available resources, and support from the organization, can impact the association between leadership styles and the well-being of nurses (Rocco et al., 2022).
Setting clear expectations for employees and rewarding them for meeting this are both components of transactional leadership. This method of leadership helps nurses to adhere to ethical principles that enable them to follow health regulations and raise the standard of care. Transactional leadership entails using performance indicators to evaluate and give feedback on the performance of the nursing staff. One-way transactional leaders show their appreciation for their team is by providing incentive programs, bonuses, and other enticing rewards that push staff to perform better to meet the expectations that enable efficient patient care. Transactional leadership and nurses’ well-being are positively correlated. Nurses who worked for transactional leaders reported better motivation, job satisfaction, and physical health. The research also discovered a connection between improved patient satisfaction, excellent healthcare, and transactional leadership.(Palenius, 2022), (Richards, 2020).
As a result, the health of the nursing staff is significantly impacted by nursing leadership styles. The well-being of nurses is positively correlated with transformational and transactional leadership, whereas the well-being of nurses is negatively correlated with laissez-faire leadership. Therefore, ensuring the provision of high-quality healthcare depends on effective nursing leadership that supports staff well-being. A supportive workplace culture and adequate staffing are also necessary for a healthy workplace for nurses.
Chapter Three
- Methodology
- Study Design:
A cross-sectional study was conducted in the Hafar AL-Batin City that located in the Eastern region of Saudi Arabia. The data collection was conducted using online questionnaires between April to May 2023.
3.3 Study Setting:
The research conducted in four governmental hospitals in Hafar aI-Batin city including:
- Hafar Al-Batin Centeral Hospital, it has a distinguished team of consultants with multiple experiences who are able to treat and follow up all medical conditions and even the most complex ones and use the latest medical equipment with international technologies in the field of healthcare.
- King Khalid General Hospital, the capacity of King Khalid Hospital is 300 beds, and it is considered one of the specialized health facilities in the governorate. It provides high-quality health services in general medicine and surgery through modern equipment and the medical and technical staff available in the hospital.
- The Mental Health Hospital in Hafar al-Batin is working hard to provide a comprehensive treatment plan that includes psychological, social, and religious aspects.
- Maternity and Child Hospital: one of the governorate specialized health facilities. The hospital provides quality health services in obstetrics, gynecology, and children.
- . Sample Size:
Four governmental hospitals were selected to represent all Hafar Al-Batin hospitals using a Convenience Sample of 174 nurses from different hospital departments. All nurses working in Hafar Al-Batin hospitals were eligible to participate in the study. Inclusion criteria includes: 1) working at least one year in the same ward, 2) has at least 6 months of experience at the current institution. Nurses were informed about the purpose of the study when were invited to participate. All hospitals gave their consent to participate in the study.
Exclusion criteria 1- working in the private hospital 2- has experience less than 6 month.
The study population consists of individuals who will collect data from the research process. The study population will include nurse manager and leaders and their nurse practitioners. Nurse leaders are empowered to lead and manage nurses within the health care system. Nurses are professionals who are registered and employed to work in certain healthcare organizations like Hafar Al-batin hospitals.
- Sampling Technique:
- Data Collection Technique:
The collection technique that used for the research includes online questionnaire, which used to collect data from nurses and their leaders. A Focus group will enable the researcher to obtain more details regarding leadership and nurses’ well-being.
Data Collection Tools:
The study questionnaire had three parts:
The first part of the questionnaire consisted of socio-demographic data, including age, gender, nationality, marital status, hospital, educational level, and job position. Data were also collected regarding the type of the nursing department, work experience in nursing.
The second part consisted of Multifactor Leadership to measure staff nurses´ opinions of their nurse managers. It contains of three sections. A)Transformational leadership (TFL) includes the characteristics of idealized influence (attributes) (IIA), idealized influence (behaviors) (IIB), inspirational motivation (IM), and individual consideration (IC). B) Transactional leadership (TAL) includes characteristics of contingent reward (CR) and management-by-exception as a leadership style. C) Laissez-faire leadership (LF) style.
The third part measuring wellbeing was determining how leadership styles are related to nurses’ life and outcome. It contained two sections. First section, Leadership outcome behavior, and he second section about how leadership styles related to nurses’ life.
3.7Statistical analysis:
The methodology that used includes the Spearman correlation to determine the correlation between the leadership styles and outcomes of nurses’ well-being. Descriptive statistics like the mean, median, and standard deviation will be determined to describe the research sample. SPSS 22.0 package will be used to analyze the data. Data collected by using a survey questionnaire. Statistical analysis used in the study includes regression analysis, and ANOVA test. The ANOVA test used to test the hypothesis and determine whether the null hypothesis will be rejected. From the ANOVA test, the null hypothesis will be rejected if the p-value is less than a 5% significance level. The conclusion will state an association between leadership styles and nurses’ well-being.
3.9 Ethical Consideration
The study obtained ethical approval from Dean of the Hafar Al batin University and the Ethical Committee of the Directorate of health affairs in Hafer Albatin city, numbered H-05-FT-083 and dated 23/5/2023. Then the researcher obtained approval from the administration of hospitals. After that, Participants were educated about the research, its reason, methods, and benefits. The researcher confirmed that participants’ information must be kept confidential, and access should be restricted to authorized faculty.
Chapter 4
Results
Demographic Profile
The sample was represented by 174 respondents, of whom 73.0% (n = 127) were female and 27.0% (n = 47) identified as male. The most represented age group in the sample was respondents 31 to 40 years old (40.8%, n = 71), immediately followed by younger participants 20 to 30 years old (39.7%, n = 69) and the oldest 40 years old (19.5%, n = 34). In terms of ethnicity, 90.7% (n = 156) identified as Saudi and 9.3% (n = 16) as non-Saudi. Approximately 2/3 of the sample (66.7%, n = 116) were married, followed by single (25.9%, n = 45), divorced (4.6%, n = 8), and widows/widowers (2.9%, n = 5).
Respondents were asked about their occupational affiliation and characteristics within the demographic block. As shown in Figure 1, the majority of the sample had 1 to 5 years of work experience (37.8%, n = 65), but the proportion who had worked for 6 to 10 years was also high (34.9%, n = 60). Respondents with minimal work experience of up to one year were the least likely in the sample (9.3%, n = 16). In terms of education, 42.5% (n = 74) of respondents had a bachelor’s degree, 32.8% (n = 57) had a graduate degree, about one in six participants (16.7%, n = 29) had a master’s and/or doctoral degree, and the remainder (8.0%, n = 14) had other unspecified levels of education.
Figure 1: Distribution of respondents’ professional experience.
As shown in Figure 2, more than half of all respondents held a nursing position, with a decreasing trend in the number of respondents as qualifications and credentials increased. Figure 3 shows the distribution of respondents by clinical unit affiliation: it appears that emergency room staff were less represented in the sample (11.6%, n = 20), but the largest number (43.0%, n = 74) were those who could not choose from the options offered and therefore worked in other clinical units. Finally, as Figure 4 shows, slightly less than half of the respondents (42.7%, n = 61) were employed at King Khalid General Hospital, a smaller number (25.2%, n = 36) at Hafar Al-Batin Central Hospital, and approximately equal numbers were represented by workers at the Mental Hospital in Hafar Albatin (16.8%, n = 24) and the Maternity and Children Hospital (15.4%, n = 22). Thus, the sample was represented by respondents from different age groups, genders, educational levels, marital status, and occupational characteristics. This indicates a highly representative sample of the diversity of the participants.
Figure 2: Distribution of the shares of respondents by professional affiliation.
Figure 3: Distribution of the shares of respondents by clinical affiliation.
Figure 4:Respondents’ affiliation with hospitals in Hafar Al-Batin
| Sample Characteristics | N | % |
| Gender | ||
| Male | 127 | 73.0 |
| Female | 47 | 27.0 |
| Age | ||
| 20 to 30 years | 69 | 39.7 |
| 31 to 40 years | 71 | 40.8 |
| ≥ 40 years | 34 | 19.5 |
| Ethnicity | ||
| Saudi | 156 | 90.7 |
| Non-Saudi | 16 | 9.3 |
| Marital Status | ||
| Single | 45 | 25.9 |
| Married | 116 | 66.7 |
| Divorced | 8 | 4.6 |
| Widows or Widowers | 5 | 2.9 |
| Work Experience | ||
| Less than 1 year | 16 | 9.3 |
| 1 to 5 years | 65 | 37.8 |
| 6-10 years | 60 | 34.9 |
| ≥10 years | 33 | 18.0 |
| Education | ||
| Bachelor’s Degree | 74 | 42.5 |
| Master’s and/or
Doctoral Degree |
29 | 16.7 |
| Graduate Degree | 57 | 32.8 |
| Others | 14 | 8.0 |
| Job Position | ||
| Nurse | 88 | 50.6 |
| Registered Nurse | 41 | 23.6 |
| Head Nurse | 22 | 12.6 |
| Supervisor | 12 | 6.9 |
| Nursing Director | 11 | 6.3 |
| Clinical Unit Affiliation | ||
| Emergency Room | 20 | 11.6 |
| Nursing Manager | 52 | 29.7 |
| Intensive Care Unit | 27 | 15.7 |
| Others | 75 | 43.0 |
| Clinics | ||
| King Khalid General
Hospital |
61 | 42.7 |
| Hafar Al-Batin Central
Hospital |
36 | 25.2 |
| Mental Hospital in
Hafar Albatin |
24 | 16.8 |
| Maternity and
Children Hospital |
22 | 15.4 |
Table 1: Demographic Data.
Descriptive Statistics
In addition to demographics, the questionnaire contained 19 main block questions that used Likert scales to assess participants’ agreement with the statement. The responses were recoded into a numerical scheme for use in further statistical analysis. Figure 5 provides information on the mean scores for each question in the questionnaire: as can be seen, participants’ mean choices never rose above 4, indicating a centrality between the neutral and agree responses, and for the last two questions, a centrality around the moderate response. Ordinal Likert question scales were recoded into continuous scales according to the questionnaire distributions for use in parametric tests. Table 1 shows the structure of each aggregate variable used in the analysis.
Figure 5: Descriptive statistics for each of the main survey questions.
Table 1: Structure of aggregated variables.
Regression Analysis
A multiple regression analysis was conducted to test the effect of leadership styles on nurses’ well-being. The results indicated a significant regression model (F(3, 170) = 38.251, p < .001) with a moderate coefficient of determination of R2 = .403. The coefficients of leadership styles were significant: thus, transformational leadership (β = 0.175, p = .038) and transactional leadership (β = 0.494, p < .001) led to an increase in nurses’ well-being, while laissez-faire leadership (β = -0.185, p = .002) led to a decrease. Notably, using simple regression models, the coefficients of transformational leadership (β = 0.513, p < .001) and transactional leadership (β = 0.593, p < .001) strengthened their effects, and laissez-faire leadership was not a significant predictor (β = -1.461, p < .146). It follows that laissez-faire leadership, unlike the other two leadership styles, does not affect nurse well-being, but when used together, such as when multiple nurse managers use different leadership styles, it leads to a decrease in well-being. Additionally, regression analysis was conducted to assess nurses’ perceptions of communication effectiveness as a function of leadership style: multiple regression (F(3, 170) = 5.413, p < .001) showed that only Laissez-faire leadership (β = -0.288, p < .001) was a significant predictor leading to decreased communication effectiveness.
Correlation Analysis
Correlational analysis was conducted to determine the relationships between leadership styles and leader behavior outcomes (Table 2). The results showed that increasing the intensity of each leadership style was significantly positively associated with both positive and negative leader behavior outcomes. It follows that using each type of leadership not only increases good leader behaviors and nurses’ feelings of satisfaction and effectiveness, but also increases unfavorable outcomes, including lack of feedback from leaders. Specifically, transformational (r = .689, p < .001) and transactional (r = .682, p < .001) leadership were more strongly associated with positive than negative outcomes. In contrast, laissez-faire leadership was more strongly associated with negative behavioral outcomes (r = .618, p < .001) than with positive outcomes (r = .220, p < .001).
Table 2: Correlation matrix.
Discussion
The results of the regression analysis showed that two of the three leadership styles, other than laissez-faire, increase nurses’ well-being and have a favorable effect on the organizational environment. This fully supports previously published findings that Laissez-faire leaders may be passive, leading to decreased motivation, productivity, and poor performance (Ferreira, 2022; Almarwany et al., 2021; Alzahrani, 2019). The correlation analysis suggests that transformational and transactional leadership based on idealized influence, motivation, intellectual stimulation, individualized approach and contingent rewards, and management-by-exception are associated with effective leadership outcomes. However, lack of feedback, increased autonomy, and nurses’ independence were more likely to result in adverse leadership behavior outcomes, which created problems for the effectiveness of the work environment. This also may indicate that each of the leadership styles does not preclude negative behaviors on the part of leaders, but the use of laissez-faire is more strongly associated with such deficits than transformational and transactional styles, which is also well supported by previously published research (Almarwany et al., 2021; Ferreira, 2022; Alzahrani, 2019). Furthermore, as emphasized by Cummings et al. (2018), the outcome of a particular leadership style will always depend on several factors that determine the corporate environment.
Chapter 5
Conclusion
This study was designed to examine the impact of leadership styles on nurses’ well-being and to assess potential problems that may arise in the nursing work environment. The statistical analyses conducted on a representative sample showed that transformational and transactional leadership styles were positively related to nurses’ well-being, while laissez-faire style decreased this indicator. Laissez-faire, unlike the other two styles, also significantly reduced the intensity of communication between supervisors and nurses. It was also found that the autonomy and increased independence of employees realized through laissez-faire leadership was more strongly associated with negative leader behavior outcomes, which were perceived by nurses as poor leadership. It is fair to say that transformational and transactional leadership did not exclude negative effects but were more strongly associated with positive leadership behavior outcomes in nurses’ perceptions. The results support the importance of leadership styles in nursing management and identify the advantages of transformational and transactional leadership over laissez-faire in achieving a highly effective work environment.
Research Limitations
The research work has several limitations that can be part of further study. First, the sample was represented by staff from only four governmental hospitals in Hafar Al- Batin, making it difficult to extrapolate the results to other medical institutions. Also, the number of variables used was limited and did not include all aspects of organizational culture and nurses’ well-being attributes.
Recommendations
The findings suggest several practical recommendations for healthcare providers. First, decision makers should pay particular attention to transformational and transactional leadership because they lead to improved work environment performance. Second, the use of laissez-faire should be cautiously limited because it is likely to reduce employee productivity and motivation. Third, there should be clear communication between supervisors and nurses, using a personalized approach and contingent reward systems that improve nursing performance.
Chapter 6
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