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PubMed2005

Development of measures of individual leadership for health promotion.

PURPOSE: This purpose of this research was to develop and establish psychometric properties of scales measuring individual leadership for health promotion. DESIGN/METHODOLOGY/APPROACH: Scales to measure leadership in health promotion were drafted based on capacity assessment instruments developed by other provinces involved in the Canadian Heart Health Initiative (CHHI), and on the literature. Content validity was established through a series of focus groups and expert opinion appraisals and pilot testing. Psychometric analyses provided empirical evidence of the construct validity and reliability of the leadership scales in the baseline survey (n = 144) of the Alberta Heart Health Project. FINDINGS: Principal component analysis verified the construct of the leadership scales of personal work-related practices and satisfaction with work-related practices. Each of the theoretically a prior determined scales factored into two scales each for a total of four final scales. Scale alpha coefficients (Cronbach's alpha) ranged between 0.71 and 0.78, thus establishing good scale internal consistencies. RESEARCH LIMITATIONS/IMPLICATIONS: Limitations include the relatively small sample size used in determining psychometric properties. In addition, further qualitative work would enhance understanding of the complexity of leadership in health organizations. These measures can be used by both researchers and practitioners for the assessment leadership for health promotion and to tailor interventions to increase leadership for health promotion in health organizations. ORIGINALITY/VALUE: Establishing the psychometric properties and quality of leadership measures is an innovative step toward achieving capacity assessment instruments which facilitate evaluation of key relationships in developing health sector capacity for health promotion.

Canada↗
PubMed2006

A study of relationship between managers' leadership style and employees' job satisfaction.

PURPOSE: The purpose of this descriptive and cross-sectional study is to explore the relationships between managers' leadership styles and employees' job satisfaction in Isfahan University Hospitals, Isfahan, Iran, 2004. DESIGN/METHODOLOGY/APPROACH: The data were collected through the distribution of two questionnaires among the 814 employees, first line, middle and senior managers of these hospitals through a stratified random sampling. FINDINGS: The dominant leadership style of managers was participative. The mean score of employee-oriented dimension of leadership style in first line, middle and senior managers were 52, 54, and 54 (from 75 credit) respectively. The mean score of task-oriented dimension of leadership style in first line, middle and senior managers were 68, 69, and 70 (from 100 credit) respectively. The mean score of employee's job satisfaction was 3.26 +/- 0.56 on a 6 scale (moderate satisfaction), 1.9, 26.1, 64.7, and 7.3 percent of hospital employees had respectively very low, low, moderate, and high satisfaction with their job. Employees demonstrated less satisfaction with salaries, benefits, work conditions, promotion and communication as satisfier factors and more satisfaction with factors such as the nature of the job, co-workers and supervision type factors. There was significant correlation (p < 0.001) between the use of leadership behaviors and employees and job satisfaction. RESEARCH LIMITATIONS/IMPLICATIONS: Employee job satisfaction depends upon the leadership style of managers. Nevertheless, participative management is not always a good management style. Managers should select the best leadership style according to the organizational culture and employees' organizational maturity. ORIGINALITY/VALUE: Although this study conducted in Iran, it is anticipated that the findings may have relevance on a broader scale. By replicating this study in different countries and contexts the results of could be very helpful for developing a new model of leadership with new implementation techniques that can be implemented easily and successfully in a cross cultural context.

Adolescent↗
PubMed2004

Leadership: a new perspective.

AIM: This overview article aimed at outlining the image of an effective future-orientated nurse leader in the health care context through a pragmatic approach. The future nurse leaders on different levels in health care institutions is challenged in the current health care environment of culturally diverse countries, such as South Africa. This article should make all nursing leaders more aware of their important role in taking the lead in challenges faced in the current health service environment. BACKGROUND: Leaders have the essentials of authority, power and influence to lead followers to their goals. The use of these essentials has changes from the past, to the present and into the future health care environment. Different changes and challenges are facing nurse leaders and they need to implement an effective leadership style in a complex health care environment. EVALUATION: This overview article focuses on key elements of an effective future leader using a conceptual framework as departure, incorporating relevant literature. It analyses and evaluates the efficiency of past and present roles of authority, power and influence in leadership and summarizes a new perspective of a future nurse leader. Solutions and future actions are indicated for the future role of the nurse leader. KEY ISSUES: The past, present and future leadership setting, role of authority, power and influence in leadership, components of the arch of leadership and solutions to effective leadership in a future dimension is all domains that is presented with the intention of motivating future nurse leaders. CONCLUSION: It was identified that a different kind of leader should emerge to lead in a new way, different from those leadership styles that we have known in the past. The 21st century is a new timeframe and different timeframes demand different leadership approaches.

Attitude of Health Personnel↗
PubMed2006

Paths to nursing leadership.

AIM: The aim was to explore why nurses enter nursing leadership and apply for a management position in health care. The study is part of a research programme in nursing leadership and evidence-based care. BACKGROUND: Nursing has not invested enough in the development of nursing leadership for the development of patient care. There is scarce research on nurses' motives and reasons for committing themselves to a career in nursing leadership. METHOD: A strategic sample of 68 Finnish nurse leaders completed a semistructured questionnaire. Analytic induction was applied in an attempt to generate a theory. FINDINGS: A theory, Paths to Nursing Leadership, is proposed for further research. Four different paths were found according to variations between the nurse leaders' education, primary commitment and situational factors. They are called the Path of Ideals, the Path of Chance, the Career Path and the Temporary Path. CONCLUSION: Situational factors and role models of good but also bad nursing leadership besides motivational and educational factors have played a significant role when Finnish nurses have entered nursing leadership. The educational requirements for nurse leaders and recruitment to nursing management positions need serious attention in order to develop a competent nursing leadership.

Adaptation, Psychological↗
PubMed2006

A nurse-physician co-leadership model in psychiatric hospitals: results of a survey among leading staff members in three sites.

In three psychiatric hospitals in Baden-Wuerttemberg, Germany, a physician-nurse shared leadership model was implemented in 1997 by the hospital management. The whole hospital, departments, and single wards are led each by a leadership team consisting of a physician, psychologist or social worker and a nurse, being responsible for organization, staff, and budgets. The consequences for staff opinion in leadership positions were evaluated. All 165 leading staff members of all professional groups were anonymously interviewed with a questionnaire containing 45 items regarding their satisfaction with this new leadership model. The response rate was 79.4%. Overall, the leading staff members were satisfied with the shared leadership model both in their own clinical practice and in general. Non-medical staff members were significantly more in favour of several aspects of shared leadership than physicians, but even the latter reported to be generally satisfied. However, both professional groups estimated leading positions to be only modestly attractive. The results yield some evidence that the change from traditional leadership models to the physician-nurse shared leadership model may have advantages in the management of psychiatric hospitals.

Attitude of Health Personnel↗
PubMed2006

Transformational and transactional leadership: association with attitudes toward evidence-based practice.

OBJECTIVE: Leadership in organizations is important in shaping workers' perceptions, responses to organizational change, and acceptance of innovations, such as evidence-based practices. Transformational leadership inspires and motivates followers, whereas transactional leadership is based more on reinforcement and exchanges. Studies have shown that in youth and family service organizations, mental health providers' attitudes toward adopting an evidence-based practice are associated with organizational context and individual provider differences. The purpose of this study was to expand these findings by examining the association between leadership and mental health providers' attitudes toward adopting evidence-based practice. METHODS: Participants were 303 public-sector mental health service clinicians and case managers from 49 programs who were providing mental health services to children, adolescents, and their families. Data were gathered on providers' characteristics, attitudes toward evidence-based practices, and perceptions of their supervisors' leadership behaviors. Zero-order correlations and multilevel regression analyses were conducted that controlled for effects of service providers' characteristics. RESULTS: Both transformational and transactional leadership were positively associated with providers' having more positive attitudes toward adoption of evidence-based practice, and transformational leadership was negatively associated with providers' perception of difference between the providers' current practice and evidence-based practice. CONCLUSIONS: Mental health service organizations may benefit from improving transformational and transactional supervisory leadership skills in preparation for implementing evidence-based practices.

Adult↗
PubMed2005

Physician leadership styles and effectiveness: an empirical study.

The authors study the association between physician leadership styles and leadership effectiveness. Executive directors of community health centers were surveyed (269 respondents; response rate = 40.9 percent) for their perceptions of the medical director's leadership behaviors and effectiveness, using an adapted Multifactor Leadership Questionnaire (43 items on a 0-4 point Likert-type scale), with additional questions on demographics and the center's clinical goals and achievements. The authors hypothesize that transformational leadership would be more positively associated with executive directors' ratings of effectiveness, satisfaction with the leader, and subordinate extra effort, as well as the center's clinical goal achievement, than transactional or laissez-faire leadership. Separate ordinary least squares regressions were used to model each of the effectiveness measures, and general linear model regression was used to model clinical goal achievement. Results support the hypothesis and suggest that physician leadership development using the transformational leadership model may result in improved health care quality and cost control.

Adult↗
PubMed2004

Sex and leadership styles: a meta-analysis of research published in the 1990s.

Empirical research on sex differences in leadership styles, published between 1987 and 2000 in peer-reviewed journals, is reviewed by means of a meta-analysis. The leadership styles examined are interpersonal, task-oriented, democratic versus autocratic, and transformational and transactional leadership. Analysis showed that evidence for sex differences in leadership behavior is mixed, demonstrating that women tend to use more democratic and transformational leadership styles than men do, whereas no sex differences are found on the other leadership styles. Sex differences in leadership styles are contingent upon the context in which male and female leaders work, as both the type of organization in which the leader works and the setting of the study turn out to be moderators of sex differences in leadership styles.

Adult↗
PubMed2006

What is leadership?

The demand for more effective leadership is heard throughout the health professions. Modern concepts of leadership differ from the traditional definition of a charismatic individual leader. Historically, leadership has been vested in positions, while today leadership is seen as a role one moves continuously into and out of, depending on the circumstance. Leadership ideas have evolved so that newer characteristics of leaders include being a team builder; possessing creative and strategic thinking skills; demonstrating honesty and integrity; and having the ability to motivate others to action. This article discusses some of the history of leadership, current thoughts on attributes of effective leaders, and the differences and similarities between leaders and managers; identifies selected teachable leadership tools; and describes various styles and purposes of existing leadership programs.

Education, Veterinary↗
PubMed2026

The Moral of the Story-Perception of Leadership With Moral Distress in Registered Nurses: A Qualitative Systematic Review.

AIM: To understand how Registered Nurses perceive the impact of nursing leadership on managing moral distress and mitigating burnout. BACKGROUND: Moral distress and burnout are pervasive issues in nursing, compromising well-being, patient safety and workforce sustainability. Leadership is a critical factor in shaping workplace culture and mitigating these challenges, yet evidence remains limited. DESIGN: Qualitative systematic review. METHODS: A qualitative systematic review was conducted following JBI methodology and PRISMA guidelines. Comprehensive searches across MEDLINE, PsycINFO, Embase, CINAHL and Scopus identified 5927 articles, with two studies meeting the inclusion criteria. Data were appraised using the JBI Critical Appraisal Checklist and synthesised via meta-aggregation. Confidence in findings was assessed using the ConQual approach. RESULTS: Four major themes emerged: (1) Behind the barriers, (2) Breaking point, (3) Weathering the storm and (4) Leadership for lasting change. Leadership influenced nurses' psychological safety, ethical decision-making and resilience. Inadequate support amplified moral distress, and effective strategies included authentic communication, team solidarity and systemic interventions. CONCLUSIONS: Leadership plays a pivotal role in mitigating moral distress and burnout. Evidence highlights the need for structural changes and support to sustain registered nurses' well-being and retention. RELATIVE TO CLINICAL PRACTICE: Findings offer direction for leadership strategies that promote ethical workplaces, shared decision-making and mental health supports to enhance resilience and patient care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Strengthening leadership capability is vital for workforce sustainability, care quality and nurse retention. REPORTING METHOD: Authors have adhered to relevant EQUATOR guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not involve patients or the public in its design, conduct or reporting.

Leadership↗
PubMed1990

Cognitive correlates of adolescents' aspirations to leadership: a developmental study.

The study examined age and gender differences in leadership aspirations among teenage adolescents. It was hypothesized that adolescents' valence, self-efficacy and attribution perceptions about leadership would be predictive of their aspirations to leadership. Altogether 52 fourth form and 78 seventh form high school students completed a questionnaire measuring (a) overall leadership aspirations, (b) 13 valence-instrumentality expectancies for 13 leadership outcomes, (c) self-efficacy perceptions, and (d) attributions of effective leadership. The results revealed significant gender differences in valence scores and significant age differences in self-efficacy and attribution measures. Regression analyses indicated that fourth formers' leadership aspirations were significantly predicted from their "ease-of-success" self-efficacy expectation; whereas seventh formers from either valence perceptions (males) or self-efficacy and attribution scores (females). These results were discussed in the context of the valence and self-efficacy models of career decision-making processes and attribution theory.

Adolescent↗
PubMed2005

Leadership and priority setting: the perspective of hospital CEOs.

The role of leadership in health care priority setting remains largely unexplored. While the management leadership literature has grown rapidly, the growing literature on priority setting in health care has looked in other directions to improve priority setting practices--to health economics and ethical approaches. Consequently, potential for improvement in hospital priority setting practices may be overlooked. A qualitative study involving interviews with 46 Ontario hospital CEOs was done to describe the role of leadership in priority setting through the perspective of hospital leaders. For the first time, we report a framework of leadership domains including vision, alignment, relationships, values and process to facilitate priority setting practices in health services' organizations. We believe this fledgling framework forms the basis for the sharing of good leadership practices for health reform. It also provides a leadership guide for decision makers to improve the quality of their leadership, and in so doing, we believe, the fairness of their priority setting.

Attitude of Health Personnel↗
PubMed2004

Leadership: reflections over the past 100 years.

Leadership, viewed by the American Dietetic Association as the ability to inspire and guide others toward building and achieving a shared vision, is a much written-about topic. Research on leadership has addressed the topic using many different approaches, from a very simplistic definition of traits to a more complex process involving interactions, emotions, and learning. Thousands of books and papers have been published on the topic of leadership. This review paper will provide examples of the varying foci of the writings on this topic and includes references for instruments used to measure leadership traits and behaviors. Research is needed to determine effective strategies for preparing dietitians to be effective leaders and assume leadership positions. Identifying ways to help dietitians better reflect on their leadership experiences to enhance their learning and leadership might be one strategy to explore.

Dietetics↗
PubMed2002

The evaluation of a clinical development unit leadership preparation program by focus group interviews - part I: positive aspects.

In 1996, in Western Sydney, Australia, the Area Health Service and the University of Western Sydney entered a strategic alliance to develop a nursing research culture in the health services. One of the strategies implemented to achieve this was the establishment of a network of research-receptive environments known as Clinical Development Units (CDUs). At the time, however, evidence suggested that research receptivity will only develop in units where the leadership style is permissive and participatory; evidence also suggested that the successful establishment of CDUs hinged critically on the effective management of CDU leadership stressors. In light of this, it was agreed to conduct a CDU Leadership Preparation Program in Western Sydney. The aim of the program was to equip CDU leaders with the participatory leadership skills required to develop and manage their units. It was anticipated that the acquisition of these leadership skills would, in turn, help them minimise the leadership stressors to which they could expect to become subject. This paper provides details of the first CDU leadership preparation course: how participants were selected, the aims of the course and its content. It focuses, however, on a discussion of the positive evaluative data harvested through 2 focus group interviews which were conducted 5 months following participants' successful completion of the program.A second paper focuses on the more negative evaluative data, 2 themes which unexpectedly emerged during data analysis and how the current program has been modified in light of this data.

Attitude of Health Personnel↗
PubMed2002

Transformational leadership and moral reasoning.

Terms such as moral and ethical leadership are used widely in theory, yet little systematic research has related a sociomoral dimension to leadership in organizations. This study investigated whether managers' moral reasoning (n = 132) was associated with the transformational and transactional leadership behaviors they exhibited as perceived by their subordinates (n = 407). Managers completed the Defining Issues Test (J. R. Rest, 1990), whereas their subordinates completed the Multifactor Leadership Questionnaire (B. M. Bass & B. J. Avolio, 1995). Analysis of covariance indicated that managers scoring in the highest group of the moral-reasoning distribution exhibited more transformational leadership behaviors than leaders scoring in the lowest group. As expected, there was no relationship between moral-reasoning group and transactional leadership behaviors. Implications for leadership development are discussed.

Adult↗
PubMed2002

Personality and leadership: a qualitative and quantitative review.

This article provides a qualitative review of the trait perspective in leadership research, followed by a meta-analysis. The authors used the five-factor model as an organizing framework and meta-analyzed 222 correlations from 73 samples. Overall, the correlations with leadership were Neuroticism = -.24, Extraversion = .31, Openness to Experience = .24, Agreeableness = .08, and Conscientiousness = .28. Results indicated that the relations of Neuroticism, Extraversion, Openness to Experience, and Conscientiousness with leadership generalized in that more than 90% of the individual correlations were greater than 0. Extraversion was the most consistent correlate of leadership across study settings and leadership criteria (leader emergence and leadership effectiveness). Overall, the five-factor model had a multiple correlation of .48 with leadership, indicating strong support for the leader trait perspective when traits are organized according to the five-factor model.

Humans↗
PubMed2004

Intelligence and leadership: a quantitative review and test of theoretical propositions.

Meta-analysis was used to aggregate results from studies examining the relationship between intelligence and leadership. One hundred fifty-one independent samples in 96 sources met the criteria for inclusion in the meta-analysis. Results indicated that the corrected correlation between intelligence and leadership is.21 (uncorrected for range restriction) and.27 (corrected for range restriction). Perceptual measures of intelligence showed stronger correlations with leadership than did paper-and-pencil measures of intelligence. Intelligence correlated equally well with objective and perceptual measures of leadership. Additionally, the leader's stress level and the leader's directiveness moderated the intelligence-leadership relationship. Overall, results suggest that the relationship between intelligence and leadership is considerably lower than previously thought. The results also provide meta-analytic support for both implicit leadership theory and cognitive resource theory.

Humans↗
PubMed2004

Personality and transformational and transactional leadership: a meta-analysis.

This study was a meta-analysis of the relationship between personality and ratings of transformational and transactional leadership behaviors. Using the 5-factor model of personality as an organizing framework, the authors accumulated 384 correlations from 26 independent studies. Personality traits were related to 3 dimensions of transformational leadership--idealized influence-inspirational motivation (charisma), intellectual stimulation, and individualized consideration--and 3 dimensions of transactional leadership--contingent reward, management by exception-active, and passive leadership. Extraversion was the strongest and most consistent correlate of transformational leadership. Although results provided some support for the dispositional basis of transformational leadership--especially with respect to the charisma dimension--generally, weak associations suggested the importance of future research to focus on both narrower personality traits and nondispositional determinants of transformational and transactional leadership.

Humans↗