Corresponding Author: Kusumaningrum Wijayanti
E-mail: [email protected]
INTRODUCTION
The complexity of today's healthcare system challenges
hospitals to provide safe, patient-oriented, and cost-effective services (DiNapoli et al., 2016). The competence and leadership of hospital managers
determine the progress and future of the hospital. In this case, the leader of
a health facility such as a hospital should have an appropriate leadership
system and style. Hospitals should be defined as organizations with a new
leadership framework for decentralization and improvement, and should seek
greater integration of various doctors and managers into patient care and the
public health system (Aini, 2018).
Leadership style in an organization is one of the
factors that play an important role in increasing or slowing down the interest
and commitment of individuals in the organization. Transactional and
transformational leadership style theories are the most widely recognized
leadership theories. The transactional leadership style looks based on the
transaction between the leader and his followers. According to the
transactional leadership style, human relationships are nothing but a chain of
transactions (Kuantan, 2015).
In contrast to the transactional leadership style, the
transformational leadership style emphasizes moral principles, cooperation, and
community together united in human ethical privilege. As defined by Bass, the
goal of transformational leaders is to empower their followers and encourage
them to 'do more than they were originally expected to do (Brahim et al., 2015).
Job satisfaction is defined as a positive emotional
orientation towards employees' work. A study showed that nurses who viewed
their work environment as reinforcing or empowering had better performance
improvement. As a result, patient satisfaction also increased, resulting in a
higher quality of care, better patient outcomes, and more connectedness (DiNapoli et al., 2016).
This literature review aims to determine the effect of
transformational leadership style on job satisfaction and performance of
hospital nurses. Several spesific aims are to know the
difference between transformational leadership style and transactional
leadership style, the advantages and disadvantages of transformational
leadership style, and the factors that affect job satisfaction and nurse
performance.
The results of this study hopefully can
be used as meaningful input for hospital management about transformational
leadership style, job satisfaction and nurse performance, as reference material
for further research, and enrich the study of hospital management, especially
those related to transformational leadership style, job satisfaction and
performance.
METHOD
The researcher searched for articles on leadership styles
on job satisfaction and nurse performance through electronic databases, namely
Ebscohost, Proquest, and Sciencedirect. The article search used a combination
of keywords "Nurse," "Transformational Leadership," "Job
Satisfaction," "Hospital," and "Performance."
Inclusion criteria included articles discussing nurse transformational
leadership style on job satisfaction or nurse performance in English, published
in the last ten years (2011-2021), respondents are nurses in hospitals, and
using a quantitative design. Systematic review or review articles and not
available for full access were not included in this review.
Article selection using the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) protocol guidelines. After
searching for articles through the database, 1047 articles were obtained.
Researchers selected through titles and abstracts and obtained 26 articles that
were reviewed as a whole. From this process, 20 articles were included in the
review.
Figure
1. PRISMA diagram
After the article selection process, the
articles obtained were synthesized with the format: researcher, year, journal
of publication, location, research objectives, research design, sample, and
results.
RESULTS AND DISCUSSION
Based on the article search results, 20 kinds of
literature met the inclusion criteria. All articles were quantitative studies
with a horizontal approach. The research was published from 2016 to 2021. The
research data obtained are studies conducted in various countries. Two studies
were conducted in Malaysia, two studies in Africa, Taiwan, Saudi Arabia, and
Indonesia, and other papers were studies from Pakistan, China, Nigeria, Jordan,
Brazil, Slovakia, Finland, Palestine, New York, and Kuwait. Looking at the 20
peer-reviewed articles above, 16 articles were sampled from multiple hospitals,
three pieces sampled from 1 hospital, and 1 article tested at a conference. Of
the 20 articles reviewed, 15 were about nurses, three were about nurses and
their managers, and two were about health workers (nurses, doctors,
pharmacists).
Table 1. Review results related to the
Effect of Transformational Leadership Style on Job Satisfaction and Hospital
Nurse Performance
|
No
|
Author(s)/
year/ journal
|
Study
Purposes
|
Design/
Sample
|
Analysis
|
Outcome
|
|
1
|
(Asif
et al., 2019)
International
Journal of
Environmental
Research
and
Public Health, Pakistan
|
The
main objective of this study is to explore the influence of TL
(transformational leadership) on nurses' assessment of APO (adverse patient
outcomes) and QOC (quality of care) through the mediating effects of SE
(structural empowerment) and JS (job satisfaction).
|
Cross-sectional
data, random sampling technique
17
government hospitals
386
female nurses
|
structural
equation modeling (SEM)
|
Transformational
Leadership to Job Satisfaction is significantly positive
(r
= 0.43 and p < 0.01)
|
|
2
|
(Asiri
et al., 2016) BMC Nursing, Saudi Arabia
|
This
study intends to measure the effects of nurses' overall perceptions of their
manager's leadership style, and psychological empowerment on their
organizational commitment.
psychological empowerment on their organizational commitment.
|
cross-sectional
survey
350
randomly selected nurses at King Abdulaziz Medical
City Hospital
quantitative,
descriptive design and stratified sampling
Participants
comprised
unit managers (n = 49) from five hospitals in a group of private hospitals in
South Africa
|
The
SPSS version 19 program was used to perform descriptive and inferential
statistics including correlation and stepwise multiple regression analysis.
|
Overall
most nurses perceived their direct care managers as not demonstrating the
ideal level of transformational leadership behavior (TFL).
|
|
3
|
(Breed
et al., 2020)
Curationis,
South Africa
|
The
purpose of this study was to determine the factors that influence the
motivation of nurse leaders.
of
nurse leaders.
|
quantitative,
descriptive design and stratified sampling Participants
comprised
unit managers (n = 49) from five hospitals in a group of private hospitals in
South Africa
|
IBM
SPSS 22.0 program
|
The
results showed that the nurse leaders in this study were intrinsically
motivated. Their motivation was influenced by support, relatedness, autonomy
and competence.
|
|
4
|
(Chairina
et al., 2019)
Problems
and Perspectives in Management, Indonesia
|
This
study analyzes the effect of transformational leadership on nurse performance
using the intervention variables of social competence, self-efficacy, and
burnout.
|
explanatory research
Population
of 160 nurses from five private hospitals in the East Java Region of
Indonesia
|
descriptive statistics
dan
PLS (partial least square)
|
The
results of this study prove that transformational leadership has no
significant effect on nurses' performance, however, it affects significantly
on social competence, self-efficacy, and has a significant negative effect on
burnout.
|
|
5
|
(Choi
et al., 2016) Human Resources for Health, Malaysia
|
This
study investigates 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.
The study also explored the mediating influence of empowerment between
transformational leadership and job satisfaction.
|
This
study used a survey to collect data from 200 nursing staff
|
Partial least squares-structural equation modeling (PLS-SEM)
|
This
analysis shows that empowerment mediates the effect of transformational
leadership on job
satisfaction
in nursing staff.
|
|
6
|
(Wang
et al., 2021)
Social
Behavior and Personality, Taiwan
|
This
study examines the interrelationship between nurse managers' transformational
leadership and nurses' job performance, and the key mediating role of psychological
safety in this relationship.
|
Personnel
at six regional private teaching hospitals in Central Taiwan participated in
this study, consisting of 73 nurse managers and 719 nurses.
|
Descriptive
statistics and related analysis
|
The
results show that when intergroup
heterogeneity
of job performance is statistically significant, a positive correlation
exists between transformational leadership and job
performance
at the group level.
|
|
7
|
(Ferreira
et al., 2018)
Acta
Paul Enferm, Brazil
|
To
analyze the implementation of transformational leadership in nurses' practice
in university hospitals.
|
Mixed-method
explanatory sequential study
152
nurses
|
Statistical
Package for the Social Sciences (SPSS) 21.
|
In
the quantitative phase, transformational leadership practices
transformational
leadership is often identified in
university
hospitals.
|
|
8
|
(Pan
et al., 2017)
International
Journal of Nursing Sciences, China
|
This
study aimed to investigate the environmental and individual factors that
contribute to the
psychological well-being of male nurses and to explore psychological
mechanisms that may explain the link between nurses' practice environment and
work engagement.
|
descriptive
cross-sectional quantitative design
A
total of 161 male nurses from three tertiary first-class hospitals in
Changsha City in China participated in this study
|
SPSS
17.0 dan�
AMOS 17.0
|
Nurse
practice environment and psychological capital positively predicted nurses'
job engagement; psychological capital fully mediated the effect of nurse
practice environment on job performance.
|
|
9
|
(Mudallal
et al., 2017)
International
Journal of Africa Nursing Sciences, Jordan
|
The
aim of this study was to investigate the influence of nurse fatigue, general
work, condition, nurse and patient characteristics
on nursing quality.
|
Cross-sectional,
correlational designs
270
registered nurses and 270 patients treated in 8 hospitals
|
Pearson
Correlation Coefficient
One
way analysis
of
variance (ANOVA)
regression
analysis
|
The
results of this study revealed that the quality of nursing care was negatively
associated with nurses' experience; an increase in years of experience was
associated with a decrease in the quality of nursing care performance level.
|
|
10
|
(Azimirad et al., 2021)
Nurse
Education in Practice, Findland
|
The
objective was to assess both nurses' attitudes about in-service education,
and the impact of attending nurse management education and knowledge of
deteriorating patients.
|
a
comparative cross-sectional study between British and Finnish nurses
180
nurses
|
Mann-
Whitney-U
dan Chi-square
|
Nurses'
views on the education program were positive; however, low self-confidence,
delays caused by hospital culture, and fear of criticism remained barriers to
management of deteriorating patients.
|
|
11
|
(Olu-Abiodun
& Abiodun, 2017)
International
Journal of Africa Nursing Sciences, Nigeria
|
This
study assessed the perception of transformational leadership
among
nurses working in public hospitals in Nigeria.
|
cross-sectional
study
176
nurses
|
Statistical
package for Social Science (SPSS) version 21.
|
There
is a statistically significant relationship between level of education and
average
leadership behavior perception score (p = 0.017). Transformational leadership
style is perceived by
general
hospital nurses to be used by Nurse Leaders.
|
|
12
|
(ALFadhalah & Elamir, 2021)
Journal
of Healthcare Leadership, Kuwait
|
To
investigate organizational culture, assess quality of care, and measure their
relationship with transformational/transactional leadership styles in six
hospitals.
|
cross-sectional dan retrospective
quantitative approaches
The
study population consisted of 9863 individuals representing Doctor, nurse,
and pharmacist professions.
|
SPSS
23.0
(chi-squared
tests, Pearson�s correlation)
|
Transformational
leadership style has a positive effect on the quality of care provided by the
organization
|
|
13
|
(Asamani et al., 2016)
Journal
of Health Sciences, Ghana, Africa
|
This
study investigates the leadership style of nurse managers and how it affects
nursing staff's job satisfaction and intention to stay in their current
workplace.
|
cross-sectional
survey design
591
nurses 21 midwives
|
Descriptive
and regression analysis
|
Nurse
managers use different leadership styles depending on the situation, but are
more inclined towards supportive (transformational) leadership style,
followed by achievement-oriented leadership style and participative
leadership style.
|
|
14
|
(Alsaqqa & Aky�rek, 2021) BMC
Health Services Research, Palestina
|
This
paper describes staff perceptions of the types of hospital organizational
culture and leadership styles of managers in the hospital and the
relationship between hospital organizational culture and managers' leadership
styles.
|
cross-sectional
descriptive study
400
participants (doctors, nurses, paramedics and administrators)
|
Statistical
Package for Social Sciences (SPSS) version 22
|
Studies
that address key concepts show a positive relationship as well as a positive
impact as well as an impact between the two leadership styles and types of
organizational culture, apart from the Laissez-faire style.
|
|
15
|
(DiNapoli
et al., 2016) The Journal of Nursing
Administration, New York
|
The
purpose of this study
was
to describe the
relationship
between
structural
empowerment,
psychological
empowerment, and engagement among
clinical
nurses.
|
descriptive
correlation
280
nurses
|
Pearson
correlation
coefficients
and multiple regression analysis
|
Overall,
nurses had high perceptions of structural empowerment and psychological
empowerment and were moderately engaged.
|
|
16
|
(Manesh
et al., 2018)
International
Journal of Management and Sustainability, Malaysia
|
This
paper investigates the influence of transformational leadership on contextual
performance of nurses in Kuala Lumpur.
|
cross
sectional study and research strategy using survey method
|
Pearson
correlation
|
This
shows a high positive correlation and indicates that there is a strong
correlation between job performance and the four dimensions of
transformational leadership namely Idealized Influence, Inspirational
motivation, Intellectual Stimulation and Individual Consideration. The
correlation coefficient is also statistically significant at the 0.01 level.
|
|
17.
|
(Jankelov�
& Joniakov�, 2021)
Healthcare
MDPI, Slovakia
|
To
examine the relationship between
communication skills and transformational style of FLNM (First-Line Nurse
Managers) management with nurses' job satisfaction.
|
descriptive
study
132
nurses and nurse managers in five university hospitals
|
IBM
SPSS 24.0
|
These
findings indicate the strong
strong
direct effects of FLNMs' communication skills and transformational leadership
style on nurses' job satisfaction.
|
|
18.
|
(Almutairi,
2016)
International
Journal of Business and Management, Saudi Arabia
|
The
purpose of this study is to examine the mediating effect of organizational
commitment on the relationship between transformational leadership style and
employee work performance.
|
A
descriptive and correlational research design
227
nurses from 4 hospitals
|
Regression
Analysis
|
These
findings reveal that affective organizational commitment mediates the
relationship between transformational leadership style and performance.
|
|
19.
|
(Lai
et al., 2020)
SAGE
Open, Taiwan
|
This
study proposes that transformational leaders use a variety of behaviors to
provoke organizationally beneficial follower behaviors (e.g., better task
performance and helping behavior) through igniting followers' work engagement..
|
multitemporal and multisource research design
507
nurses from 2 hospitals
|
multilevel
path analysis
|
Hierarchical
linear regression analysis showed that, after controlling for several
relevant variables (e.g., leader-member exchange, role-based self-efficacy,
and
transactional leadership) and some participant demographic variables (e.g.,
gender, age, and education), work engagement still mediated the positive
relationship between leaders and members.
|
|
20.
|
(Sari
et al., 2021)
International
Journal of Economics, Business and Accounting Research (IJEBAR), Indonesia
|
This
study aims to determine and analyze the relationship between leadership
style, workload, motivation and stress on nurse performance.
|
This
study was conducted using associative quantitative research with a non-experimental
research design.
45
Nurses in the central surgical installation of the Surakarta Orthopedic
Hospital
|
Multiple
Linear Regression
|
Results 1) leadership style
affects employee performance, 2) workload affects employee performance, 3)
motivation affects employee performance, and 4) stress affects employee performance
at the 0.05 significance level.
|
1.
Measure
All articles reviewed were quantitative research using
questionnaires. To assess the effect of transformational leadership style on
job satisfaction or nurse performance, there are 6 different questionnaires,
namely A short measure of transformational leadership, Multifactor Leadership
Questionnaire (MLQ), Path-Goal Leadership styles questionnaire,
Transformational leadership behavior questionnaire, Transformational Leadership
Scale Wu and Lin, 14-item transformational leadership scale. Assessment of job satisfaction
from using the One global item Job Satisfaction questionnaire, Scales for the
measurement of some work attitudes and aspects of psychological well-being, a
three-item scale, the Work-related Basic Need Satisfaction Scale, the perceived nurse work
environment scale. In
addition, several questionnaires were also used for performance, namely a
three-item scale and Motowidlo and Van Scotter's Job performance. All instruments used had Cronbach's Alpha values >
0.70.
2.
Discussion
a.
Factors affecting job satisfaction
Overall, the result documents analyzed transformational
leadership and job satisfaction have a positive relationship. There are five
articles on transformational leadership and job satisfaction of nurses in
hospitals. These articles discuss several transformational leadership styles
that affect job satisfaction.
The study by Asamani et al. was conducted in five
hospitals in the eastern region of Ghana. Hospital A is a Government-owned
secondary care hospital. Hospitals B and C were government-owned (primary care)
hospitals, while hospitals D and E were large faith-based hospitals comparable
to district hospitals. The health facilities were selected to represent primary
and secondary care as well as Government and mission hospitals in the Eastern
Region of Ghana. The five hospitals had 591 nurses and midwives (21) as the
accessible population. The Pearson correlation analysis results showed a weak
but significant negative correlation between directive leadership style and
staff job satisfaction levels (r = -0.263, P < 0.001). Furthermore, the
nurse manager's supportive or transformational leadership style was positively
correlated with the level of staff job satisfaction (r = 0.462, P < 0.001).
Similarly, the participative leadership style showed a positive and significant
but moderate relationship with the level of staff job satisfaction (r = 0.402,
P < 0.001). Achievement-oriented (transactional) leadership style was also
positively correlated with staff job satisfaction level (r = 0.399, P < 0.001)5.
Based on Asif et al., transformational leadership has a
positive effect on job satisfaction (r = 0.43)6. Transformational leadership
significantly affects job satisfaction, with a correlation coefficient of
0.9447. While the results of Choi et al. showed that the positive effect of
transformational leadership on job satisfaction remained significant (p <
0.05). Similarly, transformational transformational leadership showed a
positive effect on empowerment (p < 0.01), and empowerment, in turn, positively
affected job satisfaction (p < 0.01). It is important to note that the
relationship between transformational leadership and job satisfaction was
significantly significant at steps 1 and 2 but with a difference of 0.185. This
result suggests that the mediator (i.e. empowerment) may absorb some of the
effects of the relationship between transformational leadership and job
satisfaction.8
Leadership, especially transformational leadership, is
associated with higher levels of job satisfaction. Transformational leaders
engender job satisfaction and psychological well-being in employees. Nursing
leaders demonstrate transformational leadership more frequently in the
workplace and nurses exposed to this leadership style tend to have moderate to
high levels of job satisfaction. Nurses with supervisors who adopt a
transformational leadership style are less likely to experience job
dissatisfaction than nurses with supervisors who use other styles9.
Table
2. Factors Affecting Nurses' Job Satisfaction
|
Influencing factors
|
Results
|
Source
|
|
Opportunity to feel part of the work-related
decision-making process
|
+
|
(5),(10),(8)
|
|
Structural Empowerment
|
+
|
(6),(10),(8),(1)
|
|
Work engagement
|
+
|
(1),(14)
|
|
Work environment
|
+
|
(15),(16),(14)
|
|
Stress
|
+
|
(12)
|
+ = positive and significant effect
- = negative and significant effect
b.
Factors that affect nurse performance
Overall, all analyses of the literature on leadership and
performance found that leadership has a positive influence on nurse
performance. Only one stated no significance of transformational leadership
style on performance. Eight studies addressed leadership and nurse performance.
In Asiri et al.'s study, nurse performance was
significantly positively correlated with TAL (Transformational Leadership)
(Pearson Correlation = 0.124, p-value =0.028). In addition to correlation and
descriptive analysis, we measured the effects of nurses' perceptions of nurses'
perceptions of leadership style and psychological empowerment on nurses'
commitment and demographic factors10.
Meanwhile, according to Chairina et al., showed that
transformational leadership has a significant positive effect on SC (social
competence), that transformational leadership has a significant positive effect
on SE (self-efficacy), that transformational leadership has a significant
negative effect on burnout, that transformational leadership has no significant
positive effect on nurse performance, that SC has a significant positive effect
on nurse performance, that SE has a significant positive effect on SC, that SE
has a significant negative effect on burnout, that SE has a significant
positive effect on nurse performance, and that burnout has a significant
negative effect on nurse performance11.
Thamrin (2012) and Shahhosseini et al. (2012) in Chairina
et al., explained that transformational leadership affects performance.
However, it is different with leadership in private hospitals in East Java.
From the results of interviews with the results of interviews with these
nurses, the leadership style improves performance, but the implementation of
the leadership model is not optimally implemented. This theory also explains
another dimension of transformational leadership: inspirational motivation.
This theory explains how a leader communicates a vision, uses symbols to focus
employees, and models appropriate behavior (Miller, 1996). A hospital in East
Java The hospital in East Java has a vision of "becoming the community's
preferred hospital that prioritizes quality improvement and patient safety".
This motivates nurses quite well. However, in East Java, leaders treated all
nurses at the same level of competence without considering on-the-job training.
Instead, the hospital employs nurses as optimally as possible11.
Sari & Titisari's research results where the sig.
value of leadership style is 0.00 <0.005, meaning that leadership style
affects employee performance with a significance of 0.05. A leader is expected
to be able to change the character of his appropriate leadership style as a
strategy in dealing with problems12.
In Lai et al. hypothesis, postulated that work engagement
mediates the relationship between transformational leadership and performance.
The results showed that the relationship between transformational leadership
and task performance between transformational leadership and task performance
was not significant (unstandardized b = .12, SE = .08; ns), but work engagement
was significantly related to performance. (unstandardized b = .23, SE = .07; p
< .001). Thus, the above hypothesis is supported13.
Table
3. Factors that affect nurse performance
|
Influencing factors
|
Results
|
Source
|
|
Organizational commitment
|
+
|
(17),(16)
|
|
Employee empowerment
|
+
|
(10),(8)
|
|
Workload
|
+
|
(12),(16)
|
|
Motivation
|
+
|
(12),(18),(19)
|
|
Stress
|
+
|
(12)
|
|
Psychological safety
|
+
|
(20)
|
|
Work engagement
|
+
|
(13),(14)
|
|
Work environment
|
+
|
(21),(19),(16),(14)
|
+ = positive and significant effect
- = negative and significant effect
This literature review also has limitations. The sources
of articles obtained are still very limited to discuss the influence of
transformational leadership style. And in this review, all of them used a
quantitative research design with a cross-sectional approach. This does not
provide insight into long-term effectiveness. However, the purpose of this
review is to determine the influence of transformational leadership style on
nurses' job satisfaction and performance. Cross-sectional studies help explain
the influence between these variables. This review also failed to adequately
describe the relationships between studies. For this reason, further studies
can be conducted with systematic reviews and meta-analyses to understand and
combine quantitative data from these different studies.
CONCLUSION
Transformational leadership style influences
job satisfaction and nurse performance in hospitals. Transformational
leadership style has more influence on nurse performance than transactional
leadership in public hospitals. Nurses' job satisfaction is influenced by
opportunity, structural empowerment, job attachment, work environment, and
stress. Nurse performance is influenced by organizational commitment, employee
empowerment, workload, motivation, stress, psychological safety, work
attachment, and work environment. Hospitals can develop a training program to
build nurse leadership competencies that affect nurse satisfaction and
performance to improve health services.
REFERENCES
Aini, Q. (2018). Management skill and leadership: a case
study from hospital managers of charity business in health. The Journal of
Social Sciences Research, 4(12), 478�482. https://doi.org/10.32861/jssr.412.478.482.
Almutairi, D. O. (2016). The mediating effects of
organizational commitment on the relationship between transformational
leadership style and job performance. International Journal of Business and
Management, 11(1), 231�241. https://doi.org/10.5539/ijbm.v11n1p231.
Asif, M., Jameel, A., Hussain, A., Hwang, J., & Sahito,
N. (2019). Linking transformational leadership with nurse-assessed adverse
patient outcomes and the quality of care: assessing the role of job satisfaction
and structural empowerment. International Journal of Environmental Research
and Public Health, 16(13), 1�15. https://doi.org/10.3390/ijerph16132381.
Asiri, S. A., Rohrer, W. W., Al-Surimi, K., Da�ar, O. O.,
& Ahmed, A. (2016). The association of leadership styles and empowerment
with nurses� organizational commitment in an acute health care setting: a
cross-sectional study. BMC Nursing, 15(1), 1�10. https://doi.org/10.1186/s12912-016-0161-7.
Brahim, A. B., Ridic, O., & Jukic, T. (2015). The effect
of transactional leadership on employees performance-case study of 5 Algerian
banking institutions. Economic Review: Journal of Economics and Business,
13(2), 7�20.
Breed, M., Downing, C., & Ally, H. (2020). Factors
influencing motivation of nurse leaders in a private hospital group in Gauteng,
South Africa: A quantitative study. Curationis, 43(1), 1�9. https://doi.org/10.4102/curationis.v43i1.2011.
Chairina, R. R. L., Sularso, R. A., Tobing, D. S., &
Irawan, B. (2019). Determinants of nurse performance in accredited Indonesian
private hospitals. Problems and Perspectives in Management, 17(1),
163�175. https://doi.org/10.21511/ppm.17(1).2019.15.
Choi, S. L., Goh, C. F., Adam, M. B. H., & Tan, O. K.
(2016). Transformational leadership, empowerment, and job satisfaction: the
mediating role of employee empowerment. Human Resources for Health, 14(1),
1�14. https://doi.org/10.1186/s12960-016-0171-2.
DiNapoli, J. M., O�Flaherty, D., Musil, C., Clavelle, J. T.,
& Fitzpatrick, J. J. (2016). The relationship of clinical nurses�
perceptions of structural and psychological empowerment and engagement on their
unit. The Journal of Nursing Administration, 46(2), 95�100. https://doi.org/10.1097/NNA.0000000000000302.
Ferreira, V. B., Amestoy, S. C., Silva, G. T. R. da,
Felzemburgh, R. D. M., Santana, N., Trindade, L. de L., Santos, I. A. R. dos,
& Varanda, P. A. G. (2018). Transformational leadership in nurses� practice
in a university hospital. Acta Paulista de Enfermagem, 31(6),
644�650. https://doi.org/10.1590/1982-0194201800088.
Jankelov�, N., & Joniakov�, Z. (2021). Communication
skills and transformational leadership style of first-line nurse managers in
relation to job satisfaction of nurses and moderators of this relationship. Healthcare,
9(3), 346. https://doi.org/10.3390/healthcare9030346.
Kuantan, P. (2015). Transactional or transformational
leadership: which works best for now? In International Journal of Industrial
Management, 2289 (Vol. 9286). Malaysia: Universiti Malaysia Pahang.
Lai, F.-Y., Tang, H.-C., Lu, S.-C., Lee, Y.-C., & Lin,
C.-C. (2020). Transformational leadership and job performance: The mediating
role of work engagement. Sage Open, 10(1), 1�11. https://doi.org/10.1177/2158244019899085.
Manesh, M. H., Singh, J. S. K., & Hussain, I. A. B.
(2018). Transformational leadership and contextual performance: A quantitative
study among nursing staff in Kuala Lumpur. International Journal of
Management and Sustainability, 7(2), 101�112. https://doi.org/10.18488/journal.11.2018.72.101.112.
Mudallal, R. H., Saleh, M. Y. N., Al-Modallal, H. M., &
Abdel-Rahman, R. Y. (2017). Quality of nursing care: the influence of work
conditions and burnout. International Journal of Africa Nursing Sciences,
7(1), 24�30. https://doi.org/10.1016/j.ijans.2017.06.002.
Olu-Abiodun, O., & Abiodun, O. (2017). Perception of
transformational leadership behaviour among general hospital nurses in Ogun
State, Nigeria. International Journal of Africa Nursing Sciences, 6(1),
22�27. https://doi.org/10.1016/j.ijans.2017.02.001.
Pan, X., Mao, T., Zhang, J., Wang, J., & Su, P. (2017).
Psychological capital mediates the association between nurses� practice
environment and work engagement among Chinese male nurses. International
Journal of Nursing Sciences, 4(4), 378�383. https://doi.org/10.1016/j.ijnss.2017.09.009.
Sari, M., Titisari, K. H., & Istiatin, I. (2021).
Leadership Style, Work Load, Motivation and Stress on the Performance of Nurses
of Central Surgical Installations of Orthopedi Prof. Soeharso Hospital Surakarta.
International Journal of Economics, Business and Accounting Research
(IJEBAR), 5(3), 2644�2656.
Wang, H.-F., Chen, Y.-C., Yang, F.-H., & Juan, C.-W.
(2021). Relationship between transformational leadership and nurses� job
performance: The mediating effect of psychological safety. Social Behavior
and Personality: An International Journal, 49(5), 1�12. https://doi.org/10.2224/sbp.9712.
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the authors. Submitted for possible open access publication under the terms
and conditions of the Creative Commons Attribution (CC BY SA) license
(https://creativecommons.org/licenses/by-sa/4.0/).
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Received:
24-06-2022�������������������� ��������������� Accepted: 10-07-2022���������������������� ��������������� Published: 19-07-2022������ 
