Leadership styles and transformational leadership skills among nurse leaders in Qatar, a cross-sectional study

Relationships between transformational leadership, perceived social support, occupational coping self-efficacy and presenteeism among Chinese ICU nurses: a cross-sectional study

OBJECTIVE

This study aimed to investigate the relationship between transformational leadership and presenteeism among intensive care unit (ICU) nurses in tertiary hospitals and further investigate the chain-mediated role of perceived social support and occupational coping self-efficacy.

DESIGN

This is a cross-sectional survey study.

SETTING

Six tertiary hospitals in Sichuan Province, China.

PARTICIPANTS

590 ICU nurses were recruited from six tertiary hospitals in China for the survey.

PRIMARY AND SECONDARY OUTCOME MEASURES

Presenteeism of ICU nurses was the primary outcome indicator. Transformational leadership, perceived social support and occupational coping self-efficacy were secondary outcome indicators. The transformational leadership scale, perceived social support, occupational coping self-efficacy and Stanford presenteeism scale were used to investigate ICU nurses through convenience sampling.

RESULTS

The presenteeism score of ICU nurses was 15.46±4.45 (mean±SD), in which the incidence of high presenteeism was 53.90%. Correlation analysis showed that presenteeism was negatively correlated with transformational leadership, perceived social support and occupational coping self-efficacy (r=-0.412 to -0.486; p<0.05). Perceived social support partially mediated the relationship between transformational leadership and presenteeism, with an effect value of 0.055 (95%CI: -0.102 to -0.012; p<0.001); occupational coping self-efficacy partially mediated the relationship between transformational leadership and presenteeism, with an effect value of 0.042 (95% CI: -0.074 to -0.017; p<0.001); perceived social support and occupational coping self-efficacy chain-mediated between transformational leadership and presenteeism, with an effect value of 0.029 (95% CI: -0.046 to -0.016; p<0.001).

CONCLUSION

ICU nurses' perceived social support and occupational coping self-efficacy are chain-mediated between transformational leadership and presenteeism. Therefore, to reduce nurses' presenteeism, nursing managers should adopt targeted interventions based on the factors influencing them to improve transformational leadership and enhance their perceived social support and occupational coping self-efficacy.

Management of care for hospitalized older persons - comfort as an essential outcome: a qualitative study

BACKGROUND

The global aging population highlights the need for accurate care management, tailored to their specific needs. This study investigated the production of comfort as a therapeutic outcome of nursing care management for hospitalized older persons.

METHODS

This exploratory descriptive research was conducted in 9 medical wards and 4 surgical wards of a university hospital in the state of Rio de Janeiro, Brazil, via a qualitative approach. Between May and June, 2022, the researchs collected data from 19 nurses in management positions. Semistructured interviews were conducted, and the researchers investigated the data thus collected via thematic-categorical content analysis on the basis of the approach developed by Bardin. The theoretical framework was based on Kolcaba's Comfort Theory.

RESULTS

Inadequate staffing was the main challenge among the forces (barriers) that were observed to obstruct the care management of hospitalized older persons, what lead to task prioritization that favored techinical over comfort-focued care. Additionally, the overload and stress faced by nurses created discomfort for the team, which was reflected in the care that they provided. The results also revealed that a lack of knowledge represented a significant challenge because professional insecurity led nurses to choose restrictive interventions; however, this approach ultimately sacrified comfort. Alongside with leadership, experience emerged as a primary facilitating force. The main risks faced by hospitalized older persons that were identified by nurses included falls, pressure injuries, delirium, pneumonia, and bronchoaspiration. The main nursing interventions used to ensure comfort and safety of hospitalized older persons pertained to the environment as well as to the need to encourage the presence of family members. However, intervening variables, beyond the professional's control, such as inapproprieted hospital infrastructure and the unavailability of family members, were not considered. As a result, the interventions proved to be ineffective since they did not address these factors that impacted patient's levels of comfort.

CONCLUSIONS

Analysis of the findings of this research revealed that although care management focused on promoting comfort, safety and autonomy among patients, nursing practices prioritized patient safety while sacrificing comfort and autonomy.

TRIAL REGISTRATION

This work was approved by the Ethics Committee - no. 57513722.0.0000.5282.

Setting national nursing research priorities in Qatar: A Delphi survey

AIM

To establish consensus on the priorities of nursing research in Qatar regarding nursing administration, nursing practice and nursing education for the years 2023-2033.

DESIGN

Classic Delphi format over three phases.

METHODS

The first phase involved a qualitative round where participants identified 10 research priorities. In phase two, the collected sentences were analysed and grouped into themes. Participants were then requested to rate these sentences based on their perceived importance. During phase three, participants received their individual responses, the consolidated group response from the second round, and were given the opportunity to agree or disagree with the group ranking. The panel of experts consisted of 32 participants who agreed to participate in all three rounds. They included a mixture of nursing academics, clinical managers and nursing directors from public sectors and nursing schools in Qatar.

RESULTS

The experts reached a consensus on the research priorities for Qatar. These prioritized topics focused on improving patient care outcomes, enhancing workforce development, strengthening nursing leadership, integrating technology to improve nursing and nursing education and promoting evidence-based practice.

CONCLUSION

This research emphasizes the importance of progress in nursing to meet healthcare demands. Findings showed the need of future research to focus on improving nursing workforce and well-being, leadership styles and technology, and evidence-based practice and technology in nursing education.

IMPACT

The impact of identifying nursing research priorities in Qatar will improve healthcare practices, fostering a culture of evidence-based care. These advancements will motivate nurses to engage more actively in research, thereby enhancing overall healthcare outcomes.

PUBLIC CONTRIBUTION

Not applicable.

Transformational Leadership and Nursing Retention: An Integrative Review

Aim

To establish current evidence on the relationship between transformational nursing leadership and turnover intention.

Background

The persistent nursing shortage in healthcare has led to heightened demands for addressing both current needs and the healthcare requirements of a growing population. Recognizing the pivotal role of nursing leadership in fostering retention, this review highlights the influence of positive leadership on nursing staff. Evaluation. An integrative review, guided by Whittemore and Knafl's (2005) framework, was conducted using articles sourced from four online databases deducing to an inclusion of sixteen quantitative articles, one systematic review, and one integrative review published between 1992 and 2022. Key Issues. The study reveals conflicting evidence regarding the sole impact of transformational leadership on the nursing staff's intention to remain. However, it highlights transformational leadership's ability to enhance job satisfaction and organizational commitment contributes significantly to retention.

Conclusion

Using transformational leadership can effectively bolster nursing staff retention along with promoting other favorable workplace outcomes. Implications for Nursing Management. This review underscores the importance of enhancing leadership skills within nursing management. This involves not only fostering transformational leadership but also cultivating positive work-related outcomes to optimize nursing staff retention.

Leadership and Followership in Health Professions: A Systematic Review

Objective: Leadership discussion, including leadership development programs, is common. However, discussion of followership as a component of leadership seems less frequently discussed. With a focus on leadership and followership, this investigation reviewed the health-professions education literature and characterized leadership-followership within health-professions education. Methods: Using PubMed, ERIC, and Google Scholar, two investigators independently and systematically searched health-professions education literature for articles related to leadership and followership. Reports were categorized based on the articles by type, application, profession, leadership, and followership qualities. Results: Eighty-one articles were included. More than half [59% (48/81)] were theoretical, 27% (22/81) empirical, 7% (6/81) commentaries, and 6% (5/81) letters-to-the-editor). Empirical studies did not share outcomes that could be meaningfully combined quantitatively by meta-analysis; however, the vast majority (96%) of theoretical articles discussed a healthcare-related application of leadership and followership (e.g., improving patient care, improving communication, improving organizational efficiency). Thus, a qualitative review was completed. Of the 81 articles, 57% (n=46) involved multiple professions, while 43% (n=35) focused on a specific profession [Nursing (n=16), Medicine (n=7), Others (n=5) Surgery (n=3), Pharmacy (n=2), Veterinary Medicine (n=2)]. While most articles (75%) discussed leadership qualities (with top qualities of effective communication, visionary, and delegating tasks), fewer (57%) discussed followership qualities (with top qualities of being responsible, committed, and supportive). Of note, some qualities overlapped in both leadership and followership (with top qualities of effective communication, being supportive, and providing/receiving feedback). Conclusions: Leadership-Followership was described in many health-professions' education literature. However, Pharmacy and Veterinary Medicine had substantially fewer articles published on this topic. Notably, followership did not receive nearly as much attention as leadership. Leadership has a dynamic and complex interaction with followership highlighting that an effective leader must know how to be an effective follower and vice versa. To improve leadership within healthcare teamwork, education should focus on both leadership-followership.

Nurses, non-nurse healthcare providers, and clients' perspectives, encounters, and choices of nursing gender in Tanzania: a qualitative descriptive study

BACKGROUND

A growing share of male nurses in the nursing profession in Tanzania has changed the trend of diversity of nursing gender. This might have created a divergent perspective within the communities. Therefore, the current study aimed to explore the perspective, encounters, and choices of nursing gender among licensed nurses, non-nurse healthcare providers, and clients in Tanzania.

METHODS

The study employed a qualitative descriptive design. The data were collected between August 2022 to January 2023 by the principal investigator and one research assistant. Twelve Focus Group Discussions (FGDs) were carried out in four different hospitals in Dar es Salaam comprised of total participants (n = 59). The participants were nurses, clients, and non-nurse healthcare providers. The data was collected through an interview guide developed by the principal investigator and validated by nurse experts. The data was analyzed using qualitative content analysis to generate themes and subthemes.

RESULTS

Eight themes and twenty-seven subthemes emerged from the study. The following are themes; ① Variations of male and female nurses in communication ② Differences of male and female nurses in carrying out leadership roles ③ Divergent clinical qualities and outcomes across nursing gender ④ Positive value of male nurses in clinical facilities from colleagues and patients ⑤ Different cooperation of male and female nurses at the clinical settings ⑥ Mixed perspective towards clinical competencies across nursing gender ⑦ Perspective towards gender diversity in nursing ⑧ Preferences of nurse's gender, reasons, and opinion towards gender preferences.

CONCLUSION

Male nurses and female nurses differ in how they communicate, execute leadership roles, and clinical qualities. However, their variations don't mean one gender is underrated than the other, but every gender has unique communication styles, leadership styles, and clinical qualities that both lead to effective outcomes. Diversity in nursing gender is very important and should be strategized. Since preferences of nursing gender seems to enhance somebody's freedom and creates an environment where a person can discuss sensitive issues, nursing bodies and healthcare stakeholders might initiate a discussion about approaches to promote the implementation of nursing preference and perform the feasibility studies.

Nurses' perspectives on professional self-concept and its influencing factors: A qualitative study

BACKGROUND

Nurses with a strong professional self-concept tend to exhibit a positive mindset and strong work engagement, delivering high-quality patient care. Although numerous quantitative studies have examined the factors impacting professional self-concept, there remains a limited exploration of these factors from the perspective of nurses themselves.

METHODS

This qualitative descriptive study uses the PERMA theory and Social Cognitive Theory as the theoretical framework. Semi-structured interviews were conducted with 15 nurses from six public hospitals in China. The data were analyzed thematically using a combination of inductive and deductive approaches.

RESULTS

Nurses' understanding of professional self-concept could be divided into four categories: professional identity, competence, care, and knowledge. Factors influencing nurses' professional self-concept were categorized into eight subthemes in three domains: (1) personal factors, including psychological qualities and attitude towards the nursing profession; (2) occupational-related behavioral factors, including role-oriented behavior and knowledge-oriented behavior; and (3) work environment and external factors, including external evaluation and perceptions of nurses, time allocation, nursing work tasks, work atmosphere, school education, and perceived supports.

CONCLUSIONS

This study found that, although nurses had different personal experiences, their perceptions of professional self-concept were similar. Nurses' professional self-concept is a multidimensional concept and involves various factors, such as personality, work-related characteristics, environment, and family. To thrive in a nursing career, nurses must discern the factors that can enhance or hinder their professional self-concept. By identifying and adjusting these factors, personalized support and positive interventions can be tailored to meet nurses' specific needs, which ultimately nurtures their professional development.

TRIAL REGISTRATION

This study was registered on December 14, 2022, in the Chinese Clinical Trial Registry (ChiCTR2200066699) as part of our ongoing study.