Understanding the link between leadership style, employee satisfaction, and absenteeism: a mixed methods design study in a mental health care institution

The Effect of Transformational, Transactional, and Laissez-Faire Leadership Styles on Employees' Level of Performance: The Case of Hospital in Oromia Region, Ethiopia

Purpose

Poor performance of health service providers has a negative impact on the ability of health systems to produce desired outcomes. Lack of suitable and impactful leadership hinders employee performance in terms of providing a high standard of care. There is a paucity of evidence on the effect of leadership style on employee performance in the current study setting. Hence, this study sought to assess the effect of leadership styles on employee performance in hospitals in the Oromia region, Ethiopia, from August 1 to October, 30, 2021.

Methods

A cross-sectional study was conducted using a sample of 41 hospitals and 412 employees, selected by stratified sampling from hospitals in the Oromia region. The data were collected using self-administered questionnaires. They were then coded and entered into the Epi-Info-7.2. software, and exported to SPSS-20 for analysis. The participants' characteristics were analyzed and summarized using descriptive statistics. Employee performance was rated as low, average or high, and estimated by proportion along with a 95% confidence interval (CI). The association between leadership styles and the level of employee performance was modelled using ordinal logistic regression. The magnitude of association was estimated by odds ratio with a 95% CI. Statistical significance was set at p < 0.05.

Results

Employees had an increased odds of being a high performer when they experienced the following leadership styles: transformational with idealized influence (AOR=1.70; 95% CI: 1.12, 2.64), intellectual stimulation (AOR=1.60; 95% CI: 1.04, 2.48), laissez-faire approach (AOR=2.49; 95% CI: 1.71,3.62), effectiveness in terms of frequently fulfilling employees' job-related needs (AOR=2.09; 95% CI: 1.20,3.63), and the exertion of extra effort in motivating them (AOR=2.11; 95% CI: 1.22, 3.68).

Conclusion

Among leadership styles, transformational with idealized influence and intellectual stimulation, laissez-faire approaches were significantly associated with employee performance. However, transactional leadership was not significantly associated with employee performance.

Transformational Leadership and Emotional Labor: The Mediation Effects of Psychological Empowerment

In order to survive the fiercer competition, more and more service firms emphasize front-line employees' role of creating excellent customer experience by displaying positive emotions during the service interactions. However, the underlying mechanisms for the relationship between transformational leadership and front-line employees' emotional labor remain unclear. Drawing upon the conservation of resources (COR) theory, this study develops a conceptual model in which transformational leadership influences front-line employees' emotional labor through the mediator of psychological empowerment. By collecting data from 436 employees in five call centers, we tested our model and hypotheses through PROCESS 3.3 macro for SPSS developed by Hayes. The results show that transformational leadership shows positive and negative effects on deep acting and surface acting, respectively. The positive effect on deep acting is partially mediated by psychological empowerment, while the negative effect on surface acting is fully mediated by psychological empowerment. Specifically, two dimensions of psychological empowerment (impact, self-efficacy) play negative mediating roles between transformational leadership and surface acting, while impact, self-determination, and self-efficacy play positive mediating roles of transformational leadership and deep acting. The findings advance our understanding about how transformational leadership influences front-line employees' emotional labor by introducing psychological empowerment as a mediator.

Does small and medium enterprise differential leadership increase subordinate knowledge hiding? Evidences from job insecurity, territorial consciousness and leadership performance expectation

Leadership is considered as a significant antecedent of knowledge hiding in SMEs (small and medium enterprises), but the differential dimension of leadership has been evidently neglected in both theoretical and empirical areas. Drawing on conservation of resource theory and social cognitive theory, this research investigates whether and how SME differential leadership influences subordinate knowledge hiding. Specifically, we analyze the underlying mechanisms of a chain-mediator—job insecurity and territorial consciousness and a boundary condition—leadership performance expectation. Multi-wave and multi-source data were collected from a sample of 704 Chinese SME employees and 140 relevant leaders and applied HLM meso-mediational frameworks, and Bootstrap technique with non-parametric percentile residuals for deviation correction. The results show that differential leadership plays a potential role in promoting subordinate knowledge hiding through the serial intervening mechanism of job Insecurity and territorial consciousness in SMEs. Furthermore, the positive relationship between SME differential leadership and job insecurity becomes stronger among subordinates under higher leadership performance expectation; the positive indirect relationship between SME differential leadership and subordinate knowledge hiding is stronger with higher levels of leadership performance expectation. This study contributes to the existing academic literature by empirically analyzing the under-investigated correlation between differential leadership and subordinate knowledge hiding in SMEs, and by exploring the underlying mechanisms and a boundary condition.

Barriers and Facilitators for Return to Work from the Perspective of Workers with Common Mental Disorders with Short, Medium and Long-Term Sickness Absence: A Longitudinal Qualitative Study

Purpose Although common mental disorders (CMDs) highly impact individuals and society, a knowledge gap exists on how sickness absence can be prevented in workers with CMDs. This study explores: (1) workers' perceived causes of sickness absence; (2) perceived return to work (RTW) barriers and facilitators; and (3) differences between workers with short, medium and long-term sickness absence. Methods A longitudinal qualitative study was conducted involving 34 workers with CMDs. Semi-structured interviews were held at two time-points during their RTW process. The 68 interviews were audio-taped, transcribed and thematically analyzed to explore workers' perspective on sickness absence causes, RTW barriers and facilitators, and compare data across the three sub-groups of workers. Results Workers reported various causes for their absence, including: (1) high work pressure; (2) poor work relationships; (3) unhelpful thoughts and feelings, e.g. lacking self-insight; and (4) ineffective coping behaviors. According to workers, RTW was facilitated by work adjustments, fulfilling relationships with supervisors, and adequate occupational health guidance. Workers with short-term leave more often reported favorable work conditions, and proactive coping behavior. In contrast, the long-term group reported reactive coping behavior and dissatisfaction with their work. Conclusion Supporting workers with CMDs in gaining self-awareness and regaining control, discussing the value of their work, and creating work conditions that enable workers to do valuable work, seem central for successful RTW and might prevent sickness absence. Supervisors play a key role in enabling workers to do valuable work and further research should focus on how supervisors can be supported in this task.

Supervisors' transformational leadership style and residents' job crafting in surgical training: the residents' views

Objectives

This study aims to explore the effects of three supervisors' leadership styles (transformational, transactional, and laissez-faire) on residents' job crafting.

Methods

Sequential explanatory mixed-methods. First, a purposive sample of residents rated the leadership style of their supervisors and their own job crafting on the Multifactor Leadership Questionnaire and the Dutch Job Crafting Scale. The effects were tested through linear mixed effects regression analysis. Thereafter we conducted semi-structured interviews with residents and conducted a thematic analysis.

Results

A total of 116 residents participated. A transformational style had a positive effect on residents' job crafting (b = .19, t(112) =3.76, p=. 009), whereas the transactional and laissez-faire styles did not. This could be explained by the fact that residents felt a positive influence of the supervisors with such style on the atmosphere for training, on the job resources available to them, and on their modelling function for how to handle the demands of the environment.

Conclusions

A transformational style of the supervisor has a positive effect on residents' job crafting. Future research should explore the supervisors' perspective, as well as the effectiveness of leadership training for supervisors with a focus on resident outcomes, such as job crafting.

Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions

Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.

Leadership for a healthy work environment - a question about who, what and how

Purpose

Recruiting and retaining staff to work with elderly people in social care is a global issue. The quality of leadership is considered important because it influences employees’ job satisfaction, job turnover and health. This paper aims to identify leadership that employees in residential elderly care facilities in Sweden consider as contributing towards a healthy work environment.

Design/methodology/approach

The authors interviewed 14 persons employed in facilities organized in different ways. The data from these interviews was analysed using qualitative content analysis..

Findings

The results showed that the employees felt that their health partly depended on the attributes that leaders possessed, what leaders do and how leaders do it. This study confirms that leadership influences the perception of a healthy workplace. It also shows that questions about leadership are complex.

Originality/value

Research about factors that increase health risks is wide-ranging; however, research that examines factors that promote health, especially how leadership influences employees’ well-being, is not as comprehensive.

Business Results and Well-Being: An Engaging Leadership Intervention Study

The present quasi-experimental study tested the business impact of a leadership development program focusing on psychological well-being through the satisfaction of basic psychological needs. Based on the concept of engaging leadership and self-determination theory, the 8-month program targeted midlevel team leaders of the customer fulfilment center of a health systems multinational organization. The program was designed in co-creation between senior leadership and the team leaders that participated in the program. Outcomes showed positive business results through significant increases in a preselected key performance indicator and decreased employee absenteeism. Through changes in autonomy satisfaction and intrinsic motivation, the team leaders (N = 14) benefitted in a moderate to very large extent relative to a similar control group (N = 52). In contrast, team members (N = 148) displayed no such benefits. Specifically, higher levels of autonomy satisfaction are said to lead to higher levels of psychological well-being and motivation. Still, the link with business performance is absent in most organizational studies within self-determination theory, making the present study one of the first to fill this gap. The study discloses the program design, compares the effects to a relevant control group, evaluates the lessons learned, and provides practical suggestions.

Development of a national medical leadership competency framework: the Dutch approach

BACKGROUND

The concept of medical leadership (ML) can enhance physicians' inclusion in efforts for higher quality healthcare. Despite ML's spiking popularity, only a few countries have built a national taxonomy to facilitate ML competency education and training. In this paper we discuss the development of the Dutch ML competency framework with two objectives: to account for the framework's making and to complement to known approaches of developing such frameworks.

METHODS

We designed a research approach and analyzed data from multiple sources based on Grounded Theory. Facilitated by the Royal Dutch Medical Association, a group of 14 volunteer researchers met over a period of 2.5 years to perform: 1) literature review; 2) individual interviews; 3) focus groups; 4) online surveys; 5) international framework comparison; and 6) comprehensive data synthesis.

RESULTS

The developmental processes that led to the framework provided a taxonomic depiction of ML in Dutch perspective. It can be seen as a canonical 'knowledge artefact' created by a community of practice and comprises of a contemporary definition of ML and 12 domains, each entailing four distinct ML competencies.

CONCLUSIONS

This paper demonstrates how a new language for ML can be created in a healthcare system. The success of our approach to capture insights, expectations and demands relating leadership by Dutch physicians depended on close involvement of the Dutch national medical associations and a nationally active community of practice; voluntary work of diverse researchers and medical practitioners and an appropriate research design that used multiple methods and strategies to circumvent reverberation of established opinions and conventionalisms.

IMPLICATIONS

The experiences reported here may provide inspiration and guidance for those anticipating similar work in other countries to develop a tailored approach to create a ML framework.

Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes

OBJECTIVE

Evaluation of the effectiveness of a workplace health promotion program on employees' vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors' role on these outcomes.

METHODS

The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used.

RESULTS

Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence.

CONCLUSIONS

Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes.

The Association Between Management of the Board of Trustees and Its Effectiveness at Hospitals in Tabriz; 2011 to 2013

Background:

Reforming the structure and improving care and service system, particularly at hospitals, are the main priorities of the health system. The board of trustees of the hospitals is the main proposed strategy in this field. Hospitals with board of trustees were created with the aim of improving accountability to the community and guaranteeing efficient management and attracting public support in running the hospital.

Objectives:

The aim of this study was to investigate the association between hospital effectiveness and the board of trustee’s management method.

Materials and Methods:

This cross-sectional study was conducted in Tabriz City, Iran, during the years 2011 to 2013. To assess the effectiveness of board of trustees’ management, two hospitals in Tabriz City were compared. Hospitals selected through purposive typical case sampling method. Two hospitals had equal structure, same doctors, and both were gynecology hospitals of Tabriz City, but one of them was a gynecology hospital managed by the board of trustees and the other was managed by the chairman. The information about the five variables of hospital effectiveness was collected during the years 2011 to 2013 using standard lists and questionnaires, which were available in the hospitals; these variables included quality management, safety, medical equipment management, and patients and staff satisfaction. Then, each variable was weighted through the technique of hierarchical analysis and finally they were analyzed using SPSS 17 and Expert Choice 11.

Results:

Among the five variables related to the effectiveness, safety showed to have the highest weight and medical equipment management had the lowest weight. According to the statistical analyses, the score of the effectiveness of the hospital with the board of trustees was 33.08 (on the scale of 0 - 100) and the score of the hospital with the chairperson was 29.52. No significant association was found between the effectiveness of hospital and the board of trustees management (P = 0.81).

Conclusions:

Because there was no significant difference in the effectiveness between hospitals with and without board of trustees, decision-makers must monitor how the commands are carried out to make board of trustees for hospitals and make sure its success in achieving its objectives.