Nursing leadership in the Eastern Province of Saudi Arabia

Alsadaan, N 2018, Nursing leadership in the Eastern Province of Saudi Arabia, Doctor of Philosophy (PhD), Health and Biomedical Sciences, RMIT University.

Document type: Thesis
Collection: Theses

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Title Nursing leadership in the Eastern Province of Saudi Arabia
Author(s) Alsadaan, N
Year 2018
Abstract Aim: The aim of this study was to identify the leadership styles of nurse managers working at Saudi Arabian hospitals located in the Eastern province and also to assess the relationship between the perceived leadership style and organisational outcomes including: leaders’ effectiveness, nurses’ job satisfaction and nurses’ willingness to exert extra effort.

Method: This study adopted a mixed-methods research design. A mixed-methods design which included quantitative data (questionnaire; for nurses and nurse managers) and qualitative data (interviews; for nurse managers) was used to accomplish the aims of this study. The study was undertaken at six hospitals within the Eastern province of Saudi Arabia. It was based on the full range leadership model developed by Bass (1985) which incorporates transformational (five factors), transactional (three factors) and laissez-faire (one factor) leadership styles. The Multifactor Leadership Questionnaire MLQ 5X-Short (Avolio, Bass & Jung, 1995) was used to obtain data from nurse and nurse manager participants and additionally, all participants completed a demographic data survey. A convenience sample of 825 (600 nurses and 225 nurse managers) from the six hospitals were invited to participate in the study. The sample consisted of nurses and nurse managers who had a minimum experience of one year in nursing. From two of the hospitals included in the study, 50 nurse managers were also invited to be interviewed for the qualitative research component. Themes from the qualitative data analysis were developed by identifying recurrent patterns from the data and then organising them into groups through a process of inductive reasoning.

Results: A sample size of 404 (nurses n = 283, nurse managers n = 121) participated in the study. The results indicated that the majority of the participants were female, with a range in age of 20 to 40 years for nurses and a range in age of 30-39 years for nurse managers, with the majority of participants holding a diploma qualification. A majority of nurses had 1-2 years of experience with nurse managers having 3-10 years of experience. Overwhelmingly, most participants were expatriate who were mainly from India and the Philippines. The quantitative analysis of this study indicated that nurse managers and nurses perceived that the leadership style of nurse managers was a mix of transformational and transactional leadership styles. Furthermore, the results revealed that nurse managers utilised the five transformational leadership factors and the contingent reward transactional leadership factor. Both nurses and nurse managers rated transformational higher than transactional leadership factors. Nurses rated the nurse managers lower on the average than the nurse managers rated themselves on nine leadership factors with the exception of laissez-faire leadership and the management-by-exception passive transactional leadership factor. In regard to the relationship between leadership styles and organisational outcomes, results for both nurses and nurse managers demonstrated a significant positive correlation with each of the five transformational leadership factors and two of the transactional leadership factors. However, there was a negative correlation between laissez-faire leadership and management-by-exception passive with each of the three organisational outcomes.

The themes identified from the qualitative data analysis included the following: ensure good patient care and safety, leadership according to the situation, be a role model, maintain good working relationship, caring about staff, know how to motivate staff, be a good communicator, challenges and need to go through all the steps.

Conclusion: This study provides an evidence base for nursing leadership in Saudi Arabia. It presents insights into current leadership styles practiced in Saudi Arabian hospitals and in particular, the Eastern province. In addition, this study helped to identify the predominant and the most effective leadership model which is expected to improve the nursing workforce and overall healthcare services in Saudi Arabian hospitals. Nursing administrators should consider providing training and development of nurse managers, particularly in transformational leadership. Nurse educators should also encourage nurse managers to utilise the transformational leadership style to enhance learning and organisational outcomes in healthcare services in Saudi Arabian hospitals. For future research, there is a need to expand this study to incorporate other regions in Saudi Arabia, including teaching hospitals and the private healthcare sector to facilitate generalisability of findings and for improving educational programs for future nursing leaders.
Degree Doctor of Philosophy (PhD)
Institution RMIT University
School, Department or Centre Health and Biomedical Sciences
Subjects Nursing not elsewhere classified
Keyword(s) nursing leadership
transformational leadership
transactional leadership
leadership styles
nurse manager
organisational outcomes
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Created: Wed, 28 Nov 2018, 14:39:13 EST by Keely Chapman
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