Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required.
The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables.
The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care.
These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.
To investigate the effect of nurses’ emotional labor on their turnover intention that was mediated by burnout and to examine the moderated mediation effect of authentic leadership.
A total of 227 nurses working at two general hospitals in Seoul were recruited from March 21 to May 6 in 2016. Emotional labor including surface acting and deep acting; burnout factors such as emotional exhaustion and personal accomplishment; and turnover intention were assessed. The data were analyzed using SPSS 22.0 and SPSS PROCESS macro.
Surface acting significantly increased emotional exhaustion and reduced personal accomplishment. Deep acting significantly increased personal accomplishment. Emotional exhaustion significantly increased turnover intention. Conversely, personal accomplishment significantly reduced turnover intention. Surface acting had an indirect effect on turnover intention that was mediated by emotional exhaustion. Deep acting had an indirect effect on turnover intention that was mediated by personal accomplishment. Authentic leadership had a moderated mediation effect on the relationship between surface acting and turnover intention that was mediated by emotional exhaustion.
The findings of this study indicate that the establishment of strong authentic leadership by head nurses would help nurses reduce their burnout and turnover intention. Conducting intervention studies would be also important to promote better work environments that would enable nurses to fortify the positive aspect of emotional labor and to reduce their burnout levels.
Today's healthcare environment is changing driven by demographic, environmental, social, political and technological forces. These rapidly changing healthcare environment and increasingly professional nursing practice indicate that identifying leadership characteristic of nursing leaders and executives is a vital importance in today's time and also mandate innovative leadership for nursing service. Therefore, the purpose of this study is to examined the transformational, transactional leadership styles of the Nurse Administrators. Also described are the relationships between these leadership style and the job satisfaction, the organizational commitment of their subordinates. The sample consisted of sixteen mid-level nurse administrators, fifty head nurses and one hundred and fifty-three staff nurses of 4 public and private University Hospitals and 1 General Hospital. Data for this study was collected from Sep. 20 to Oct. 5by Questionnaire(Bass' MLQ, Job Satisfaction scale developed by Poter et al(1978). Organizational Commitment scale by Poter at al(1070). The data was analyzed by frequency, percentage, one-way ANOVA, Pearson's Correlation Coefficient with SPSS PC+ program. Major findings are as follows : Appropriate one-way ANOVA tests revealed that the difference for transformation and transactional leadership styles of nurse executives, mid-level nurse administrators, head nurses as perceived by their immediate subordinates were statistically significant(P<.05). The scores of transformational and contingent reward behaviors were declined of the mid-level nurse administrators, nurse executives. The transactional scores of nurse administrators were lower than transformational ones, which is desirable findings. The result of the highest transformational leader by their subordinates, and second was the mid-level nurse administrators. The nurse executives received the lowest transformational leadership scores from their subordinates. These results were opposit to the previous studies. And significant positive correlations were founded between transformational leadership including charisma, intellectual stimulation, individual consideration and contingent reward of nurse administrators and the job satisfaction, the organizational commitment of their subordinates. From the data, it can be concluded that transformational leadership style of nurse administrators promotes the job stratification, the organizational commitment of their staff nurses. Therefore leader looks for potential motives in subordinates, seeks to satisfy higher need, and engages the full person of the subordinate resulting in a relationship of mutual stimulation and elevation.
PURPOSE: The Purpose of this study was to identify the relationship among leadership style of nurse managers, job satisfaction, organizational commitment, and turnover intention. METHOD: The subjects were 468 nurses and 19 head nurses who were working at the 3 general hospitals in seoul. The data were collected from July 6 to September 14, 2001 by the structured questionnaires. For data analysis, descriptive statistics, ANOVA, Pearson correlation coefficient, and stepwise multiple regression with SAS package were used. RESULT: 1) The score of the nurse managers' transformational leadership perceived by surbodinates' were higher than that of the nurse managers' transactional leadership. Among 5 subdimensions of the leadership styles perceived by surbodinates', the scores of 'charisma' and 'intellectual stimulation' were highest and 'management by exception' were lowest. 2) 'Charisma', 'intellectual stimulation', 'individual consideration' and 'contingent reward' were positively related to all of variables except 'turnover intention'. 'Management by exception' was negatively related to all of variables and was positively related to 'turnover intention'. 3) 'Job satisfaction' was positively related to 'organizational commitment' and 'Job satisfaction', 'organizational commitment' were negatively related to 'turnover intention'. 4) As a result of stepwise multiple regression analysis, the key determinants of 'turnover intention' were 'organizational commitment' and this explained 44.4% of the total variance of it.
PURPOSE: This study investigated the effect of transformational leadership and individual characteristics on nurses' job involvement. METHOD: The sample for this study consisted of 594 nurses from 8 large Korean hospitals. The factor analysis was drawn from the Cronbach's alpha analysis, the Pearson correlation analysis, the multiple regression analysis, and the hierarchical multiple regression analysis. Result: This study found that; (1) charisma dimension of transformational leadership has positive influence on job involvement; but intellectual stimulation and individualized consideration did not showed significant effects on job involvement (2) nurse individual characteristics (age, marital status, educational level, tenure, position) moderated the effect of transformational leadership on job involvement. Conclusion : Therefore, to improve job involvement nurses are required to apply the charisma dimension of transformational leadership in hospital organization.
This study has been attempted using the Q methodology to clarify leader type of nurse managers that head nurses and general nurses recognize, and to clarify its relative relation. Sixty-three statements were extracted through interviews with general and professional people interested in the subject of nurse leaders to extract the Q population. Atotal of 314 Q population was formed added with 251 questions extracted from related documents. Final 32 Q samples were selected by reorganization of 314 Q population after reexamining statements through inquiry of 1 professor of the nurse department, 2 students in course of nurse science masters degree and 2 students in course of doctoral degree. The P sample selection standard of this study were 25 nurses and 30 head nurses. Examination subjects themselves filled out 32 statements classified in a measure of 9 points from agreeable items to disagreeable items, Principal component factors were analyzed using the QUANL pc program after grading the contents of the P sample. Nurses recognizing subjective structure for leader behaviors of nurse manager were analyzed to be 3 factors: vision presentation type, self-capability consideration type, relationship consideration type, and head nurses recognizing subjective structure were analyzed to be 2 types ; task pursuit leader type, and concord pursuit type. Nursing manager's leader behavior, expected by staff nurse are more complex and higher level which may combined with task pursuit leader type in concord pursuit leader of head nurse. Also according to Hersey and Blanchard theory(1977), the effectiveness of leadership becomes to be larger as the accordance rate between the behaviors of nurse leaders and followers reaction increase. Two suggestions have been made based on the conclusion. 1. Studies on creating strategies in relation to development, management, selection of nurse leaders should be made based on this study. 2. There is a need for relative study of production and degree of similarity of leadership types based on this study.
This paper was conducted to examine the effects of transformational leadership behaviors, within the substitutes for leadership model (Kerr and Jermier, 1978).
Data was collected from 181 staff nurses in 3 general hospitals, with self-reporting questionnaires (MLQ developed by Bass, rd-SLS developed by Podsakoff, et al., and MSQ developed by Weiss, et al.). Descriptive statistics, factor analysis, Cronbach's alpha and moderated regression analysis were used.
1) The transformational leader behaviors and substitutes for leadership each had correlations with job satisfaction. 2) The total amount of variance accounted for by the substitutes for leadership was substantially greater than by the transformational leadership behaviors. 3) Few of the substitutes variables moderated the relationships between the transformational leader behaviors and job satisfaction in a manner consistent with that specified by Howell, Dorfman, and Kerr (1986).
The finding of this study suggest that leaders need to have a better understanding of those contextual variables that influence job satisfaction. Thus future research should focus attention on the moderating effects of substitutes, as well as the things that leaders can do to influence them. In addition, it may be good to examine the effects of substitutes on other criterion variables.
The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance.
Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires.
For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity.
The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.
The aim of this study was to examine the mediating effect of empowerment in the relationship of nurse managers' authentic leadership, with nurses' organizational commitment and job satisfaction.
The participants in this study were 273 registered nurses working in five University hospitals located in Seoul and Gyeonggi Province. The measurements included the Authentic Leadership Questionnaire, Condition of Work Effectiveness Questionnaire-II, Organizational Commitment Questionnaire and Korea-Minnesota Satisfaction Questionnaire. Data were analyzed using t-test, ANOVA, Scheffé test, Pearson correlation coefficients, simple and multiple regression techniques with the SPSS 18.0 program. Mediation analysis was performed according to the Baron and Kenny method and Sobel test.
There were significant correlations among authentic leadership, empowerment, organizational commitment and job satisfaction. Empowerment showed perfect mediating effects in the relationship between authentic leadership and organizational commitment. It had partial mediating effects in the relationship between authentic leadership and job satisfaction.
In this study, nurse managers' authentic leadership had significant influences on nurses organizational commitment and job satisfaction via empowerment. Therefore, to enhance nurses' organizational commitment and job satisfaction, it is necessary to build effective strategies to enhance nurse manager's authentic leadership and to develop empowering education programs for nurses.
The purpose of this study was to understand and describe the leadership experience of clinical nurses.
During 2014, data were collected using focus group interviews. Three focus group interviews were held with a total of 20 clinical nurses participating. All interviews were recorded as they were spoken and transcribed and data were analyzed using qualitative content analysis.
Fifteen categories emerged from the five main themes. 1) Thoughts on the leadership category: to lead others, to cope with problem situations adequately and to serve as a shield against difficulties. 2) Situations requiring leadership: situation that requires correct judgement, coping and situations that need coordination and cooperation. 3-1) Leadership behaviors: other-oriented approach and self-oriented approach. 3-2) Leadership behavior consequences: relevant compensation and unfair termination. 4-1) Facilitators of leadership: confidence and passion for nursing and external support and resources. 4-2) Barriers to leadership: non-supportive organization culture and deficiency in own leadership competencies. 5) Strategies of leadership development: strengthen leadership through self-development and organizational leadership development.
In conclusion, the results indicate that it is necessary to enhance clinical nurses' leadership role in healthcare. Enhancement can be achieved through leadership programs focused on enlarging leadership experience, constant self-development, leadership training, and development of leadership competencies suited to the nursing environment.
The purpose of this study was to validate the Korean version of the Ethical Leadership at Work questionnaire (K-ELW) that measures RNs' perceived ethical leadership of their nurse managers.
The strong validation process suggested by Benson (1998), including translation and cultural adaptation stage, structural stage, and external stage, was used. Participants were 241 RNs who reported their perceived ethical leadership using both the pre-version of K-ELW and a previously known Ethical Leadership Scale, and interactional justice of their managers, as well as their own demographics, organizational commitment and organizational citizenship behavior. Data analyses included descriptive statistics, Pearson correlation coefficients, reliability coefficients, exploratory factor analysis, and confirmatory factor analysis. SPSS 19.0 and Amos 18.0 versions were used.
A modified K-ELW was developed from construct validity evidence and included 31 items in 7 domains: People orientation, task responsibility fairness, relationship fairness, power sharing, concern for sustainability, ethical guidance, and integrity. Convergent validity, discriminant validity, and concurrent validity were supported according to the correlation coefficients of the 7 domains with other measures.
The results of this study provide preliminary evidence that the modified K-ELW can be adopted in Korean nursing organizations, and reliable and valid ethical leadership scores can be expected.
The purpose of this study was to evaluate the effects of the Spirituality Promotion Program(SPP) for young nurses working in the stressful university hospital environment.
The study included 41 nurses in the experimental group, nurses who had worked less than 5 years and completed 8 weeks of SPP between June and July in 2011. The control group, 44 nurses, also received the same program after the study was completed. For the study, a survey was conducted of all participants concerning spirituality, perceived stress, positive and negative affect, empathy, job satisfaction, and leadership practice.
No significant difference was found between the two groups on study variables. Perceived stress decreased significantly in the experimental group (
The results show that the Spirituality Promotion Program has positive effects on the spiritual and psychosocial aspect of young nurses. Continuation of this program for nurses is recommended in order to help them develop their selfcare ability and improve nursing competency.
The purpose of this study was to develop a tool to evaluate patient safety culture in nursing homes and to test its validity and reliability.
A preliminary tool was developed through interviews with focus group, content validity tests, and a pilot study. A nationwide survey was conducted from February to April, 2011, using self-report questionnaires. Participants were 982 employees in nursing homes. Data were analyzed using Cronbach's alpha, item analysis, factor analysis, and multitrait/multi-Item analysis.
From the results of the analysis, 27 final items were selected from 49 items on the preliminary tool. Items with low correlation with total scale were excluded. The 4 factors sorted by factor analysis contributed 63.4% of the variance in the total scale. The factors were labeled as leadership, organizational system, working attitude, management practice. Cronbach's alpha for internal consistency was .95 and the range for the 4 factors was from .86 to .93.
The results of this study indicate that the Korean Patient Safety Culture Scale has reliability and validity and is suitable for evaluation of patient safety culture in Korean nursing homes.
This study was done to examine the effects of nurses' perception of servant leadership on leader effectiveness, satisfaction and promoting additional effort. The focus was the mediating effects of leader trust and value congruence.
Data were collected from 361 RN-BSN students and nurses participating in nationally attended in-service training programs. Data were analyzed using descriptive statistics and structural analysis with SPSS 17.0 windows program and Amos 7.0.
Direct effects of nurses' perception of servant leadership were negative, but mediating effects of trust and value congruency were positively correlated with leader effectiveness, satisfaction and additional effort, that is servant leadership should be effective through mediating factors.
The study results indicate that if the middle managers of nurses can build leader trust and value congruency between nurses through servant leadership, leader effectiveness, satisfaction and additional effort on the part of the nurses could result in a positive change in the long term.
The purpose of this study was to identify the moderating and mediating effects of self-leadership in the relationship between organizational culture and nurses' informatics competency.
Participants in this study were 297 nurses from the cities of Busan and Ulsan. The scales of organizational culture, self-leadership and informatics competency for nurses were used in this study. Descriptive statistics, Pearson correlation coefficient, stepwise multiple regression were used for data analysis.
Nursing informatics competency of the participants was relatively low with a mean score 3.02. There were significant positive correlations between subcategories of perceived organizational culture, self-leadership and nursing informatics competency. Self-leadership was a moderator and a mediator between organizational culture and informatics competency.
Based on the results of this study, self-leadership promotion strategies to improve nursing informatics competency are needed.
This study was conducted to identify the factors that influence nurses' organizational citizenship behavior.
A cross-sectional design was used, with a convenience sample of 547 nurses from four university hospitals in Seoul and Gyeonggi province. The data were collected through a questionnaire survey done from September 22 to October 10, 2008. The tools used for this study were scales on organizational citizenship behavior (14 items), self-leadership (14 items), empowerment (10 items), organizational commitment (7 items), job satisfaction (8 items) and transformational·transactional leadership (14 items). Cronbach's alpha and factor analysis were examined to test reliability and construct validity of the scale. The data collected were processed using SPSS Window 15.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and means, standard deviations, correlation coefficients and multiple regression analysis.
The factors influencing nurses' organizational citizenship behavior were identified as self-leadership (β=.247), empowerment (β=.233), job satisfaction (β=.209), organizational commitment (β=.158), and transactional leadership (β=.142). Five factors explained 42.0% of nurses' organizational citizenship behavior.
The results of this study can be used to develop further management strategies for enhancement of nurses' organizational citizenship behavior.
This study was to determine the mediator or moderator role of empowerment in the relationship between the head nurse's transformational leadership and organizational commitment as perceived by staff nurses.
Data was collected from 451 nurses in a tertiary hospital located in B city by means of structured questionnaires. Data was analyzed with descriptive statistics, Pearson's correlation coefficient and hierarchial multiple regression using the SPSS program.
Empowerment showed mediating effects between the head nurse's transformational leadership and organizational commitment as perceived by staff nurses. However, empowerment did not show moderating effects.
Nurses' perception of empowerment, the head nurse's transformational leadership and organizational commitment have a strong relationship. This finding suggests the importance of empowering nurses to increase organizational commitment.
This paper was conducted to test the reliability and validity of rd-SLS, developed by Podsakoff, et al. (1993) which measured ‘substitutes for leadership’
The subjects were 345 nurses in 5 general hospitals. Cronbach's and the Guttman split-half coefficient were used to test the reliability of rd-SLS. Factor analysis, and the correlations of the rv-SLS and SLS with rd-SLS were used for convergent and discriminant validity.
Cronbach's data was 0.76 and the Guttman split-half coefficient was 0.52. Twelve factors evolved by factor analysis, which explained 70.4% of the total variance. This result was similar to previous study results. However, ‘Indifference toward organizational rewards’-related items were classified two factors. It was not clear t hat the rd-SLS consisted of 13 concepts(factors). The correlations of the rv-SLS and SLS with the rd-SLS were 0.93 and 0.87 respectively.
The rd-SLS showed a moderate degree of validity and reliability. Thus, it is recommended to use the rd-SLS in general nursing organizations for screening for leadership substitutes. In addition, it is necessary to clarify the concept of organizational rewards. In a further study, the factor structure of the rd-SLS may be considered.