Greta G. Cummings, ... Gargi E. Chatterjee, in International Journal of Nursing Studies, 2018
3 Results
3.1 Search results
The electronic database search yielded a total of 50,941 titles and abstracts, with 16,277 titles and abstracts resulting from the search update. Following removal of duplicates in the updated search, 5898 titles and abstracts were screened using the inclusion criteria and 351 manuscripts were retrieved for full-text screening. After final selection using the inclusion criteria for this review, 76 studies (reported in 84 papers) were added to the 53 studies included in the original review (1985–2009). In cases where multiple manuscripts were published from a single study, we counted them as one study in our analysis. Therefore, 129 studies (53 original and 76 updated) were included. All studies were quantitative in design. See Table 1 for search results.
Table 1. Search strategy.
leadership AND | 352 | 139 | 491 |
• research (Subject) | |||
• evaluation (Subject) | |||
• measurement (Subject) | |||
leadership AND | 278 | 46 | 324 |
• research (KW) | |||
• evaluation (KW) | |||
• measurement (KW) | |||
leadership AND exp research | 3303 | 2439 | 5742 |
leadership AND | 906 | 223 | 1129 |
• research (KW) | |||
• evaluation (KW) | |||
• measurement (KW) | |||
leadership AND | 139 | 403 | 542 |
• research (MP) | |||
• evaluate$ (MP) | |||
• measure$ (MP) | |||
leadership AND | 2617 | 4257 | 6874 |
• research (MP) | |||
• evaluate$ (MP) | |||
• measure$ (MP) | |||
leadership AND | 7828 | 105 | 7933 |
• research (MP) | |||
• evaluate$ (MP) | |||
• measure$ (MP) | |||
leadership AND | 4515 | 3242 | 7757 |
• research (MP) | |||
• evaluate$ (MP) | |||
• measure$ (MP) | |||
leadership AND | 5587 | 4101 | 9688 |
• research (MP) | |||
• evaluate$ (MP) | |||
• measure$ (MP) | |||
leadership AND | 9139 | 1322 | 10461 |
• research (MP) | |||
• evaluate$ (MP) | |||
• measure$ (MP) | |||
34,664 | 16,277 | 50,941 | |
18,963 | 5, 898 | 24,861 | |
127 | 351 | 478 | |
63/53 | 84/76 | 137/129 |
Note: For the updated search (2007–2017) the term nurs* was added as a search heading for each database in order to return only nursing relevant studies.
Of the 129 included studies, published between 1985 and 2017, 74 were conducted in North America (43 in the United States, 29 in Canada, 1 in Canada and the United States, and 1 in Canada and Australia), 24 in Europe, 11 in Asia, 8 in the Middle East, 4 in Australasia, 2 in Africa, and 6 had no stated country. See Table 2 for all characteristics of included studies.
Table 2. Characteristics of included studies.
Al-Hussammi (2008), Euro J Sci Res, USA | n = 55 RNs/ LPNs | - Minnesota Satisfaction Questionnaire (Weiss et al., 1967) | 20 items, 5 pt scale | α = 0.91 | NR | Pearson product-moment correlation coefficients |
RR = 92% | - Organizational Commitment Questionnaire (Meyer et al., 1993) | 23 items, 7 pt scale | α = 0.85 | NR | Multiple regression | |
4 long term care facilities | - Survey of Perceived Organizational Support (Eisenberger et al., 1986) | 16 items, 7 pt scale | α = 0.75 | NR | ||
- Multifactor Leadership Questionnaire, Form 6S (Bass and Avolio, 1992) | 18 items, 5 pt scale | Mean score | NR | |||
Avolio et al. (2004), J Org Behav, Singapore | n = 502 nurses | - Modified Multifactor Leadership Questionnaire, Form 5X (Bass and Avolio, 1997) | 20 items, 5 pt scale | α = 0.87 & 0.82 | NR | Aggregation |
RR = 80% | - Organizational Commitment (Cook and Wall, 1980) | 9 items, 5 pt scale | α = 0.87 | NR | HLM | |
1 hospital | - Psychological Empowerment (adapted from Jones’ self–efficacy scale, 1986, Ashforth’s Helplessness Scale 1989, Tymon, 1988, Hackman & Oldham’s autonomy scale, 1980). | 2 items, 7 pt scale | α = 0.75 & 0.84 | NR | ||
Boström et al. (2007), J Eval in Clin Practice, Sweden | N = 132 NAs, ENs, RNs, & rehab professionals, | - Research Utilization Questionnaire (Champion and Leach, 1989; Pettengill et al., 1994; Humphris et al., 1999 NR) 5 subscales | 5 pt scale | α = 0.89 | NR | Chi-square, t-test, Fischer’s exact test |
RR = 67% | - Creative Climate Questionnaire: (author NR) | 50 items, 4 pt scale | α = 0.77 & 0.91 | NR | Spearman’s test Multiple | |
7 elderly care units | logistic regression | |||||
Boumans and Landeweerd (1993, 1994), J Adv Nurs & Heart Lung, Netherlands | 305 ICU nurses | - Leadership (Leadership Behavior Description Questionnaire (Stogdill, 1963) | 20 items, 5 pt scale | α = 0.90 & 0.82 | NR | ANOVA |
256 general nurses | - Job Satisfaction (Algera, 1981; Boumans, 1990) | 42 items | α = 0.80 | NR | ANCoVA | |
16 hospitals | - Health Complaints (Organizational Stress Questionnaire (Reiche and Van Dijkhuizen, 1979; Reichert and Smeltzer, 1999; Algera, 1981) | 28 items | α = 0.75 | NR | Fisher's Z | |
- Absenteeism (self report) | Frequency | r = 0.75 | Piloted | |||
- Job Significance (no title, Hackman and Oldham, 1975) | 11 items, sum | α = 0.56 | NR | |||
Boyle et al. (1999), Am J Crit Care, Country NR | 255 nurses | - Leadership (no title: (Kruse and Stogdill, 1973) | Range 10–50, 12–60 | α = 0.83 & 0.92 | NR | Pearson r Multiple regression |
14 ICU's | - Job Satisfaction (no title, (Hinshaw et al., 1987; Price and Mueller, 1981) | Range 11–66, 6–36 | α = 0.85 & 0.78 | NR | ||
- Intent to Stay (no title: (Price and Mueller, 1986)) | Range: 4–20 | α = 0.87 | NR | |||
Bycio et al. (1995), J Appl Psychol, Country NR | 1376 RNs | - Multifactor Leadership Questionnaire-1 (MLQ-1, Bass, 1985) | 40 items, 5 pt scale | α = 0.71–0.97 | No measures were reported | Factor Analysis Regression |
Multiple hospitals | - Extra Effort, Satisfaction with Leader, Leader Effectiveness (MLQ -1 (Bass, 1985)) | 9 items | α = 0.79–0.91 | |||
RR = 57% | - Intent to Quit/Leave Profession (no title & author) | 3 items | α = 0.87 | |||
- Organizational Commitment (Affective, Continuance, & Normative: (Allen and Meyer, 1990)) | 24 items | α = 0.73–0.86 | ||||
Casida and Pinto-Zipp (2008), Casida et al. (2012), Casida and Parker (2011), Nurs Econ, Res Theory Nurs Pract, J Nurs Manag, USA & Nurs Econ, USA | 37 NMs | - Multifactor Leadership Questionnaire, form 5X-short (Avolio and Bass, 2004) | 36 items, 5 pt scale | α = >0.90 | CFI=0.91, Goodness of Fit = 0.92 | Correlational |
278 staff nurses | - Nursing unit organizational culture (Denison’s Organizational Culture Survey (Denison, 2007)) | 60 items, 5 pt scale | α = 0.87–0.92 | CFI = 0.91, Goodness of Fit = 0.99 | ||
RR = 70% | ||||||
4 hospitals | ||||||
Chen et al. (2005), Chen and Baron (2006), J Nurs Schol & J Nurs Educ, Taiwan | 286 nursing faculty members | Multifactor Leadership Questionnaire 5X Chinese Version: (Shieh et al., 2001) 9 subscales | 36 items, 5 pt scale | α = 0.64–0.88 | NR | Hierarchical multiple regression, t-test, one-way ANOVA bivariate correlations |
RR = 73% | - Job Satisfaction (Minnesota Satisfaction questionnaire Chinese Version: (Lin, 2016)) | 20 items, 5 pt scale | α = 0.80–0.91 | NR | ||
Chiok Foong Loke (2001), J Nurs Manage, Singapore | 20 managers | - Leadership Practices Inventory: self & observer (Kouzes and Posner, 1995) | 30 items × 2, 5 pt scale | α = 0.81–0.91 | NR | ANOVA |
RR = 100% | - Job-In-General scale (Smith et al., 1989) | 18 items, yes/no/? | α = 0.91–0.95 | Convergent | ||
97 RNs | - Productivity (Productivity scale (McNeese-Smith, 1995) | 15 items, 5 pt scale | α = 0.90–0.93 | NR | Regression | |
RR = 97% | - Organizational Commitment scale (Porter et al., 1974) | 15 items, 7 pt scale | α = 0.82–0.93 | NR | ||
Cummings (2004), Cummings et al. (2005), Can J Nurs Leadership & Nurs Res, Canada | 6526 RNs | - Resonant Leadership (Emotional Intelligence (Goleman et al., 2002) | 13 items | NR | NR | Structural Equation Modeling (SEM) |
- Hospital Restructuring (Alberta RN Survey (Giovannetti et al., 2002); also included Revised Nursing Work Index: (Aiken and Patrician, 2000) & Maslach Burnout Inventory (Maslach et al., 1996)) | 139 items; NWI-R 4 pt scale, MBI – 6 pt | NR | NR | |||
All AB acute care hospitals | - Emotional Exhaustion (NWI-R) (Aiken and Patrician, 2000) | Not reported | ||||
- Emotional Health (MBI (Maslach et al., 1996) | 6 pt scale | |||||
- Workgroup collaboration (NWI-R) (Aiken and Patrician, 2000) | 4 pt scale | |||||
- Job satisfaction (Alberta RN Survey (Giovannetti et al., 2002) | 4 pt scale | |||||
4 pt scale | ||||||
Dunham-Taylor (2000), J Nurs Admin, USA | 396 Nurse Executives (NE), & 1115 staff reporting to 360 NE | - Multifactor Leadership Questionnaire, Form 5X: (Bass, 1994) | 87 items | α = 0.82–0.94 | Construct | Pair-wise correlation |
- Profile of Organizational Characteristics: (Likert, 1994) | 2 × 18 items, 8 pt scale | α = 0.90–0.96 | NR | |||
- Staff Satisfaction, Work Group effectiveness, Extra Effort (no title & author) | NR | NR | NR | |||
Ferris (1985), J Appl Psychology, USA | 68 RNs & their supervisors | - Turnover (Leader-Member Exchange (LMX): (Graen, et al., 1982) | 5 items, 5 pt scale | α = 0.83 | All measures NR | Correlation Within & Between Group Correlations |
- Average Leadership Style (ALS) (Graen et al., 1982) | Average MLX score | NR | ||||
Gardulf et al. (2008), Nilsson Kajermo et al. (2008), Scand J Caring Sci & J Nurs Manage, Sweden | n = 833 RNs & RNMs | - Work satisfaction: (Quality Work Competence Questionnaire (Arnetz et al., 1995) | 11 enhancement areas, 5 pt scale | α = 0.70–0.94 | NR | Stepwise multiple linear regression |
RR = 51% | - Professional issues: (Huddinge University Hospital Model Questionnaire (author & year NR) | 34 items, only 21 used | NR | NR | Multiple, stepwise, linear & logistic regression analysis | |
1 University hospital | - Barriers to research implementation: Barriers Scale (Funk et al., 1991) 4 subscales | 29 items, 4 pt scale | α = 0.69–0.83 | NR | ||
- Organizational & staff well-being: Quality Work Competence Scale (Arnetz and Arnetz, 1996; Arnetz, 1997, 2001; Thomsen et al., 1998) | 11 enhancement areas, 3–6 multipoint items | α = 0.70–0.94 | NR | |||
- Professional issues: (Huddinge University Hospital Model Questionnaire (Author, year NR) | 34 items, fixed response & 4 pt scale | NR | NR | |||
Garrett (1991), J New York State Nurs Assoc, USA | 188 RNs | - Leader Behaviour Description Questionnaire-Form XII & Ideal Leader Behaviour Description Questionnaire-Form (author NR) | Mean score | NR | NR | Multiple regression |
RR = 62% | - Job Satisfaction (Job Descriptive Index: author NR) | Mean score | NR | NR | ANOVA | |
Gil et al. (2005), J Managerial Psych, Spain | 318 healthcare professionals in 67 healthcare teams | - Leadership (Managerial Practices Survey (Yukl et al., 2002) 3 subscales | Aggregate score, 5pt | α = 0.66–0.96 | NR | Descriptive Stats |
RR = 68.4% | - Team Satisfaction (Gladstein, 1984) | 3 items, 5 pt scale | α = 0.85 | NR | Hierarchical Regressional | |
- Team Performance (Ancona and Caldwell, 1992) | 5 items, 5pt scale | α = 0.83 | NR | |||
Ginsburg et al. (2005), Health Serv Res, Canada | n = 244 nurses in clinical leadership roles baseline & follow up questionnaires | - Leadership (Soberman Ginsburg, 2003) | 9 items, 7 pt scale | α = 0.84 | NR | EFA, ANOVA |
- Patient Safety Culture (Singer et al., 2003) 3 sections same for pre & post test | 32 items, 5 pt scale | α = 0.66–0.86 | NR | t-test, Hierarchical regression | ||
Hendel et al. (2005), J Nurs Manage, Israel | 54 Head Nurses from 5 hospitals | - Multifactor Leadership Questionnaire, Form 5X Short (Bass and Avolio, 1995b) | 36 items, 5 pt scale | α = NR | NR | Descriptives, Wilcoxon Rank Test, MANOVA |
RR = 90% | - Conflict Management (Conflict Mode Instrument (Thomas and Kilmann, 1974) 5 subscales | Forced Choice pairs | α = 0.61–0.68 | PV | Regression | |
Hernandez et al. (1988), Public Health Nurs, USA | 20 nursing work groups | - Social Psychological Processes -Organizational Climate, Supervisory & Peer Leadership & Group Processes (Survey of Organization (Likert, 1961) 4 indices | All measures together totalled 36 items, 5 pt scales | α = 0.66–92 | All measures NR | Correlational |
Health Departments | | |||||
Holdnak et al. (1993), Healthc Manage Rev, USA | 256 nurses | - Leader Behavior Description Questionnaire, XII (Stogdill, 1963) | 5 pt scale | α = 0.75–0.87 | NR | ANOVA |
3 hospitals | - Job Satisfaction (Job Description Index (Smith et al., 1969) | NR | α = 0.58–0.82 | NR | Hierarchical moderator regression | |
Houser (2003), Capuano et al. (2005), J Nurs Admin & Healthc Manage Rev, USA | n = 1142 RNs | - Leadership Practices Inventory: (Kouzes and Posner, 1987) | NR | α = 0.69–0.85 | Construct & Discriminant | SEM |
n = 55 Nurse Managers | - Turnover (Raw turnover rate, accession rate & vacancy rate) | Math equation | NR | NR | ||
6 Hospitals & 3 LTC Centers | - Staff expertise (RN’s rated according to Benner’s criteria by their manager (Benner et al., 1996)) | Math equation | NR | NR | ||
Howell and Dorfman (1986), J Applied Behav Sci, USA | 140 professionals | - Leadership (modified form of path-goal theory (Schriesheim, 1978) | Mean | α = 0.69–0.90 | NR | T-test |
108 non-prof | - Organizational Commitment Questionnaire (Porter and Smith, 1970) | Mean | α = 0.92 | NR | Multiple linear regression | |
Several hospitals | - Job Satisfaction (Minnesota Satisfaction Questionnaire (Weiss et al., 1967) | Mean | α = 0.88 | NR | ||
Kennerly (1989), J Nurs Admin, USA | 23 deans/ chairs | - Leader Behavior Description Questionnaire-Form XII (Stogdill, 1963) | 10 items, 5 pt scale | α = 0.90 & 0.78 | NR | Regression, Pearson product correlation coefficients |
181 nurse faculty | - Index of Job Satisfaction (Brayfield and Rothe, 1951) | 18 items, 5 pt scale | α = 0.85 | NR | ||
Klakovich (1996), J Nurs Admin, USA | 113 RNs | - Leadership Achieving Styles Inventory-13 (Lipman-Bluman, 1991) | 45 items, 7 pt scale | α = 0.81–0.91 | Construct | Stepwise regression |
1 hospital | - Reciprocal Empowerment Instrument: (Klakovich, 1995) | 24 items, 5 pt scale | α = 0.77–0.89 | Pilot Study | Power analysis | |
- Organizational Culture Inventory (Cooke and Lafferty, 1987) | 120 items, 5 pt scale | α = 0.74–0.92 | ||||
Krogstad et al. (2006), Human Resources for Health, Norway | n = 1066 nurses | - Work Experiences (Work Research & Quality Improvement Questionnaire (Krogstad et al., 2002)) | 5 items, 5 pt scale | α = 0.85 | 1998 pilot study | Linear regression |
n = 358 doctors | - Local Leadership | 4 items, 4 pt scale | α = 0.76 | |||
n = 390 auxillaries | - Top management | 3 items, 10 pt scale | α = 0.77 | |||
- Competence | 3 items, 10 pt scale | α = 0.82 | ||||
- Work Organization | 2 items, 5 pt scale | α = 0.74 | ||||
- Professional Development | ||||||
Larrabee et al. (2003), J Nurs Admin, USA | 90 RNs | - Multifactor Leadership Questionnaire-5X (Bass and Avolio, 1995b) | 45 items, 5 pt scale | α = 0.63–0.95 | Construct | ANOVA |
1 hospital | - Intent to Leave (Price and Mueller, 1981, 1986) | 1 items, 5 pt scale | NR | NR | Multivariate regression | |
- Job Satisfaction (Work Quality Index (Whitley and Putzier, 1994)) | 38 items, 7 pt scale | α = 0.76–0.90 | Construct | |||
- Empowerment (Spreitzer, 1995) | 12 items, 7 pt scale | α = 0.86–0.96 | Construct | |||
Laschinger et al. (1999), J Nurs Admin, Canada | 537 RNs | - Leader Empowering Behavior Scale (Conger and Kanungo, 1988) | 27 items, 7 pt scale | α = 0.77–0.95 | All measures NR | SEM |
2 hospitals | - Empowerment (Conditions of Work Effectiveness Questionnaire (Kanter, 1977)) | 37 items, 7 pt scale | α = 0.80–0.88 | |||
- Formal Power (Job Activities Scale (Kanter 1977, 1993)) | 12 items, 5 pt scale | α = 0.69 | ||||
- Informal Power (Organizational Relationship Scale (Kanter, 1977, 1993)) | 20 items, 5 pt scale | α = 0.89 | ||||
- Job Tension (Job Tension Index (Lyons, 1971)) | 9 items, 7 pt scale | α = 0.81 | ||||
Leiter and Laschinger (2006), Laschinger and Leiter (2006), J Nurs Admin & Nurs Res, Canada | 8597 nurses | - Leadership (Practice Environment Scale of the Nursing Work Index (Lake, 2002) | 28 items, 4 pt scale | α = 0.84 | PV | SEM |
2 provinces, ON & AB | - Burnout (Maslach Burnout Inventory: Human Service Scale (Maslach et al., 2001) 3 subscales | 22 items, 7 pt scale | α = 0.78–0.91 | PV | ||
Lok and Crawford (2001), Lok et al. (2005), J Manage Psych & App Psych, Australia | 251 nurses | - Leader Behaviour Description Questionnaire (Stogdill, 1974) | 40 items, 5 pt scale | α = 0.78–0.82 | NR | Correlation |
RR=63% | - Organizational Culture Index (Wallach, 1983) | 24 items, 4 pt scale | α = 0.71–0.87 | NR | Multiple regression analysis | |
- Organizational Commitment Questionnaire: (Mowday et al., 1979) | 15 items, 7 pt scale | α = 0.84–0.94 | NR | Descriptive stats | ||
- Job Satisfaction Survey (Mueller and McClosky, 1990) | 31 items, 5 pt scale | α = 0.83 | NR | |||
Manojlovich (2005a,b), J Nurs Admin, USA | 308 medical-surgical nurses | - Nursing Leadership (Manager’s Activities Scale (Laschinger, 2004)) | 11 items | α = 0.82–0.94 | NR | t-test |
RR = 73% | - Conditions for Work Effectiveness Questionnaire II (Laschinger, 1996a,b) 4 subscales, (Job Activities Scale II), (Organizational Relationships Scale II, author & date NR) | 12, 3, 4 items | α = 0.78–0.93 | Content & construct | correlations path analysis | |
Marchionni and Ritchie (2008), J Nurs Manage, Canada | n = 20 nurses | - Organizational Learning Survey (Goh and Richards, 1997) | 21 items, 7 pt scale | α = 0.63 | NR | Fisher’s exact test |
RR = 25% | - Multifactor Leadership Questionnaire (Avolio and Bass, 2004) | 45 items, 4 pt scale | α = 0.65–0.92 | NR | ||
1–50 bed medical unit | ||||||
1–15 bed surgical unit | ||||||
McDaniel and Wolf (1992), J Nurs Admin, USA | 1 Nurse Executive | - Multifactor Leadership Questionnaire (Bass, 1987) | 76 items, 5 pt scale | α = 0.92 | PV | T-test |
9 Admin | - Job Satisfaction (Work Satisfaction Scale (Hinshaw et al., 1987)) 5 subscales | 32 items, scale | α = 0.87 | Construct | Paired scoring | |
46 RNs | ||||||
McGillis Hall and Doran (2007), J Nurs Manage, Canada | n = 1116 nurses | - Nurse staffing: Information provided by NMs | NA | NA | NA | Correlational co-efficients |
77 acute care med/surg units | - Patient complexity: Hospital records | NA | NA | NA | ANOVA | |
19 hospitals | - Care delivery models: Three variables used to describe type of care given | NA | NA | NA | Multilevel hierarchical linear modelling | |
- Coordination of care (Shortell et al., 1991) | 5 items | α = 0.80 | NR | |||
- Job satisfaction: Job description index (Ironson et al., 1989) | 18 items | α = 0.88 | NR | |||
- Job stress: Stress in General Scale (Smith et al., 1992; Stanton et al., 2001) | 15 items | α = 0.91–0.92 | NR | |||
- Nursing role tension: Tension Index (Lyons, 1971) | 9 items | α = NR | NR | |||
- Quality of care (Shortell et al., 1991) | 6 items | α = 0.76 | NR | |||
- Nursing leadership (Shortell et al., 1991) | 5 items | α = 0.87 | Factor Analysis | |||
McGuire and Kennerly (2006), Nurs Econ, USA | 63 nurse managers | - Multifactor Leadership Questionnaire Form 5X, (Bass and Avolio, 2000) 12 subscales, 2 versions used leader & rater form | 45 items, 5 pt scale | Previously established | PV | Pearson’s product-moment correlation |
500 RN’s | - Organizational Commitment (Organizational Commitment Questionnaire, (Mowday et al., 1979)) | 15 items, 7 pt scale | α = 0.82–0.93 | Convergent, discriminant & predictive | ||
RR not stated | ||||||
McIntosh (1990), Work Stress, USA | 97 RNs & LPNs | - Supportive Leader Behavior (Caplan et al., 1975) | 4-items 5-pt scale | α = 0.89 | NR | Moderated Hierarchical Regression. Descriptive statistics |
- Job satisfaction (Minnesota Satisfaction Questionnaire (Aldag et al., 1981)) | 20 items | α = 0.85 | NR | |||
- Anxiety (State-Trait Personality Inventory, (Spielberger, 1980)) | 10 items | α = 79 | NR | |||
McNeese-Smith (1995, 1996), Hosp & Health Serv Admin & J Nurs Admin, USA | Seattle sample only | - Leadership Practices Inventory: Self & Other (Posner and Kouzes, 1987, 1990) | 30 items × 2, 5 pt scale | α = 0.58–0.94 | Criterion | ANOVA |
41 managers (1/2 non nurses) | - Productivity scale (researcher developed) | 15 items, 5 pt scale | α = 0.90 | Face/PilotedConvergent | Regression | |
471 employees | - Job-in-General scale (Smith et al., 1989): subscale of JDI | 18 items, yes/no/? | α = 0.88 | |||
2 hospitals | - Organizational Commitment (Porter et al., 1974) | 15 items, 7 pt scale | α = 0.92 | NR | ||
McNeese-Smith (1995, 1999), J of Org Beh & J Nurs Admin, USA | LA Sample only | - Leadership Practices Inventory: Self & Other (Posner and Kouzes, 1987, 1990) | 30 items × 2, 5 pt scale | α = 0.58–0.94 | Criterion | ANOVA |
19 managers & 221 nurses | - Productivity scale (researcher developed) | 15 items, 5 pt scale | α = 0.90 | Face/Piloted | Regression | |
1 hospital | - Job-in-General scale (Smith et al., 1989): subscale of JDI | 18 items, yes/no/? | α = 0.88 | Convergent | ||
- Organizational Commitment (Porter et al., 1974) | 15 items, 7 pt scale | α = 0.92 | NR | |||
- Motivation (Job Choice Exercise (JCE), (Stahl, 1986; Stahl and Harrell, 1982) | 30 items, scores regressed & equation | α = 0.59–0.89 | Criterion/Construct | |||
McNeese-Smith &Yang (2000), Hong Kong Nursing J, Shanghai & USA | Shanghai sample only | - Leadership Practices Inventory: Self & Other: (Posner and Kouzes, 1987, 1990) | 30 items × 2, 5 pt scale | α = 0.58–0.94 | Criterion | ANOVA |
48 head nurses, 292 nurses | - Productivity scale (researcher developed) | 15 items, 5 pt scale | α = 0.90 | Face/Piloted | Regression | |
8 hospitals | - Job-in-General scale (Smith et al., 1989) subscale of JDI) | 18 items, yes/no/? | α = 0.88 | Convergent | ||
- Organizational Commitment (Porter et al., 1974) | 15 items, 7 pt scale | α = 0.92 | NR | |||
Medley and Larochelle (1995), Nurs Manage, USA | 122 staff nurses | - Multifactor Leadership Questionnaire (Bass and Avolio, 1995b) | 70 items, 4 pt scale | α = 0.80–0.86 | Content | Correlation, factor analysis |
4 hospitals | - Index of Work Satisfaction (Slavitt et al., 1986) | 44 items, 7 pt scale | α = 0.82 | NR | ||
Meyer-Bratt et al. (2000), Am J Crit Care, USA & Canada | 1973 RNs | - Leader Empowering Behaviours (Good and Nelson, 1973; Baggs et al., 1992) | 27 items, 7 pt scale | α = 0.96 | NR | ANOVA |
65 peds acute care facilities | - Work Satisfaction Scale & Nursing Job Satisfaction Scale (Hinshaw and Atwood, 1985) | 32 + 23 items, 5 pt scale | α = 0.83 & 0.86 | Multiple regression | ||
Morrison et al. (1997), J Nurs Admin, Country NR | 275 nurses (licensed & unlicensed) | - Multifactor Leadership Questionnaire Form 5X (Bass and Avolio, 1995a) 4 subscales | 5pt scale | α = 0.67–0.93 | All measures NR | ANOVA |
RR = 64% | - Psychological Empowerment (Spreitzer, 1995) | 4 items, 5pt scale | α = 0.72 | Hierarchical Multiple Regression | ||
- Job Satisfaction (title NR: (Warr et al., 1979) | Likert type | α = 0.90 & 0.78 | ||||
Mosser and Walls (2002), South Online J Nurs Res, USA | 253 nursing faculty | - Leadership Orientations Instrument, Other (Boleman and Deal, 1991) | 32 items, 5 pt scale | α = 0.91–0.93 | Varimax rotation | Pearson Correlation |
60 schools | - Organizational Climate Description Questionnaire-Higher Education (Borrevik, 1972) | 42 items, 5 pt scale | α = 0.68–0.93 | ANOVA | ||
RR = 42% | Tukey’s HSD test (post hoc) | |||||
Nielsen et al. (2008), J of Adv Nurs, Denmark | n = 447 staff | - Global Transformational Leadership Scale (Carless et al., 2000) | 7 items, 5 pt scale | NR | NR | Independent sample t-tests |
RR = 81% | - Influence, meaningful work, involvement, job satisfaction, & well-being | NR except for job satisfaction (5 items, 4 pt scale) | NR | NR | SEM | |
- Copenhagen Psychosocial Questionnaire (Kristensen et al., 2002, 2006) | ||||||
Peiro et al. (1996), Work Stress, Country NR | 155 nurses | - Leadership: Supervisory Behaviour Questionnaire (Fleishman, 1957, 1953) | 6 items, 5 pt scale | α = 0.64–0.72 | PV | Within & Between Group Analysis Correlation |
127 physicians | - Job Satisfaction Questionnaire for PHCT Professionals (Peiro et al., 1990) | 7 pt scale | α = 0.76–0.95 | NR | ||
28 Primary Healthcare Teams | - Workteam Climate (de Witte and de Cock, 1985) | 4 pt scale | α = 0.77–92 | NR | ||
- Role Stress: Role Conflict (Rizzo et al., 1970) | 6 items, 7 pt scale | α = 0.77–0.75 | Construct | |||
- Role Clarity (Rizzo et al., 1970) | 7 items, 7 pt scale | α = 0.90–0.92 | NR | |||
- Job Related Tension (Rizzo et al., 1970) | 6 items, 5 pt scale | α = 0.67–0.87 | ||||
Prenkert and Ehnfors (1997), J Nurs Manage, Sweden | 23 head nurses & assistant head nurses | - Modified Multi-Leadership Questionnaire (Bass, 1985) 2 items removed & 3 items added renamed Leadership Nursing Effectiveness Questionnaire) | 84 items, 5 pt scale | NR | NR | Correlations |
1 hospital | - Organizational Effectiveness = Nursing Recipients × Quality of Nursing Care | Equation | ||||
- Resources Used | NR | NR | ||||
Searle-Leach (2005), J Nurs Admin, USA | Nurse Executives n = 102, nurse managers n = 148 | - Transformational Leadership Profile (Sashkin et al., 1992) | 50 items, 5 pt scale | α = 0.63–0.88 | NR | Spearman’s rank order correlation coefficients |
RNs = 651 | - Organizational Commitment Scale (Penley and Gould, 1988) | 15 items, 6 pt scale Sum & average score | α = 0.78–0.82 | NR | Descriptive stats | |
Sellgren et al. (2008), J Nurs Manage, Sweden | 77 Nurse managers | - Leadership behavior (‘Change, production, employee’ tool (Ekvall and Arvonen, 1991, 1994)) | 30 items, 6 pt scale | α = 0.86–0.94 | NR | Correlations |
n = 426 staff | - Job Satisfaction Questionnaire (Ekvall, no year) | 20 items | α = 0.74–0.92 | NR | Duncan’s post-hoc test | |
RR = 55% | - Work climate (Creative Climate Questionnaire, (Ekvall and Arvonen, 1996)) | 50 items, 4 pt scale | α = 0.66–0.90 | NR | Analysis of variance | |
1 university hospital | ||||||
Shieh et al. (2001), J Nurs Educ, Taiwan | 233 nurse faculty | - Multifactor Leadership Questionnaire 5–45 (Bass and Avolio, 1995b) | 38-items, 5 pt scale | α = 0.71–0.94 | Content & Construct | Hierarchical Multiple Regression |
21 nursing programs | - Nursing Faculty Satisfaction Questionnaire modified (Martin, 1991) | 40 items, 5 pt scale | NR | Concurrent | Chi-square | |
- * Note: all measures translated into Chinese | ||||||
Stordeur et al. (2001), J Adv Nurs, Belgium | 625 RNs | - Multifactor Leadership Questionnaire Form-5X: (Bass and Avolio, 1991) | 70 items, 5 pt scale | α = 0.68–0.90 | All measures NR | Multiple Regression |
1 hospital | - Work Stressors (Nursing Stress Scale: (Gray-Toft and Anderson, 1985; Gray-Toft and Anderson, 1981a,b)) | 34 items, 4 pt scale | α = 0.47–0.77 | |||
- Role Conflict (House and Rizzo, 1972) | 3 items, 4 pt scale | α = 0.82 | ||||
- Role Ambiguity (House and Rizzo, 1972) | 3 items, 4 pt scale | α = 0.95 | ||||
- Emotional Exhaustion (Maslach Burnout Inventory: (Maslach and Jackson, 1981)) | 9 items, 7 pt scale | α = 0.87 | ||||
Stordeur et al. (2000), Nurs Res, Belgium | 464 - nurses, head nurses & associate directors | - Multifactor Leadership Questionnaire-5X (Bass and Avolio, 1991) | 70 items, 5 pt scale | α = 0.68–090 | All measures NR | ANOVA |
8 hospitals | - Perceived Unit Effectiveness (Shortell et al., 1989) | 10 items, 5 pt scale | α = 0.84 | Regression | ||
- Extra Effort (MLQ (Bass and Avolio, 1991) | 3 items, 5 pt scale | α = 0.86 | ||||
- Satisfaction with Leader (MLQ (Bass and Avolio, 1991) | 2 items, 5 pt scale | α = 0.91 | ||||
- * Note: all measures translated into French | ||||||
Taunton et al. (1997), West J Nurs Res, USA | 95 Nurse managers & 248 RNs | - Ohio State University Leader Behaviour Description Questionnaire (Kruse and Stogdill, 1973) + 2 questions (Camman et al., 1983) | NR | α = 0.61–0.94 (all measures) | All measures NR | Multiple Regression |
(124 leavers & 124 stayers) | - Retention (3 indicators: turnover [resignation], unit separation [transfer] & retention) | Proportion remaining >6 m | Path Coefficients | |||
4 hospitals | - Stress (Hinshaw and Atwood, 1983,1985 adapted from Bailey and Claus, 1978; Claus and Bailey, 1977) | NR | ||||
- Job satisfaction (2 of 8 scales from Hinshaw & Atwood’s job satisfaction questionnaire (Hinshaw and Atwood, 1985)) | NR | |||||
- Group cohesion (Hinshaw and Atwood, 1985) | NR | |||||
Taunton et al. (1989a,b), J Nurs Admin, USA | 59 RNs | - Leadership Style (Michigan Organizational Questionnaire, no date) | NR | α = 0.70–93 across all study measures | Factor analysis | Correlations |
12 dieticians & social workers | - Retention – percentage of study period that participant remained on the job | % | Experience with measures | ANOVA | ||
- Job Satisfaction Index, (Price & Mueller, no date) | NR | -Duncan test (post hoc) | ||||
- Intent-to-Stay (Intent to Stay Index, (Price & Mueller, no date)) | NR | |||||
Wakefield-Fisher (1987), J Prof Nurs, USA | 215 Faculty | - Leader Behaviour Description Questionnaire-XII: (House, 1971): 2 subscales | NR | α = 0.88 | Content, Construct | Regression |
21 doctoral programs participated | - Scholarly Productivity (Scholarly Productivity Index: researcher developed) 3 sub-scales (publication activities, prepublication & research activity & editorial activities) | NR | α = 0.75 | Factor Analysis | ||
Womack (1996), J Prof Nurs, USA | 106 Nursing Department Chairs | - Leadership Effectiveness & Adaptability Description-Self Instrument (Hersey and Blanchard, 1988) | 12 items, 4 pt scale | NR | NR | Chi-square |
104 schools | - Scholarly Productivity Index: (Wakefield-Fisher, 1987), Researchers used the corrected version, now called SPIC (SPI Corrected) | 3 dimensions (see above) | NR | NR | T-tests | |
Abdelhafiz et al. (2016), J Nurs Manage, Jordan | n = 200 RNs | - The Multifactor Leadership Questionnaire, (Bass and Avolio, 1995) | 45 items, 5 pt scale | NR | PV | ANOVA; t-test; Pearson’s correlation coefficient |
88.8% RR | - Job Satisfaction Questionnaire –author developed | 7 items, 3 pt scale | α = 0.819–0.871 | NR | ||
AbuAlRub and Alghamdi (2012), J Nurs Manage, Saudi Arabia | n = 308 RNs | - Multifactor Leadership Questionnaire | 35 items, 5 pt scale | α = 0.87 | PV | Pearson’s regression; hierarchical regression analysis |
51.3% RR | - Bass and Avolio (2004) | 36 items, 6 pt scale | α = 0.73 | PV | ||
- Job Satisfaction Survey (Spector, 1985) | 5 items, 5 pt scale | α = 0.80 | PV | |||
- McCain’s Intent to Stay Scale (McCloskey and McCain, 1987) | ||||||
Allen-Gilliam et al. (2016), J Nurs Admin, USA | n = 15 SCNs | - Yukl’s Managerial Practices Survey (Yukl et al., 2002, 2009) | 48 items, 5 pt scale | α = 0.75–0.93 | PV | Cronbach’s alpha, aggregation indices |
82 RNs | - Safety Assessment Scale (Agnew et al., 2013; 2014) | 10 items, 5 pt scale | “satisfactory reliability” | NR | ||
79% SCN response rate | ||||||
Allen-Gilliam et al. (2016), JONA, USA | N = 218 RNs/LPNs | - Nursing Work Index-Revised (NWI-R) (Aiken and Patrician, 2000) | 57 items, 4 pt scale | α = 0.96 | Content, Criterion and Construct | A correlation matrix; Multiple linear regressions |
RR = 24% to 65% (varied over the 5 years) | - Shared Governance Survey (Frith and Montgomery, 2006) | 39 items, 4 pt scale | α = 0.95 | Content, Construct | ||
- Index of Work Satisfaction (IWS)-1997 Revision (Stamps, 2007) | 44 items, 7 pt scale | α = 0.91 | NR | |||
- Work Practice Breakdown Survey (Kenward and Zhong, 2004) | 16 items, 0, 1 or >1 | NR | Content, Construct | |||
- Developing Evidence-Based Practice (Gerris et al., 2008) | 49 items, 5 pt scale | α = 0.87 | ||||
Alshahrani and Baig (2016), Coll Physicians Surg Pak | N = 94 licensed nurses | - Multifactor leadership questionnaire (Bass and Avolio, 2004) | 45 items, 5 pt scale | α = 0.96 | Pilot tested | ANOVA with Post Hoc-Tukey HSD |
RR = 59% | - Job satisfaction survey (JSS) (Spector, 1985) | 39 items, 6 pt scale | α = 0.81 | Pilot tested | Multiple linear regression analysis | |
Andrews et al. (2012), Int J Nurs Stud, USA | N = 16 supervisors and n = 179 RNs | - Multifactor Leadership Questionnaire (Form 5X) (Bass and Avolio, 2004) | 45 items, 5 pt scale | α = 0.74–0.96 | PV | Parametric statistics; Multivariate analysis of variance with Bonferroni post hoc testing; four-step hierarchical regression |
Asiri et al. (2016), DMC Nursing, Saudi Arabia | n = 332 nurses | - The Multifactor Leadership Questionnaire (MLQ), (Bass and Avolio, 2004) | 44 items, 5 pt scale, | α = 0.94 | PV | Pearson correlation, stepwise regression; ANOVA, post-hoc analysis |
RR = 95% | - Psychological Empowerment Scale (Spreitzer, 1995) | 12 items, 6 pt scale | α = 0.94 | NR | ||
- Three-Component Model of Employee Commitment (Meyer and Allen, 1997) | 18 items, 7 pt scale | α = 0.79 | NR | |||
Cheng et al. (2016), Pers Rev, Australia | N = 201 registered nurses | - The Multifactor leadership questionnaire (MLQ, Form 5X-short) (Bass and Avolio, 1995b) | 20 items, 5pt scale | α = 0.83 idealised influence (attributed), α = 0.75 idealised influence (behavior), α = 0.85 inspirational motivation, α = 0.80 intellectual stimulation, α = 0.76 individual consideration | PV | SEM |
RR = 28.4 % | - Team climate inventory (Anderson and West, 1998) | 38 items, 7pt scale | α = 0.95 team vision, α = 0.88 task orientation, α = 0.92 participation safety, α = 0.91 support innovation, α = 0.89 interaction frequency, α = 0.75 and 0.77 | PV | ||
- Oldenburg burnout inventory (Demerouti et al., 2010) | 8 items, 5pts | α = 0.75 disengagement, α = 0.77 exhaustion | PV | |||
- modified version of the patient satisfaction scale as adapted from (Bartram et al., 2012) | 1 scale, 2 subscales, Technical 4 items, 5 pt scale, Social 5 items, 5pt scale | α = 0.79 social, α = 0.61 technical | PV | |||
- The Michigan Organizational Assessment Questionnaire (Cammann et al., 1979) | 3 items, 7pt scale | α = 0.90 | PV | |||
Choi et al. (2016), Human Resources for Health, Malaysia | n = 200 RNs | - Author developed survey including items adapted from: | 17 items, 5 pt scale | NR | Content and Face validity | Descriptive Statistics; Partial least squares SEM |
57.14% RR | - Multifactor Leadership Questionnaire (Bass and Avolio, 2000) | 8 items | α = 0.89 | |||
- Empowerment (Matthews et al., 2003) | 5 items | α = 0.88 | ||||
- Job Satisfaction (Warr et al., 1979) | 4 items | α = 0.80 | ||||
Cummings et al. (2008b, 2013), J Nurs Manag, Can Oncol Nurs J, Canada | N = 515 | - Subset of 14 items from the Nursing Work Index-Revised (NWI-R) (Aiken and Patrician, 2000) | 14 items, 4 pt scale | NR | PV | Pearsons chi-square test stepwise logistic regression; SEM |
RR = 31% | - Job features questions | NR | Pilot-tested | |||
Dahinten et al. (2014), J Nurs Manag, Canada | N = 1067 nurses | - Conditions of Work Effectiveness (II) Scale (CWEQII) (Laschinger et al., 2001) | 19 items, 5 pt scale | α = 0.88 intervention (i) | PV | Multiple regression analysis, Pearsons correlations, Descriptive statistics |
RR = 11% | α = 0.90 comparison (c) | |||||
=23% | α = 0.85 (i) | |||||
- Psychological Empowerment Scale (PES) (Spreitzer, 1995) | 5 pt scale | α = 0.85 (c) | PV | |||
- Leader Empowering Behaviors Scale (LEBS) (Hui, 1994) | 7 pt scale | α = 0.98 (both) | PV | |||
- Perceived Organisational Support Scale (POSS) (Rhoades and Eisenberg, 2002) | 8 items, 7 pt scale | α = 0.90 (both) | PV | |||
- Organisational Commitment Questionnaire (OCQ) affective commitment subscale (Meyer and Allen, 1991; Meyer et al., 1993). | 8 items, 7 pt scale | α = 0.84 (i) | PV | |||
α = 0.82 (c) | ||||||
Dirik and Intepeler (2017), J Nurs Manag, Turkey | N = 350 nurses from three hospitals | - The Authentic Leadership Questionnaire (ALQ) (Avolio et al., 2007) | 16 items, 5 pt scale | α = 0.95 | Translated and Pilot-tested | Descriptive statistic, hierarchical regression, |
- Safety Climate Survey (Sexton et al., 2003) | 19 items, 5 pt scale | α = 0.84 | Translated and Pilot-tested | Analysis and percentage of problematic responses (PPR) | ||
Duffield et al. (2009, 2011), Collegian; J Clin Nurs, Australia | n = 2141 nurses from 91 wards in 21 hospitals | - Nursing Work Index-Revised (Aiken and Patrician, 2000) | 49 items, 4 pt scale | α = 0.74 autonomy α = 0.77 control over practice α = 0.83 nurse-physician relations α = 0.80 leadership α = 0.80 resource adequacy | PV | Regression analyses using hierarchical linear modelling (HLM); Beta weights calculated |
RR = 80.9% | - Nurse Survey (adapted from (Aiken et al., 2001; O’Brien-Pallas et al., 2004) | 29 items, 4 pt scale | NR | |||
Ebrahimzade et al. (2015), Shiraz E Medical Journal, Iran | N = 207 nurses | - Maslach Burnout Inventory (MBI) (subscales: emotional exhaustion, deal with depersonalization, and reduced personal accomplishment within the profession) (Maslach et al., 1996) | 22 items, 7 pt scale | α = 0.73, 0.81, 0.70 | PV | Independent t-tests; 1-way ANOVA, Pearson’s correlation analysis; Stepwise multiple regression analysis using beta coefficients. |
RR = 90% | - Multifactor leadership questionnaire (MLQ) (subscales: transformational, transactional, and laissez faire leadership styles) (Bass and Avolio, 1997) | 36 items, 5 pt scale | α = 0.80, 0.76, and 0.95 | PV | ||
Failla and Stichler (2008), J Nurs Admin, USA | N = 92 (15 nurse managers and their direct report nursing staff) | - Multifactor Leadership Questionnaire (Form 5X) (Bass and Avolio, 1995) | 45 items, 5 pt scale | α = 0.39–0.84 | Confirmatory factor analysis Construct validity | Descriptive statistics; Pearson product-moment correlation coefficients; 1-way ANOVA |
RR = 59% | - Leader form | α = 0.61–0.84 | ||||
- Rater form | ||||||
- Index of Work Satisfaction Questionnaire-Part B (IWS-B) (Stamps, 2007) | 44 items, 7 pt scale | α = 0.56–0.88 | ||||
Fallatah and Laschinger (2016), J Res Nurs, Canada | N = 93 RNs | - Authentic Leadership Questionnaire (ALQ) (Avolio et al., 2007) | 16 items, 5 pt scale | α = 0.92 | PV | Descriptive statistics; mediation analysis (Baron and Kenny, 1986) |
RR= | - Revised Nursing Worklife Index (NWI-R) (Aiken and Patrician, 2000) | 6 items, 4 pt scale | α = 0.79 | PV | ||
- North Carolina Center for Nursing – Survey of Newly Licensed Nurses (Scott et al., 2008). | 4 items, 5 pt scale | α = 0.79 | PV | |||
Farag and Anthony (2015), J PeriAnesthesia Nurs, USA | n = 40 RNs | - Multifactor Leadership Questionnaire (Bass and Avolio, 2004) | 36 items, 5 pt scale | α = 0.62–0.95 | PV | Regression analysis; correlation analysis |
59.7% RR | - Patient Safety Climate in Health care Organizations tool (Nieva and Sorra, 2003) | 20 items, 5 pt scale | α = 0.62–0.94 | NR | ||
Friese and Himes-Ferris (2013), J Nurs Admin, USA | n = 402 oncology nurses | - Revised Practice Environment Scale of the Nursing Work Index (Lake, 2002; Friese, 2005) | 23 items, 5 pt scale | α = 0.87 | PV | Student’s t-test; chi-square logistic regression; CFI, RMSEA |
30%RR | ||||||
Garbee and Killacky (2008), Int J Nurs Educ Scholars, USA | 782 nursing faculty: (RR = 40.4%; 316 responses) | - Index of Job Satisfaction (Brayfield and Rothe, 1951) | 18 items, 5 pt scale | α = 0.87 | NR | Pearson correlation; Multiple regression (stepwise) |
- Mentoring Scale (Dreher and Ash, 1990) | 18 items, NR | α = 0.95 | PV | |||
- Organizational Commitment Questionnaire (Mowday et al., 1979) | 9 items, 7 pt scale | α = 0.82–0.93 | PV | |||
- Leadership Behavior Description Questionnaire (Stogdill, 1963) | 20 items, NR | α = 0.76–0.80 | PV | |||
- Intent to Stay (combined Price and Mueller, 1981; Yoder, 1995; Kosmoski and Calkin, 1986) | 6 items, NR | α = 0.89 | NR | |||
Giallonardo et al. (2010) J Nurs Manag, Canada | N = 170 RNs | - The Authentic Leadership Questionnaire (ALQ) (Avolio et al., 2007) | 16 items, 5 pt scale | α = 0.70–0.90 | PV | Descriptive statistics; Pearson’s correlations; hierarchical |
RR = 39% | - The Utrecht Work Engagement Scale (UWES) (Schaufeli and Bakker, 2003) | 17 items, 7 pt scale | “the alphas were acceptable except for the absorption subscale which was 0.60” | multiple regression and mediation analysis (Baron and Kenny, 1986) | ||
- Part B of the Index of Work Satisfaction scale (IWS) (Stamps, 2007) | 44 items, 7 pt scale | α = 0.89 | ||||
Gillet et al. (2013), Int J Nurs Stud, France | N = 343 nurses and auxiliary nurses | - Global Transformational Leadership scale (Carless et al., 2000) | 7 items, 7 pt scale | Satisfactory reliability | Convergent and Discriminant | SEM; chi-square value (x2), the |
RR = 68.6% | - Organizational Justice Scale (Niehoff and Moorman, 1993) | 14 items, 7 pt scale | adequate factorial structure and internal consistency | Validity | normed chi-square (x2/df), the Non-Normed Fit Index | |
- Quality of Work Life (QWL) Questionnaire (Elizur and Shye, 1990; Delmas et al., 2001) | 16 items, 7 pt scale | PV | (NNFI), CFI, IFI, RMSEA, | |||
- Modified Utrecht Work Engagement Scale (UWES-9, Schaufeli et al., 2006a,b) | 9 items, 7 pt scale | high internal reliability of the scale | Confirmatory factor analyses | SRMR | ||
Hayati et al. (2014), Springerplus, Iran | n = 240 nurses | - Multifactor Leadership Questionnaire (Bass and Avolio, 1997) | 20 items NR | α = 0.81–0.94 | “validity results were significant and satisfactory” | Descriptive statistics; inferential statistics |
(RR = NR) | - Work Engagement Scale (Schaufeli et al., 2002) | 17 items, 6 pt scale | α = 0.73 | |||
Hunt (2014), J Nurs Manag, USA | n = 92 RNs | - Satisfaction in Nursing Scale (Lynn et al., 2009) | 55 items, 5 pt scale | α = 0.81–0.93 | PV | Pearson’s Product Moment Correlation analysis; multiple regression; Spearman’s Rank Correlation |
21 NMs | - Leadership Practices inventory (Kouzes and Posner, 2008, 2012) | 30 items | α = 0.73–0.92 | PV | ||
- Anticipated Turnover Scale (Hinshaw et al., 1987) | 12 items | NR | PV | |||
- Value of Patient Outcomes Scale (Hunt, 2012) | 8 items, 4 pt scale | NR | PV | |||
Jenkins and Stewart (2010), Healthc Manage Rev, USA | n = 210 nurses | - Commitment to Serve (Barbuto and Wheeler, 2006) | 23 items, 5 pt scale | α = 0.80 | PV | Multivariate regression |
(RR = 73%) | - Role Inversion Behavior (Sherman, 2002) | 3 items, 5 pt scale | α = 0.72 | NR | ||
- Job Satisfaction from Work Climate Survey (Jackson Group Inc., 2007) | 2 items, 5 pt scale | α = NR | NR | |||
Kanste et al. (2009), Scand J Caring Sci, Finland | n = 660 nurses, public health nurses, head nurses (RR = 73%) | - Adapted Multifactor Leadership Questionnaire (transformational) (Bass and Avolio, 1995; Kanste et al., 2007a,b) | 23 items, 5 pt scale | α = 0.96 | Construct validity | Descriptive statistics; chi-square, NFI, IFI, RMSEA, standardized regression, squared multiple correlations |
- Willingness to exert extra effort | 3 items, 5 pt scale | α = 0.92 | NR | |||
- Satisfaction with the leader | 2 items, 5 pt scale | α = 0.92 | NR | |||
Kanste et al. (2007a,b), J Nurs Manag, Finland | n = 601 nurses and nurse managers (RR = NR) | - Multifactor Leadership Questionnaire (Bass and Avolio, 1995) | 78 items, 5 pt scale | above α = 0.70 for all measures | PV | Descriptive statistics, Pearson product moment correlation coefficient, LMR analysis, two-way ANOVA and t-test |
- Maslach Burnout Inventory-Human Services Survey (Maslach et al., 1996) | 22 items, 7 pt scale | NR | ||||
Kodama et al. (2016), J Nurs Manag, Japan | N = 396 | - Multifactor Leadership Questionnaire Form 5X–Short (MLQ; Avolio and Bass, 2004). | 36 items | α = 0.80 | Face validity (all measures) | Two-tailed significance tests; Logistic regression analysis; a chi square (v2) test multiple logistic |
RR = 53.8 nurses | - Transformational | 5 components with 20 items | α = 0.73–0.87 | |||
- Transactional | 3 components, 12 items | α = 072–0.85 | ||||
- Laissez-faire | 1 component, 4 items | α = 83 | ||||
- Affective Commitment Scale (Meyer and Allen, 1991) | 8 items, 3 pt scale | α = 0.77 | ||||
- Organisational Justice Questionnaire (Shibaoka et al., 2010) | 26 items. 4 pt scale | α = 0.70–0.95 | ||||
Laschinger and Fida (2015), J Nurs Admin, Canada | n = 723 RNs | - Authentic Leadership Questionnaire (Walumbwa et al., 2008) | 16 items, 5 pt scale | α = 0.97 | PV | Comparative fit index; incremental fit index; standardized root mean residual |
- Conditions of Work Effectiveness-II (Kanter, 1977) | 12 items, 5 pt scale | α = 0.79 to 0.82 | Construct validity | |||
- Items from Nursing Work Index Revised (Aiken and Patrician, 2000) | 6 items, 5 pt scale | α = 0.80 | NR | |||
- Camman’s measure of job satisfaction (Camman et al., 1983) | 3 items, 5 pt scale | α = 0.77 | NR | |||
Laschinger et al. (2015), Inter J Nurs Studies, Canada | N = 1009 New grad nurses | - The Authentic Leadership Questionnaire (Walumbwa et al., 2008) | 16 items, 5 pts | α = 0.96 | PV | Descriptive statistics and scale reliabilities; |
RR = 27% | - Areas of Worklife Scale (Leiter and Maslach, 2011) | 18 items, 5pts | α = 0.81 | PV | Little’s MCAR test | |
- Occupational Coping Self-Efficacy scale (Pisanti et al., 2008) | 9 items, 5pts | α = 0.83 | PV | hybrid SEM approach; | ||
- The Maslach Burnout Inventory-General Survey: emotional exhaustion and cynicism subscales (Maslach et al., 1996) | 10 items, 6 pt scale | α = 0.82 | PV | Chi-square (x2), Chi-square ratio (x2/df), CFI, IFI, RMSEA | ||
α = 0.92 | ||||||
- Interpersonal strain at work (Borgogni et al., 2012) | 6 items, 6pts | α = 0.92 | PV | |||
- General Health Questionnaire (Goldberg and Williams, 1988) | 12 items, 4 pts | α = 0.85 | PV | |||
Laschinger et al. (2014), Nursing Economics, Canada | N = 1241 Nurses | - Resonant Leadership Scale (Cummings, 2006) | 10 item, 5 pts | α = 0.95 | PV | Descriptive, inferential, and reliability analyses; SEM |
RR = 35% | - Global Empowerment Scale (Laschinger, 1996a,b) | 2 items, 5 pts | a = 0.84–0.88 | PV | ||
- Workplace Incivility Scale (Cortina et al., 2001) | 7 items, 6pts | a = 0.89 | PV | |||
- The Maslach Burnout Inventory-General Survey (Schaufeli et al., 1996) | 7 items, 6pts | a = 0.82–0.94 | PV | |||
- Four-item global measure of work satisfaction (Laschinger et al., 2001) | 4 items, 5pt scale | a = 0.78–0.84) | PV | |||
Laschinger et al. (2013, 2012a,b), J Nurs Admin; J Nurs Manage; Inter J Nurs Stud, Canada | N = 615 RNs total | - The Conditions of Work Effectiveness Questionnaire-II (CWEQ-II) – measure structural empowerment (Laschinger et al., 2001) | 12 items, 5 pt scale | NN, EN α = 0.84, 0.83 | PV | Multi- group path analysis using SEM; Means, standard deviations, range, Cronbach’s alpha and correlation coefficients |
342 New graduates (NN) RR = 37.7, and 273 Experienced nurses (EN) | - The Authentic Leadership Questionnaire (ALQ) (Avolio et al., 2007) | 16 items, 5 pt scale | α = 0.97, 0.95 | PV | ||
RR=48% | - The Maslach Burnout Inventory–General Survey (Schaufeli et al., 1996) | 10 items, 7 pt scale | no overall provided | PV | ||
- Cynicism | α = 0.89, 0.85 | |||||
- Emotional exhaustion | α = 0.93, 0.92 | |||||
- Negative Acts Questionnaire-Revised (Einarsen and Hoel, 2001) | 22 items, 5pt scale | α = 0.77–0.92 | NR | |||
- Job satisfaction scale (Hackman and Oldham, 1975) | 4 items, 5pt scale | α = 0.82 | NR | |||
- Turnover Intentions Scale (Kelloway et al., 1999) | 3 items, 5pt scale | α = 0.92 | NR | |||
Laschinger et al. (2009), Laschinger and Finegan (2011), J Nurs Admin; Nurs Res, Canada | N = 3156 Staff nurses | - Leader-Member Exchange Multidimensional Measure (LMX-MDM) (Liden and Maslyn, 1998) | 12 item, 7pt scale | a = 0.94 | Exploratory and confirmatory factor analysis | Multilevel SEM; covariance, CFI, Tucker-Lewis Index, RMSEA, descriptive, inferential (Wilcoxon, Student t, and one-way ANOVA tests) |
RR = 40% | - Conditions for Work Effectiveness Questionnaire-II (Laschinger et al., 2001) | 19 items, 6pt scale | a = 0.87 | NR | ||
- Core self-evaluation scale (Judge et al., 2003) | 12items, 7pt scale | a = 0.69 | PV | |||
- Psychological Empowerment Scale (Spreitzer, 1995) | 12 item, 5pt scale | a = 0.70–0.90 | PV | |||
- Affective Commitment Scale (Meyer and Allen, 1993) | 6 items, 7pt scale | a = 0.79 | PV | |||
- Emotional Exhaustion and Cynicism subscales of the Maslach Burnout Inventory General Survey (Schaufeli et al., 1996) | 10 items, 7 pt scale | α = 0.93 emotional exhaustion, α = 0.94 cynicism | ||||
- Global measure of work satisfaction (Laschinger et al., 2001) | 4 items, 5 pt scale | α = 0.82 | ||||
Laschinger et al. (2012a,b), J Nurs Manag, Canada | N = 231 MMs | - Leadership Practices Inventory (LPI; Posner and Kouzes, 1988) | 30 items, 10pt scale | α = 0.72–0.85 | PV | path analysis within the AMOS SEM |
RR = 60.2% response rate | - Structural empowerment was measured using The Conditions of Work Effectiveness Questionnaire II (CWEQ-II; Laschinger et al., 2001) | 19 items, 5pts | α = 0.79–0.82 | PV | ||
N = 788 FLMs | - Shorter eight-item version of the original 36-item Survey of Perceived Organizational Support (SPOS; Rhoades and Eisenberg, 2002) | 8 items, 6 pts | α = 0.74–0.95 | Full scale PV | ||
RR = 53.9% | - Two items from the International Survey of Hospital Staffing and Organization of Patient Outcomes (Aiken et al., 2002) | |||||
- Perceived quality of nursing care | 1 item, 4 pt scale | NR | NR | |||
- Turnover intention | 1 item, 3 pt scale | NR | NR | |||
Lavoie-Tremblay et al. (2016), J Adv Nurs, Canada | N = 541 | - Global Transformational Leadership scale (GTL; Carless et al., 2000) | 7 items, 5 pt scale | a = 0.94 | NR | linear regression |
RR = 20.8 Nurses | - Abusive leadership scale (Tepper, 2000) | 15 items, 5 pt scale | a = 0.88 | NR | ||
- Quality of care scale (Aiken et al., 2002) | 4 items, 4 pt scale | a = 0.84 | NR | |||
- Turnover intention-measured using single item adapted from (O’Driscoll and Beehr, 1994) | 2 items, 7 pt scale | NR | NR | |||
Lewis and Cunningham (2016), Nurs Res, USA | n = 120 nurses (RR = NR) | - Transformational leadership (Rafferty and Griffin, 2004, 2006) | 18 items, 7 pt scale | α = 0.97 | Internal, convergent, and discriminant validities (all measures) | PROCESS analysis tool, descriptive statistics, multiple mediator analyses, and bivariate correlations |
- Areas of Worklife Scale (Leiter and Maslach, 2002, 2003) | 29 items, 7 pt scale | |||||
- Maslach Burnout Inventory (Schaufeli et al., 1996) | 16 items, 7 pt scale | α = 0.89 | ||||
- Utrecht Work Engagement Scale (Schaufeli and Bakker, 2003; Schaufeli et al., 2006a,b) | 17 items, 7 pt scale | α = 0.88 | ||||
Liang et al. (2016), J of Adv Nursing, Taiwan | N = 414 nurses | - Multifactor Leadership Questionnaire (MLQ) (Bass and Avolio, 1997) – Chinese version (Lee and Hong, 2008) | 20 items, 5 pt scale | α = 0.96 | PV | Descriptive Statistics; SD |
2 hospitals | - Safety Attitudes Questionnaire (SAQ) (Sexton et al. 2006) – Chinese Version (Lee et al., 2010) | 26 items, 5 pt scale | α = 0.89 | PV | Confirmatory factor analysis | |
(RR = 91.6%) | - Emotional Labour Questionnaire (ELQ) (Wu, 2003) | 26 items, 6 pt scale | α = 0.89 | NR | SEM: x2, RMSEA, goodness of fit index, CFI, NFI and SRMSR | |
- Intention to Stay Scale (Wang et al., 2006) | 4 items, 5 pt scale | α = 0.84 | NR | |||
Lin et al. (2015), BMC Nursing, Taiwan | N = 651 | - Multifactor Leadership Questionnaire (Bass and Avolio, 1994) | 4 pt scale | α = 0.975 | Convergent Validity | Pearson correlations |
RR = 80.7 | - Job Content Questionnaire (JCQ) (Karasek et al., 1998) | 22 items, 4 pt scale | α = 0.721 | Convergent Validity | Analysis of variance | |
- Job satisfaction scale from Occupational Stress Indicator (OSI) (Cooper et al., 1988) | 12 items, 6 pt scale | α = 0.939 | Convergent Validity | exploratory factor analysis (EFA) | ||
- Organisational Commitment Questionnaire (Mowday et al., 1979) | 15 items, 7 pt scale | α = 0.878 | NR | |||
- General Health Questionnaire (Chinese Version) (Goldberg and Williams, 1988) | 12 items, 4 pt scale | α = 0.81 | PV | |||
Lucas et al. (2008), J Nurs Manag, Canada | N = 203 nurses (unspecified) | - Emotional Competence Inventory, Version 2 (ECI 2.0) (HayGroup, 2006) | 72 items, 5 pt scale | α = 0.48–0.97 | NR | Descriptive statistics, correlational analyses, moderated regression analysis |
(RR = 68%) | - The Conditions of Work Effectiveness-II (Laschinger et al., 2001) | 19 items, 5 pt scale | α = 0.86 | PV | ||
Ma et al. (2015), J Nurs Admin, USA | N = 29742 RN | - Supportive nursing management scale adapted from the Practice Environment Scales of Nursing Work Index (PES-NWI) (Lake, 2002) | 5 items, 6 pt scale | α = 0.79–0.88 | NR | Descriptive statistics |
200 hospitals (41 states) | - Intent to leave and job satisfaction | 2 items, 6 pt scale | NR | NR | ANOVA | |
(RR – at least 50%) | Three-level HLM models | |||||
Malik et al. (2016), Inter J Nurs Stud, India | N = 405 nurses + 81 supervisors | - Authentic Leadership (Walumbwa et al., 2008) | 16 items, 5 pt scale | α = 0.973 | Convergent validity | Path analysis |
43 hospitals | - Knowledge sharing behaviour (Lu et al., 2006) | 8 items, 5 pt scale | α = 0.960 | Discriminant validity | Confirmatory factor analysis | |
(RR = 65%) | - Use of information technology (Saga and Zmud, 1993) | 7 items, 5 pt scale | α = 0.934 | Fit indices | ||
- Employee creativity (Oldham and Cummings, 1996) | 3 items, 5 pt scale | α = 0.838 | ||||
Malik and Dhar (2017) Pers Rev, India | N = 520 nurses + 163 supervisors | - Authentic Leadership Questionnaire (Avolio and Chan, 2008) | 16 items, 5 pt scale | α = 0.987 | Convergent validity | Path analysis; confirmatory factor analysis; conventional fit indices |
42 facilities | - Psychological Capital (Luthans et al., 2007) | 24 items, 5 pt scale | α = 0.989 | |||
(RR = 58%) | - Autonomy (Park and Searcy, 2012) | 4 items, 5 pt scale | α = 0.948 | |||
- Extra Role Behaviour (Eisenberger et al., 2010) | 8 items, 5 pt scale | α = 0.974 | ||||
Malloy and Penprase (2010), J Nurs Manag, Country NR | N = 122 RN | - Multifactor Leadership Questionnaire (MLQ) Form 5· (Bass and Avolio, 2004) | 45 items, 5 pt scale | α = 0.90 | PV | Pearsons correlation coefficient, |
(RR = 30.5%) | - Copenhagen Psychosocial Work Environment Questionnaire (COSOQ) (Kristensen and Borg, 2000) | 144 items | α = 0.59–0.87 | PV | Statistical ANOVA post hoc Tukey | |
Manning (2016), J Nurs Admin, USA | N = 441 RN 3 hospitals (RR = 31%) | - Multifactor Leadership Questionnaire 5X Short Form (Bass and Avolio, 1995) | 45 items, 5 pt scale | α = 0.76 | PV | Descriptive |
- Utrecht Work Engagement Scale (UWES) (Schaufeli and Bakker, 2003) | 17 items, 7 pt scale | α = 0.71 | PV | Multivariate analysis (multiple regression) | ||
Mauno et al. (2016), J Adv Nurs, Finland | N = 3466 nurses | - Emotional Leadership (Zapf et al., 1999) | 3 items, 5 pt scale | α = 0.61 | PV (all measures) | Pearson’s correlations |
(RR = 21%) | - Utrecht Work Engagement Scale (Schaufeli et al., 2002) | 6 items, 7 pt scale | α = 0.93 | Hierarchical regression analysis | ||
- Public Service Motivation (Kim et al., 2013) | 4 items, 5 pt scale | α = 0.87 | Explanation rates | |||
- Global Transformational Leadership scale (Carless et al., 2000) | 7 items, 5 pt scale | α = 0.94 | ||||
- Work ethic feasibility | 1 item, 5 pt scale | |||||
McCutcheon et al. (2009), Nurs Leaders, Canada | n = 717 RNs/RPNs | - Multifactor Leadership Questionnaire (Bass and Avolio, 2000) | 36 items, 5 pt scale | α = 0.94 | PV | HLM; multiple regression analysis |
n = 680 patients | Transformational | 20 items | α = 0.95 | |||
n = 41 managers | Transactional | 4 items | NR | |||
(RR = 99%) | Management by exception | 8 items | α = 0.57 | |||
Laissez-faire | 4 items | NR | ||||
- McCloskey-Mueller Satisfaction Scale (Mueller and McClosky, 1990) | 31 items, 5 pt scale | α = 0.92 | NR | |||
McGilton et al. (2013), J Nurs Manag, Canada | n = 155 regulated nurses | - Nurse Manager Ability, Leadership, and Support of Nurses subscale of the Revised Nursing Work Index (NWI-R) (Lake, 2002) | 4 items, 5 pt scale | α = 0.84 | Face/content validity | Two-level, mixed-effects linear regression analysis |
(RR = 20–55%) | 1 item, 5 pt scale | NR | ||||
- Intent to stay | 2 subscales | NR | ||||
- McCloskey-Mueller Satisfaction Scale (Mueller and McClosky, 1990) | ||||||
- Emotional exhaustion subscale of the Maslach Burnout Inventory (MBI) (Maslach and Jackson, 1981) | 9 items, 7 pt scale | “acceptable” | Construct validity | |||
Merrill (2015), J Nurs Admin, USA | n = 466 | - Hospital Unit Safety Climate survey (Blegen et al., 2005) | 33 items, 5 pt scale | NR | PV | Multiple regression |
RR = 29.5% | - Multifactorial Leadership Questionnaire (Avolio and Bass, 2004) | 45 items, 4 pt scale | NR | PV | Multiple regression | |
9 hospitals | ||||||
Meyer et al. (2011), J Nurs Manag, Canada | N = 558 nurse + 31 managers, 4 hospitals, (RR = 33.6%) | - Leadership Practices Inventory (Posner and Kouzes, 1988) | 30 items, 10 pt scale | α = 0.98 | PV | Descriptive statistics; ANOVA; Coefficient regression HLM |
Meyer et al. (2014), Nurs Res, Canada | N = 754 teamwork (73,7% nurses) + 30 nurse managers | - Leadership Practices Inventory (Posner and Kouzes, 1993) | 30 items, 10 pt scale | α = 0.98 | PV | Descriptive statistics; HLM |
−35% | - Relational Coordination Survey for General Health Care Settings (Gittell, 2004) | 7 items, 5 pt scale | α = 0.89 | |||
Mills et al. (2017), J Res Nurs, Australia | N = 161 RNs | - Nurse Self-Concept Questionnaire (NSCQ) (Cowin, 2001, 2002; Cowin and Hengstberger-Sims, 2006; Cowin et al., 2008) | 36 items, 8 pt scale | α = 0.79 to 0.91 | NR | One-way ANOVA and Tukey’s post-hoc tests |
RR = 44% | - Practice Environment Scale of the Nursing Work Index (PES-NWI) (Lake, 2002; Parker et al., 2010) | 30 items, 4 pt scale | α = 0.80 to 0.89 | PV | ||
- Connor–Davidson Resilience Scale (CD-RISC 10) (Campbell-Sills and Stein, 2007; Connor and Davidson, 2003) | 10 items, 5 pt scale | NR | PV | |||
- Nurse Retention Index (NRI) (Cowin, 2001, 2002) | 6 items, 8 pt scale | α = 0.93 | NR | |||
Moneke and Umeh (2015), J Nurs Adm, USA | N = 112 RN | - Leadership Practices Inventory (LPI) (Kouzes and Posner, 2002) | 30 items, 10 pt scale | α = 0.91 | PV | Pearson product-moment correlation |
(RR = 81.7%) | - Organizational Commitment Questionnaire (OQC) (Mowday et al., 1979) | 18 items, 7 pt scale | α = 0.86 | PV | Multiple regression techniques and analysis of variance (ANOVA) | |
- Job in General (JIG) questionnaire | 18 items, Y/N/U scale | α = 0.87 | NR | |||
Negussie and Demissie (2013), Ethiop J Health Sci., Ethiopia | N = 186 | - Minnesota Satisfaction Questionnaire (MSQ) (Weiss et al., 1967) | 18 items, 5 pt scale | α = 0.96 | Face validity, pilot tested (all measures) | Descripitive statistics; principal Component Analysis, Pearson Product-Moment Coefficient and Multiple Regression |
(RR = 94%) | - Multifactor Leadership Questionnaire (MLQ) (Bass and Avolio, 2002) | 45 items, 5 pt scale | α = 0.74 | |||
Nelson et al. (2014), Burnout Research, Canada | N = 406 | - Authentic Leadership Questionnaire (French adapted version) (Walumbwa et al., 2008) | 8 items, 5 pt scale | α = 0.95 | Temporal separation between measures | Least squares path analysis |
(RR = 10.7%–71.8%) | - Work Climate Scale (Roy, 1989) | 17 items, 6 pt scale | α = 0.97 | Regression analyzes | ||
- Psychological well-being at work (Gilbert et al., 2011, 2006) | 25 items, 5 pt scale | α = 0.95 | Structural equations and the bootstrap approach | |||
Neubert et al. (2016), Leaders Quart, USA | N = 1485 nurses + 105 nurse managers | - Servant Leadership (Ehrhart, 2004) | 14 items, 5 pt scale | α = 0.96 | PV (all measures) | Multiple regression |
(RR = 38%) | - Helping behaviour (Van Dyne and LePine, 1998) | 4 items, 5 pt scale | α = 0.77 | SAS Proc Mixed | ||
- Creative behaviour (Scott and Bruce, 1994) | 3 items, 5 pt scale | α = 0.82 | Ordinary Least Squares (OLS) | |||
- Organizational structure (Covin and Slevin, 1989) | 7 items, 5 pt scale | α = 0.63 | PROCESS macro | |||
- Items from Work Satisfaction Index (Stamps, 2007) | 1 item, 5 pt scale | NR | ||||
- Patient Satisfaction (Press-Ganey, 2018) | 9 items, 5 pt scale | α = 0.91 | ||||
Pyc et al. (2017), Int J Stress Manage, USA | N = 232 nurses + n = 24 supervisors | - Abusive Supervision Scale (Tepper, 2000) | 15 items, 5 pt scale | α = 0.95 | Convergent and predictive validity | Descriptives, internal reliability coefficients, intercorrelations |
(RR = NR) | - Authoritarian leadership style (Cheng et al., 2004) | 9 items, 5 pt scale | α = 0.86 | |||
- Anxiety - subscale of the Emotional Strain Scale (Caplan et al., 1975). | 4 items, 4 pt scale | α = 0.69 | ||||
- Depression - subscale of the Emotional Strain Scale (Caplan et al., 1975) | 5 items, 4 pt scale | α = 0.78 | ||||
- Exhaustion- Maslach Burnout Inventory (Maslach and Jackson, 1981) | 5 items, 7 pt scale | α = 0.90 | ||||
- Physical Symptoms Inventory (Spector and Jex, 1998) | 18 items, 3 pt scale | α = 0.88 | ||||
- Job satisfaction (Cammann et al., 1979) | 3 items, 6 pt scale | α = 0.80 | ||||
- Intention to quit (Spector et al., 1988) | 1 item, 5 pt scale | NR | ||||
- In-Role Job Performance Scale was used (Williams and Anderson, 1991) | 5 items, 7 pt scale | α = 0.93 | ||||
Read and Laschinger (2015), J Adv Nurs, Canada | Time 1: n = 342 RNs | - Authentic Leadership Questionnaire (Walumbwa et al., 2008) | 16 items,5 pt scale | α = 0.95 | PV (all measures) | Chi-square test |
Time 2: n = 191 matched usable RN returns | - Conditions of Work Effectiveness II (CWEQ-II) (Laschinger et al., 2001) | 12 items, 5 pt scale | α = 0.80 | Structural equation modelling | ||
(RR = 48.2%; 55.8%) | - Areas of Worklife Scale, Community Subscale (Leiter and Maslach, 2003) | 3 items, 5 pt scale | α = 0.81 | Fit statistics | ||
- The Mental Health Inventory (Ware and Kosinski, 2000) | 5 items, 6 pt scale | α = 0.86 | ||||
- Job Satisfaction (Shaver and Lacey, 2003) | 4 items, 5 pt scale | α = 0.82 | ||||
Regan et al. (2016), J Nurs Manag, Canada | n = 220 RNs | - Conditions of Work Effectiveness Questionnaire – II (Laschinger et al., 2001) | 14 items, 5 pt scale | All scales demonstrated acceptable reliability (Cronbach’s α >0.80). | PV | Hierarchical multiple regression analysis |
13% RR | - Authentic Leadership Questionnaire (Avolio et al., 2012) | 16 items, 5 pt scale | PV | |||
- Nursing Work Index Revised (Aiken and Patrician, 2000) | 6 items, 5 pt scale | |||||
- Interprofessional Collaboration Scale (Laschinger and Smith, 2013) | 4 items, 5 pt scale | |||||
Roberts-Turner et al. (2014), Pediatri Nurs, USA | N = 935 | - 3 subscales of the Healthcare Environment Survey (HES) – (Nelson, 2007; Persky and Bakkan, 2008): | SEM; RMSEA, The Mardia multivariate skewness, kurtosis tests were applied to examine multivariate non-normality of data before analysis | |||
RR = 76.5% | - Distributive justice scale (from the Job Satisfaction Scale of (Price and Mueller, 1986)) | 8 items, 7 pt scale | α = 0.95–0.96 | NR | SEM | |
- Autonomy scale from Index of Work Satisfaction (IWS) survey (Stamps and Piedmonte, 1986) | 8 items, 7 pt scale | α = 0.74–0.84 | NR | |||
- Job satisfaction (three items from Hackman and Lawler (1971) and two from Brayfield and Rothe (1951)) | 5 items, 7 pt scale | α = 0.84 | NR | |||
Roche et al. (2015), J Nurs Stud, Canada and Australia | n = 4811 RNs | - Practice Environment Scale of the Nursing Work Index (Lake, 2002) | 31 items, 7 pt scale | α > 0.7 | PV | |
40% RR | ||||||
Savic et al. (2007), Healthc Manage Rev, Slovenia | n = 558 nurses (RR = 52%) | - Leadership Practices Inventory deriving prevalence of transformational leadership (TF) style, transactional leadership (TA) style and laissez-faire (LF) leadership (Kouzes and Posner, 2003) | 11 items, 5 pt scale | TF α = 0.92 | PV | Descriptive statistics; reliability analysis, factor analysis, one-way ANOVA, paired samples test, bivariate correlations, and linear regression analysis |
n = 106 physicians (RR = 26%) | TA α = 0.66 | |||||
n = 70 non-healthcare professional (RR = 26%) | LF α = 0.80 | NR | ||||
- “Personal Involvement” | 4 items, 5 pt scale | α = 0.78 | ||||
Shi et al. (2015), Inter J Nurs Pract, China | N = 378 | - General Regulatory Focus Measure (GRFM) (Lockwood et al., 2002; Jia et al., 2012) | 18 items, 9 pt scale | α = 0.79 and 0.87 | PV | Pearson’s correlations, chi-square statistic (χ2), χ2/df, RMSEA, CFI, SRMR |
RR = 61% | - Validated Chinese version of the Transformational Leadership Inventory (TLI) (Podsakoff et al., 1990) | 22 items, 5 pt scale | α = 0.89 | test–retest reliability, internal consistency reliability and construct validity | ||
- Chinese version of the Maslach Burnout Inventory—General Survey (MBI-GS) (Qiao and Schaufeli, 2011) | 9 items, 7 pt scale | α = 0.84 | PV | |||
Sili et al. (2014), Medicina del Lavoro, Italy | n = 110 nurses (RR = 57%) | - Positive Leadership- Nursing Organizational Health Questionnaire (Sili et al., 2010) | 5 items, 4 pt scale | α = 0.79 | PV (all measures) | Pearson’s R correlations; |
- Work Satisfaction: Nursing Organizational Health (Sili et al., 2010) | 10 items, 4 pt scale | α = 0.86 | SEM: Chi square | |||
- Maslach Burnout Inventory – General Survey (Maslach et al., 1996) | (χ2) and incremental indexing; CFI; RMSEA, | |||||
- Cynicism (detached) | 5 items, 7 pt scale | α = 0.76 | SRMR | |||
- Emotional Exhaustion | 5 items, 7 pt scale | α = 0.90 | ||||
Simon et al. (2010), J Adv Nurs, Germany | n = 2119 RNs | - Leadership Quality | 4 items, 5 pt scale | α = 0.91 | PV (all measures) | Generalized linear mixed model approach; highest posterior density intervals, pseudo-R2 odds ratio. |
(RR = 38%–83% across 16 hospitals) | - Intent to leave profession | 1 item, dichotomized (potential leavers/potential stayers) | Reported as: ‘high consistency’ | |||
- Intent to leave organization | 5 items, dichotomized (potential leavers/potential stayers) | |||||
Sojane et al. (2016), Curationis, South Africa | n = 204 RNs | - Practice Environment Scale of the Nurse Work Index (Lake, 2002): | 4 items, 4 pt scale | α = 0.71 | PV (all measures) | Spearman’s rank order correlation, |
RR = 33.3% | - leadership scale | t-test, Cronbach’s alpha and statistical significance | ||||
9 hospitals | - job satisfaction | 1 item, 4 pt scale | α = 0.7–0.8 | |||
- intent to leave | 1 item, 2 pt scale (y/n) | NR | ||||
- Maslach Burnout Inventory (Maslach et al., 1996) | 9 items, 4 pt scale | NR | ||||
Suliman (2009), Nurs Admin Quart, Saudi Arabia | N = 31 nurse managers and to 118 staff nurses | Multifactor Leadership Questionnaire (MLQ) (Bass and Avolio, 1995) | 47 items, 5 pt scale | α = 0.67–0.84 | Content validity established by principal component analysis. | Descriptive statistics and inferential statistical methods (ANOVA, MANOVA, and t-test independent sample) |
RR = 79.4% and 30.2% | Dichotomous question measuring the intention to continue at work | 1 item, yes/no | NR | |||
Tourangeau et al. (2014) Nurs Educ Today, Canada | 1328 nurse faculty: RNs RPNs or NPs | - Psychological Empowerment Scale – self-determination subscale (Spreitzer, 1995) | 3 items, 7 pt scale | α = 0.92 | Confirmatory factor analysis (all measures) | Simultaneous and stepwise multiple regression |
(RR = 49%; 650 responses) | - Job Routinization and Formalization scale – routinization subscale (Bacharach et al., 1990) | 3 items, 7 pt scale | α = 0.80 | |||
- Resonant Leadership Scale (Cummings et al., 2005) | 10 items,5 pt scale | α = 0.96 | ||||
- Perceived Organizational Support Scale (Eisenberger et al., 1986) | 9 items, 7 pt scale | α = 0.93 | ||||
- Conditions for Work Effectiveness Questionnaire — global empowerment subscale (Laschinger et al., 2001) | 2 items, 5 pt scale | α = 0.83 | ||||
- Physical Work Environment Scale (Developed by authors) | 7 items, 7 pt scale | α = 0.82 | ||||
- Work Group Relationships Scale (Riordan and Weatherly, 1999) | 11 items, 7 pt scale | α = 0.97 | ||||
- McCloskey/Mueller Satisfaction Scale — salary and benefits subscale (Mueller and McClosky, 1990) | 3 items, 5 pt scale | α = 0.78 | ||||
Van der Heijden et al. (2017), Medicine, Belgium, Germany, Finland, France, Italy, the Netherlands, Poland, and Slovakia | n = 39,894 | - Quality of leadership: The Copenhagen Psychosocial Questionnaire (COPSOQ) (Kristensen and Borg, 2000) | 4 items, 5 pt scale | α = 0.87–0.92 | PV (all measures) | SEM: Chi square, RMSEA; CFI/Tucker |
(RR = 51%) | - Nurse Well Being, manifested through: | 4 items, 4 pt scale | α = 0.69–0.82 | Lewis Index TLI, and SRMR] | ||
Job Satisfaction: (COPSOQ) | ||||||
Positive affectivity: Positive & Negative Affect Schedule (PANAS) (Watson et al., 1988) | 10 items, 5 pt scale | α = 0.68–0.077 | ||||
Satisfaction with salary | 3 items, 5 pt scale | α = 0.70–0.84 | ||||
- Psychological distress, manifested through: | ||||||
Personal Burnout: COPSOQ | 6 items, 5 pt scale | α = 0.84–0.91 | ||||
Negative affectivity: PANAS | 10 items, 5 pt scale | α = 0.79–0.91 | ||||
Wade et al. (2002), J Adv Nurs, USA | n = 731 RNs | - Practice Environment Scale (Lake, 2002) | 31 items, 4 pt scale | NR | PV | Descriptive statistics, regression analysis, frequencies |
(RR = 34%) | - Caring attributes of managers: Nyberg’s Caring Assesesment Scale (Nyberg, 1990) | 20 items, 4 pt scale | α = 0.97 | PV | ||
- Job Enjoyment Subscale (JES) of the Nursing Job Satisfaction Scale (Atwood and Hinshaw, 1980; Hinshaw et al., 1987) | 11 items, 5 pt scale | α = 0.89 | PV | |||
Wagner et al. (2013), Can J Nurs Res, Canada | n = 148 | - Modified Condition for Work Effectiveness Questionnaire II (Laschinger et al., 2001) | 19 items, 5 pt scale | α = 0.78–0.81 | Confirmatory factor analysis | SEM indices: Chi-square showed final model fit |
(RR = 31%) | - Psychological empowerment scale (Spreitzer, 1995) | 12 items, 7 pt scale | α = 0.62–0.72 | Convergent/diverged validity | ||
- SAW questionnaire (Kinjerski and Skrypnek, 2006) | 18 items, 6 pt scale | α = 0.93 | Face/content validity | |||
- Resonant Leadership (Estabrooks et al., 2009) | 10 items, 6 pt scale | α = 0.95 | Face/content validity (correlations between variables above 0.5) | |||
- Job satisfaction (Quinn and Shepard, 1974) | 4 items, 7 pt scale | α = 0.72 | Face/content validity | |||
- Organizational commitment (Meyer et al., 1993) | 6 items, 7 pt scale | α = 0.74–0.85 | ||||
Walumbwa et al. (2012), Leaders Quart, USA | Time 1: n = 338 nurses (RR = 82%) | - Ethical leadership scale (Brown et al., 2005) | 10 items, 5 pt scale | α = 0.94 | PV | Chi-square (χ2), comparative fit index (CFI), root-mean-square residual (RMR), and root-mean-square error of approximation (RMSEA). |
Time 2: n = 316 nurses | - Group conscientiousness (Goldberg, 1992) | 10 items, 5 pt scale | α = 0.88 | PV | ||
(RR = 93%) | - Group voice behavior (Van Dyne and LePine, 1998) | 6 items, 5 pt scale | α = 0.81 | NR | ||
3rd survey: n = 83 supervisors | - Group in-role performance (Williams and Anderson, 1991) | 7 items, 5 pt scale | α = 0.70 | NR | ||
Wang et al. (2012), J Adv Nurs, China | N = 238 | - The Chinese version of the Leadership Practice Inventory (LPI) (Chen and Baron, 2007) | 30 items, 5 pt scale | α = 0.91 | Content validity, pilot testing | Pearson’s Product–Moment Correlation Coefficient |
RR = 95.2% | - The Nurse Job Satisfaction Scale (NJSS) (Cao, 2000) | 62 item, 5 pt scale | α = 0.93 | Content validity, pilot testing | ||
Weng et al. (2015), J Nurs Manag, Taiwan | n = 439 RNs | - Leadership assessment (Scandura and Williams, 2004; Sosik et al., 2004; Gowen et al., 2009) | 19 items, 5 pt scale | α = 0.92–0.93 | PV (all measures) | HLM model analysis |
97.55% RR | - Patient safety climate scale (Katz-Navon et al., 2005; Naveh et al., 2005) | 28 items, 5 pt scale | α = 0.91–0.94 | Kolmogorov–Smirnov test | ||
- Innovation climate (Sarros et al., 2008; Dackert, 2010; Wong and He, 2003) | 9 items, 5 pt scale | α = 0.87 | ||||
- Nurse innovation behaviour (Weng et al., 2012; Chang and Liu, 2008) | 9 items, 5 pt scale | α = 0.95 | ||||
Wong et al. (2013, 2010), J Nurs Manag, J Adv Nurs, Canada | N = 280 | - Authentic Leadership Questionnaire (ALQ) (Avolio et al., 2007) | 16 items, 5 pts | α = 0.7–0.9 | NR | reliability estimates and Pearson correlations |
RR = 48% | - Trust in Management Scale (Mayer and Gavin, 2005) | 10 items, 5 pts | α = 0.76 to 0.82 | NR | Sobel test | |
- Areas of Worklife Scale (AWS) (Leiter and Maslach, 2003). | 29 items, 5 pts | α = 0.70 to 0.82 | NR | |||
- Nursing Quality Indicators (American Nurses Association (ANA), 2000) | 4 items, 4pts | α = 0.75 | NR | |||
Wong et al., (2010), J of Nurs Manag, Canada | N = 280 | - Authentic Leadership Questionnaire (ALQ) (Avolio et al., 2007) | 16 items, 5 pt scale | α = 0.97 | Confirmatory factor analysis | Descriptive statistics, reliability estimates and Pearsons correlations |
Nurses | - Personal identification scale developed by (Kark, 2001) | 10 items, 7pt scale | α = 0.96 | |||
RR = 48% | - The Trust in Management Scale (Mayer and Gavin, 2005) | 10 items, 5 pt scale | α = 0.83 | |||
Grad Nurses | - Utrecht Work Engagement Scale (UWES) short version (Schaufeli and Bakker, 2003) | 9 items, 6 pt scale | α = 0.90 | |||
N = 342 | - Helping and Voice Behaviours Scale –voice subscale (Van Dyne and LePine, 1998) | 6 items, 7 pt scale | α = 0.82–0.96 | |||
RR = 37.7% | - International Survey of Hospital Staffing and Organization of Patient Outcomes (Aiken et al., 2001) | 1 items, 4 pt scale | NR | |||
Yokoyama et al. (2016), J Clin Nurs, Japan | n = 898 nurses | - Negative Acts Questionnaire-Revised (Tsuno et al., 2010) | 22 items, 5 pt scale | a = 0.93 | PV | multivariate logistic regression analysis |
78% RR | - Practice Environment Scale of Nursing Work Index (Ogata et al., 2008) | 31 items, 4 pt scale | a = 0.73–0.84 | PV | ||
Yoon et al. (2016), J Nurs Manag, Korea | n = 180 RNs | - Confidence and Intent to Delegate Scale (Parsons, 1999) | 11 items, 10 pt scale | α = 0.83 | PV | Kolmogorov–Smirnov, Shapiro–Wilk, Spearman’s rho |
86% RR | - The Multifactor Leadership Questionnaire (MLQ), (Bass and Avolio, 1997) | 25 items, 5 pt scale | α = 0.92 |
PV = Previously Validated.
NR = Not Reported.
3.2 Summary of quality review
Weaknesses in the 129 quantitative study designs related to sampling, design, and analysis (see Table 3). All 129 studies used correlational, non-experimental, or cross-sectional designs and were rated as moderate (scores = 5–9) or high quality (scores ≥ 10). However, these correlational designs limit interpretations of causality. Only 33 of the 129 included studies used probability sampling, partially due to the difficulty in using random sampling methods to study leadership in specific individuals or units. Many studies used correlational and regression analyses and 100 studies did not report the management of outliers. Only 65 studies addressed appropriateness of sample size and 95 of 129 addressed anonymity of respondents. Ninety-six of 129 studies used samples from more than one site. Effects or outcomes of leadership were most often self-reported (n = 110), rather than observed.
Table 3. Summary of Quality Assessment – 129 included quantitative studies.
45 | 84 |
33 | 96 |
65 | 64 |
95 | 34 |
97 | 32 |
57 | 72 |
123 | 6 |
109 | 20 |
19 | 110 |
114 | 15 |
112 | 17 |
109 | 20 |
29 | 100 |
A strength of included studies was the pervasive use of theory to guide research (113 of 129 studies), with some authors integrating several established theories to guide their research. These leadership theories and frameworks most often applied included Bass (and Avolio)’s Transformational and Transactional Leadership (33 studies), and Full Range Leadership Model (4 studies), Avolio and Gardner’s Authentic Leadership (11 studies), Kanter’s Organizational Empowerment Theory (10 studies), Kouzes and Posner’s Leadership Practices (6 studies), Hersey and Blanchard’s Situational Leadership Model (2 studies), Path Goal Theory (2 studies), Magnet Hospital Model (2 studies), and Consideration and Initiation (2 studies). Promoting Action on Research Implementation in Health Services (PARIHS) was used to frame the research design in 2 studies. All remaining leadership theories were used in single studies.
Twenty studies in this review employed higher level multivariate statistical procedures, such as hierarchical regression, and 22 studies specifically applied structural equation modeling. Of those using structural equation modeling, 18 studies were published within the last 10 years.
3.3 The outcomes of leadership
A total of 121 identified outcomes were grouped into six categories, 1) staff satisfaction with job factors, 2) staff relationships with work, 3)staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. See Table 4 for all outcomes sorted by category, relational leadership style (shaded), task-focused leadership (non-shaded), frequency, and significance of outcomes or effects. In studies examining multiple relational and/or task-focused leadership styles, outcomes are accounted for in each category in which they were reported in Table 4. For the following results section, we present categories, most frequently cited outcomes, and difference in outcomes. In text citation numbers for each outcome refers to study numbers in Table 2.
Table 4. Outcome differences between relationally focused (shaded) and task focused (non-shaded) leadership styles. Total: 121 outcomes in 129 studies.
Note: Numbers in each column = reference numbers of included studies from Table 2.
Shaded results = Relational leadership styles.
Non-shaded results = Task focused leadership styles.
Some studies examined multiple relational and/or task-focused styles with mixed results, and are accounted for in each category they were reported for.
Staff Satisfaction with work, job and their Leaders. Sixty-five studies reported 18 outcomes influenced by leadership style related to staff satisfaction with work, job and their leaders, which also included satisfaction with roles, policies and rewards. The most frequently examined outcome of leadership in this review was nursing job satisfaction (n = 57). Fifty-two of 57 studies reported highest job satisfaction associated with a variety of relational focused leadership styles, such as socio-emotional, consideration, authentic, inspirational, resonant and transformational leadership (4, 5, 7–10, 14, 19, 21, 22, 24, 25, 28, 31, 32, 34, 35, 36, 38–40, 46, 47, 50, 54, 55, 58, 62, 63, 66, 68, 69, 73, 77, 80, 83–85, 90, 92, 98, 105, 107, 109, 111, 112, 115, 117, 118, 122, 124, 126). In 4 studies, the task-focused style transactional leadership was associated with increased job satisfaction (54, 98, 105, 111). Sixteen studies reported that job satisfaction was significantly lower with task-focused forms of leadership, such as management by exception, instrumental, and laissez faire leadership (5, 7, 8, 10, 21, 25, 28, 32, 40, 47, 50, 54, 58, 105, 108, 117). Relational leadership styles were not significantly associated with job satisfaction in two studies (37, 42).
Significantly higher satisfaction with their leader was reported in 9 studies when leadership styles were authentic, charismatic, resonant, or transformational (6, 10, 11, 19, 43, 49, 78, 117, 126). Two studies examining consideration and initiating structures found equivocal results (19, 43). Management by exception (6), transactional and laissez faire (11, 58, 59, 117), and dissonant (10) leadership styles were associated with significantly lower satisfaction with their leader in 6 studies. The next most frequently examined outcomes included satisfaction with organizational work, work itself, and power, which were reported significantly higher with authentic, resonant, empowering, initiating structure and consideration styles of leadership (10). Results for remaining outcomes were equivocal or reported in a small number of studies.
In this category about how staff engaged with or felt about their work and job, 72 studies reported 41 outcomes. Outcomes most frequently examined were staff reports of organizational commitment, empowerment, intent to stay or leave, and retention. Outcomes most frequently examined in this category include staff reports of organizational commitment, empowerment, intent to stay or leave, and retention.
Seventeen studies reported significantly increased organizational commitment with transformational leadership (2, 9, 35–37, 45, 80, 89, 90), supportive leadership (21, 76), consideration (28), charismatic leadership (6, 33), empowerment based leadership (64, 85) and resonant leadership (122). Six studies reported significantly lower organizational commitment with transactional, management by exception and instrumental leadership styles (6, 21, 28, 33, 35 60). One study reported significantly lower organizational commitment with the leadership practice of inspiring a shared vision (35).
Significantly higher staff empowerment at work was reported for relational leadership styles in 16 studies; transformational leadership (2, 25, 40, 62, 86), authentic leadership (81, 84, 110, 126), resonant leadership (83), supportive leadership (76), and motivational or empowering leadership (29, 64, 85). Passive management and transactional styles were related to nurses’ reports significantly lower empowerment (40, 60).
Nurses’ intent to stay was significantly higher with supportive and consideration leadership styles, and lower with decision decentralization (5, 71, 76, 112, 117). Nurses’ intent to leave was significantly higher with management by exception leadership, abusive leadership, authoritarian leadership, or when nurses reported their leaders were not engaging in relational leadership (6, 87, 108, 117), and lower with transformational and charismatic leadership (6, 61, 66, 86, 87, 92, 117). Actual retention was significantly higher with consideration and supportive styles (50, 103, 112, 117), and better subordinate relations (51), while a decrease in turnover was found with leader-member exchange (12), and transformational leadership practices (20). Retention was significantly lower following decision decentralization (51). Relational leadership styles also were associated with increased engagement (73, 75, 88, 96, 97), job autonomy (43, 46, 68, 73, 110) and decreased reports of personalization (27, 67, 79, 115) and turnover (12, 20, 55). Results for remaining outcomes were equivocal or reported in a small number of studies.
Twenty-three studies reported 23 outcomes associated with leadership style related to relations among staff, or how individuals or groups of staff interacted with each other. The most frequently examined outcomes included teamwork between physicians and nurses, team innovation/creativity, work-team climate, conflict management and nursing work group collaboration. Teamwork between physicians and nurses was reported to be better in association with authentic leadership (110) resonant leadership (10), greater nurse manager ability, supportive leaderships (27, 28, 112), and leader empowering behaviours (39). Team innovation/creativity increased significantly with authentic (94), servant (107) and transformational (100) leadership styles. Work-team climate was enhanced when leaders enacted authentic (110), consideration (43) and transformational (100) styles, or with leadership characterized by responsiveness and clear communication (32). Conflict management and nursing workgroup collaboration improved with relational leadership styles (63), such as authentic leadership (128), transformational (100) and servant leadership (107) styles, respectively, and was lower in association with transactional leadership (17) and dissonant leadership (10), respectively. Results for remaining outcomes were equivocal or reported in a small number of studies.
Thirty studies reported 13 outcomes related to staff health and well-being. Emotional exhaustion and job stress were reported lower with transformational leadership (48, 67, 79), empowering leadership (26), resonant leadership (10, 83), authentic leadership (82,84), transactional leadership (67), and nurse assessed nurse manager ability, leadership and support of nurses (27). Dissonant leadership (10) and management by exception (48) were associated with poorer emotional health and greater emotional exhaustion. Job tension or stress decreased when nurses had a positive perception of nursing leadership or when leaders embodied an authentic leadership style (26, 32, 39). Transformational leadership was also associated with decreased burnout (61, 88, 114). Results for remaining outcomes were equivocal or reported in a small number of studies.
Twenty-eight studies reported 13 outcomes influenced by leadership style pertaining to organizational environment factors, specific to the organizational environment, culture, community and structures. Outcomes most commonly examined were organizational climate or culture, organizational support and staffing. Eight studies reported that culture and climate were better in association with authentic leadership, supportive leadership, transformational leadership, structural leadership, initiative structure, and change oriented leadership (15, 16, 18, 32, 41, 43, 70, 100, 106, 125). Perceived support was highest with relational leadership styles (56), specifically transformational leadership (43, 86, 90, 100), authentic (84), empowering (64), and support (76) styles. Staffing was perceived to be better or increased when leaders employed supportive (27, 76, 112, 117) or authentic (81) leadership styles. Results for remaining outcomes were reported in a small number of studies.
Thirty-two studies reported 13 outcomes related to productivity and effectiveness outcomes influenced by leadership style in. Factors frequently examined were extra effort by staff, productivity and effectiveness. Extra effort by staff was significantly higher in association with transformational leadership styles in eight studies (1, 6, 7, 42, 58, 78, 80, 118). Outcomes reflecting individual, team and organizational productivity and effectiveness were significantly higher in 18 studies with charismatic, authentic, supportive, transformational, and change oriented leadership (1, 6, 7, 9, 11, 15, 18, 20, 26, 35, 36, 37, 49, 58, 87, 60, 118, 78). Leadership styles such as management by exception, transactional, laissez faire, and peer leadership were associated with reported significant decreases in effectiveness and productivity (6, 11, 18, 26, 36). Results for remaining outcomes were equivocal or reported in a small number of studies