Abstract
BackgroundAlthough leadership is considered as a key factor in health care, leadership styles and outcomes in nursing homes often remain a black box. Therefore, this study explored leadership styles and leadership outcomes of head nurses and directors of nursing (DoN) in nursing homes based on well-defined leadership concepts.MethodsA multicenter cross-sectional analysis was conducted on baseline data of an ongoing cohort study comprising a convenience sample of nursing home staff (n = 302). Leadership styles and leadership outcomes of head nurses and DoN were measured through the rater form of the Multifactor Leadership Questionnaire 5X (MLQ-5X). Based on the Full Range of Leadership Model, the MLQ-5X visualizes transformational (relation and change focused), transactional (task-focused) and passive-avoidant (absence of leadership) leadership styles. Scores of head nurses and DoN for leadership styles and outcomes were compared with European Reference Scores (ERS) using two-sided one-sample t-tests.ResultsCompared with ERS, head nurses and DoN scored significantly lower (p < 0.001) on transformational and transactional leadership styles and significantly higher (p < 0.001) on passive-avoidant leadership styles. All leadership outcomes were significantly lower (p < 0.001) for head nurses. Similar results, however not statistically significant, were found concerning leadership outcomes of DoN.ConclusionsResults indicate that passive-avoidant leadership styles are excessively present in contrast to transformational leadership styles in nursing homes. This highlights an urgent need to invest in leadership development. Therefore, future research should focus on interventions for the development of transformational leadership.
Highlights
Leadership is considered as a key factor in health care, leadership styles and outcomes in nursing homes often remain a black box
Head nurses In total 242 staff received the questionnaires on leadership styles and outcomes of 22 head nurses of which 235 completed these questions
Our study describes that passive-avoidant leadership styles are excessively present in contrast to transformational leadership styles in nursing homes
Summary
Leadership is considered as a key factor in health care, leadership styles and outcomes in nursing homes often remain a black box. Poels et al BMC Health Services Research (2020) 20:1009 reports financial and work environment related challenges, such as low wages and job dissatisfaction, in the recruitment and retention of direct-care workers [12]. Both intention to leave and to stay among nurses are associated with leadership practices [13]. Literature increasingly describes leadership as a key factor in solving challenges in health care. When staff perceives leadership as good it positively influences their retention and job satisfaction [13, 16]
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