Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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A Meta-Analytic Path Analysis on the Outcome Variables of Nursing Unit Managers' Transformational Leadership: Systemic Review and Meta-Analysis

간호단위 관리자의 변혁적 리더십 결과변인에 관한 메타경로분석

  • Kim, Sunmi (College of Nursing, Jeonbuk National University) ;
  • Jeong, Seok Hee (College of Nursing, Research Institute of Nursing Science, Jeonbuk National University)
  • 김선미 (전북대학교 간호대학) ;
  • 정석희 (전북대학교 간호대학.간호과학연구소)
  • Received : 2020.08.24
  • Accepted : 2020.11.12
  • Published : 2020.12.31
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Abstract

Purpose: The purpose of this study was to identify the outcome variables of nursing unit managers' transformational leadership and to test a hypothetical model using meta-analytic path analysis. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Data analysis, conducted using R version 3.6.2 software, included 49 studies for the meta-analysis and 119 studies for meta-analytic path analysis. Results: In the meta-analysis, four out of 32 outcome variables were selected. These four variables were empowerment, nursing performance, job satisfaction, and organizational commitment, which showed larger effect sizes than the median and more than five k. The hypothetical model for the meta-analytic path analysis was established by using these four variables and transformational leadership. A total of 22 hypothetical paths including nine direct effects and 13 indirect effects were set and tested. The meta-analytic path analysis showed that transformational leadership had direct effects on the four variables. Finally, eight direct effects, 12 indirect effects, and six mediating effects were statistically significant, and the hypothetical model was verified. Conclusion: Nursing unit managers can use the transformational leadership to improve empowerment, nursing performance, job satisfaction, and organizational commitment of nurses. This study empirically showed the importance of transformational leadership of nursing managers. This finding will be used as evidence to develop strategies for enhancing transformational leadership, empowerment, nursing performance, job satisfaction, and organizational commitment in nursing science and practice.

Keywords

Acknowledgement

We would like to thank Yoonlee Kim, the professor of Hanil university and Presbyterian Theological Seminary, and Hana Kim & Jeongju Kim, the librarians of Jeonbuk National University, for the assistance of literature searching.

References

  1. Korean Nurses Association (KNA). Definition of nursing [Internet]. Seoul: KNA; c1999 [cited 2019 Jul 20]. Available from: http://www.koreanurse.or.kr/about_KNA/definition.php.
  2. Kim IS, Jang KS, Lee MH, Ha NS, Lee TW, Kim JS, et al. Nursing management. 4th ed. Seoul: Hyunmoonsa; 2015. p. 3-49.
  3. Northouse PG. Leadership: Theory and practice. 7th Ed. Seoul: Kyeongmunsa; c2018. p. 1-635.
  4. American Organization of Nurse Executives. The role and functions of the hospital nurse manager. Nursing Management. 1992;23(9):36-38.
  5. Bass BM. Leadership: Good, better, best. Organizational Dynamics. 1985;13(3):26-40. https://doi.org/10.1016/0090-2616(85)90028-2
  6. Yukl G. Leadership in organizations. 8th Ed. Seoul: Sigmapress; c2013. p. 461-504.
  7. Cowden T, Cummings G, Profetto-McGrath J. Leadership practices and staff nurses' intent to stay: A systematic review. Journal of Nursing Management. 2011;19(4):461-477. https://doi.org/10.1111/j.1365-2834.2011.01209.x
  8. Cummings GG, Tate K, Lee S, Wong CA, Paananen T, Micaroni SPM, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies. 2018;85:19-60. https://doi.org/10.1016/j.ijnurstu.2018.04.016
  9. Grant B, Colello S, Riehle M, Dende D. An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model. Journal of Nursing Management. 2010;18(3):326-331. https://doi.org/10.1111/j.1365-2834.2010.01076.x
  10. Curtis E, O'Connell R. Essential leadership skills for motivating and developing staff. Nursing Management. 2011;18(5):32-35. https://doi.org/10.7748/nm2011.09.18.5.32.c8672
  11. Robbins B, Davidhizar R. Transformational leadership in health care today. The Health Care Manager. 2020;39(3):117-121. https://doi.org/10.1097/HCM.0000000000000296
  12. Kim S, Seo MH, Jeong SH, Kim HS, Kim YL. A literature review of research on leadership of Korean hospital nurse. Journal of Korean Academy of Nursing Administration. 2019;25(5):404-423. https://doi.org/10.11111/jkana.2019.25.5.404
  13. Park EH. Analysis of studies on nursing managers' transformational leadership -The literature review and meta-analysis- [master's thesis]. Seoul: Korea University; 2009. p. 1-49.
  14. Park D. Leadership styles and organizational effectiveness: A meta-analytic approach [dissertation]. Seoul: Hanyang University; 2019. p. 1-259.
  15. Song MG. A meta-analysis on factors related to organizational effectiveness of healthcare employees [dissertation]. Gimhae: Inje University; 2016. p. 1-162.
  16. Hoch JE, Bommer WH, Dulebohn JH, Wu D. Do ethical, authentic, and servant leadership explain variance above and beyond transformational leadership? A meta-analysis. Journal of Management. 2018;44(2):501-529. https://doi.org/10.1177/0149206316665461
  17. Lowe KB, Kroeck KG, Sivasubramaniam N. Effectiveness correlates of transformational and transactional leadership: A meta-analytic review of the MLQ literature. The Leadership Quarterly. 1996;7(3):385-425. https://doi.org/10.1016/S1048-9843(96)90027-2
  18. Wang G, Oh IS, Courtright SH, Colbert AE. Transformational leadership and performance across criteria and levels: A meta-analytic review of 25 years of research. Group & Organization Management. 2011;36(2):223-270. https://doi.org/10.1177/1059601111401017
  19. Barlow KM. A meta-analysis of transformational leadership and subordinate nursing personnel organizational commitment, job satisfaction, and turnover intentions [dissertation]. Baltimore (MD): University of Maryland; 2013. p. 1-275.
  20. Viswesvaran C, Ones DS. Theory testing: Combining psychometric meta-analysis and structural equations modeling. Personnel Psychology. 1995;48(4):865-885. https://doi.org/10.1111/j.1744-6570.1995.tb01784.x
  21. Kim H, Yu K. An ecological, meta-analytic path analysis of variables related to internet addiction in adolescents. The Korean Journal of Counseling and Psychotherapy. 2017;29(3):659-687. https://doi.org/10.23844/kjcp.2017.08.29.3.659
  22. Park BS, Bae SW. Testing the general strain theory of adolescent delinquency using meta-analytic path analysis. Health and Social Welfare Review. 2016;36(3):270-302. https://doi.org/10.15709/hswr.2016.36.3.270
  23. Jin HM, Bae SW. Meta-analytic path analysis of suicidal ideation in adolescence -based on the stress process model-. Journal of Youth Welfare. 2016;18(2):85-113. https://doi.org/10.19034/KAYW.2016.18.2.05
  24. Hong S, Jo K, Lee H, Son S, Kim H, Kang Y, et al. A meta-analytic path analysis of variables related to resilience in adolescents. Forum for Youth Culture. 2020;63:109-134. https://doi.org/10.17854/ffyc.2020.07.63.109
  25. Fragkos KC, Makrykosta P, Frangos CC. Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta-analysis. Journal of Advanced Nursing. 2020;76(4):939-962. https://doi.org/10.1111/jan.14289
  26. Nei D, Snyder LA, Litwiller BJ. Promoting retention of nurses: A meta-analytic examination of causes of nurse turnover. Health Care Management Review. 2015;40(3):237-253. https://doi.org/10.1097/HMR.0000000000000025
  27. Guo JL, Wang TF, Liao JY, Huang CM. Efficacy of the theory of planned behavior in predicting breastfeeding: Meta-analysis and structural equation modeling. Applied Nursing Research. 2016;29:37-42. https://doi.org/10.1016/j.apnr.2015.03.016
  28. Clarke S. Safety leadership: A meta-analytic review of transformational and transactional leadership styles as antecedents of safety behaviours. Journal of Occupational and Organizational Psychology. 2013;86(1):22-49. https://doi.org/10.1111/j.2044-8325.2012.02064.x
  29. Nohe C, Hertel G. Transformational leadership and organizational citizenship behavior: A meta-analytic test of underlying mechanisms. Frontiers in Psychology. 2017;8:1364. https://doi.org/10.3389/fpsyg.2017.01364
  30. Koh D, Lee K, Joshi K. Transformational leadership and creativity: A meta-analytic review and identification of an integrated model. Journal of Organizational Behavior. 2019;40(6):625-650. https://doi.org/10.1002/job.2355
  31. Korea Health Industry Development Institute (KHIDI). Survey on the status of nurse activities [Internet]. Cheongju: KHIDI; c2014 [cited 2019 Apr 5]. Available from: https://bit.ly/35JtgED.
  32. Kim YI, Geun HG. Comparing organizational commitment, nursing organization culture, and job satisfaction of Korean nurses working in Korea and the U.S. Korean Journal of Occupational Health Nursing. 2015;24(1):19-30. https://doi.org/10.5807/kjohn.2015.24.1.19
  33. Seo K, Kim M. Clinical work experience of Korean immigrant nurses in U.S. hospitals. Journal of Korean Academy of Nursing. 2016;46(2):238-248. https://doi.org/10.4040/jkan.2016.46.2.238
  34. Han J, Kim M. The impact of the followership style on the organizational effectiveness in nursing organization. Journal of Korean Academy of Nursing Administration. 2009;15(2):233-243.
  35. Han J. Effects of the nursing organizational culture and head nurse's leadership on the job satisfaction. Korea Journal of Hospital Management. 2009;14(3):1-22.
  36. Yoo MJ, Kim JK. A structural model of hospital nurses' turnover intention: Focusing on organizational characteristics, job satisfaction, and job embeddedness. Journal of Korean Academy of Nursing Administration. 2016;22(3):292-302. https://doi.org/10.11111/jkana.2016.22.3.292
  37. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Healthcare Collaborating Agency (NECA); 2011. p. 1-271.
  38. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [Internet]. London: The Cochrane Collaboration; c2011 [cited 2019 Apr 1]. Available from: http://handbook.cochrane.org/.
  39. Hwang SD. Meta analysis. Seoul: Hakjisa; 2014. p. 113-126.
  40. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. Chichester: John Wiley & Sons Ltd.; 2009. p. 3-7.
  41. Cohen J. Statistical power analysis for the behavioral sciences. New York (NY): Academic Press; 1977. p. 109-133.
  42. Kim BM, Lee YM, Yoon SH, Choi EO. A study of the head nurse's leadership and the organizational effectiveness as perceived by staff nurses. Journal of Korean Academy of Nursing Administration. 2007;13(3):373-383.
  43. Lee YM, Kim BM. The mediator effect of empowerment in relationship between transformational leadership and organizational commitment. Journal of Korean Academy of Nursing. 2008;38(4):603-611. https://doi.org/10.4040/jkan.2008.38.4.603
  44. Cheung MWL, Chan W. Meta-analytic structural equation modeling: A two-stage approach. Psychological Methods. 2005;10(1):40-64. https://doi.org/10.1037/1082-989X.10.1.40
  45. Yoo SM. R-meta analysis: For program effect verification & structure equation modeling analysis. Seoul: Slow & Steady Publishing Co; 2019. p. 70-105.
  46. Jak S. Meta-analytic structural equation modelling. Cham: Springer; 2015. p. 1-88.
  47. Cheung MW. metaSEM: An R package for meta-analysis using structural equation modeling. Frontiers in Psychology. 2015;5:1521. https://doi.org/10.3389/fpsyg.2014.01521
  48. Duval S, Tweedie R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455-463. https://doi.org/10.1111/j.0006-341X.2000.00455.x
  49. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta analysis detected by a simple, graphical test. BMJ: British Medical Journal. 1997;315(7109):629-634. https://doi.org/10.1136/bmj.315.7109.629
  50. House RJ. Path-goal theory of leadership: Lessons, legacy, and a reformulated theory. The Leadership Quarterly. 1996;7(3):323-352. https://doi.org/10.1016/S1048-9843(96)90024-7
  51. McGuire E, Kennerly SM. Nurse managers as transformational and transactional leaders. Nursing Economics. 2006;24(4):179-185.
  52. Min S, Kim HS. Correlation between perception of nurses about transformational leadership and nursing performance. Korea Journal of Business Administration. 2005;18(2):871-885.
  53. Kim MJ, Han JY. Effect of head nurses' authentic leadership on nurses' job satisfaction and nursing performance: Focusing on the mediating effects of empowerment. Journal of Korean Academy of Nursing Administration. 2019;25(1):25-34. https://doi.org/10.11111/jkana.2019.25.1.25
  54. Seo JA, Lee BS. Effect of work environment on nursing performance of nurses in hemodialysis units: Focusing on the effects of job satisfaction and empowerment. Journal of Korean Academy of Nursing Administration. 2016;22(2):178-188. https://doi.org/10.11111/jkana.2016.22.2.178
  55. Choi HG, Ahn SH. Influence of nurse managers' authentic leadership on nurses' organizational commitment and job satisfaction: Focused on the mediating effects of empowerment. Journal of Korean Academy of Nursing. 2016;46(1):100-108. https://doi.org/10.4040/jkan.2016.46.1.100
  56. Yom YH. The workplace empowerment on staff nurses' organizational commitment and intent to stay. Journal of Korean Academy of Nursing Administration. 2006;12(1):23-31.
  57. Lee SY, Lee MH, Kim HK, Park OL, Sung BJ. Effects of head nurses' servant leadership on organizational commitment among clinical nurses: Focused on the mediating effect of empowerment. Journal of Korean Academy of Nursing Administration. 2015;21(5):552-560. https://doi.org/10.11111/jkana.2015.21.5.552
  58. Lee JH. Development and evaluation of empowerment improving program for long-term care hospitals nurse [dissertation]. Busan: Kosin University; 2018. p. 1-140.
  59. Lee YT. The impact of empowerment on the relationship between transformational leadership and job satisfaction. Korea Journal of Business Administration. 2004;17:2139-2160.
  60. Choi SL, Goh CF, Adam MB, Tan OK. Transformational leadership, empowerment, and job satisfaction: The mediating role of employee empowerment. Human Resources for Health. 2016;14(1):73. https://doi.org/10.1186/s12960-016-0171-2
  61. Miner JB. Organizational behavior 1. Essential theories of motivation and leadership. New York (NY): Routledge; 2015. p. 94-113.
  62. Lawler EE III, Porter LW. The effect of performance on job satisfaction. Industrial Relations. 1967;7(1):20-28. https://doi.org/10.1111/j.1468-232X.1967.tb01060.x
  63. Oh IS, Kim K, Darnold TC, Hwang JO, Yoo TY, Park YA, et al. Relationships among job satisfaction, organizational commitment, job performance, and turnover intention: A literature review and meta-analysis with Korean samples. Korean Journal of Management. 2007;15(4):43-86.
  64. Babin BJ, Boles JS. The effects of perceived co-worker involvement and supervisor support on service provider role stress, performance and job satisfaction. Journal of Retailing. 1996;72(1):57-75. https://doi.org/10.1016/S0022-4359(96)90005-6
  65. Kim SY, Kim EK, Lim HM, Lee MY, Park KO, Lee KA. Structural equation modeling on nursing productivity of nurses in Korea. Journal of Korean Academy of Nursing. 2013;43(1):20-29. https://doi.org/10.4040/jkan.2013.43.1.20
  66. Park WY, Yoon SH. The mediating role of organizational citizenship behavior between organizational justice and organizational effectiveness in nursing organizations. Journal of Korean Academy of Nursing. 2009;39(2):229-236. https://doi.org/10.4040/jkan.2009.39.2.229
  67. Sung MH, Choi WJ, Chun HK. The relationship of negative emotion, emotion suppression, and job satisfaction to organizational commitment in hospital nurses. Journal of Korean Academy of Fundamentals of Nursing. 2011;18(2):258-266.
  68. You MA, Son YJ. The relationships of work-family conflict, social support, job satisfaction, and organizational commitment in Korean married hospital nurses. Journal of Korean Academy of Fundamentals of Nursing. 2009;16(4):515-523.
  69. Lee IH. Easy flow regression analysis. Seoul: Hannarae Publishing Co; 2014. p. 1-459.
  70. Eo YS, Kim YH, Lee NY. Path analysis of empowerment and work effectiveness among staff nurses. Asian Nursing Research. 2014;8(1):42-48. https://doi.org/10.1016/j.anr.2014.02.001
  71. Park HK. The structural equation modeling on job performance of clinical nurses [dissertation]. Busan: Kosin University; 2013. p. 1-77.
  72. Park HT. Transformational and transactional leadership styles of the nurse administrators and job satisfaction, organizational commitment in nursing service. Journal of Korean Academy of Nursing. 1997;27(1):228-241. https://doi.org/10.4040/jnas.1997.27.1.228
  73. Leach LS. Nurse executive transformational leadership and organizational commitment. The Journal of Nursing Administration. 2005;35(5):228-237. https://doi.org/10.1097/00005110-200505000-00006

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