Table of Contents
Project Title: “The Impact of Leadership Style on Employee Engagement and Job Satisfaction in Healthcare Organisations”
Submitted By: Hoda Taher Mohamed Khater Farag
Abstract
This systematic review offers a thorough evaluation of data obtained from previous research as it digs into the complex interplay between leadership styles, employee engagement, and job satisfaction within healthcare companies. The main goal was to clarify the impacts of various leadership philosophies on these core elements of the healthcare workforce. The qualitative systematic review used previously published papers on the topic. The meta-synthesis of data from several inquiries yields significant revelations and wide-ranging ramifications for healthcare administration and future research projects. The findings demonstrate the significant influence that leadership styles have on work satisfaction and staff engagement in healthcare settings. Transformational leadership stands out as a vital and advantageous quality connected to employee engagement and work happiness. Additionally, there is a positive correlation between employee engagement and transactional leadership, which emphasises clear expectations and incentives. Additionally connected to greater job satisfaction are ethical and servant leadership philosophies. Dysfunctional, laissez-faire, and passive leadership styles regularly show negative relationships with work satisfaction. The outcomes of present study can have significant implications for medical sector. On the basis of findings it can be recommended that Healthcare businesses should invest in leadership training initiatives that help leaders build their transformational, transactional, ethical, and servant leadership abilities. Leaders should avoid dysfunctional, laissez-faire, and passive-avoidant behaviours since they might reduce employee work satisfaction.
Keywords: Leadership Style, Employee Engagement, Job Satisfaction, Healthcare Organisations
In a constantly demanding environment, healthcare systems face the intricate task of synchronously improving public health and controlling the escalating healthcare costs (Moustaghfir, El Fatihi and Benouarrek, 2020). Several research efforts have demonstrated that the approaches utilised by managers and their styles of leadership have the potential to influence not just the performance of their staff but also the overall performance of healthcare systems (Kamel, 2019; Pasricha, Singh and Verma, 2018). In a more general sense, leadership is labelled as the ability to effectively guide others to unlock their full potential in achieving tasks, objectives, or projects. Leadership theories have historical roots and have evolved over time, demonstrating distinct characteristics as they have adapted to changing individuals and historical contexts (Pasricha and Rao, 2018). Conversely, Wen et al. (2019) have emphasised the indispensability of leadership in all types of organisations. The quality of leadership profoundly influences whether an organisation prospers or faces setbacks. Its efficacy relies on the specific context; what may be effective in one situation may not yield the same results in another (Kellner, Townsend and Wilkinson, 2017). A proficient leader should possess the capacity to adjust their strategies according to the unique circumstances, especially in service sectors such as education and healthcare.
The UAE, like other developed countries known for its rapid expansion and diversification, has recently made significant strides in its healthcare sector. Through strategic investments, a highly skilled workforce, and cutting-edge medical equipment, the UAE has propelled the development of its healthcare industry (Alhashmi, Salloum and Abdallah, 2019). When compared to other Gulf Cooperation Council (GCC) nations, the UAE stands out for its exceptionally rapid growth in healthcare spending. Projections suggest that healthcare expenditures in the UAE will reach US$30.7 billion (equivalent to AED 112.6 billion) by 2027, demonstrating a consistent compound annual growth rate of 7.4%. Additionally, the UAE Vision 2021 National Agenda underscores the aspiration to establish a world-class healthcare system (Fadhil et al., 2022). The achievement of these objectives relies on promoting employee engagement. Fostering employee engagement necessitates the development of a supportive leadership environment that facilitates the attainment of organisational goals (Mughal and Iraqi, 2021). Moreover, Hawkes, Biggs, and Hegerty (2021) have emphasised the vital part that successful management plays in raising engagement among employees. Therefore, it makes sense for healthcare organisations to have an in-depth awareness of the impact of styles of leadership on work satisfaction and staff engagement. To fully establish the association between governance and worker engagement in the field of healthcare, empirical studies are necessary. As a result, the goal of the current study is to scritinise the way servant leadership approaches affect worker engagement and job satisfaction in the healthcare industry.
1.2 Background
1.2.1 Job Satisfaction of the Employees
For many years, research on job satisfaction has been a focus in many different sectors and regions (Kellner, Townsend, and Wilkinson, 2017). It is defined as the favourable feelings or attitudes people have about their jobs as a result of their expectations and goals for their jobs being in line (Baig et al., 2021). Various studies published in literature revealed the influence of job satisfaction on organisational success, employee morale, innovation and creativity stimulation as well as the organisational citizenship behaviour (Al-Sada, Al-Esmael, and Faisal, 2017; Abelha et al., 2018; Olsen, Bjaalid, and Mikkelsen, 2017; Agha, 2017). All these studies highlight the importance of job satisfaction for overall organisational success by influencing a numebr of dimensions. Furthermore, improving job happiness has a positive impact on absence rates, productivity, staff retention, and the delivery of high-quality services. Happy and contented workers often demonstrate a greater commitment to their companies (Labrague and de Los Santos, 2021).
Several hypotheses have been suggested in an effort to understand the nuanced idea of satisfaction with work and all the variables that influence it. According to Davidescu et al. (2020), theoretical frameworks fall into two primary categories including needs theories and process theories. Process theories of work satisfaction indicate leaders and managers should learn about the nuanced aspects of the motivating system and be able to sway the choices of individuals within this complicated structure (Ramalho Luz et al., 2018). Leaders and mangers make decisions according to an assortment of reasons. According to Nambisan, Zahra, and Luo (2019), such procedures involve considering people similarly, creating difficult but achievable targets, balancing requirements for everybody involved, and acknowledging excellent success. Conversely, interests theory highlight how everybody differentiates as a result of their distinctive wants and beliefs (Dong et al., 2017). Due to this, management and other leadership need to be completely cognisant of and skilled in managing the unique requirements of their workplace. Taeuscher, Zhao, and Lounsbury (2022) classify these requirements into two groups: lower-level needs, including social interaction, stable employment, adequate benefits, and advantageous conditions for work, and more complex requirements, which consist of achievement, as self-fulfillment, and acceptance. Yang et al. (2017) defined a servant leader as an individual motivated by a desire to meet the needs and ensure the well-being of others. Servant leadership represents an approach where the leader goes beyond self-interest to address the needs of others, support their growth, and provide opportunities for both material and emotional advancement (Mayer, von Niekerk and Fouché, 2023). It has been depicted that a servant leader prioritises the needs of their followers, ensuring they are attended to first. Their goal is to promote the growth, well-being, wisdom, and empowerment of their followers (Harju, Schaufeli and Hakanen, 2018). Not only this, but servant leaders have been reported to uphold moral values, demonstrate care for others, and foster the development of their followers. Through role modelling, they inspire their followers and build relationships to achieve objectives (Ruiz-Palomino et al., 2018). Beside this, it has been mentioned that leaders following servant leadership style show a significant responsibility for their disciples and other stakeholders, thus, offering them emotional support and displaying empathy (Taylor, 2021). In addition to this, this leadership style has been signified for emphasising a leader’s personal integrity and their ability to serve various entities, including employees, customers, and communities (Jit, Sharma and Kawatra, 2017).
A wide range of characteristics is used to define servant leaders. While different frameworks use distinct terminology to describe similar models, there are clear similarities among the various traits outlined in these different contexts (Sousa and Van Dierendonck, 2017). Diverse frameworks also use different proportions of traits to demonstrate servant leadership. As an example, in their studies, Iannotta, Meret, and Marchetti (2020) focused on five servant leadership features, while Belanche et al. (2020) investigated twelve basic attributes of leaders following this style. However, Bavik (2020) analysed 11 of them, and Autiosalo et al. (2019) investigated seven professional traits. Regarding this, Crippen and Willows (2019) pointed out that it is important to keep in consideration that every design has a unique combination of advantages and disadvantages.
1.3 Literature Gap
Most of the previous researches has been found to be focused on analysis of the connections among managerial styles, staff satisfaction and engagement in a broader context, occasionally overlooking the complicated dimensions particular to the healthcare industry. The consequences of standard management doctrines, such as autocratic and democratic doctrines, on staff participation and satisfaction with work, for examples, were the focus of Cottey and McKimm’s (2019) study. Nevertheless, the effects of a number of management philosophies, such as transformational, transactional, or servant leadership, on employees’ happiness at work in the healthcare sector remains relatively unstudied. In addition, just a few of the research investigations that clarify the way styles of leadership influence job fulfilment and worker engagement use empirical evidence to back up the findings they draw (Aij and Rapsaniotis, 2017; Gunnarsdóttir, Edwards, and Dellve, 2018). Consequently, empirical research is needed in order to strengthen the argument in different dimensions in order to evaluate the efficiency of servant leadership. In a nutshell, the present dearth of expertise underlines the need for an improved understanding of the management’s role in promoting satisfaction and engagement among staff within healthcare businesses. The present study is being executed to precisely determine how the attributes and behaviour of different leadership styles influence workforce satisfaction and engagement in medical facilities in order to close this gap.
1.4 Review Aim, Question and Objectives
1.4.1 Research Aim
To investigate and evaluate the connection among a leader’s style, staff engagement and work satisfaction in healthcare enterprises.
1.4.2 Research Question
What effects does a leader’s style have on work satisfaction and staff engagement in healthcare organisations?
1.4.3 Research Objectives
• To explore the factors that contribute to higher engagement and satisfaction levels among employees.
• To evaluate how well leadership practices in healthcare companies contribute to increased worker engagement and job satisfaction.
Table 1: Research Question formulation through SPICE framework
S Setting Healthcare sector
P Perspective Healthcare professionals
I Intervention Leadership
C Comparison Leadership
E Evaluation Employee engagement and job satisfaction at healthcare organisations
2 Methodology and Protocol
2.1 Design
This article seeks to conduct a qualitative systematic review within the framework of investigating the influence of managerial approaches on job fulfilment and dedication among staff members within healthcare organisations. Consolidating previous researches in a specific field by a methodical examination of primary evidence and organising the outcomes is a crucial method for conducting qualitative systematic assessment. There exists a discussion regarding the necessity of conducting an detailed search in this process as it can provide enough evidences for answering the central study question. The methodologies employed for systematic reviews of quantitative research are firmly established, with explicit procedures that have been refined over time, notably through initiatives like the Cochrane Collaboration. In contrast, methodologies for conducting qualitative systematic reviews have emerged more recently and continue to develop. Therefore, the present systematic review follows the Cochrane framework for qualitative reviews. Moreover, the present review adopts qualitative methods for the systematic review of relevant literature.
2.2 Search Strategy
The data for present research has been obtained from papers published in the English language and accessible from January 2009 to September 2023. This 15-year timeframe was selected to ensure the retrieval of the most pertinent and current evidence. To validate the effectiveness of the search strategy, a trial run was performed, confirming its ability to retrieve three key papers that were directly related to the subject matter. The Pubmed, CINAHL and Embase databases were thoroughly searched using the following search parameters to answer the research question: (nurses* OR Healthcare professional staff OR employees OR staff members in Healthcare OR Healthcare Staff OR healthcare workers OR employees) AND (leader*) AND (result OR performance OR Engagement OR Satisfaction OR outcome OR Job Engagement OR satisfaction OR Leadership) A hospital, a healthcare facility, a department, a division, a directorate, a ward, a service, or a unit, etc. The “title/abstract” columns in PubMed were the only searchable areas, and the database also only allowed searches on human research. Contrastingly, no particular restrictions has been applied regarding the research type or publication in CINAHL or Embase.
number of tseps has been followed for the screening process where firstly, publications has been examined on the basis of their titles. In this analysis, the studies that looked to be relevant were subjected to the second examination where their abstracts has been analysed. After an initial screening based on titles and abstracts, about nine publications that fulfilled the first requirements received a thorough assessment of their full content. The purpose of this phase was to verify their final eligibility. In-depth records were kept in order to give a precise explanation for why any study was not included in this stage. The complete texts of the articles that still fit the predetermined criteria were then carefully examined. When there was uncertainty or dispute about whether to include an article, the research team members were able to reach an agreement after discussion. This cooperative strategy made sure that the final outcomes of the research were based on a thorough and well-informed evaluation. Finally, the entire search process is summarised through the PRISMA flowchart (see figure 1). A total of 09 studies were included for the systematic review. The Zotero citation manager was updated with the whole set of search results from each database..
2.3 Study Selection
It is accepted practice that at least two individuals carefully examine abstracts and names with the goal to minimise inaccuracies and removing bias in selection. A particular strategy for accomplishing this is that each of the reviewers perform an individual assessment, or, as recommended by Whiting et al. (2016), having a single reviewer examine the research articles and another independently examine the results. Requirements for Inclusion: An extensive list of admission requirements were established in order to discover articles that aligned with the goals of the investigation. These completely carefully planned standards incorporate study on leadership styles, employee involvement, and occupational fulfilment in medical facilities. These requirements are the base on which articles are selected and included in the assessment; they have to be established to guarantee emphasis and relevance. Titles, the abstracts, and the full texts of every publication that were included and excluded at every phase of the investigation’s decision-making process have been thoroughly recorded. The distinct combination of parameters insured that the research chosen would contribute considerably to knowledge of the ways in which management style impacts workplace fulfilment and staff engagement in health care organisations. This section highlights the methodological rigour and systematic approach employed in the study selection process. The present systematic review followed the SPICE framework to devise the research questions, further SPICE framework served as guide for the exclusion criteria of studies to be included in the qualitative review. Moreover, the studies conducted in other sectors have been excluded from the scope of the review and studies conducted on the healthcare departments were included in the review to remove any potential biases in the study.
2.4 Critical Appraisal
Using critical assessment techniques,systematic reviews’ credibility (conduct quality) and faith in the quality of the synthesised evidence are both assessed. A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2) is a well-liked and practical instrument for assessing the execution of a systematic review (see Appendix). The risk of bias, consistency or divergence in findings, correctness of results, application of the evidence, and the potential for publication bias are a few factors to take into account when deciding the degree of confidence in the efficacy estimates. The following paragraphs explains the criteria used to assess the calibre of the chosen research and gives an explanation for their selection. It goes on to clarify the methods used to evaluate the studies and highlights how the findings of this assessment support the systematic review’s overall interpretation. The selection of the criteria is based on how relevant they are to the research issue and how important it is that the included studies meet the requirements necessary to produce reliable data. The researcher also evaluated the review’s quality using the CASP method (see the Appendix). A methodical assessment of research follows a clearly defined process in which experts in the field carefully rate every study that is included using predetermined criteria. During this method of assessment, factors that include the design of the study, techniques, potential prejudices, and ultimate accuracy of reporting are meticulously taken into account. The final results of the assessment process play an essential part in helping to determine the reliability of the data in the studies that have been chosen. Therefore, this increases the overall reliability of the systematic investigation and offers vital details for condensing its conclusions. Every evaluation procedure and outcome, particularly assessments of each study’s quality and prejudice risk, is carefully documented. To provide judgements with the most accurate and long-lasting evidence achievable, the technique of synthesis allocates higher importance for studies with greater quality of method and low possibility of biases. On the contrary hand, publications with significant methodological flaws are evaluated for potential prejudice and the way it influences the findings of the study.
2.5 Ethical Appraisal
This section of the study gives an in-depth assessment of moral appraisals, which is an essential component of the overall examination which my either be primary of secondary. It encompasses the approaches used to ensure ethical standards of the assessment, criteria applied in evaluating it, choices established through the legal review interpret. A careful examination of the ethical dilemmas brought about all moral standards throughout the process of inquiry. In order to do this, a researcher has to supervise multiple problems including the clear attribution of the utilised studies by providing accurate citations. In addition, research emphasised on strictly sticking to the standards of academic integrity by properly rephrasing the data and citing the accurate sources appropriately. Furthermore, researcher ensured that the study relied only on the well reputed and well established publications while ignoring the sources lacking credibility. Beside this, researcher tried to avoid bias and objectivity by presenting balanced review and acknowledging the diversity and clashes in interpretations and perspectives of different authors. In addition to this, it has been depicted that the publications are the intellectual property of authors and while conducting a systematic analysis of the previous literature, it is crucial respect the intellectual property and researchers need to be well aware of the copyright laws while reproducing the data from literature. Considering this, researcher attempted to properly cite the literature.
For the purpose of preserving the validity of the studies, investigators adhere to important ethical rules while considering the legally allowed degree of the examination. These conditions include an unflinching commitment to the thorough recording of standards, integrity in the presentation of data, and fastidious avoidance of potential differences of interest. Through the aforementioned moral assessments, the analyst respects the highest guidelines for professional conduct and undertakes the review thoroughly in accordance with moral standards. A thorough examination of the moral dilemmas of the investigation led to the development of the Moral Judgement Framework. This involves recording ethical problems, noticing problems, and setting up means of resolving ethical difficulties that may have arisen through the assessment process. The philosophical structure of the examination is profoundly affected by outcomes of a moral assessment processes, which also ensures the study is being carried out with the greatest trustworthiness and commitment to the standards of ethics. A critical part of the moral review process is an unequivocal willingness to uphold principles of ethics across the entire investigation. Moral are needed for maintaining the preciseness and reliability of the results of the examination, safeguard the confidential information of the individuals involved and social service recipients, and maintaining the reliability of the scientific effort. Systematic methodical study has an established ethically underpinning since its stated fundamentals and approach align with company procedures and modern achievements. The last section highlights how important it is to conduct investigations with integrity of ethics and delves into what steps are taken to follow ethical guidelines.
2.6 Data Abstraction
The information extraction process employs an ordered and organised method. To maintain accuracy and consistency, particular forms or models for data abstraction were developed and confirmed. Furthermore, as part of a process of verification that minimises the probability of inaccuracies and mistakes, two people separately proceed over all the information that was collected. Solving differences includes talking it over or, if necessary requesting opinion from a third assessor. Moreover, a comprehensive list of variables for which data was sought is established. These variables encompass key aspects related to leadership styles, employee engagement, job satisfaction, and contextual factors within healthcare organisations. Even if certain information is not available in all studies, all variables are documented to provide transparency and clarity regarding the scope of data sought.
The variables include but are not limited to: types of leadership styles (e.g., transformational, transactional or servant), measures of employee engagement, measures of job satisfaction and characteristics of the healthcare organisations (e.g., size, location on). On the other hand, in instances where data is missing or incomplete in the selected studies, strategies for managing missing data are employed. These strategies may involve contacting study authors for additional information or clarification. If data cannot be obtained, sensitivity analyses are considered to assess the potential impact of missing data on the review’s findings. The approach to handling missing data is outlined to ensure transparency and reliability in the data synthesis process.
2.7 Analysis
The present systematic review used the meta-synthesis for the analysis of the collected data, as the researcher utilised the qualitative data for the study. Further, meta-synthesis would allow the researcher to deduce useful results from the collected data.
3 Results and Discussion
3.1 Results
3.1.1 Characteristics of studies included in SLR
The studies included in the review were conducted on the healthcare departments or the healthcare employees. Further, the studies included having one of the two variables of the study i.e., employee engagement or job satisfaction. Most of the included studies were in domain of the influence of leadership style on either employee commitment or job fulfillment.
3.1.2 Data extraction tables
Author(s) Purpose Sample/setting Method/analysis Key findings
Authentic Leadership
Giallonardo, Wong and Iwasiw, 2010.
Country:
Ontario, Canada The aim of this study is to investigate the associations between the perceptions of authentic leadership in preceptors among newly graduated nurses, their levels of work engagement, and job satisfaction. The final sample comprised 170 Registered Nurses (RNs) who were randomly selected for participation. They employed a predictive non-experimental survey design to explore the relationships between the variables of interest in this study. • Newly graduated nurses who are paired with preceptors displaying elevated levels of authentic leadership tend to experience higher levels of engagement and job satisfaction.
• Engagement serves as a significant intermediary factor through which authentic leadership influences job satisfaction in this context.
Transformational Leadership
Risambessy et al., 2012
Country:
Malang Raya, Indonesia The primary objective of this research was to provide a comprehensive description and analysis of how transformational leadership styles, motivation, burnout, job satisfaction, and employee performance interrelate. The study focused on nursing paramedics working at a hospital in the Malang Raya region as its unit of analysis. Data were gathered through a combination of interviews using questionnaires and observation techniques. Structural Equation Modelling (SEM) analysis was employed as the analytical tool. The research encompassed 105 respondents from the hospital as participants. • The research findings reveal that the transformational leadership style exerts a noteworthy and positive impact on job satisfaction. Furthermore, this leadership style significantly and positively influences employee performance.
• These outcomes highlight the direct and constructive role of transformational leadership in enhancing motivation, reducing burnout among nursing paramedics, and ultimately improving both job satisfaction and the overall performance of paramedic nursing staff in the hospital.
Participative Leadersip
Mosadeghrad and Ferdosi, 2013
Country:
Iran This study aims to provide additional clarity regarding the connections between the leadership behaviours exhibited by managers and the work-related attitudes of employees, specifically focusing on job satisfaction and organisational commitment within the context of public hospitals in Iran. In this cross-sectional study, self-administered questionnaires were employed for data collection. These questionnaires were distributed among a total of 814 hospital employees and managers, and the sampling method used was stratified random sampling. All the collected data were subjected to analysis using SPSS (Statistical Package for the Social Sciences) software. To ensure consistency and normalisation of the Likert scale across all domains within the job satisfaction and commitment questionnaires, a transformation was applied, converting the original responses into a uniform 1 to 6 scale. This standardisation allowed for a more consistent and meaningful analysis of the data. • This study elucidates the causal relationships between job satisfaction and commitment, underscoring the pivotal role of leadership in shaping these aspects of employee attitudes.
• However, it is essential to note that participative management may not always be the most effective leadership style.
• Managers should carefully consider and select the most appropriate leadership style based on the specific organisational culture and the maturity level of their employees.
Dysfunctional Leadership
Leary et al., 2013
Country:
United States The aim of this study is to investigate the connection, as perceived by subordinates, between dysfunctional leadership dispositions and key employee outcomes, including engagement, job satisfaction, and burnout. This field study utilised a survey to collect data from employees engaged in dyadic relationships with their leaders. The survey focused on assessing three categories of dysfunctional leadership dispositions and three key employee variables. To test the hypothesised relationships between dysfunctional behaviors and employee outcomes (engagement, job satisfaction, and burnout), multiple regression analysis was employed as the statistical method of choice. • Leadership behaviours characterised by intimidation and avoidance have been found to have a significant and impactful relationship with employee engagement, job satisfaction, and burnout.
• However, in this particular case, leadership factors associated with charm, manipulation, ingratiation, and building alliances do not appear to be related to employee engagement, job satisfaction, or burnout.
Transformational and Transactional Leadership
Manning, 2016.
Country:
United States
This study seeks to assess the impact of nurse manager leadership style factors on the work engagement of staff nurses.The survey instruments used for data collection included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form.In this study, a descriptive correlational research design was employed to survey a total of 441 staff nurses across three acute care hospitals. •The study findings indicate that both transactional and transformational leadership styles exhibited by nurse managers have a positive impact on staff nurse work engagement.
• Conversely, the passive-avoidant leadership style in nurse managers exerts a negative influence on the work engagement of staff nurses.
Transformational and Transactional Leadership Style
Asiri et al., 2016
Country:
Saudi Arabia This study aims to assess the impacts of nurses’ collective perceptions regarding the leadership style of their managers and their psychological empowerment on their levels of organisational engagement within acute care units. This study employed a cross-sectional survey design, collecting data from nurses working at King Abdulaziz Medical City. A total of 350 hard-copy questionnaires were randomly distributed to selected nurses. The study utilised a theoretical model that conceptually connects leadership, empowerment, and organisational commitment as key constructs of interest. Statistical analysis, including descriptive and inferential statistics such as correlation and stepwise multiple regression analysis, was conducted using the SPSS program version 19 to analyse the data. • A sizable proportion of nurses who responded to the survey said that their direct nursing supervisors did not demonstrate the appropriate degree of transformational leadership (TFL) behaviours.
• Interestingly, the research showed that the TFL style and nurses’ perceived psychological empowerment had a negative correlation with nurses’ engagement.
• In contrast, commitment and the Transactional Leadership (TAL) style revealed a favourable link.
Transactional, transformational, and laissez-faire leadership
Abasilim, Gberevbie and Osibanjo, 2019.
Country:
Nigeria This article investigates the relationship between several leadership philosophies (namely, transformational, transactional, and laissez-faire leadership) and worker loyalty. It also seeks to understand how demographic factors affect the relationship between leadership practises and employee engagement. Workers at the company provided the information for the survey. The statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 22.0. • In the study, it was found that there is a notably moderate positive association between transformational leadership style and employee engagement.
• Conversely, the transactional leadership style exhibited an inconsequential, minor negative relationship with employees’ engagement.
• Additionally, in the study’s context, the laissez-faire leadership style displayed an insignificant, minor positive correlation with employees’ engagement.
Ethical Leadership
Ahmad and Umrani, 2019
Country:
Pakistan The aim of this paper is to explore the influence of ethical leadership style (ELS) on employees’ job satisfaction (JS), with a particular focus on the mediating role played by Green Human Resource Management (Green HRM) and psychological safety. This study is conducted within the context of health sector organisations. In this study, a quantitative research methodology was employed. Data were gathered from a total of 177 respondents working within a public sector healthcare organisation in Pakistan using paper-based questionnaires. The reliability and validity of the measurement tools were assessed using AMOS (version 18) software. To test the hypotheses proposed in the study, the mediation analysis was conducted using the Preacher and Hayes (2008) macro. • Interestingly, the study did not find any substantiated evidence supporting the initial hypothesis of a direct influence of Ethical Leadership Style (ELS) on employees’ Job Satisfaction (JS).
• However, the results did provide support for the mediating roles of Green Human Resource Management (Green HRM) and psychological safety in this context.
Transformational authentic, resonant, and servant leadership styles
Specchia et al., 2021
Country:
Italy The objective of this research was to identify and comprehensively analyse the existing body of knowledge regarding the relationship between different leadership styles and the job satisfaction of nurses. The inclusion criteria for the review focused on studies that examined the influence of various leadership styles on nurses’ job satisfaction within a secondary care nursing setting. Additionally, studies needed to be available in full text and either in the English or Italian language to be considered for inclusion.
A systematic review was conducted, encompassing a comprehensive search on the PubMed, CINAHL, and Embase databases.•The transformational leadership style exhibited the most frequent positive correlations, followed by the authentic, resonant, and servant leadership styles.
• Conversely, both the passive-avoidant and laissez-faire leadership styles displayed consistent negative correlations with job satisfaction across all instances.
Transformational Leadership
Jankelová and Joniaková, 2021
Country:
Slovakia The paper’s objective is to investigate the relationship between communication skills and the transformational leadership style of Frontline Nurse Managers (FLNMs) in relation to nurses’ job satisfaction. Additionally, we aim to assess the impact of three moderators on the strength of this relationship. The study sample included 132 Frontline Nurse Managers (FLNMs) drawn from five university hospitals in Slovakia. Data were collected through a questionnaire format. All collected data were analysed using the SPSS 24 software package. To assess the proposed hypotheses, a series of regression analyses were employed. Additionally, ANOVA analysis was used to investigate multiple dependencies within the dataset. • The results of the study indicate robust direct effects of both communication skills and the transformational leadership style of Frontline Nurse Managers (FLNMs) on the job satisfaction of nurses.
3.1.3 Results of the Data Synthesis
The result of the present systematic review shows varied results, as different type of leadership styles found to have positive or negative correlation with employee engagement and job satisfaction. Around six studies have guided research on the impact of transformational leadership style either on employee engagement or job satisfaction. As in a study the constructive role of transformational leadership has been found that can enhance motivation, reduce burnout among healthcare professionals, and ultimately improve job satisfaction (Risambessy et al., 2012). Further, in two more studies the positive association of transformational leadership and job satisfaction has been which indicate robust direct effects of the transformational leadership style of leaders in healthcare facilities on the job satisfaction of employees (Specchia et al., 2021; Jankelová and Joniaková, 2021).
Research additionally demonstrates that transformational leadership benefits employee loyalty in the medical field. An outcome of the research suggests the nurse managers’ use of both transformational and transactional managerial styles benefits staff nurses’ involvement at work (Manning, 2016). Some of studies have shown a favourable correlation between worker engagement and the approach used by transformational leaders (Asiri et al., 2016; Abasilim, Gberevbie, and Osibanjo, 2019). In contrast, analysts discovered in their research that getting involved provides a key mediating component connecting honest management and work engagement (Giallonardo, Wong, and Iwasiw, 2010). Moreover, one study has elucidated the causal relationships between job satisfaction and commitment, underscoring the pivotal role of participative leadership in shaping these aspects of employee attitudes (Mosadeghrad and Ferdosi, 2013).
On the other hand, a study by Leary et al. (2013) discussed the role of dysfunctional leadership in employee engagement and job satisfaction and concluded that leadership behaviours characterised by intimidation and avoidance have a significant relationship with employee engagement, job satisfaction, and burnout. Few studies have discussed transactional leadership along with the other two variables of the study. As per the view point of Manning (2016) and Asiri et al. (2016), transactional leadership styles exhibited by nurse managers have a positive impact on staff nurse work engagement. While, in one study transactional leadership style exhibited an inconsequential, minor negative relationship with employees’ engagement (Abasilim, Gberevbie and Osibanjo, 2019). Moreover, in one study both the passive-avoidant and laissez-faire leadership styles displayed consistent negative correlations with job satisfaction (Specchia et al., 2021). However, in one study ethical leadership has been found to have positive correlation with the employee job satisfaction (Ahmad and Umrani, 2019). Further, as per the findings of Specchia et al. (2021) servant leadership has been found to have positive correlation with employee job satisfaction.
3.2 Discussion
3.2.1 Summary of Major Findings
The outcomes of the current systematic review reveal a range of findings, with different leadership styles showing both positive and negative correlations with employee engagement and job satisfaction. Approximately six studies have investigated the impact of the transformational leadership style, either on employee engagement or job satisfaction that satisfies the needs of the first objective of the present systematic review. In most of the studies under review, the constructive influence of transformational leadership was identified, highlighting its potential to boost motivation, decrease burnout among healthcare professionals, and ultimately enhance job satisfaction. Moreover, in two additional studies, a positive gathering between transformational leadership and job fulfilment was observed, with researchers affirming that the study results demonstrate strong direct effects of leaders’ transformational leadership style within healthcare settings on employee job satisfaction. In two additional studies, researchers have affirmed a positive association between the transformational leadership style and employee engagement. Therefore, the transformational leadership style was found to be correlated the employee engagement and job satisfaction. Moreover, transactional leadership style was also found to have a positive association with employee engagement and job satisfaction. Nevertheless, in another study, ethical leadership was identified as having a positive correlation with employee job satisfaction. Servant leadership style has also included among the leadership styles which have a positive association with the employee job satisfaction. However, in a specific study, both passive-avoidant and laissez-faire leadership styles consistently exhibited negative correlations with job satisfaction. Moreover, dysfunctional leadership also have a negative association with employee job satisfaction.
3.2.2 Situate the Research Findings within the Broader Context of Current Knowledge
In line with the findings of earlier studies reported in the literature, this review emphasises that there is a strong correlation between leadership styles and job satisfaction, employee engagement, regardless of sample characteristics, work environment, location, or leadership approach used. Particularly, just three of the nine studies included in this analysis failed to find any connection between leadership style, particularly transactional leadership, and nurses’ work satisfaction. The remaining research, on the other hand, consistently found meaningful positive or negative associations between the two variables under study. Our results further support the notion that, in comparison to leaders who follow a transactional leadership style, those who adopt a transformational leadership style likely to create better levels of work satisfaction among nursing staff. This is consistent with other studies that highlight the beneficial effects of an open, two-way communication strategy on employee work satisfaction (Gazi et al., 2022).
When it comes to managing and coordinating staff, the laissez-faire and passive-avoidant leadership styles are the least productive. This study emphasises the strong direct relationship between these specific leadership philosophies and employee professional satisfaction (Puni, Mohammed and Asamoah, 2018). Even though not all of these investigations were carried out in nursing situations, these findings are consistent with earlier research. The inherent pressure that these leadership styles put on people to reach predefined goals without the direction and support—either practical or emotional—that they need may be what unites these results. Both leadership philosophies leave employees to choose their own objectives, targets, and decision-making procedures since they lack clear direction. Present research identifies situations in which the transactional leadership style might have the least negative effects on nurses’ work satisfaction. This is consistent with the body of research that contends that the transactional leadership style is the worst predictor of job satisfaction (Alkassabi et al., 2018).
3.2.3 Limitations of the Review
This study has a number of limitations that need to be carefully considered. It was possible to identify a sizable number of eligible studies, but it was impossible to conduct a thorough meta-analysis to ascertain the overall size and direction of the impact due to the wide range in research designs, methodology, and results. Additionally, just two reviewers handled the task of collecting data from the abstracts, assessing the risk of bias, and screening them for mistakes or the omission of pertinent research. There was also no validation phase to guarantee precision and inclusion. Not all attempts to contact the primary research authors were successful in getting a response within the time range for the review due to scheduling restrictions. Four writers were contacted in an attempt to collect entire copies of their possibly pertinent dissertations, but only one author responded with the needed information. It is crucial to remember that this evaluation was limited to papers written in English, which might have introduced bias. The likelihood of missing important non-English literature is highlighted by research that indicates statistically significant discoveries are more likely to be published in English.
4 Conclusion and Recommendations
4.1 Conclusion
Investigators explored the intricate relationships between methods of management, employee drive, and work contentment in medical facilities in this cautious study. The primary objective was to learn how different leadership philosophies influenced those important elements of the healthcare sector. The evaluation of the information from numerous investigations revealed major findings with major repercussions for both the leadership of health care organisations and future research endeavours.
4.2 Recommendations
4.2.1 Implications for Healthcare Leadership
Investigators revealed a significant relationship between principles of management and workers’ satisfaction with their work and involvement with health care settings. More specifically, studies suggests that transformational management is a dynamic positive quality that appears to be associated to job fulfilment and employee involvement. This style of leadership prioritises encouragement, inspiration, and innovation, which has been proved to boost employee retention in the healthcare sector, reduce stress, and subsequently enhance employee satisfaction. If healthcare managers wish to foster a more engaged and happy workers, they ought to consider about introducing transformational leadership. Furthermore, there is a beneficial connection between satisfaction with work and staff involvement and managerial behaviour, which is characterised with straightforward goals and rewards. Throughout healthcare settings, implementing such management concepts may contribute to the building of a more upbeat motivated work environment. Evidence has demonstrated that healthcare workers who experienced ethical leadership—which promotes ethical behaviours and principles—have higher levels of fulfilment in their jobs. Since servant leadership focuses an increased emphasis on assisting others and fostering a supportive work environment, satisfaction at work additionally demonstrated a beneficial relationship with it. The results show that different styles of leadership could enhance health care worker commitment and health.
4.2.2 Management of Negative Correlations
The present analysis revealed the negative correlations between leadership philosophies and work satisfaction. Negative relationships between passive avoidance and laissez-faire leadership and work satisfaction were consistently present. Employee job satisfaction demonstrated a negative correlation with dysfunctional leadership, which is characterised by disengagement and negative behaviours. The negative effects of applying leadership ideologies on healthcare workers’ job satisfaction are demonstrated by these results. Leaders in the healthcare industry should be cautious when contemplating dysfunctional, laissez-faire, or passive-avoidant leadership styles since they have the potential to lower employee job satisfaction. They should be considering the strong communication to enhance transparency and build a supportive work culture.
4.2.3 Guidelines for Practise
Many suggestions for medical practice can be presented considering the results of present systematic investigation. First and foremost, it is suggested that healthcare institutions should fund leadership development initiatives that emphasise strengthening leaders’ transformational, transactional, ethical, and servant leadership capacities. These programmes can give managers the tools they need to motivate and engage their staff, which will eventually improve the job satisfaction of healthcare professionals (Gazi et al., 2022). A popular way to promote positive working conditions is to encourage healthcare staff members in exercising ethical and servant leadership. A strong focus on ethical and moral behaviour and an obligation to assisting others could give rise to a greater sense of fulfilment as a heath expert. Addressing dysfunctional, laissez-faire, and passive-avoidant leadership styles, healthcare companies ought to become cognisant of how these strategies can adversely affect staff satisfaction.
4.2.4 Recommendations for future research
Despite the fact that the research we conducted revealed significant information, some of the dimensions of research area still needs to be explored. It must undergo additional study in order to determine the ways that various leadership approaches effect staff loyalty and satisfaction with their work in healthcare organisations. To offer a deeper comprehension of the subject at hand, academics in this field might include the points of view and expertise offered by healthcare experts in the field. Furthermore, longitudinal research may help to clarify the long-term impacts of leadership styles on employees’ performance outcomes. Research needs to look into factors including organisational culture, job demands, and individual traits as possible moderators and mediators of these interactions. Beside this it is crucial to address any potential restrictions encountered by leaders caused by linguistic prejudice. In conclusion, this systematic analysis has shown the nuanced interplay in healthcare organisations between leadership styles, staff engagement, and work satisfaction. While passive-avoidant, laissez-faire, and dysfunctional leadership styles have shown negative associations, transformational, transactional, ethical, and servant leadership styles have been linked to favourable outcomes. Healthcare organisations may build a more engaged and content staff, eventually improving the quality of care given to patients, by employing evidence-based leadership practises and continuing to investigate these links.
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6 Appendices
6.1 Appendix 1: Table of studies excluded at full text reading
Sr No. Study Reference Population
1 Purba, C., 2021. Digital transformation in the Indonesia manufacturing industry: the effect of e-learning, e-task and leadership style on employee engagement. International Journal of Data and Network Science, 5(3), pp.361-368. Technology sector
2 Abbas, M., 2017. The effect of organisational culture and leadership style towards employee engagement and their impact towards employee loyalty. Asian Journal of Technology and Management Research (AJTMR) ISSN, 2249, p.0892. Technology sector
3 Zhao, R. and Sheng, Y., 2019. The effect of leadership style on employee engagement: The moderating role of task structure. Open journal of social sciences, 7(7), pp.404-420. Hotel and Tourism
4 Pratama, S.A., 2022. Literature Review The Effect Of Leadership Style And Work Culture On Job Satisfaction And Performance. Dinasti International Journal of Education Management And Social Science, 3(5), pp.743-753. Education sector
5 Erwin, S., Rahmat, S.T.Y., Angga, N.D. and Semerdanta, P., 2019. Transformational leadership style and work life balance: The effect on employee satisfaction through employee engagement. Russian Journal of Agricultural and Socio-Economic Sciences, 91(7), pp.310-318. Agriculture sector
6 Wen, T.B., Ho, T.C., Kelana, B.W.Y., Othman, R. and Syed, O.R., 2019. Leadership styles in influencing employees’ job performances. International Journal of Academic Research in Business and Social Sciences, 9(9), pp.55-65.
Public sector
7 Sims, C.M., 2018. The diversity intelligent servant leader: Developing leaders to meet the needs of a diverse workforce. Advances in Developing Human Resources, 20(3), pp.313-330.
Manufacturing sector
6.2 Appendix 2: Critical appraisal tool
Figure 2: AMSTAR Checklist
Figure 3: CASP Checklist
Completed search summary for at least one full database search.
Supervisor checklist, signed and dated by supervisor.