Leadership in Health Services最新文献

Purpose: This study aims to examine the mediating role of employee engagement in the relationship between adaptive leadership and service quality within the health-care sector in Ethiopia.

Design/methodology/approach: A quantitative research design was adopted, using a cross-sectional survey method. Data was collected from health-care professionals through structured questionnaires. Partial least squares structural equation modeling was used to analyze the hypothesized relationships.

Findings: This study found that adaptive leadership (ADL) indirectly enhances service quality (SVQ) through employee engagement (EME). While ADL had no direct effect on SVQ, it positively influenced EME, which, in turn, significantly improved SVQ. These findings emphasize the critical role of employee engagement in translating leadership into better service outcomes in health-care setting.

Practical implications: The findings offer valuable insights for health-care managers and policymakers, emphasizing the need for ADL strategies that foster employee engagement to improve SVQ.

Originality/value: This study uniquely examines how ADL translates into improved health-care SVQ through the engagement of frontline staff in a dynamic and resource-constrained environment.

Purpose: This study aims to investigate autonomy support and self-valuation as potential mechanisms by which supportive leadership improves physician well-being. Supportive leadership is one of the strongest predictors of physician well-being. However, mechanisms by which leadership behavior influences well-being remain unknown. The authors hypothesized that autonomy support and self-valuation mediate this relationship.

Design/methodology/approach: This was a cross-sectional survey-based study of physicians in a tri-hospital cardiovascular health system in southwestern USA. An anonymized multidimensional questionnaire comprising standardized and pre-validated measures of leadership behavior, self-valuation, autonomy support, fulfillment and burnout was e-mailed to 815 eligible physicians in February 2024. Hypothesized multivariable pathways were investigated via structural equation modeling.

Findings: In total, 122 participants answered the survey, 99 providing complete responses. Respondents were 75.76% male, 54.54% aged 41 to < 65 years, 44.44% white, 21.21% Asian and 52.52% in practice for ≥ 15 years. Reliabilities of ordinal scales were all ≥ 0.700, and univariate correlations were in expected directions. Fully, 24.24% of respondents were burned out, 63.64% professionally fulfilled, 70.71% had high autonomy support and 55.56% high self-valuation. Indirect effects of leadership support on fulfillment and burnout, mediated via autonomy support and self-valuation, were more significant than direct effects. Findings supported the study hypothesis that leadership support improves fulfillment and reduces burnout among physicians partly by fostering autonomy and self-valuation.

Originality/value: Autonomy support and self-valuation within physician teams are highlighted as factors whose improvement well-being-centered leadership training programs specifically should target.

Purpose: The implementation of artificial intelligence (AI) in health care presents significant opportunities for improving efficiency, decision-making and patient outcomes. However, health-care leaders often face resistance and multiple challenges in adopting AI technologies, leading to slow and inconsistent implementation. This study aims to explore the perspectives of health-care leaders in Uganda regarding AI adoption, focusing on barriers, innovation drivers and strategic considerations necessary for effective AI integration.

Design/methodology/approach: The study used a qualitative, exploratory approach using semi-structured interviews with 24 leaders from various public health-care institutions in Uganda. Data collection took place from December 2023 to February 2024. The analysis was conducted using qualitative content analysis with an inductive approach to identify key themes related to AI implementation challenges and strategies.

Findings: The study identified three main categories of challenges affecting AI implementation in Uganda's health-care system: External Constraints, including regulatory gaps, limited funding and infrastructure deficits; Institutional Capacity for Change Management, highlighting resistance to change, lack of technical expertise and inadequate leadership support; and Transformation of health-care practices, which includes concerns about AI's impact on job roles, ethical considerations and data security. Despite these challenges, health-care leaders acknowledged AI's potential to enhance service delivery, improve diagnostic accuracy and optimize health-care workflows.

Practical implications: The findings underscore the need for targeted implementation strategies, including investment in AI education and training for health-care professionals, the development of clear policies and regulatory frameworks and fostering collaboration between health-care institutions, policymakers and technology providers. Strengthening leadership capacity in change management and ensuring ethical AI deployment are crucial for successful adoption.

Originality/value: This study contributes to the limited body of research on AI adoption from the perspective of health-care leaders in developing countries, particularly in Uganda. Unlike previous studies that focus on general AI acceptance, this research provides a leadership-centric analysis of the barriers and strategic approaches necessary for AI implementation. The insights generated can inform policymakers, health-care administrators and technology developers on designing more effective AI adoption frameworks tailored to resource-constrained settings.

Purpose: This study aims to explore the archetypes of bad leaders as perceived by Finnish physicians across various hierarchical levels. Understanding these archetypes is essential for addressing leadership deficiencies and mitigating the detrimental effects of bad leadership and the positivity bias in leadership research.

Design/methodology/approach: Data were collected through in-person, semi-structured interviews with Finnish physicians (n = 50), including residents, specialists, heads of departments and chief physicians. Inductive content analysis, followed by thematization, was used to identify recurring themes and patterns of bad leadership behaviors. Initial codes were generated and subsequently categorized into archetypes of bad leadership, which were further organized into broader thematic categories of bad leadership.

Findings: Based on our findings, the authors identified four main themes of bad leadership encompassing seven archetypes of bad leaders, addressing incompetence, lack of transparency, exploitation, bad workload management, bullying, psychological harassment and inequity: lack of support and accessibility (absent and dismissive), authoritarianism and abuse of power (autocratic, bully and manipulative), incompetence and ineffectiveness (incompetent) and unfairness and discrimination (unfair). These issues occurred occasionally in different situations.

Practical implications: The findings indicate that a leader's behavior and leadership style directly affect physicians' well-being and work satisfaction, potentially contributing to higher physician turnover and reduced quality of patient care. These results underscore the importance of fostering leadership education that emphasizes communication skills, emotional intelligence and conflict resolution to enhance constructive leadership behaviors.

Originality/value: To the best of the authors' knowledge, no prior empirical research has specifically examined the archetypes of bad physician leaders.

Purpose: The purpose of this paper is to investigate the experiences of engaging leadership and work recovery among preparers of a major health-care and social services reform in Finland in 2022; to investigate whether engaging leadership was associated with work recovery; and to investigate whether engaging leadership alleviated the harmful effect of job demands on work recovery.

Design/methodology/approach: Altogether 258 reform preparers participated in four job well-being surveys. Means and paired t-test were used to measure engaging leadership and work recovery during the study period. Hierarchical multiple linear regression analysis was used to analyze associations between engaging leadership, job demands and recovery from work.

Findings: Experiences of engaging leadership and recovery from work decreased during the study period. A change in engaging leadership had a small positive association with work recovery at endpoint. A change in job demands had a stronger association with work recovery at endpoint. Engaging leadership did not alleviate the association between job demands and recovery from work.

Originality/value: This study expands previous work recovery literature by demonstrating that engaging leadership style can improve work recovery during health and social care reforms. However, engaging leadership style alone is insufficient to alleviate job demands, and therefore more effective management of job demands is needed. Practically, the findings can be used to plan and lead future reforms.

Purpose: This paper aims to evaluate the psychometric properties of the "rater" version of the Authentic Leadership Questionnaire in nursing practice within the context of Saudi Arabia.

Design/methodology/approach: The analysis of the psychometric properties of Avolio et al.'s Authentic Leadership Questionnaire (2007). This version of the Authentic Leadership Questionnaire was in the English language. A convenience sampling method was used to obtain data from 215 Saudi early career nurses working at public hospitals affiliated with the Ministry of Health in Saudi Arabia. Data analysis included assessing internal consistency (Cronbach's alpha) analysis and the exploratory factor analysis using the Statistical Package for Social Sciences version. Face and content validity were evaluated using a content validity index, and Mplus was also used to assess the factor structure of the Authentic Leadership Questionnaire by conducting confirmatory factors analysis.

Findings: The results of psychometric testing of the Authentic Leadership Questionnaire provide initial support for the content and construct validity and internal reliability of the instrument among early career nurses in Saudi Arabia.

Originality/value: The results supported that the 16 items of the rater's version of the Authentic Leadership Questionnaire measure nurses' perceptions of the authentic leadership of their leaders. The psychometric properties of the Authentic Leadership Questionnaire yield a valuable contribution to empirical research within the nursing population. The results of this study suggest that the Authentic Leadership Questionnaire will be useful for health service researchers and nursing leaders seeking to understand and capture authentic leadership qualities in Saudi Arabia.

Purpose: The purpose of this study is to explore the lived experience of leadership within outpatient physical therapists and to assess if the participants' lived experience of leadership is congruent with existing leadership theory.

Design/methodology/approach: Qualitative, in-depth, semi-structured interviews were conducted with eight outpatient physical therapists within a single southeastern state of the USA to discuss their lived experience with leadership within their professional roles. The data was analyzed inductively through in vivo coding, second cycle coding and development of themes.

Findings: The results of this study produced three themes surrounding the lived experience of leadership by outpatient physical therapists: How they lead, the important skills necessary to lead and the rewards of leadership.

Research limitations/implications: The lived experience of outpatient physical therapists appears to be congruent with transformational leadership theory. Researchers should consider using the transformational leadership theory framework to investigate and assess the effectiveness of leadership within physical therapy.

Originality/value: To the best of the authors' knowledge, this research is the first time that the perspectives of those living the experience of leadership in physical therapy have been sought out for their perspectives on what leadership is within the field, which has implications for future research, leadership development and assessment of effective leadership.

Purpose: Based on social exchange theory, this study aims to determine the relationship between inclusive leadership in their managers and organizational justice perceived by healthcare workers and work engagement and organizational citizenship behavior.

Design/methodology/approach: A cross-sectional and correlational study was performed by healthcare workers (n = 330) working in a city hospital for at least six months in Türkiye. Descriptive statistics, correlation and regression analysis were used in data analysis. The hypotheses were tested using Hayes' PROCESS macro (v4.1).

Findings: It was determined that inclusive leadership had a positive significant effect on organizational justice, work engagement and organizational citizenship behavior; and organizational justice had a positive significant effect on work engagement and organizational citizenship behavior. In addition, it was found that work engagement also had a significant effect on organizational citizenship behavior. It was found that organizational justice had a partial mediating role between inclusive leadership and work engagement, while its mediating role between inclusive leadership and organizational citizenship behavior was not statistically significant. In addition, work engagement was found to have a partial mediating role in the effect of inclusive leadership on organizational citizenship behavior.

Research limitations/implications: The limitations of this study can be summarized as follows: First, the data were collected from the employees in a hospital based on the self-reports of the participants. The fact that the study used a cross-sectional design limited the establishment of a causal relationship between variables. Since the study was planned during the COVID-19 period, the participants were reached through convenience sampling. Isolation measures due to the pandemic led to a lower response rate than expected. To reveal more generalizable results, it may be recommended to collect the data at different periods in future studies and to include different types of healthcare institutions.

Practical implications: Inclusive leadership of the healthcare managers will lead to positive employee outcomes by preventing the disadvantages brought by internal conflict in the work environment.

Originality/value: This study indicates that managers' inclusive leadership style will improve perceived organizational justice and work engagement and will lead employees to exhibit the desired extra-role behavior, such as organizational citizenship behavior.

Purpose: This study aims to test the nurses' authentic leadership's direct and indirect impact on job satisfaction and intent to stay through work-to-family conflict (WFC) in health-care organizations.

Design/methodology/approach: Data were gathered at three different time points from 262 nurses employed in public hospitals across Bangladesh. Hierarchical regression analysis using structural equation modeling and PROCESS Macro were used to test the hypotheses.

Findings: Findings disclosed that nurses' authentic leadership impacts job satisfaction, intention to stay and WFC. Moreover, WFC is identified as a mediator in the relationship between nurses' authentic leadership and job satisfaction and intent to stay.

Research limitations/implications: Due to the cross-sectional nature of the study, it does not establish a causal relationship among the study variables.

Practical implications: This research helps health-care managers understand the necessity of developing nurses' authentic leadership. By implementing training, development and mentoring programs, organizations can cultivate authentic leadership among the nurses' supervisors, which ensures higher job satisfaction and intention to stay.

Originality/value: Although many studies exist on the influence of authentic leadership on nurses' work-related outcomes, still no study explored the relationship between authentic leadership and WFC. Moreover, the study explores the indirect effect of authentic leadership on job satisfaction and intent to stay through WFC, which was ignored in earlier studies.