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Influence of nurse and midwife managerial leadership styles on job satisfaction, intention to stay, and services provision in selected hospitals of Rwanda.

ABSTRACT: BackgroundNurses and midwives are a critical part of the healthcare team and make up the largest section of health professionals. Leadership styles are believed to be an important determinant of job satisfaction and retention making effective leadership within nursing and midwifery crucial to health systems success. In Rwanda, there are gaps in knowledge of managerial leadership styles of nurses and midwives and the influence of these styles on job satisfaction and retention for nurses and midwives who report to them, as well as their influence on the provision of health services. This study describes the managerial leadership styles adopted by nurses/midwives and examines the relationship between managerial leadership styles and job satisfaction, intention to stay, and service provision.MethodsThe Path-Goal Leadership questionnaire was adopted and used to collect data on leadership styles while other questionnaires with high validity and reliability were used to collect data on job satisfaction, intention to stay and service provision. The study involved 162 full-time nurses and midwives practicing in 5 selected hospitals with a minimum of 6 months of experience working with their current direct managers. Regression analysis was used to draw conclusions on relationships between variables.ResultsNurses and midwives managers were more inclined to the directive leadership style followed by a supportive leadership style, and the participative leadership style. The nurse and midwife’s managerial leadership styles together significantly explained 38, 10 and 23% of the variance in job satisfaction, intention to stay and service provision, respectively.ConclusionThe findings of this study indicate that managerial leadership styles play a substantial role in enhancing job satisfaction, intention to stay and service provision.The implication for nursing and midwifery managementThere is a need to develop a comprehensive formal professional continuous development course on leadership styles and ensure that all nurses and midwives managers benefit from this course prior to or immediately after being appointed as a manager. Having such a course may even prepare future leaders for their role early in their career. Effective leadership in nursing and midwifery should be enhanced at all levels to improve the job satisfaction of nurses and midwives, address the issue of retention in their respective health facilities and strengthen service provision.

SUBMITTER: Ngabonzima A

PROVIDER: S-EPMC7201775 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Project description:A shortage of competent health-care providers is a major contributor to poor quality health care in sub-Saharan Africa. To increase the retention of skilled health-care providers, we need to understand which factors make them feel satisfied with their work and want to stay in their job. This study investigates the relative contribution of provider, facility and contextual factors to job satisfaction and intention to stay on the job among health-care providers who performed obstetric care in Uganda and Zambia. This study was a secondary analysis of data from a maternal and newborn health program implementation evaluation in Uganda and Zambia. Using a Likert scale, providers rated their job satisfaction and intention to stay in their job. Predictors included gender, cadre, satisfaction with various facility resources and country. We used the Shapley and Owen decomposition of R2 method to estimate the variance explained by individual factors and groups of factors, adjusting for covariates at the facility and provider levels. Of the 1134 providers included in the study, 68.3% were female, 32.4% were nurses and 77.1% worked in the public sector. Slightly more than half (52.3%) of providers were strongly satisfied with their job and 42.8% strongly agreed that they would continue to work at their facility for some time. A group of variables related to facility management explained most of the variance in both job satisfaction (37.6%) and intention to stay (43.1%). Among these, the most important individual variables were satisfaction with pay (20.57%) for job satisfaction and opinions being respected in the workplace (17.52%) for intention to stay. Doctors reported lower intention to stay than nurses. Provider demographics and facility level and ownership (public/private) were not associated with either outcome. There were also differences in job satisfaction and intention to stay between Ugandan and Zambian health-care providers. Our study suggests that managers play a crucial role in retaining a sufficient number of satisfied health-care providers providing obstetric care in two sub-Saharan African countries, Uganda and Zambia. Prioritizing and investing in health management systems and health managers are essential foundations for high-quality health systems.

Project description:There is general agreement that styles of leadership evolved from mammalian group living strategies that form social ranks. In both non-human primates and humans, different styles of hierarchical dominant-subordinate and leader-follower behavior can be observed. These can be described in terms of dimensions of antisocial (relatively self-focused, aggressive and threat-based) and prosocial (relatively empathic, caring, and supportive) interpersonal styles. The aim of this study was to explore how a set of established self-report questionnaires might relate to these two dimensions. Two hundred and nineteen students completed questionnaires assessing ruthless self-advancement, coalition building, and dominant leadership styles, as well as hypercompetitiveness, narcissism, striving to avoid inferiority, compassion focused and ego focused goals, fears of compassion, social safeness and attachment (in)security. A principal component analysis supported an antisocial leadership style factor which comprised of ruthless self-advancement, narcissism and hypercompetitiveness. This was significantly correlated with fears of compassion, ego focused goals, insecure striving (striving to avoid inferiority), fears of losing out, fears of being overlooked, fears of being rejected, and avoidant relating in close relationships. It was significantly negatively correlated with compassionate goals. As the results did not reveal a clear factor solution for a prosocial leadership style, we chose to use the coalition building leadership style variable. This showed the opposite pattern, being significantly negatively correlated with narcissism, hypercompetitiveness, fears of compassion, fears of active rejection, and avoidance in close relationships. It was significantly positively correlated with secure striving, compassionate goals, and social safeness. We also found that fears of compassion for others was a partial mediator of the relationship between insecure striving with antisocial leadership style. Moreover, lower fears of compassion for the self emerged as a key mediator for the relationship between non-avoidant attachment with coalition building leadership style and, secure non-striving with coalition building leadership style. While the motive to accumulate social power, resources and dominance may be linked to antisocial forms of leadership, the intensity of the drive may also be linked to unaddressed threats and fears of rejection and fears of compassion. Efforts to promote more ethical, moral and prosocial forms of leadership may falter if such fears are left unaddressed.

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Influence of nurse and midwife managerial leadership styles on job satisfaction, intention to stay, and services provision in selected hospitals of Rwanda.

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