Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Yolanda Babenko-Mould

2nd Supervisor

Michael Kerr

Co-Supervisor

3rd Supervisor

Lisa Cranley

Affiliation

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto

Co-Supervisor

Abstract

Leadership plays a vital role in the creation and sustainment of healthy work environments that are both structurally and psychologically empowering. Authentic leaders are instrumental in creating the conditions necessary to facilitate such environments for nurses in acute care contexts. By extension, healthy work environments are invaluable to enabling early career nurses (ECN) to focus on providing optimal care to clients in collaboration with their colleagues. Such collegial relationships in practice can support ECNs’ satisfaction in their role and desire to remain in their practice contexts and the nursing profession.

A non-experimental, predictive, correlational, cross-sectional survey design study was used to assess the relationship between authentic leadership, structural empowerment, psychological empowerment, interpersonal conflict, job satisfaction, and turnover intention among ECNs (n=215) working at public hospitals affiliated with the Ministry of Health in Saudi Arabia. The hypothesized model was analyzed using structural equation modelling (SEM).

The results of this dissertation revealed that authentic leadership had a significant positive effect on structural empowerment and a significant indirect positive effect on psychological empowerment. Authentic leadership also had a significant indirect negative (inverse) effect on interpersonal conflict and a significant indirect and positive effect on job satisfaction. Structural empowerment had a significant direct effect on psychological empowerment and on job satisfaction, and a significant negative (inverse) direct effect on interpersonal conflict. Psychological empowerment was found to be significantly and positively related to interpersonal conflict, job satisfaction, and turnover intention. The results showed that interpersonal conflict had a significant and positive effect on turnover intention, whereas job satisfaction had a significant negative (inverse) effect on turnover intention.

The results reinforce the importance of authentic leadership in facilitating structural empowerment, which subsequently fosters psychological empowerment of ECNs working in Saudi Arabia. Findings highlight the influence that authentic leadership could have in reducing interpersonal conflict and increasing ECNs’ job satisfaction through enabling and creating empowering working conditions, which could ultimately support the delivery of quality and safe client care.

Summary for Lay Audience

Nursing leadership plays a substantial role in creating conditions that can lead to healthy work environments for nurses in general and early career nurses in particular. Authentic leadership is a positive, relationship-focused, leadership style that can be utilized to facilitate early career nurses’ transition to practice. Engagement in authentic leadership could help mitigate work environment challenges and support positive nurse and organizational outcomes such as promoting empowerment, thus decreasing interpersonal conflict, enhancing job satisfaction, and reducing turnover intention.

The current study investigated the influence of early career nurses’ perceptions of authentic leadership, structural empowerment, psychological empowerment, interpersonal conflict, and job satisfaction on turnover intention. The study data was obtained from Saudi early career nurses working at public hospitals affiliated with the Ministry of Health in Saudi Arabia. The results of this study revealed that authentic leadership had a significant and direct effect on structural empowerment and a significant and indirect effect on psychological empowerment. There was also a significant indirect negative effect of authentic leadership on interpersonal conflict and an indirect significant positive effect of authentic leadership on job satisfaction. Structural empowerment directly affected psychological empowerment and job satisfaction. Structural empowerment was also found to contribute to decreased interpersonal conflict among early career nurses. Psychological empowerment was significantly and positively related to interpersonal conflict, job satisfaction, and turnover intention. Interpersonal conflict is more likely to increase early career nurses’ turnover intention, whereas job satisfaction was found to contribute to reducing early career nurses’ intention to leave their jobs.

The results of this study contribute to nursing knowledge through the use of theory in research. In particular, the use of authentic leadership theory and Kanter's expanded model of empowerment in nursing practice in Saudi Arabia. The results supported that authentic leadership plays a role in creating a positive and healthy work environment. Nurse leaders who exhibit authentic leadership behaviours can contribute to reducing interpersonal conflict and increasing early career nurses’ job satisfaction by enabling and creating empowering working conditions. The result can also help guide nurse educators in nursing schools in Saudi Arabia to integrate a theoretical model of authentic leadership and expansion of Kanter’s model of empowerment in the nursing curriculum. Future studies are needed to examine the relationships between authentic leadership and other important nursing outcomes.

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Available for download on Monday, December 30, 2024

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