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. 2019 Jul 4;16(13):2381.
doi: 10.3390/ijerph16132381.

Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment

Muhammad Asif  1 , Arif Jameel  1 , Abid Hussain  1 , Jinsoo Hwang  2 , Noman Sahito  3
Affiliations

Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment

Muhammad Asif et al. Int J Environ Res Public Health. .

Abstract

The purpose of this study was to examine the relationships between transformational leadership (TL), structural empowerment (SE), job satisfaction (JS), nurse-assessed adverse patient outcomes (APO), and the quality of care (QOC). The study further investigates the mediating effects of SE and JS on TL-APO and TL-QOC relationships. A total of 600 nurses working at 17 government hospitals in Pakistan completed the survey. The hypothesized model was tested using a confirmatory factor analysis and structural equation modeling. We found a positive relationship between TL, SE, JS, and QOC but negative relationships between TL and APO, SE and APO, and JS and APO. Our study further suggests that SE and JS strongly mediate both TL-APO and TL-QOC relationships.

Keywords: Pakistan; government hospitals; job satisfaction; nurse-assessed adverse patient outcomes; quality of care; structural empowerment; transformational leadership.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The results of the structural equation modeling (SEM) for mediation effects.
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