Impact of Nursing Leadership Styles on the Staff Turnover Intention in Saudi Arabia: A Cross-Sectional Study

Abstract

Background and objectives The efficiency of healthcare systems and nursing care depends on appropriate leadership. The purpose of this study was to determine the association between leadership styles of nurse managers and the staff turnover intention in Saudi Arabia. The nurses' intention to quit their jobs was considered as indicative of staff turnover intention. Methods A quantitative cross-sectional questionnaire-based study was conducted among 279 nurses, employed in three hospitals in Hafar Al-Batin City, Saudi Arabia. The questionnaire comprised three parts to determine the association between leadership styles of nurse managers and staff turnover intention, and how they related to participants' demographic variables (gender/age/education/income/marital status/experience). The first part collected demographic data, and the second part was an adapted and validated version of the multifactor leadership questionnaire (MLQ-6S) used to assess the perceived leadership styles of nurse managers, based on 21 items. The third part, comprising seven items, was used to assess nurses' turnover based on intention to quit. The second and third parts of the questionnaire were scored using a five-point Likert scale. Collected data were tabulated and analyzed using a statistical software package for descriptive and inferential statistics (t-test, one-way analysis of variance (ANOVA), and correlation), comparing dependent outcome variables against independent demographic variables. Statistical significance was assumed when p-value was less than 0.05. Results Based on leadership style scores, transactional (13.32 out of a maximum of 24; 55.48%) and transformational (26.58 out of a maximum of 48; 55.37%) leadership were the most frequently perceived leadership styles among nurse managers. Laissez-faire leadership (6.31 out of a maximum of 12; 52.57%) was the least frequently perceived style. Upon comparing perceived leadership styles of nurse managers against demographic variables, no significant differences were observed for transformational leadership. However, income and experience of nurses showed significant relationship with the perceived transactional and laissez-faire leadership style scores, respectively. Based on perceived "intention to quit" scores, majority of the nurses expressed uncertain intention to quit (n = 193; 69.2%) and there was a significant yet weak negative correlation between the perceived leadership styles and intention to quit. The correlation coefficient (Pearson's-r) was lowest for laissez-faire leadership (-0.258) followed by transactional (-0.295) and transformational styles of leadership (-0.348). Conclusions The present study indicated a greater degree of transactional and transformational leadership styles among nurse managers than laissez-faire leadership style. While most of the nurses mentioned an uncertain intention to quit, correlating it with the perceived leadership styles it was found that transformational leadership among nurse managers indicated greater retention of nurses within their present jobs. The present research findings underline the importance of prioritizing and fostering healthy workplace environment by the nurse managers, through inculcation of transformational leadership practices. Furthermore, focused, multi-centric studies from around the world can help understand the leadership practices of nursing leaders and its relationship with the intention of nurses to quit their respective roles.

Keywords: leadership styles; nurse retention; nurse turnover; nursing leadership and management; registered nurse.

Figure 1. Frequency distribution of participants according to their intention to quit and based on the different demographic variables.

Score ranges for "intention to quit": Low - less than or equal to 15; Uncertain - 16 to 25; High - greater than or equal to 26.