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. 2025 Aug 5;24(1):1025.
doi: 10.1186/s12912-025-03685-7.

Transformational leadership, psychological empowerment, work engagement and intensive care nurses' job performance: a cross-sectional study using structural equation modeling

Qian Huang  1 , Lina Wang  2 , Haitao Huang  3 , Haishan Tang  4 , Jie Liu  5 , Chaoran Chen  6   7
Affiliations

Transformational leadership, psychological empowerment, work engagement and intensive care nurses' job performance: a cross-sectional study using structural equation modeling

Qian Huang et al. BMC Nurs. .

Abstract

Background: The global nursing shortage has intensified the need for effective leadership strategies to enhance nurse performance and retain skilled staff, particularly in high-stress environments like intensive care units Transformational leadership has been recognized as a critical factor in improving nurses'job performance. However, the mechanisms underlying this relationship remain underexplored. This study investigates the direct impact of transformational leadership on ICU nurses'job performance and examines the mediating roles of psychological empowerment and work engagement.

Methods: A cross-sectional study was conducted. Between October to November 2024, a total of 584 intensive care nurses from China completed the survey, which included standard assessments on transformational leadership, psychological empowerment, work engagement, and job performance. Structural equation modeling was employed to analyze the direct and indirect effects of transformational leadership on job performance, with psychological empowerment and work engagement as mediators.

Results: The results indicated significant positive correlations among transformational leadership, psychological empowerment, work engagement, and job performance (all P < 0.01). Transformational leadership not only directly affected the job performance of intensive care nurses but also influenced it through the partial mediating roles of psychological empowerment and work engagement, with the mediating effects accounting for 24.64% and 21.74% of the total effect, respectively. Additionally, the analysis found that psychological empowerment and work engagement, played a chain mediating role in the relationship between transformational leadership and the job performance, with the mediating effect accounting for 15.94% of the total effect.

Conclusions: This study highlights the association between transformational leadership and ICU nurses' job performance, both directly and indirectly through psychological empowerment and work engagement. The findings suggest that transformational leadership is related to key psychological and behavioral factors that may support better job performance. Fostering transformational leadership behaviors may serve as a valuable approach for nursing managers to enhance psychological empowerment and engagement among ICU nurses, with potential benefits for patient care outcomes.

Clinical trial number: Not applicable.

Keywords: Job performance; Nurses; Psychological empowerment; Transformational leadership; Work engagement.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board of Henan Provincial Key Laboratory of Psychology and Behavior (Approval No. HUSOM2023-478). This study was conducted in strict accordance with the ethical principles outlined in the Declaration of Helsinki. Prior to distributing the questionnaire, informed consent was obtained from the nursing management departments of the participating hospitals. The purpose and significance of the study were thoroughly explained to all participants to ensure their understanding of the research. On this basis, informed consent was obtained from all participants, who voluntarily signed the consent form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The mediating roles of psychological empowerment and work engagement in the relationship between transformational leadership and job performance. Abbreviations: MM, Morale Modeling; IC, Individualized Consideration; SE, Self-efficacy; MW, Meaning of Work; AU, Autonomy; WIT, Work Impact; WC, Work coordination; WE, Working enthusiasm; WI, Work involvement; ***P < 0.001
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References

    1. Yu JF, et al. Professional identity and emotional labour affect the relationship between perceived organisational justice and job performance among Chinese hospital nurses. J Nurs Manag. 2022;30(5):1252–62. - PubMed
    1. Wang J, et al. Nurses’ colleague solidarity and job performance: mediating effect of positive emotion and turnover intention. Saf Health Work. 2023;14(3):309–16. - PMC - PubMed
    1. Al-Ajarmeh DO, et al. Nurse-nurse collaboration and performance among nurses in intensive care units. Nurs Crit Care. 2022;27(6):747–55. - PubMed
    1. Fusaro MV, Becker C, Scurlock C. Evaluating Tele-ICU implementation based on observed and predicted ICU mortality: A systematic review and Meta-Analysis. Crit Care Med. 2019;47(4):501–7. - PubMed
    1. Gabbard ER, et al. Clinical nurse specialist: A critical member of the ICU team. Crit Care Med. 2021;49(6):e634–41. - PubMed

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