Posted: March 23rd, 2023
Organizational commitment plays a vital role in firms that perform exceptionally. The aspect is at the core of the positive performance and positive quality outcomes in health care settings. Commitment is linked to job satisfaction, and hence, it is an essential factor in the intention of nurses to remain in the organization. Organizational commitment prevents turnover and associated negative outcomes, such as the shortage of nurses (Somers, Birnbaum, Finch, & Casal, 2018). In organizational research, organizational commitment is an important concept. Various researchers have explored the concept as it relates to the behavior of nursing staff in the workplace. From the analysis, it is evident that organizations should consider human feelings and attitudes in the workplace. Increasing research proves that organizational commitment is a critical outcome variable in nursing and healthcare settings. Workplaces that lack commitment can have detrimental effects, such as poor performance (Hamdi & Rajablu, 2012). Therefore, healthcare organizations should consider the factors that relate to organizational commitment to manipulate them to enhance the concept in the firm.
The main concepts in the study are leadership style and organizational commitment. The current research will apply the definition of leadership as a process by which one person influences others to achieve a shared vision or goal. Therefore, the leadership style is the specific approach that the leader uses to influence others. Wong, Cummings, and Ducharme (2013) suggested that the quality of leadership style is measurable by considering the effect on the followers. Effective leadership ensures a conducive working environment for nurses. It determines the quality of care and optimal patient outcomes. The second concept in the study is organizational commitment, which depends on the effectiveness of the leadership style.
Organizational commitment is a critical construct when discussing behavioral aspects that affect the efficiency and performance of organizations. The construct is associated with job satisfaction among employees, such as nursing staff. Organizational commitment suggests the array of beliefs and feelings that people have about their workplace. The concept is critical in the intention of the nurses to stay in the organization for a long time (Al-Yami, Galdas, & Watson, 2018). Besides, it determines the levels of satisfaction among nurses in their organizations. The researcher will measure the concept by establishing the feelings and perceptions of nurses that promote retention.
Nurse turnover and intentions to leave because of burnout and other organizational factors are considerable problems in healthcare organizations around the world. Some countries, such as Saudi Arabia, have an insufficient number of nurses employed per 10,000 population. In the country, the number of nurses is 36 per 10,000 population, which is lower compared to other countries such as Bahrain (58/10,000), the United States (98/10,000), and the United Kingdom (101/10,000) (WHO, 2010 as cited in Al-Yami, Galdas, & Watson, 2018). Hence, given such a trend, Saudi Arabia largely depends on nurses from other countries. Regardless of efforts by the Saudi government, through “Saudization” to attract more nationals into the workforce, barriers remain, such as poor working conditions, inadequate family-work balance, and a negative image of nursing. Besides, cultural factors continue to prevail, which prevent women from pursuing careers in nursing (Al Hosis, Mersal, & Keshk, 2013). Moreover, job dissatisfaction is a critical factor that causes turnover in the country, necessitating effective leadership to address the problem.
Regardless of the vast amount of literature on organizational commitment, the factors that cause it have not been extensively explored in the Saudi Arabian context. From the research on the antecedents, correlates, and outcomes of organizational commitment, gaps remain in Saudi Arabia. Many of the current studies fail to mention the way variables relate to leadership style in the country’s nursing and healthcare settings. The research is critical in this area because some researchers have mentioned that leadership behavior and qualities might affect organizational commitment (Al-Yami, Galdas, & Watson, 2017). Leadership might affect the performance of an organization through such variables as commitment. However, research remains insufficient in determining the role of leadership approaches in organizational commitment to health care. The proposed study will empirically investigate the relationship between leadership style and organizational commitment in Saudi Arabia.
Considering the challenges involved in the provision of quality and safe care due to high nurse turnover, it is essential to establish the factors that are likely to improve retention. Retention is associated with a high level of satisfaction among nurses to promote their possibility of working for an organization longer. Various antecedents of job satisfaction are evident in previous research (Mosadeghrad & Ferdosi, 2013). The studies indicate the importance of effective leadership as a determinant of organizational commitment to health care. However, research is not exhaustive regarding the style of leadership that is likely to provide the best results in terms of organizational commitment. The proposed study will examine the connection between organizational commitment and leadership style among nurses in the Saudi Arabian context. The results of the study will have significant implications for nursing education, practice, research, and policy.
The findings of the study might prove the positive relationship between leadership style and organizational commitment. The results will be beneficial to nursing through leadership training to adopt the type of style that might have a positive impact on organizational commitment, satisfaction, and performance among nursing staff in Saudi Arabia. Besides, the findings will help nurse leaders to develop the necessary skills to support their followers to develop and achieve positive goals for their organization. Implementation of effective leadership will improve practice, especially in terms of the quality and safety of care that nurses provide to their patients. Research has proven that leaders play a critical role in the performance outcomes of their subordinates (Mosadeghrad, 2014). Therefore, nurse leaders should develop the most beneficial style to motivate employees to achieve positive results.
The results of the study can be significant for future research on the factors that affect organizational commitment among nursing staff. Research in the area is limited, especially in the Saudi Arabian context (Al-Yami, Galdas, & Watson, 2017). Therefore, current findings will inform further exploration in this area to improve organizational commitment among nurses in Saudi Arabia. In addition, the results will inform policy in nursing and healthcare leadership. Policy-makers in health depend on considerable research evidence to implement policies that improve the quality and safety of care provided to patients (Lavoie-Tremblay, Fernet, Lavigne, & Austin, 2016). The study has critical implications for leadership in healthcare systems in Saudi Arabia and across the world. It will help leaders to determine the most effective leadership style that would improve commitment and satisfaction, leading to enhanced performance in health care. Improved leadership and evidence-based healthcare policy will reduce turnover among nurses, which is a huge factor in the shortage of nurses in the country.
The purpose of this study is to examine the relationship between leadership style and organizational commitment among nursing staff in Saudi Arabia. The study will relate leadership style to organizational commitment among nursing staff. The researcher will collect data from healthcare settings in Saudi Arabia to accomplish the research purpose. Analysis of the data will demonstrate whether leadership style has an impact on organizational commitment among nursing staff in Saudi Arabia.
The model is based on transformational leadership, which is one of the most effective models linked to positive performance outcomes among the nursing staff and other employees in various organizational settings. Besides the leadership style, the model is founded on Burns’ (1978) conceptualization (as cited in Al-Yami, Galdas, & Watson, 2017). The model is useful in creating positive grounds for effective leadership and helps to develop the necessary skills and knowledge among leaders. Transformational leadership has other qualities, such as “charisma or idealized influence; inspirational motivation; intellectual stimulation, and individualized consideration, which tend to be positively associated with ‘emotional intelligence” (Echevarria, Patterson, & Krouse, 2017 as cited in Al-Yami, Galdas, & Watson, 2017, p. 532). Idealized influence is a quality among leaders capable of being role models in the organization. The model uses a laissez-faire approach in which leaders allow followers to make critical decisions that affect the organization.
While various other factors might affect commitment and other outcomes, such as performance, effective nursing leadership is one of the most effective aspects (Al-Yami, Galdas, & Watson, 2017). The leadership approach improves outcomes for nurses, patients, and the organization. Al-Yami, Galdas, and Watson (2017) reviewed a study conducted in the Netherlands that involved 699 nurses. The outcome of the study revealed that an effective leadership style reduced the rate of absence among nursing staff. Consequently, training nursing leaders to become effective could have positive effects on the workforce and the organization, such as reduced understaffing. The current study aims at exploring the association between leadership style and organizational commitment among nursing staff in Saudi Arabia.
The conceptual framework for the proposed study emanates from the research question and the hypothesis. The PICOT question for the study is: Among nursing staff (P), how does leadership style (I) compared to the lack of effective leadership (C) affect organizational commitment (O)? The researcher hypothesizes that effective leadership is an essential factor in improving commitment among nursing staff.
Transformational leadership theory will be used to inform the current research. James MacGregor Burns first proposed the concept of transformational leadership, suggesting the connection between the leader and followers through a motivational influence upon each other to achieve higher results. The relationship leads to a value system congruence between the two. Bernard M. Bass extended the original thoughts suggesting that all transformational leaders have a strong vision and personality. The theory relates to the current study because of the motivational aspect of the theory (Xu, 2017). For example, to achieve commitment outcomes, the leader must be able to motivate employees to achieve a high vision and objectives. Research evidence has revealed that such leaders create commitment and satisfaction among their followers. Besides, due to the effect of the style on individual and institutional outcomes, it is highly useful in all organizational settings.
In clinical settings, the theory is vital among leaders because they are expected to work as change agents. Nursing leaders should utilize their personalities and qualities to motivate their followers to achieve individual and organizational objectives. They should empower them to share a vision and work towards its realization. The theory helps leaders to create the necessary relationship with followers, a connection based on trust that can motivate them to make decisions that generate positive outcomes for the organization. The theory informs the current study because of the need for the leader to motivate commitment among nursing staff to achieve goals (Xu, 2017). Such leadership should create a sense of belonging to the organization and allow nurses to participate in making decisions, such as regarding patient care. The such workforce becomes committed to the organization. Therefore, transformational leadership is an essential factor in determining the level of commitment among nursing staff.
The concept refers to the process in which a person influences other people to achieve a vision and objectives. Leadership style is an approach that leads people, which relates to the characteristics and behavior of the leader. The concept involves the ability of a person to influence, motivate, and support employees to work towards organizational success (Mosadeghrad & Ferdosi, 2013). Leaders have several approaches of leadership they can use, such as “autocratic, bureaucratic, laissez-faire, charismatic, democratic, participative, transactional, and transformational leadership styles” (Mosadeghrad & Ferdosi, 2013, p. 121). However, none of the styles is universal because the leader can apply any depending on the situation.
The concept defines a psychological attachment of a member of staff to the organization. The feeling occurs at three levels: Affective, Continuance, and Normative. When individuals have Affective commitment, they are emotionally attached to the organization and its goals. Continuance commitment is common among people who are cognitively attached to the workplace because of the costs that might incur by leaving. Normative commitment is a typical feeling of obligation to continue working in an organization (Mosadeghrad & Ferdosi, 2013). The three types of engagement are critical for organizational success. Notably, they support workplace satisfaction and, ultimately productivity.
The review of literature focused on recent articles on the subject of leadership, styles, and organizational commitment. The researcher searched online databases to obtain sources that relate to the topic, written in English, and published between 2012 and 2019. The search generated hundreds of sources, but most of the articles related to organizational commitment were on other subjects outside nursing and health care, such as management. Therefore, after filtering the sources, only 12 were found relevant for inclusion in the review.
Leadership is critical in organizations because it is the process through which a person (the leader) influences others to realize organizational objectives. Xu (2017) adds that leadership is a process by which an individual influences followers to comprehend and agree with the objective and how to achieve it, as well as facilitating personal and common attempts to achieve goals. It is the art of influencing and motivating others to work towards organizational vision and goals (Mosadeghrad & Ferdosi, 2013). From the definition, leadership is a critical part of the organization and plays a role in efficiency maximization. Effective leadership in clinical settings is an essential element in the achievement of quality care and a successful workforce (Lavoie-Tremblay, Fernet, Lavigne, & Austin, 2016). Within the healthcare sector, the significance of effective leadership is evident in research and practice.
Effective leadership is based on the type of style the leader uses to influence followers. A leadership style is a particular approach that a leader uses to inspire followers to work toward organizational effectiveness (Xu, 2017). Leadership can engage some of the commonly used styles, such as “autocratic, bureaucratic, laissez-faire, charismatic, democratic, participative, transactional, and transformational leadership styles” (Mosadeghrad & Ferdosi, 2013, p. 121) based on the circumstances. However, some styles, such as transformational leadership are more effective than others in nursing.
Research has revealed the role of commitment in the intention to continue working in a healthcare organization. Somers, Birnbaum, Finch, and Casal (2018) define organizational commitment as the psychological state guiding a course of action toward a particular target. It occurs in three types: affective, continuance, and normative (Mosadeghrad & Ferdosi, 2013). Commitment creates a mindset of attachment to the workplace. Various factors affect the level of attachment to the organization, including effective leadership. The style of leadership used in an organization determines the level of commitment. An effective leader empowers employees to improve their work. The leader creates a productive environment for the staff to work towards achieving goals and objectives (Giddens, 2018). Employees follow the communicated vision to create a culture characterized by commitment and performance. It also motivates and sustains the quality of care and patient safety.
Effective leaders in healthcare settings play an essential role in improving outcomes for nurses, patients, and the entire organization. Research has revealed that leaders who are supportive of their subordinates impact a sense of duty toward the organization. They motivate them to remain committed to the organization and the workplace. Leadership might affect the decision of employees to continue working in an organization. Besides, researchers have revealed that organizational commitment can support productivity in the healthcare setting to improve the quality of care provided to patients. Employees who are committed to the organization because of effective leadership have a high level of performance and productivity (Hamdi & Rajablu, 2012).
The prevailing nursing leadership style relates to organizational commitment and eliminates dissatisfaction among the nursing staff in healthcare facilities. It is a significant factor in eradicating turnover and intentions to leave; hence, promoting nursing retention (Lavoie-Tremblay, Fernet, Lavigne, & Austin, 2016). Research is available that associate nurse retention with job satisfaction (Abualrub & Alghamdi, 2012). Besides, the variables relate positively to effective leadership style in healthcare organizations.
Regardless of the evidence of effectiveness in leadership style and the effect on nursing staff commitment, gaps remain prevalent in research. For example, in Saudi Arabia, research on the connection between leadership style and staff commitment and empowerment remains inadequate. Specifically, the work commitment construct remains untested within the context of Saudi Arabia. Therefore, additional research is necessary to test the relationship between the two variables from the nursing context in Saudi Arabia. The researcher will conduct the study in Medinah, Saudi Arabia.
The literature review covers 12 sources that contain relevant information on the topic of the relationship between leadership style and organizational commitment among nursing staff. The analysis explores the crucial concepts under study, leadership, leadership style, and organizational commitment. The review of the literature is critical because it points to gaps in research that will be filled using the current study.
The study will use a quantitative research design to collect data and establish the potential relationship between leadership style and organizational commitment among nursing staff in Saudi Arabia. The particular research approach will be a cross-sectional design.
The study will be conducted in MOH in Medinah, Saudi Arabia. Nurses in the two settings will form the population for the study from which the sample will be obtained. Only nurses who can speak Arabic will be included in the study. The research will use a sample of 150 nurses from two medical cities in the region. Two hundred and sixty nurses from two medical cities in Medinah, Saudi. The sample will be based on a power analysis to obtain the sample randomly.
The numerical data will be collected using the research tools described in the measurements section. The research will use two structured questionnaires to collect data relating to the two variables, including leadership style and organizational commitment.
The researcher will use two measures to test the two variables, leadership style, and organizational commitment. The first one is the Arabic and English versions of the Multifactor Leadership Questionnaire (MLQ). Permission to use the tool will be obtained from Bass and Avolio (1990) who are the authors. The second one is Organisational Commitment Questionnaire (OCQ; in Arabic format). The MLQ (Bass, 1985) measures the type of leadership, transactional or transformational used in an organization. It has 36 items with three dimensions: “transformational leadership; transactional leadership; and passive/avoidant.” Previous studies have proven the reliability and validity of the Arabic version of the tools (Abualrub & Alghamdi, 2012). It has Cronbach’s alpha >.60 for dimensions. The OQC will measure the level of commitment to the organization. The tool has 15 items: “value commitment (9 items) and commitment to stay (the remaining 6 negatively worded items).” The tool had Cronbach’s alpha of .77. (Al-Yami, Galdas, & Watson, 2017, p. 532). Since the tools do not contain demographic data, a section to collect the data, such as age, gender, educational background, income level, and experience will be added.
Ethical approval is critical and the researcher will seek consent from the Institutional Review Board before collecting data. Participation in the study will be voluntary and subjects will be free to leave the study at any stage if they wish. Participants will sign an informed consent to participate. Anonymity will be assured to ensure privacy and confidentiality.
The researcher will analyze the collected data using statistical analyses using SPSS version 20.0. The analysis will also include t-tests, Pearson’s correlation, as well as hierarchical regression. The researcher will exclude all instances of missing data. Furthermore, the researcher will use a box and whisker plot applying Hoaglin and Iglewicz’s (1987) rules to identify any outliers (Al-Yami, Galdas, & Watson, 2017). The MLQ and the OCQ will measure the primary outcome of the relationship between the two variables under study, leadership style, and organizational commitment. The researcher will use Cohen’s (1992) criteria for power analysis.
Abualrub, R. F., & Alghamdi, M. G. (2012). The impact of leadership styles on nurses’ satisfaction and intention to stay among Saudi nurses. Journal of Nursing Management, 20(5), 668-678. doi:10.1111/j.1365-2834.2011.01320.x
Al Hosis, K. F., Mersal, F. A., & Keshk, L. I. (2013). Effects of job stress on health of Saudi nurses working in ministry of health hospitals in Qassim region in KSA. Life Science Journal, 10(1), 1036-1044.
Al‐Yami, M., Galdas, P., & Watson, R. (2018). Leadership style and organisational commitment among nursing staff in Saudi Arabia. Journal of Nursing Management, 26(5), 531-539. doi:10.1111/jonm.12578
Asiri, S. A., Rohrer, W. W., Al-Surimi, K., Da’ar, O. O., & Ahmed, A. (2016). The association of leadership styles and empowerment with nurses’ organizational commitment in an acute health care setting: a cross-sectional study. BMC Nursing, 15(1), 38. doi:10.1186/s12912-016-0161-7
Bass, B. M., & Avolio, B. J. (1990). Transformational leadership development: Manual for the multifactor leadership questionnaire. Palo Alto, CA: Consulting Psychologists Press.
Giddens, J. (2018). Transformational leadership: What every nursing dean should know. Journal of Professional Nursing, 34(2), 117-121. doi:10.1016/j.profnurs.2017.10.004
Hamdi, S., & Rajablu, M. (2012). Effect of supervisor-subordinate communication and leadership style on organizational commitment of nurses in health care setting. International Journal of Business and Management, 7(23), 7. doi:10.5539/ijbm.v7n23p7
Lavoie‐Tremblay, M., Fernet, C., Lavigne, G. L., & Austin, S. (2016). Transformational and abusive leadership practices: impacts on novice nurses, quality of care and intention to leave. Journal of Advanced Nursing, 72(3), 582-592. doi:10.1111/jan.12860
Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality. International Journal of Health Policy and Management, 3(2), 77-81
Mosadeghrad, A. M., & Ferdosi, M. (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: Proposing and testing a model. Materia Socio-Medica, 25(2), 121. doi:10.5455/msm.2013.25.121-126
Somers, M. J., Birnbaum, D., Finch, L., & Casal, J. (2018). Psychological attachment to nursing in the early career: Occupational commitment profiles, motivational patterns, retention, and performance. Journal of Vocational Education & Training, 1-18. doi: 10.1080/13636820.2018.1535516
Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709-724. doi: 10.1111/jonm.12116
Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4), 155-157. doi:10.1016/j.cnre.2017.10.001
Multifactor Leadership Questionnaire (MLQ) Form 6S
(Retrieved from https://pdfs.semanticscholar.org/2f2f/781ea62c6b42d6214de09e92ce2bef2e682f.pdf)
INSTRUCTIONS: This questionnaire provides a description of your leadership style.
Twenty‐one descriptive statements are listed below. Judge how frequently each statement
fits you. The word others may mean your followers, clients, or group members.
0 ‐ Not at all 1 ‐ Once in a while 2 = Sometimes 3 = Fairly often 4 = Frequently, if not always
The MLQ‐6S measures your leadership on seven factors related to transformational
leadership. Your score for each factor is determined by summing three specified items on
the questionnaire. For example, to determine your score for factor 1, Idealized influence,
sum your responses for items 1, 8, and 15. Complete this procedure for all seven factors.
Idealized influence (items 1, 8, and 15) __________ Factor 1
Inspirational motivation (items 2, 9, and 16) __________ Factor 2
Intellectual stimulation (items 3, 10, and 17) __________ Factor 3
Individual consideration (items 4, 11, and 18) __________ Factor 4
Contingent reward (items 5, 12, and 19) __________ Factor 5
Management‐by‐exception (items 6, 13, and 20) __________ Factor 6
Laissez‐faire leadership (items 7, 14, and 21) __________ Factor 7
Score range: HIGH = 912,
MODERATE = 58,
LOW = 04
Multifactor Leadership Questionnaire (MLQ) Form 6S
Factor 1 – IDEALIZED INFLUENCE indicates whether you hold subordinates’ trust, maintain their faith and respect, show dedication to them, appeal to their hopes and dreams, and act as their role model.
Factor 2 – INSPIRATIONAL MOTIVATION measures the degree to which you provide a vision, use appropriate symbols and images to help others focus on their work, and try to make others feel their work is significant.
Factor 3 – INTELLECTUAL STIMULATION shows the degree to which you encourage others to be creative in looking at old problems in new ways, create an environment that is tolerant of seemingly extreme positions, and nurture people to question their own values and beliefs of those of the organization.
Factor 4 – INDIVIDUALIZED CONSIDERATION indicates the degree to which you show interest in others’ well‐being, assign projects individually, and pay attention to those who seem less involved in the group.
Factor 5 – CONTINGENT REWARD shows the degree to which you tell others what to do in order to be rewarded, emphasize what you expect from them, and recognize their accomplishments.
Factor 6 – MANAGEMENT‐BY‐EXCEPTION assesses whether you tell others the job requirements, are content with the standard performance and are a believer in “if it ain’t broke, don’t fix it.”
Factor 7 – LAISSEZ‐FAIRE measures whether you require little of others, are content to let things ride, and let others do their own thing.
THE OCQ (adopted from Al-Yami, Galdas & Watson, 2019, p.56)
|1||I am willing to put in a great deal of effort beyond what is normally expected in order to help this organization be successful.||
|2||I talk up this organization to my friends as a great organization to work for.|
|3||I feel very little loyalty to this organization.|
|4||I would accept almost any type of job assignment in order to keep working for this organization.|
|5||I find that my values and the organization’s values are very similar.|
|6||I am proud to tell others that I am part of this organization.|
|7||I could just as well be working for a different organization as long as the type of work were similar.||
|8||This organization really inspires the very best in me in the way of job performance.|
|9||It would take very little change in my present circumstances to cause me to leave this organization.||
|10||I am extremely glad that I chose this organization to work for over others I was considering at the time I joined.||
|11||There’s not too much to be gained by sticking with this organization indefinitely.|
|12||Often, I find it difficult to agree with this organization’s policies on important matters relating to its employees.||
|13||I really care about the fate of this organization.|
|14||For me, this is the best of all possible organizations for which to work.|
Comm=communality; FPUC=first principal unrotated component; putative loadings on factors are shown in bold
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