Leadership and nursing work satisfaction: an integrative review

An integrative review of the MEDLINE, CINAHL, EMBASE, PubMed, Web of Science, and LILACS databases to answer the guiding question: What knowledge was produced about the relationship between leadership and nursing job satisfaction in the period from 2011 to 2016? Searches were made to obtain articles, theses, dissertations, and reviews (systematic, narrative and integrative); opinion articles and editorials were excluded. The searches were carried out between October 2016 and January 2017, using the inclusion criteria: primary articles; full text available; written in English, Portuguese or Spanish; and published in the last six years (2011-2016). The extraction of study results was carried out by two reviewers, who defined four thematic categories, with the purpose of analyzing the data obtained in the articles and comparing them with the literature.

Results

Out of a total of 582 articles, 15 were selected; four categories were established: the use of the theoretical reference of leadership in the construction of the articles; the use of instruments to measure leadership and job satisfaction, and the correlation between these variables; the predominance of nursing leadership in the hospital setting; and the direct and indirect relationship between leadership and job satisfaction.

Conclusion

The results showed that nursing leadership has a positive and significant impact on job satisfaction, and the need to develop this competency in nursing professionals was demonstrated.

Keywords
Leadership; Job satisfaction; Nursing team

Author(s)/Country/Year	Design/Number of participants/Article evaluation	Leadership theoretical reference	Data Collection instruments for leadership and job satisfaction	Outcomes
MEDLINE
Choi et al.⁽⁸8. Choi SL, Goh CF, Adam MB, Tan OK. Transformational leadership, empowerment, and job satisfaction: the mediating role of employee empowerment. Hum Res Health. 2016; 14(1):73.⁾/Malaysia/2016	Correlational Study/n=200 nursing professionals/(strong-10/14)	Transformational leadership	Multifactor Leadership Questionnaire (MLQ)/Scale described by Warr, Cook and Wall	Study analyses showed that empowerment mediated the effect of transformational leadership on job satisfaction in the nursing team. (p=0.001; t-value= 3.28).
Lin et al.⁽⁹9. Lin P-Y, MacLennan S, Hunt N, Cox T. The influences of nursing transformational leadership style on the quality of nurses’ working lives in Taiwan: a cross-sectional quantitative study. BMC Nurs. 2015; 14(1):33.⁾/Taiwan/2015	Correlational Study /n=651 nurses/(moderate-9/14)	Leadership transformational	MLQ Occupational Stress Indicator	An indirect relationship was demonstrated between the transformational leadership style and job satisfaction, mediated by supervision support; (p<0.01; β=0.37).
Negussie and Demissie⁽¹⁰10. Negussie N, Demissie A. Relationship between leadership styles of nurse managers and nurses’ job satisfaction in Jimma University Specialized Hospital. Ethiop J Health Sci. 2013; 23(1):49-58.⁾/Ethiopia/2013	Correlational study/n=175 nurses (moderate- 9/14)	Transformational leadership	MLQ Minnesota Satisfaction Questionnaire	Based on the transactional leadership style, it was found that only contingent reward was statically significant and correlated with extrinsic satisfaction (β = 0.45; p <0.01) (β = 0.32; p <0.05), while all five dimensions of transformational leadership style were statistically significant and correlated with intrinsic and extrinsic satisfaction at work. Dimensions of transformational leadership and intrinsic satisfaction: idealized influence (behavior) (β=0.32; p<0.01), idealized influence (attribute) (β=0.29; p<0.01), inspiring motivation (β=0.49; p<0.01), and individual considerations (β=0.35; p<0.01); and extrinsic: idealized influence (behavior) (β=0.19; p<0.05), idealized influence (attribute) (β=0.21; p<0.05), inspiring motivation (β=0.19; p<0.05), intellectual stimulation (β=0.42; p<0.05) and individual considerations (β=0.17; p<0.05).
Lorber and Skela-Savič⁽¹¹11. Lorber M, Skela Savič B. Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals. Croat Med J. 2012; 53(3):263-70.⁾/Slovenia/2012	Correlational study/n=509 (with 96 leader nurses & 413 nursing professionals)/(moderate-8/14)	Does not describe theoretical reference	Questionnaires structured by the authors	Showed statistically significant association between job satisfaction and personal characteristics of leaders (p <0.001; β = 0.158), and leaders’ management skills (p < 0.000; β = 0.634).
CINAHL
Brewer et al.⁽¹²12. Brewer CS, Kovner CT, Djukic M, Fatehi F, Greene W, Chacko TP, et al. Impact of transformational leadership on nurse work outcomes. J Adv Nurs. 2016; 72(11):2879-93.⁾/United States/2016	Correlational study/n=1,037 registered nurses starting in the career/(moderate-8/14)	Transformational leadership	Leadership scale adapted from two other scales Job satisfaction described by Quinn and Staines	Transformational leadership did not have a significant impact on the intention to stay at the service (p=0.947) and on job satisfaction (p=0.125), but it was significantly associated with organizational commitment (p=0.001).
Fallatah and Laschinger⁽¹³13. Fallatah F, Laschinger HK. The influence of authentic leadership and supportive professional practice environments on new graduate nurses job satisfaction. J Res Nurs. 2016; 21(2):125-36.⁾/Canada/2016	Correlational study/n=93 newly graduated nurses (moderate-9/14)	Authentic leadership	Authentic Leadership Questionnaire (ALQ) North Carolina Center for Nursing - Survey of Newly Licensed Nurses	The supportive environment of professional practice mediated the relationship between authentic leadership and professional satisfaction of new graduate nurses (β = 0.16; p <0.001). The results suggest that managers using authentic leadership create supportive environments for professional practice and are more likely to improve the professional satisfaction of new graduate nurses.
Laschinger et al.⁽¹⁴14. Laschinger HKS, Wong CA, Cummings GG, Grau AL. Resonant leadership and workplace empowerment: the value of positive organizational cultures in reducing workplace incivility. Nurs Econ. 2014; 32(1):5-15.⁾/Canada/2014	Correlational study/n=1.241 nurses/(moderate-8/14)	Resonant leadership	Resonant Leadership Scale Global Job Satisfaction Survey	Resonant leadership had both a direct influence on job satisfaction (r = 0.43; β = 0.16; p <0.05) and an indirect effect by creating a greater sense of empowerment and subsequently less incivility and Burnout.
Roberts-Turner et al.⁽¹⁵15. Roberts-Turner R, Hinds PS, Nelson J, Pryor J, Robinson NC, Wang J. Effects of leadership characteristics on pediatric registered nurses’ job satisfaction. Pediatr Nurs. 2014; 40(5):236-41.⁾/United States/2014	Correlational study/n =935 registered nurses/(moderate-8/14)	Transformational and transactional	Healthcare Environment Survey (HES)	The results showed that both autonomy (transformational leadership, β = 0.069; p = 0.002) and distributive justice (transactional leadership, β = 0.047; p <0.001) had significant positive effects on registered nurses’ job satisfaction, but the greater source of influence was autonomy.
Abualrub and Alghamdi⁽¹⁶16. AbuAlRub RF, Alghamdi MG. The impact of leadership styles on nurses’ satisfaction and intention to stay among Saudi nurses. J Nurs Manag. 2012; 20(5):668-78.⁾/Saudi Arabia/2012	Correlational study/n=308 registered nurses/(strong-11/14)	Transformational and transactional	MLQ Job Satisfaction Survey	It was observed that the transformational leadership style increased nurses’ job satisfaction level (r = 0.45; p <0.001); the results also revealed that the perceived transactional leadership style negatively influences nursing job satisfaction (r = 0.14; p <0.01).
Wong and Laschinger⁽¹⁷17. Wong CA, Laschinger HK. Authentic leadership, performance, and job satisfaction: the mediating role of empowerment. J Adv Nurs. 2013; 69(4):947-59.⁾/Canada/2013	Correlational study/n= 280 nurses/(strong-11/14)	Authentic leadership	ALQ Global Job Satisfaction Survey	This study showed a positive association between authentic leadership and job satisfaction, mediated by structural empowerment (β = 0.19; p <0.01) of experienced nurses in acute care.
Havig et al.⁽¹⁸18. Havig AK, Skogstad A, Veenstra M, Romøren TI. The effects of leadership and ward factors on job satisfaction in nursing homes: a multilevel approach. J Clin Nurs. 2011; 20(23-24):3532-42.⁾/Norway/2011	Correlational study/444 nursing employees, interviews and questionnaire for 13 nursing directors and 40 nursing managers/(strong-12/14)	Leadership styles guided to tasks and relationship	Leadership styles were determined by the selection of items present in three questionnaires: Instrument developed by Brayfield and Rothe	There was a significant correlation between job satisfaction and task-oriented leadership styles (β = 0.55; (p = 0.11) and relationships (β = 0.16; p = 0.07), with a stronger effect on task orientation.
Wang, Chontawan and Nantsupawt⁽¹⁹19. Wang X, Chontawan R, Nantsupawat R. Transformational leadership: effect on the job satisfaction of registered nurses in a hospital in China. J Adv Nurs. 2012; 68(2):444-51.⁾/China/2012	Correlational study/n=238 nurses/(moderate-9/14)	Transformational leadership	Leadership Practice Inventory (LPI) Nurse Job Satisfaction Scale (NJSS)	There was a positive and statistically significant correlation between the transformational leadership of nursing managers and job satisfaction (r = 0.556; p <0.001).
Furtado, Batista and Silva⁽²⁰20. Furtado LC, Batista MG, Silva FJ. Leadership and job satisfaction among Azorean hospital nurses: an application of the situational leadership model. J Nurs Manag. 2011; 19(8):1047-57.⁾/Portugal/2011	Correlational study/n=266 nurses (22 nursing managers and 244 professionals of the nursing team)/(moderate-8/14)	Situational leadership	Leadership Effectiveness and Adaptability Description Questionnaire Instrument for job satisfaction was developed by the authors	The relationship between leadership components and job satisfaction was statistically significant for leadership profile (p = 0.008), in particular.
EMBASE
Moneke and Umeh⁽²¹21. Moneke N, Umeh OJ. Factors influencing critical care nurses’ perception of their overall job satisfaction. JONA J Nurs Adm. 2014; 43(4):201-7.⁾/United States/2014	Correlational study/n=137 intensive care nurses/(moderate-5/14)	Does not describe	LPI Job satisfaction was one of the 65 items on a sociodemographic questionnaire	Job satisfaction was found to be positively and significantly correlated with various perceived leadership practices: leaders who shape the path; leaders who inspire a shared view; and leaders who empower others to act. Data analysis also revealed a weak significant correlation between job satisfaction and challenging leaders. Encouraging the heart was not significantly correlated with job satisfaction (no p value).
LILACS
Álvarez et al.⁽²²22. Álvarez LG, Sotomayor EG, Figueroa GM, Hernández, Paulina Segura Martínez CL. Relación de la satisfacción laboral con estilos de liderazgo en enfermeros de hospitales públicos, Santiago, Chile. Cienc Enferm. 2013; 19(1):11-21.⁾/Chile/2013	Correlational study/n=214 nurses/(moderate-7/14)	Situational leadership	SBDQ (Supervisory Behavior Description Questionnaire) Satisfacción Laboral, extracted from the instrument of Instituto Nacional de Seguridad e Higiene del Trabajo de España	It showed a positive relationship between job satisfaction and leadership styles described by the theory used in the study (χ²= 20.787; p<0.001).

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[1] Corresponding author André Almeida de Moura Rua Prof. Hélio Lourenço, 3900, 14040-902, Ribeirão Preto, SP, Brazil. andalmo@usp.br