Purpose This study aimed to explore the mediating role of organizational silence in the effect of leader-member exchange on patient safety culture among perioperative nurses. Methods This descriptive study surveyed 201 perioperative nurses from five university hospitals. Data were collected via online questionnaires from November 8, 2022, to February 6, 2023, measuring demographics, work-related factors, leader-member exchange, organizational silence, and patient safety culture. The Data were analyzed using SPSS 26.0 and PROCESS Macro model 4. Results Leader-member exchange showed a significant direct effect on patient safety culture (β=.44, p<.001). The indirect effect of leader-member exchange on patient safety culture through acquiescent silence was also significant (β=.05, 95% CI: 0.02 to 0.13).
The total effect of leader-member exchange on patient safety culture (β=.52, p<.001) was larger than its direct effect, indicating that acquiescent silence partially mediated the relationship between leader-member exchange and patient safety culture. Conclusion To improve perioperative nurses perception of patient safety culture, healthcare organizations should enhance leader-member exchange by promoting strong emotional connections and open communication between nurse managers and staff nurses. Additionally, encouraging autonomous decision-making and reducing acquiescent silence are essential to facilitate the active expression of patient safety concerns.
Purpose This study aimed to determine the mediating effect of leader-member exchange (LMX) on the relationship between nursing unit managers’ethical leadership and nurses’turnover intentions. Methods A cross-sectional nationwide survey was performed using structured questionnaires. A total of 225 clinical nurses working in general tertiary hospitals were recruited through proportional quota sampling; the quota used represented the location of working hospitals in South Korea. Data were collected through an online survey and snowball sampling from June to September 2022 and analyzed using the SPSS 25.0 program. A mediation analysis was performed using a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. Results In bootstrapping, the indirect effect (X→M→Y) was statistically significant (B=-0.77, 95% CI:-1.02 to -0.50). LMX showed a mediating effect on the relationship between nursing unit managers’ethical leadership and clinical nurses’ turnover intention. In this model, the total effect was B=-0.93 (p<.001). Conclusion These findings suggest that LMX must be considered when making a strategy for nursing retention in the hospital setting. Nursing unit managers with ethical leadership could decrease nurses’ turnover intention by improving the LMX.
Purpose This study is a hypothetical model of the effect of the leader-member exchange relationship on psychological ownership, job engagement, and turnover intention. Methods Data collection was conducted for general nurses who have worked for at least 6 months in a university hospital. The collected data were analyzed using the SPSS/WIN 25.0, and AMOS 18.0 program was used to conduct confirmatory factor analysis as well as goodness of fit verification and hypothesis testing for the hypothetical model. Results The leader-member exchange had a significant, static effect on psychological ownership. The leader-member exchange relationship did not have a significant effect on job engagement and psychological ownership had a significant, static effect on job engagement.
The leader-member exchange relationship did not have a significant effect on turnover intention and psychological ownership and job engagement had significant, negative effects on turnover intention. Conclusion Intervention and the development of programs to increase the psychological ownership and job engagement of members are proposed to improve the leader-member exchange relationship through leadership education and training and reduce the turnover intention of nurses.
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Purpose This study was done to analyze effects of leader-member exchange as perceived by nurses who returned to work after parental leave: conflict between work and family via job stress. Methods A cross-sectional study design was adopted and data were collected from 140 nurses. Collected data were analyzed using the SPSS 23.0 program (descriptive statistics, t-test, ANOVA, Pearson correlation, and regression analysis). Results Mean scores were 3.44±0.64 out of 5 for leader-member exchange, 3.45±0.59 out of 5 for job stress, and 2.82±0.80 out of 5 for conflict between work and family. The leader-member exchange had negative correlations with job stress (r=-.31, p=.003) and conflict between work and family (r=-.36, p<.001). The leader-member exchange had direct impacts on conflict between work and family (β=-.26, p=.002) and indirect via job stress (β=.35, p<.001). Job stress had partial mediating effects on relations between leader-member exchange and conflict between work and family (Z=-3.00, p<.001). The leader-member exchange and job stress explained 41% of the conflict between work and family. Conclusion The findings from this study indicate that active human resource management policies should be established in order to increase the leader-member exchange.
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PURPOSE This study was done to investigate the relationships between nursing work environment, leader-member exchange(LMX), peer support, and organizational commitment in one city with a severe nurse shortage. METHODS Participants were 198 nurses who had worked for more than 6 months with the same head nurse. They worked in five general hospitals located in one city. In April 2016 participants completed a survey questionnaire about their nursing work environment, LMX, peer support, and organizational commitment. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression. RESULTS There was a significant difference in nursing work environment by experience of turnover (t=−2.58, p=.010). LMX showed significant difference by department (F=3.81, p=.011). Factors influencing nurses' organizational commitment were nurse participation in hospital affairs (β=.23, p=.028) and nurse manager ability, leadership and support (β=.18, p=.022). Explanatory power was 18.2% in the regression model. CONCLUSION The results suggest that it is necessary to improve the nursing work environment in order to increase organizational commitment. Improvement of the nursing system should be considered along with supplementation of nurses particularly during a severe nurse shortage.
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