Influence of nurse and midwife's managerial leadership styles on job satisfaction, intention to stay and services provision in hospitals of Rwanda NGABONZIMA Anaclet ASINGIZWE Domina KYRIAKOS Kouveliotis RPA&RSOG conference 13 th September 2019 1
Outline Introduction Study Objectives Methods Results Conclusion Recommendations 2
Introduction Nurses and midwives are a critical part of healthcare and make up the largest section of the health professions They are the frontline HCPs being the first to meet people in critical conditions. NM have to be properly managed to provide the best quality of care for + outcomes 3
Problem statement N/M managerial LS is still unclear in Rwanda In the same line, the influencece on managerial LS on JS and JR for NM subordinates and their influence on provision of health of services needs to be explored. Because this may affect the staff turnover as it is one of the challenge being faced by the country health system. 4
Study objectives Describe the managerial leadership styles adopted by nurse/midwife managers 1 Determine the relationship between nurse/ midwife managerial LS on job satisfaction and intention to stay 2 Examine the relationship between nurse/ midwife managerial LS on services provision 3 5
Methodology Study design : Quantitative cross-sectional Population: Full-time 292 NMs practicing in 5 hospitals (Byumba, Kinihira, Ruli, Nemba and Rutongo) of with a minimum of six months working experience with their current direct managers (Henri F Principles) 6
Variables Directive LS Job satisfaction Supportive LS Intention to stay Participative LS Perception on Achievement service provision oriented LS 7
Measurements Each leadership style was measured using five items with scores ranging from 5 to 25 (PGL). Scores below 12 indicated non-use of a particular leadership style and scores above 20 a typical (high) use of a particular LS. 8
Data analysis A job satisfaction scale comprising seven (7) items with Likert‘s scale response was used to measure the level of job satisfaction of nursing and midwifery staff. Higher scores indicated higher level of job satisfaction of the nurses or midwives. 9
Data analysis Staff intention to stay at their current workplaces (hospitals) was measured using a five (5) point scale, where higher score reflect higher intention to stay. Services provisions were measured using four items with Likert scale response and higher scores reflect higher level of services provision. 10
RESULTS 11
Nurse and midwife's managerial leadership styles
Job satisfaction, intention to stay and service provision
Regression analysis Job satisfaction Steps Variables Model 1 Model 2 Beta P value Beta P value Age of participant -0.059 0.670 0.009 0.935 Gender 0.014 0.885 0.048 0.529 qualification of the participants 0.046 0.640 -0.108 0.188 years of experience 0.201 0.110 0.024 0.810 1 Years of experience in the unit -0.072 0.470 0.071 0.387 Years of experience with manager 0.074 0.450 -0.039 0.624 level of workload 0.040 0.676 -0.117 0.144 civil status -0.061 0.576 -0.011 0.900 Directive style 0.400 0.001 Supportive style 0.178 0.180 2 Participative style 0.020 0.883 Achievement oriented style 0.201 0.014 R 2 0.033 0.838 0.413 0.000
Regression analysis con’t Intention to stay Model 1 Model 2 Steps Variables Beta P value Beta P value Age of participant -0.178 0.187 -0.129 0.325 Gender 0.055 0.553 0.058 0.524 qualification of the participants -0.078 0.422 -0.104 0.283 years of experience 0.199 0.104 0.146 0.228 1 Years of experience in the unit 0.107 0.270 0.143 0.139 Years of experience with manager -0.109 0.254 -0.147 0.117 level of workload 0.152 0.100 0.155 0.102 civil status 0.022 0.838 0.032 0.756 Directive style 0.390 0.005 Supportive style 0.142 0.362 2 Participative style -0.384 0.019 Achievement oriented style 0.081 0.395 R 2 0.083 0.208 0.183 0.008
Regression analysis con’t Services provision Model 1 Model 2 Steps Variables Beta P value Beta P value Age of participant 0.005 0.973 0.074 0.539 Gender 0.069 0.459 0.088 0.294 qualification of the participants 0.233 0.018 0.126 0.162 years of experience -0.078 0.527 -0.213 0.057 1 Years of experience in the unit -0.090 0.359 0.034 0.705 Years of experience with manager 0.006 0.952 -0.074 0.388 level of workload 0.053 0.570 -0.022 0.805 civil status 0.105 0.327 0.142 0.138 Directive style 0.546 0.000 Supportive style -0.149 0.300 2 Participative style -0.004 0.980 Achievement oriented style 0.136 0.124 R 2 0.074 0.289 0.303 0.000
CONCLUSION 17
Conclusions This study found no single ‗all -purpose ‘LS suitable for all circumstances. Though moderate scores were recorded for all the 4 LS of PGL tool, NMs Managers use the DLS (Mean=18.8 SD = 3.6) more than any other LS. This was followed by SLS (Mean = 17.3, SD = 4) and PLS (Mean = 17, SD=4.1). The least used leadership style was AOLS (Mean = 15.8, SD = 2.9) 18
Conclusions con’t NM managers used varied LS depending on the circumstance of NMs they are leading and the goals which is in line with the tenets of the contingency leadership theories such PGL theory. NMs exhibited moderate levels of job satisfaction ranging from 1 to 5 with an average of 3.5 (SD = 0.7) As for JS, NMs had moderate intentions to continue working in their hospitals (Mean =3.3, SD= 0.7). 19
Conclusions con’t This level of satisfaction overlaps with the one with their N/M leadership styles (Mean= 3.5, SD=1) and the level of satisfaction with relationship with their N/M managers However, NMs exhibited a bit higher levels of satisfaction towards services they are providing (Mean=3.8 SD= 0.6) and they exhibited higher levels of commitment to provide better quality services (Mean =4, SD= 0.7). 20
RECOMMENDATIONS 21
Recommendations Central level: Develop a structured CPD in- service training programme on leadership and management for current and prospective NM and other health professional managers. Hospitals: Ensure N&M managers benefit from the training on leadership and management before or after taking up managerial positions. CNM/Associations: Ensure NM curriculum at all levels include substantial management and leadership courses 22
Recommendations Con’t Researchers : Consider examining other factors affecting staff JS , retention and services provision and in Rwandan context Replicate the study in other many health facilities including health centers to provide holistic view of the subject. 23
Thank you!!!!!!!! Thank you? 24
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