Nurses´ perception of the leadership exercised by their managers: an observational study

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DOI:

https://doi.org/10.29352/mill0222e.44683

Abstract

Introduction: Effective leadership practices in nursing are critical for fostering positive work environments, motivation, and professional satisfaction. They are particularly relevant in increasingly complex and demanding organizational contexts, with a direct impact on the quality and safety of care.

Objective: To characterize nurses’ perceptions of nurse managers’ leadership roles and to analyze their relationship with sociodemographic and professional variables.

Methods: An observational, descriptive, quantitative, cross-sectional study was conducted with a sample of 338 nurses, obtained through non-probabilistic sampling. A leadership questionnaire adapted for Portugal was used. Descriptive and inferential analyses were performed using IBM SPSS Statistics, with a significance level set at 5%.

Results: Nurses reported overall positive perceptions of their managers’ leadership, with scores above the cutoff point. Roles related to support, guidance, organization, and results orientation stood out. In contrast, roles linked to innovation and external mediation showed lower scores. Significant associations were found between leadership roles and sociodemographic and professional variables, with higher perceptions among older nurses, females, widowed/divorced individuals, specialists, and those working in primary health care.

Conclusion: The findings highlight the importance of leadership styles focused on support, planning, and organization, reinforcing the need for strategies tailored to professional maturity and different organizational contexts. There is also a clear need to invest in the development of leadership competencies related to innovation and strategic mediation, with potential impact on improving work environments and quality of care.

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References

Alilyyani, B., Althobaiti, E., Al-Talhi, M., Almalki, T., Alharthy, T., Alnefaie, M., Talbi, H., & Abuzaid, A. (2024). Nursing experience and leadership skills among staff nurses and intern nursing students in Saudi Arabia: A mixed methods study. BMC nursing, 23(1), 87. https://doi.org/10.1186/s12912-024-01750-1

Asif, M., Jameel, A., Hussain, A., Hwang, J., & Sahito, N. (2019). Linking transformational leadership with nurse-assessed adverse patient outcomes and the quality of care: Assessing the role of job satisfaction and structural empowerment. International Journal of Environmental Research and Public Health, 16(13), 1–15. https://doi.org/10.3390/ijerph16132381

Azevedo, A. (2022). Liderança transformacional, empenhamento e intenção de turnover dos enfermeiros: O papel mediador da perceção de suporte organizacional [Dissertação de mestrado, Universidade do Minho, Escola de Economia e Gestão]. RepositóriUM. https://shre.ink/7VEC

Balsanelli, A. P., David, D. R., & Ferrari, T. G. (2018). Nursing leadership and its relationship with the hospital work environment. Acta Paulista de Enfermagem, 31(2), 187–193. https://doi.org/10.1590/1982-0194201800027

Brzozowski, S. L., Cho, H., Shuman, C. J., Scott, L. D., Mundt, M. P., & Steege, L. M. (2022). Primary care nurses' perception of leadership and the influence of individual and work setting characteristics: A descriptive study. Journal of nursing management, 30(7), 2751–2762. https://doi.org/10.1111/jonm.13752

Carvalho, M. C., & Lucas, P. R. (2020). A eficácia da prática do enfermeiro líder clínico – revisão sistemática da literatura . Millenium - Journal of Education, Technologies, and Health, 2(11), 57–64. https://doi.org/10.29352/mill0211.06.00274

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International journal of nursing studies, 85, 19–60. https://doi.org/10.1016/j.ijnurstu.2018.04.016

Cziraki, K., Wong, C., Kerr, M., & Finegan, J. (2020). Leader empowering behaviour: relationships with nurse and patient outcomes. Leadership in Health Services, 33(4), 397–415. https://doi.org/10.1108/LHS-04-2020-0019

Duarte, M. R. N. (2022). Influência da liderança das chefias na satisfação profissional dos enfermeiros: Estudo de caso [Dissertação de mestrado, Escola Superior de Enfermagem de Coimbra]. ESEnfC Repositório. https://repositorio.esenfc.pt/

Fernandes, S. C. F. (2019). Perceções de liderança: O caso dos enfermeiros chefes [Dissertação de mestrado, Universidade do Minho]. RepositóriUM. https://shre.ink/7VEh

Gasparino, R. C., Ferreira, T. D. M., Oliveira, H. C., Alves, D. F. S., & Balsanelli, A. P. (2021). Leadership, adequate staffing and material resources, and collegial nurse–physician relationships promote better patients, professionals and institutions outcomes. Journal of Advanced Nursing, 77(6), 2739–2747. https://doi.org/10.1111/jan.14805

Hughes, V. (2019). Nurse leader impact: A review. Nursing Management, 50(4), 42–49. https://doi.org/10.1097/01.NUMA.0000554338.47637.23

Jiang, D., & Kira, J. (2024). New nurse turnover intention and related factors in Japan and China: Focusing on nursing practice environment and burnout. Journal of Nursing Research, 32(5), e346. https://doi.org/10.1097/jnr.0000000000000636

Kachie, A. D. & Zhou, L. (2021). Job satisfaction, organizational commitment, transformational leadership and turnover intention among newly recruited nurses in Chinese hospitals. International Journal of Healthcare Sciences, 8(2), 22–36. https://www.researchpublish.com

Lappalainen, M., Härkänen, M., & Kvist, T. (2020). The relationship between nurse manager's transformational leadership style and medication safety. Scandinavian journal of caring sciences, 34(2), 357–369. https://doi.org/10.1111/scs.12737

Marôco, P. (2021). Análise de equações estruturais: Fundamentos teóricos, software & aplicações (3.ª ed.). ReportNumber.

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Wolters Kluwer Health.

Melo, R. C., Silva, M. J., & Parreira, P. (2014). Effective leadership: Competing values framework. Procedia Technology, 16, 921–928. https://doi.org/10.1016/j.protcy.2014.10.047

Mendes, C. M. F. G. da S., Jesus, Élvio H. de, & Araújo, B. R. (2025). Turnover dos enfermeiros, qualidade de cuidados, segurança do doente e estilos de liderança: Revisão integrativa. Revista Recien - Revista Científica De Enfermagem,15(43), 99–110. https://doi.org/10.24276/rrecien2025.15.43.991

Morcelli, L. M. B., Dias, B. M., Gabriel, C. S., & Bernardes, A. (2023). Influência da liderança do enfermeiro na segurança dos pacientes: uma revisão integrativa. Rev Baiana Enfermagem,37, e54967. https://doi.org/10.18471/rbe.v37.54967

Özkan A. H. (2022). Abusive supervision climate and turnover intention: Is it my coworkers or my supervisor ostracizing me? Journal of nursing management, 30(6), 1462–1469. https://doi.org/10.1111/jonm.13398

Parreira, P. M., Felício, M., Lopes, A., Nave, F., & Parreira, F. (2006). Papéis de liderança: Um instrumento avaliativo. Revista Investigação em Enfermagem, 13, 3–14. https://shre.ink/7VEs

Parreira, P., Lopes, A., Salgueiro, F., Carvalho, C., Salgueiro-Oliveira, A., Castilho, A., Mónico, L., Sena, C. & Fonseca, C. (2015). Papéis de liderança de Quinn: Um Estudo realizado em Serviços de Saúde Portugueses com recurso à análise fatorial confirmatória. RIASE- Revista Ibero-Americana de Saúde e Envelhecimento, 1(2), 192-217. http://dx.doi.org/10.24902/r.riase.

Pereira, C. M. C., Bem-Haja, I. M. S., Ferreira, M. M. F. & Rodrigues, P. M. S. (2008). Perceção de liderança de enfermeiros prestadores de cuidados: estudo realizado numa unidade hospitalar de Coimbra. Revista de Enfermagem Referência, Série II(8), 51-58. https://www.redalyc.org/articulo.oa?id=388239955005

Quinn, R. E. (1988). Beyond rational management: Mastering paradoxes and competing demands of high effectiveness. Jossey-Bass.

Quinn, R. E., Faerman, S. R., Thompson, M. P., & McGrath, M. R. (1990). Maestría en la gestión de organizaciones: Un modelo operativo de competencias. Ediciones Díaz de Santos

Quinn, B. G., McLaughlin, C., Bunting, A., McLaughlin, L., Scales, S., Craig, S., & Copeland, S. (2021). Exploring the role of effective nurse leadership during COVID-19. Nursing Management, 28(4),23–29. https://doi.org/10.7748/nm.2021.e1984

Quinn, R. E., Bright, D. S., & Sturm, R. E. (2021). Becoming a master manager: A competing values approach (7th ed.). John Wiley & Sons.

Robbins, B. & Davidhizar, R. (2020). Transformational leadership in health care today. The Health Care Manager, 39(3), 117–121. https://doi.org/10.1097/HCM.0000000000000296

Seljemo, C., Viksveen, P., & Ree, E. (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: a cross-sectional study. BMC Health Services Research, 20(1), 799. https://doi.org/10.1186/s12913-020-05671-y

Shen, Q., & Tucker, S. (2024). Fostering leadership development and growth of nurse leaders: Experiences from Midwest Nursing Research Society Leadership Academy. Nursing outlook, 72(6), 102293. https://doi.org/10.1016/j.outlook.2024.102293

Silva, B. (2023). The relationship between nurse managers’ leadership styles and nurses’ turnover intention [Dissertação de mestrado, Faculdade de Economia da Universidade do Porto]. Repositório Aberto da Universidade do Porto. https://repositorio-aberto.up.pt/handle/10216/151274

Sousa, T., & Guimarães, A. (2018). Instrumento de avaliação das competências de liderança nas chefias de enfermagem: estudo das propriedades psicométricas. Port J Public Health 18, 36(1), 50–58. https://doi.org/10.1159/000486471

Yurumezoglu, H. A., Kocaman, G., & Haydari, S. M. (2019). Predicting nurses' organizational and professional turnover intentions. Japan Journal of Nursing Science, 16(3), 274–285. https://doi.org/10.1111/jjns.12236

Published

2026-06-03

How to Cite

Mendes, C., Pinto, I., Araújo, B., & de Jesus, É. (2026). Nurses´ perception of the leadership exercised by their managers: an observational study. Millenium - Journal of Education, Technologies, and Health, 2(22e), e44683. https://doi.org/10.29352/mill0222e.44683

Issue

Section

Life and Healthcare Sciences