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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 3  |  Page : 206-213

Relationship between nurse manager leadership style and staff nurses’ work engagement


Department of Nursing Administration, Faculty of Nursing, Cairo University, Cairo, Egypt

Date of Submission17-May-2020
Date of Decision30-May-2020
Date of Acceptance02-Jun-2020
Date of Web Publication20-Aug-2020

Correspondence Address:
Walaa A Mousa
Department of Nursing Administration, Faculty of Nursing, Cairo University, Cairo, 33515
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ENJ.ENJ_16_20

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  Abstract 


Background Nowadays, organizations are in a constant state of change, hence the guidance of visionary leadership is vital to the success of any organization. Supportive leadership behaviors are very important for employees’ engagement.
Aim The study aimed to investigate the relationship between nurse manager leadership style and staff nurses’ work engagement (WE).
Design A descriptive correlational design was used.
Participants and methods The study was conducted at a teaching hospital that is affiliated to Cairo University Hospitals. A proportional randomly selected sample was used (N=271) of staff nurses. Two questionnaires were used for data collection. The first consist of two parts, first, personal characteristic data sheet; and second, multifactor leadership questionnaire (21 items), and the second questionnaire was the Utrecht work engagement scale (17 items).
Results The results of the study revealed that the highest mean percent score of nurses’ leadership style perception was regarding transformational and transactional leadership style (75.09 and74.87%, respectively) and the lowest mean score was regarding laissez-faire leadership style (62. 29%). Moreover, the highest mean percent score of nurses’ WE was dedication (91.51%), and the lowest mean percent score for absorption (80.42%) domain. Most staff nurses had a high level of WE (89.3%). In addition, there was a highly strong significant positive correlation between each of transformational, transactional leadership styles of unit nurse manager, and staff nurses’ WE (r=0.325 and P=0.000, and r=0.260, and P=0.000), whereas there was a negative significant correlation between laissez-faire leadership style of unit nurse manager and staff nurses WE (r=–0.125 and P=0.040).
Conclusion The study concluded that there was a highly strong significant positive correlation between each of transformational and transactional leadership styles of unit nurse manager and staff nurses WE. However, there was a negative significant correlation between laissez-faire leadership style of unit nurse manager and staff nurses’ WE.
Recommendation The study recommended that hospital administrators should support staff with adequate rewards to motivate them. Nurse managers should perform regular meetings with their staff nurses to identify staff work problems and help them to find solutions which improve their WE. Moreover, hospital administrators should perform regular assessment of unit nurse managers’ skills, knowledge, and behavior before enrollment in the leadership position.

Keywords: Laissez-fire leadership style, staff nurses, transactional, transformational, work engagement


How to cite this article:
Mousa WA, EldinFekry NE, Elewa AH. Relationship between nurse manager leadership style and staff nurses’ work engagement. Egypt Nurs J 2019;16:206-13

How to cite this URL:
Mousa WA, EldinFekry NE, Elewa AH. Relationship between nurse manager leadership style and staff nurses’ work engagement. Egypt Nurs J [serial online] 2019 [cited 2020 Sep 30];16:206-13. Available from: http://www.enj.eg.net/text.asp?2019/16/3/206/292492




  Introduction Top


Today’s work places are more complex and sophisticated, requiring knowledgeable leaders. Owing to global economic competitiveness, leaders are confronted with unpredictable challenges, which require different types of leadership behavior. Therefore, effective management of employees may be assumed to be achievable through leadership behavior, which is very important in improving employees’ performance, increasing the chance to achieve organizational goals, and increasing employees’ engagement with the organization, thus increasing organizational productivity (Babalola, 2016).

According to Northouse (2018), leadership is a process whereby one individual influences a group of individuals to achieve organizational goal. Amanchukwu et al. (2015) stated that‘ a good leader with excellent leadership skills is able to influence a group or team to achieve certain objectives and goals; they can motivate their follower through their knowledge and skills.’ Leaders play an important role in the attainment of organizational goals by creating a climate that would influence employees’ attitudes, motivation, and behavior. Without effective leadership, the organization would lose clear directions, suffer low morale, slow decision making skills, lead to resource mismanagement, and increase employee’s intention to leave (Denhardt et al., 2018).

Regarding modern leadership styles, transformational leadership is composed of four dimensions (idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration), characteristics of democratic and bureaucratic (Tsigu and Rao, 2015).

Transformational leadership is described as empowering, inspiring, and stimulating behaviors of a leader that foster a positive change in employees, whereas transactional leadership is defined as a set of behaviors that motivate and guide followers in the direction of goal by providing clear expectations, and providing resources for the completion of the work.

Transactional leadership has been centered on leader-follower exchanges; the baseline is reward system which can be positive or negative. It also includes in its dimensions contingent reward and management by exception; (Sosik and Jung, 2018).

Work engagement (WE) is identified as a vital workplace approach to attain a high-performing workforce by ensuring that employees are personally satisfied (Padhi et al. (2016). It is a transient, positive, fulfilling, and work-related state of mind that is characterized by vigor, dedication, and absorption and fluctuates within individuals over a period of time (Orth and Volmer, 2017). Vigor refers to high levels of energy and mental flexibility. Dedication means being enthusiastic about work and inspired by the work tasks. Finally, absorption refers to being fully concentrated on work and feeling like time flies when working (Matziari et al., 2017).

Blanchard (2018) emphasized that an engaged workforce has certain elements that contribute to organizational success such as higher levels of commitment to the organization, higher rates of satisfaction, and lower levels of intentions to leave, and these elements are what we call engagement. A disengaged workforce is costly to an organization in competitive global market. However, transformational leaders create a supportive work environment, which is an important requisite for employees to become more engaged in their work.

Deichmann and Stam (2015) asserted that leadership styles are vital for encouraging employee engagement. When employees decide to leave the organization, they leave their managers, not the organization, and this brings the assumption that leadership practices have strong implications in the intentions of employees to leave. This implies that engaged employees are less likely to leave their jobs and their managers, which essentially affect the extent of such engagement. One of the most important factors that can affect employee job satisfaction and their feeling regarding WE is the leadership behavior of managers (Kim et al., 2018).

Significance of the study

Over the past two decades, globalization and rapid technological advancements have raised situations where organizations encounter challenges like varying customer demands and increased competition. To keep pace with these changes and to maintain competitive edge, organizations need to have employees that are more motivated, inspired, innovative, and engaged in work. Moreover, nowadays, the criterion of success for any health organization has changed from how hard employee work to how organization faces several changes to be more responsive to the needs of their customers, These changes force organizations to have new styles of leadership that clearly encourage subordinates to be more productive, motivated, and engaged in their work.

Nowadays, nurse shortage is increasing owing to many causes, and one of them may be leadership style, which may affect nurses’ WE, and this is costly for the organization, as it may lead to low productivity. So leadership styles are very important to be studied to know which style makes followers more engaged in their work and thus more involved in decision and being creative, which all lead to increased employee commitment, satisfaction, and decreased intention to leave. So, employee engagement and organizational productivity would increase.

Yahaya and Ebrahim (2016) documented that leadership style is vital for encouraging employee engagement. There has been little published research into the relationship between leadership styles and employee engagement. This area would benefit from empirical research into what type of leadership can foster more employee engagement, and such a study would both fill a gap in the literature and have an important potential effect on practical activities. Results of studying the leadership styles would affect education, which will make the faculty members stress teaching the most effective leadership styles, so that students who will be graduated and become future leader nurses will be able to use these styles while practicing nursing.

Moreover, the results of the present study will delineate nurses’ perception about leadership behaviors that they are exposed to and if they have engagement at their work or not. This may guide the planning for using leadership behaviors that may enhance engagement and thus enhance organizational productivity, raise quality of care, and generate an attention for further research study. Moreover, it will give a baseline of nurses’ perception of the relation between leadership styles and WE.


  Participants and methods Top


Aim

This study aims to investigate the relationship between nurse manager leadership style and staff nurses’ WE.

Research questions

To fulfill the aim of this study, the following questions were formulated:
  1. What is the perception of staff nurses regarding their nurse manager leadership style?
  2. What is the level of staff nurses’ WE?
  3. What is the relationship between nurse manager leadership style and staff nurses’ WE?


Research design

A descriptive correlational design was used for this study.

Setting

This study was conducted at a hospital affiliated to Cairo University Hospitals which provide paid services, with total hospital bed capacity of 920 beds.

Sample

A proportional randomly selected sample was used in this study. The sample included 271 staff nurses working in different departments at the hospital, excluding nurses working in outpatients clinics, operating rooms, and nurses having less than 6 months of experience.

Tools of the study

The following two questionnaires were used to collect the data of the present study.

The first questionnaire was composed of the following:
  1. Personal characteristics data sheet: it was developed by the investigator and included age, sex, level of education, current position, marital status, years of experience in nursing, and years of experience in the current hospital.
  2. Multifactor leadership questionnaire: it was adopted from Sabry (2013) to assess leadership style of unit nurse manager from the perspective of staff nurses. It was composed of 21 items, which were subdivided into three dimensions of leadership styles: transformational (12 items), transactional (six items), and laissez-faire leadership style (three items). Data were scored on a five-point Likert scale that ranged from never=1 to always=5.


The second questionnaire was the Utrecht work engagement scale. It was adopted from Abed and Elewa (2016), to assess staff nurses’ WE. It included 17 items that were subdivided into three dimensions, namely, vigor (six items), dedication (five items), and absorption (six items). Items were measured against three-point Likert scale, scored as follows: disagree=(1), neutral=(2), and agree=(3).

The total score was expressed as percentage scores from 1 to 17, which represent 1–34%, indicating low engagement level; scores from 18 to 34, which represent 35–67%, indicating moderate engagement level; and scores from 35 to 51, which represent 68–100%, indicating high level of engagement. These levels were done by an expert in statistics.

Validity

Content validity is defined as the degree to which the instrument measures what it is supposed to measure. Regarding the multifactor leadership questionnaire adopted from Sabry (2013) and utretch WE scale, which was used and translated to Arabic by Abed and Elewa (2016), both questionnaires were valid.

Reliability

Reliability was done using Cronbach’s α test, which measures the internal consistency. The estimated result of reliability for the multifactor leadership questionnaire was 0.84 and for WE was 0.83, which was considered highly reliable.

Pilot study

The pilot study was carried out on 10% of the study sample, which was 271 staff nurses, from different sites of the hospital to ensure the clarity of the items and estimate the time needed to complete the questionnaire. Based on the pilot study analysis, no modifications were done in the questionnaire; therefore, the pilot study participants were included in the total of the study sample.

Data collection procedure

It was started upon receiving a formal approval through formal channels. The investigator was granted an approval letter from the faculty of nursing after getting an approval of the hospital and the nursing director of the hospital to conduct the study. Separate letters were handed to the managers explaining the purpose, nature, and significance of the study. After getting the approval, the investigator divided the hospital into four specialties or stratum as follows: medical (61 nurses), surgical (64 nurses), critical (55 nurses), and other units (91 nurses); these represented 25% of the population from each specialty. The investigator has taken approximately equal percentages of nurses, and the sample was taken randomly from each department as all even numbers taken from nurses’ work schedule of selected units. Investigator explained the purpose, nature, and significance of the study for every unit manager or charge nurse and staff nurses to get their maximum cooperation and participate in the present study. The study was conducted from January 2018 till May 2018.

Ethical and legal considerations

An official permission to conduct the proposed study was obtained from the officials of Faculty of Nursing, Cairo University, and general medical director, as well as general nursing director of selected hospital. The protocol of this study was approved by the Ethical Committee for Faculty Research. Written informed consents were secured from all participants before data collection. Data were collected during different shifts of the day. Meeting with the study participants and filling the self-reporting questionnaire took 30–40 min.

Statistical analysis

Data were coded, scored, tabulated, and analyzed by computer using Statistical Package for the Social Sciences (SPSS windows) version 21 (IBM, Armonk, New York, USA). Numerical data were expressed as mean±SD, and range. Correlation coefficient was used to determine direction and strength of the relationship of selected variables. This study used t-tests to identify the significant differences between the selected variables. The significance level of all statistical analyses was set at 0.05 (P value). The P value greater than 0.05 indicates insignificant result. The P value less than 0.05 indicates significant result. Analysis of variance test was done to find the effects of some independent variables on the participants’ perception. The negative items were reversed in the statistical analysis when indicated.


  Results Top


[Table 1] illustrates that most staff nurses (73.8%) were female, and more than two-thirds (69.4%) were in the age group of more than 27 years. Moreover, the majority of them (73.8%) were married. Approximately one-third (33.2%) of them were working in other places rather than medical, surgical, or critical.
Table 1 Percentage distribution of staff nurses according to their personal characteristics (N=271)

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[Figure 1] indicates that more than half of the staff nurses (59.1%) had a diploma degree and the least percentage of them (7.0%) had bachelor degree.
Figure 1 Percentage distribution of staff nurses according to their educational level (n=271).

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[Table 2] shows that the highest mean and mean score of nurses’ leadership style perception were regarding transformational and transactional leadership style (75.09 and 74.87%, respectively). The lowest mean score was regarding to laissez-faire leadership style (62.29%).
Table 2 Mean, SD, and mean percent of nurses’ perception of leadership style (n=271)

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[Table 3] reveals that staff nurses had the highest mean score (91.51%) regarding dedication dimension. Moreover, vigor and absorption dimensions had nearly the same mean scores (80.42 and 80.32%, respectively).
Table 3 Means, SD, and mean percent of staff nurses’ perception regarding work engagement dimensions

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[Table 4] shows that most staff nurses (89.3%) had a high level of WE.
Table 4 Levels of staff nurses’ work engagement

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[Table 5] demonstrates that there was a highly strong significant positive correlation between both transformational and transactional leadership styles of unit nurse manager and staff nurses’ WE (transformational: r=0.325** and P=0.000, and transactional: r=0.260** and P=0.000), whereas there were negative significant correlations between laissez-faire leadership style of unit nurse manager and staff nurses’ WE (r=−0.125 and P=0.040).
Table 5 The relationship between unit nurse manager leadership style and staff nurses’ work engagement (n=271)

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  Discussion Top


Nursing managers in health care organizations demonstrate leadership behaviors. They invest in their own development and continue to work on improving themselves every day. These are many leadership styles that determine methods of managing different situation; those leadership styles affect staff nurses’ behaviors and attitude toward their organizations (Adams et al., 2018). WE is the willingness of an individual to spend his/her efforts and time beyond the minimum requirements, to commit and work on task or job that is related to his/her position in an organization, in order to ensure organizational success (Keyko et al., 2016).

The present study revealed that the highest mean and mean percentage as perceived by staff nurses regarding unit nurse manager leadership style was transformational leadership style, and the lowest mean of unit nurse manager leadership style was laissez-fair leadership style. This result may be because most unit managers had bachelor’s degree, which consequently means most of them had leadership skills, had competencies, and were empowered to act as transformational and transactional leaders.

The previous results were congruent with the study done in Saudi Arabia by Al-Yami et al. (2018), who found that transformational leadership was the dominant leadership style. Additionally, Pishgooie et al. (2019), reported that the highest mean and mean percentage of unit nurse manager leadership style was transformational and transactional leadership style and the lowest mean of unit nurse manager leadership style was laissez fair style.

Regarding mean score of staff nurses’ perception about WE. The study showed that the highest mean and mean percentage of staff nurses WE was dedication dimension and the lowest mean was absorption. This could be because staff nurses feel they are involved in one’s work, finding meaning in one’s work, being challenged, and experiencing sense of enthusiasm.

This finding is in agreement with Rahmadani et al. (2019), who found that the highest mean is dedication and the lowest is absorption. Moreover, the results of Sullivan Havens et al. (2013) were in line with this, and they found that the sample scored highest on dedication and lowest on vigor.


  Results Top


of this study revealed that most staff nurses had high level of WE. This result may be owing to the supportive work environment which includes good communication and collaboration between staff nurses, justice, and skillful leaders that affect and reflect on staff. Similarly, this result is congruent with the study done by Manning (2016), who mentioned that more than half of the participants showed high level of WE in their workplace.

This result is in agreement with the study done by Mauno et al. (2016), who stated that most participants reported high level of WE and satisfaction with their work. Additionally, the result obtained in Egypt by Abou Ramadan et al. (2018) revealed that ∼50% of nursing staff reported that they never have WE, whereas the other half of staff nurses reported that they have WE. This result is contrary to Wan et al. (2018), who found that WE of staff nurses was relatively low.

Regarding the correlation between unit nurse manager leadership style and staff nurses’ WE, this study revealed that there were a highly strong significant positive correlation between each transformational and transactional leadership style of unit nurse manager and staff nurses’ WE, whereas there were a negative significant correlation between laissez-faire leadership style of unit nurse manager and staff nurses’ WE.

This result may be owing to the fact that transformational and transactional leaders are able to influence their followers’ attitude and behaviors because they have sufficient sources of power, and the two leadership styles motivates staff nurse. Transactional leadership style motivates through exchange process, whereby the leader identified organizational goals and encourages subordinates.

Additionally, transformational leaders transfer their enthusiasm and high power to their subordinates by the way of modeling. This manner can increase the power as a component of WE. Idealized influence among these leaders can result in forming a specific belief among employees toward those leaders and leaders can easily transmit their inspirational motivation to them. Consequently, it leads to creation of a positive vision, by which, and by setting high standards, challenges the employees.

This result is congruent with the study done by Mauno et al. (2016), who stated that there was a highly statistical significant correlation between transformational leadership style and subordinates’ WE, which indicated the importance of this style. Moreover, this result was in the same line with the study done by Joo and Kim (2016), who found a statistically positive correlation between each transactional and transformational leadership styles and all dimensions of WE. Additionally, Hayati et al. (2014) found a statistically positive correlation between transformational leadership style and WE. Moreover, Essays (2018) found a positive relationship between each of transformational and transactional leadership style and employee engagement.

On the contrary, Widmann (2013) found a statistically positive correlation between transformational leadership style and WE and negative correlation between transactional leadership style and WE, and also found a negative correlation between laissez-faire leadership style and WE. In addition, Garg and Ramjee (2013), revealed that there was a statistically significant relationship between transformational and WE, but there was no statistically significant relationship between each of transactional leadership style and laissez-faire leadership style and overall employee engagement.


  Conclusion Top


The result of the current study concluded that the highest mean and mean score of nurses’ leadership style perception were regarding transformational and transactional leadership style and the lowest mean score was regarding laissez-faire leadership style. Moreover, it showed that the highest mean and mean score of nurses’ WE was dedication and the lowest mean score was absorption. Adding to that, most staff nurses had a high level of WE. In addition, there were highly strong significant positive correlations between each of transformational and transactional leadership style of unit nurse manager and staff nurses’ WE, whereas there was a negative significant correlation between laissez-faire leadership style of unit nurse manager and staff nurses’ WE.

Recommendations

  1. Hospital administrators should support staff with different rewards to motivate them.
  2. Nurse managers should perform regular meetings with their staff nurses to identify staff work problems and help them to find solutions, which may improve their WE.
  3. Hospital administrators should perform regular assessment of unit nurse manager skills, knowledge, and behavior before and after enrollment in their position.
  4. Design training program for unit nurse managers about how to choose effective leadership behaviors
  5. Provide regular training and workshops for leaders to improve their knowledge, awareness, and skill about transformational leadership behaviors and its dimensions.
  6. Future studies should be encouraged to be done at different hospitals and settings with different sample size through which results can be generalized.
[24]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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