Self-leadership of nurses in a critical care outreach service: The development of a conceptual framework

Background: Globally, critical care outreach services (CCOS) were implemented in health care facilities; however, compliance with guidelines is poor. The authors have noticed that a gap exists in the literature on how self-leadership might influence nurses' implementation of CCOS. Self-leadership is about leadership applied to oneself. Critical care outreach services assist nurses with the nursing care of a patient whose health is declining. Leadership is needed for the successful implementation of CCOS. Aim: This article aims to outline the method the authors followed for developing the conceptual framework for how self-leadership amongst nurses influenced the functioning of CCOS. Setting: The research was conducted at a private hospital in Pretoria. Methods: A qualitative approach was followed to provide an accurate description of nurses' experiences on their self-leadership in a CCOS. The practice-oriented theory of Dickoff (1968) was the reasoning map for developing and constructing the conceptual framework. Results: Bedside nurses experienced the following self-leadership strategies: constructive thought patterns, natural rewards and behaviours focused on their implementation of CCOS. Conclusion: The conceptual framework was part of another study and provided the authors with a rationale that guided the authors with the development of self-leadership strategies in a CCOS. Contribution: The conceptual framework provided the authors with an understanding of how nurses' self-leadership influenced the implementation of CCOS. The conceptual framework can also assist in developing training programmes for nurses to improve their self-leadership and ultimately improve nurses' competence in providing quality nursing care to patients.

Effects of Psychological Ownership, Self-leadership, and Social Exchange Relationships on Innovative Behavior of Military Hospital Personnel / 산업간호학회지

PURPOSE: The purpose of the study was to identify factors affecting the innovative behavior of military hospital personnel. METHODS: The study involved the analysis of 146 structured questionnaires received from military hospital personnel in D city and S city. Data were collected from January 10 to February 9, 2019. The SPSS/WIN 24.0 program was used for data analysis, which included the t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, and multiple regression analysis. RESULTS: The multiple regression analysis showed that factors affecting innovative behavior of military hospital staff were the natural reward strategies of self-leadership, behavior-focused strategies of self-leadership, and organization-based psychological ownership (R2=.30). CONCLUSION: The results suggest that to promote innovative behavior in military hospital staff, it is necessary to implement strategies that inspire self-leadership and psychological ownership.

Factors related to Self-leadership of Korean Clinical Nurses: A Systematic Review and Meta-analysis / 간호행정학회지

PURPOSE: In this study a systematic review and meta-analysis was used to examine the variables related to self-leadership in Korean clinical nurses. METHODS: A search and screening of the literature uncovered, 49 related studies done between 2003 and 2016 were then reviewed. A meta-analysis of 44 studies from doctoral dissertations, master's thesis and published articles was also carried out. The correlational effect size (ESr) for each related variable was calculated. RESULTS: Sixty-nine related variables were identified from the systematic review. Twenty-three (5 personal, 13 professional and 5 organizational) variables were eligible for meta-analysis. The overall effect size was .47. The personal factors (ESr=.48) and the professional factors (ESr=.44) had larger effect size than the organizational factors (ESr=.28). Factors with the largest effect size among personal, professional and organizational factors were self-efficacy (ESr=.58), nursing service (ESr=.68) and supervisor's leadership (ESr=.36) respectively. CONCLUSION: The results of this study show that for Korean clinical nurses individual factors including personal or professional factors have a stronger impact on self-leadership than organizational factors. It is necessary to develop interventions and training programs which focus on improving self-efficacy to promote self-leadership in clinical nurses.

Factors Influencing Self-leadership of Nursing Students according to Locus of Control / 간호행정학회지

PURPOSE: The purpose was to identify factors which affect nursing students' self-leadership according to their locus of control. METHODS: This study was a descriptive research. Participants were 600 D city junior and senior nursing students who had completed clinical training. RESULTS: Results showed the following characteristics of students who had high self-leadership: For students with external locus of control the following correlations with self-leadership were found:, general creativity (r=.46), social support (r=.48), academic self-efficacy (r=.29), and communication competence (r=.49). For students with internal locus of control, self-leadership was correlated with general creativity (r=.46), social support (r=.41), academic self-efficacy(r=.36), and communication competence (r=.48). For the nursing students with external locus of control, age (β=−.24, p=.010), satisfaction with campus life (β=.16, p=.027), general creativity (β=−.20, p=.017), and social support (β=−.20, p=.028) had significant effects on their self-leadership: explanatory power of 44% (F=6.53, p < .001). For students with internal locus of control, self-leadership was effected by general creativity (β=.20, p=.011) and social support (β=.19, p=.012): explanatory power was 42%(F=5.96, p < .001). CONCLUSION: Applying these findings to the curriculum of nursing students would improve their self-leadership and increase the efficiency of organizational culture and contribute to goal achievement in nursing organizations.

The Effects of Self-leadership Reinforcement Program for Hospital Nurses

PURPOSE: This study has been carried out in order to develop and verify the effects of self-leadership reinforcement program for hospital nurses. METHODS: The research design was a non-equivalent control group pre-posttest design. Participants were 64 individuals (32 in each group), all of whom were nurses working at a university hospital, with less than five years of job experience. Experimental group was provided with two hours of self-leadership reinforcement program, once per week, for four weeks. The questionnaire for pre and post test included general characteristics, transfer motivation for learning, self-leadership, communication ability, clinical nursing competency, organizational commitment, and turnover intentions. RESULTS: There was a significant difference in self-leadership scores between experimental group and control group (F=15.10, p < .001). There was also a significant difference between the experimental group and the control group in terms of transfer motivation for learning (t=−5.44 p < .001), communication ability (F=15.29, p < .001), clinical nursing competency (F=15.23, p < .001), and organizational commitment scores (F=7.21, p=.009). CONCLUSION: The self-leadership reinforcement program developed in this study was effective in improving self-leadership, communication ability, clinical nursing competency, and organizational commitment. Thus, by implementing the program at clinical levels, it will be a basis for nursing personnel resource administration.

Relationship among Types of Nursing Organizational Culture, Self-leadership and Burnout as Perceived by Perioperative Nurses / 간호행정학회지

PURPOSE: This study was designed to assess the types of nursing organizational culture, and degree of self-leadership and burnout as perceived by perioperative nurses, and to identify correlations between these variables. METHODS: Participants were 155 nurses from 3 tertiary hospitals in Seoul and data were analyzed using descriptive statistics, ANOVA, Scheffé, and Pearson correlation coefficient. RESULTS: In the types of nursing organizational culture, the mean score for hierarchy-oriented culture was 3.57, and for self-leadership, 3.61 and for burnout, 2.87. In the relationship between the types of nursing organizational culture, self-leadership and burnout, relation-oriented culture (r=.24, p<.01), innovation-oriented culture (r=.23, p<.01) and task-oriented culture (r=.22, p<.01) had a slight positive correlation with self-leadership in that order. The innovation-oriented culture (r=-.29, p<.01) and relation-oriented culture (r=-.42, p<.01) among the types of nursing organizational culture showed a negative correlation with burnout while the hierarchy-oriented culture (r=.28, p<.01) showed a positive correlation with burnout. Self-leadership showed a negative correlation with burnout (r=-.42, p<.01). CONCLUSION: The results show that nurses in operating rooms have a high awareness of hierarchy-oriented culture that affects burnout in a negative way while having a low awareness of relation-oriented culture that has a positive influence on burnout.

Influence of Professional Self-concept and Self-leadership on Clinical Competence in Nursing Students / 기본간호학회지

PURPOSE: This study was done in order to identify nursing students' professional self-concept, self-leadership and clinical competence and to analyze the correlation among the variables and the factors influencing clinical competence. METHODS: The research participants were 294 senior nursing students in the nursing departments of 3 universities located in Jeollabuk-do. The students had completed 3 semesters of clinical practice. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and Multiple Regression. RESULTS: Participants' scores for professional self-concept, self-leadership, clinical competence were 2.78±0.36, 3.63±0.47, 3.80±0.40 respectively. Professional self-concept, self-leadership and clinical competence had positive correlations. Factors influencing nursing students' clinical competence included professional self-concepts in professional practice, self-expectations in self-leadership, constructive thinking, self-compensation and self-criticism in that order, and these variables explained 48%of the variance in clinical competence. CONCLUSION: Based on these results, it is important to develop and apply educational programs to increase professional self-concept and self-leadership in order to improve nursing students' clinical competence.

Factors Affecting Clinical Competence of Dental Hygienists / 치위생과학회지

This study sought to examine the factors influencing clinical competence of dental hygienists. A survey on burnout, critical thinking tendency, self-esteem, self-leadership, professional self-concept and clinical competence was conducted with 254 dental hygienists using self-administered questionnaires. Correlation analysis was performed between study variables, and linear regression analysis identified factors influencing clinical competence. To determine a causal relationship among these factors, a path analysis was conducted at the 0.05 level of significance. Relationships among research variables showed significant positive correlations (p<0.01). Self-esteem, self-leadership, and professional self-concept were found to influence clinical competence (p<0.01). A causal relationship was also found among variables influencing clinical competence. Burnout and critical thinking had an indirect effect, whereas self-esteem, professional self-concept, and self-leadership had both direct and indirect effects. In conclusion, important factors influencing clinical competence of dental hygienists include self-esteem, self-leadership, and professional self-concept. Based on these findings, programs to enhance clinical competence of dental hygienists should be developed.

The Effects of Hospital Nurses' Self-Esteem and Communication Skill on Self-Leadership and the Quality of Nursing Service / 간호행정학회지

PURPOSE: The objective of this study was to investigate the influence of hospital nurses' self-leadership, communication skill, and self-esteem on the quality of nursing service. METHODS: The participants, 230 nurses working at a general hospital in Seoul, completed a cross-sectional descriptive questionnaire survey between January 17 and 28, 2014. The collected data were analyzed using the SPSS 19.0 program for descriptive statistics, t-test, one way & two way ANOVA, correlation, and multiple regression analysis. RESULTS: Nurses' self-esteem and communication skill had significant main effects on self-leadership and the quality of nursing service, but the interaction effect of the two independent variables was not significant. Variables that significantly influenced the quality of nursing service were self-leadership, communication skill, self-esteem, and career longevity. The explanatory power of these variables for the quality of nursing service was 54.4%. CONCLUSION: Findings indicate a need for education programs for nurses which are designed to promote communication skill and enhance self-esteem and self-leadership skills which will in turn enhance the quality of nursing service.

Factors Influencing the Career Preparation Behavior of Nursing Students / 간호행정학회지

PURPOSE: The purpose of this study was to identify the effects of nursing professionalism, satisfaction with major, and self-leadership on nursing student career preparation behavior. METHODS: Data were collected from August 1 to August 31, 2014. Participants were 400 students who completed self-report questionnaires covering career preparation behavior, nursing professionalism, satisfaction with major and self-leadership. The SPSS/WIN/PC 21.0 program was used for descriptive statistics, t-test, ANOVA, Pearson correlational coefficients and stepwise multiple regression. RESULTS: The average scores for career preparation behavior, nursing professionalism, satisfaction with major, and self-leadership were 2.51, 3.80, 3,89, and 3.51 respectively. There were positive correlations among career preparation behavior, nursing professionalism, satisfaction with major, and self-leadership. Age, academic year, nursing professionalism, self-leadership, general satisfaction in satisfaction with major were significant predictors of career preparation behavior. CONCLUSION: It is necessary to provide career educational programs considering according to the academic year of nursing students and to develop educational programs to improve the nursing professionalism of nursing students.

The Relationship among Nurses' Perception of Super-leadership, Self-leadership and Organizational Commitment / 간호행정학회지

PURPOSE: This study was designed to assess the level of super-leadership and self-leadership, identify correlations among variables and identify the factors influencing organizational commitment of clinical nurses. METHODS: Participants were 217 nurses working in four hospitals located in Seoul and Gyeonggi Province. Data were analyzed using descriptive statistics, independent t-test, one way ANOVA, Scheffé test, Pearson Correlation, and Multiple Regression. RESULTS: The most influential factor for organizational commitment was super-leadership (β=.28, p<.001), followed by education (β=.16, p=.007), the number of unit nurses (β=-.18, p=.003), self-leadership (β=.17, p=.008), and the number of patients being under 10 (β=.12, p=.046). These factors accounted for 23% of the variance in organizational commitment (F=13.46, p<.001). CONCLUSION: The results of this study suggest a need for strategies to improve organizational commitment of nurses by enhancing nurse' self-leadership through nursing managers' super-leadership.

Relationship between Positive Affectivity, Self-Leadership, and Satisfaction of Clinical Practice among Nursing Students / 한국간호교육학회지

PURPOSE: This study aimed to identify the relationship between positive affectivity, self-leadership, and satisfaction of clinical practice among nursing students. METHODS: This study was a descriptive correlational study. A total of 205 participants were obtained by convenience sampling from third- and fourth-year nursing students in three nursing schools. The data were collected by using a self-reporting questionnaire. Collected data were analyzed with SPSS Win 18.0. RESULTS: Mean scores were 3.40 (5-point scale) for positive affectivity, 3.68 (5-point scale) for self-leadership, and 3.30 (5-point scale) for satisfaction of nursing clinical practice. There was a significant positive correlation of nursing students among positive affectivity (r=.43, p<.001), self-leadership (r=.41, p<.001), and satisfaction of clinical practice. The predictors were levels of satisfaction about nursing major, grade, positive affectivity, and rehearsal, which accounted for 34% of the variance in satisfaction with clinical practice nursing students. CONCLUSION: It is necessary to enhance the levels of satisfaction about nursing major, the level of positive affectivity, and self-leadership in nursing students. The results of this study delineate the need for the development and application of diverse educational programs that can increase positive affectivity and self-leadership for clinical practice.

The Influence of Personality Characteristics and Decision Making Type on Self-Leadership of Nursing Students / 한국간호교육학회지

PURPOSE: This study aimed to examine the effects of personality characteristics and decision making type on the self-leadership of nursing students. METHODS: The participants were 336 nursing students using a self-report questionnaire. Data were analyzed using a t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: There were significant positive correlations between self-leadership and extraversion (r=.50, p<.001), agreeableness (r=.22, p<.001), conscientiousness (r=.60, p<.001), openness to experience (r=.36, p<.001), and rational style (r=.47, p<.001). However the correlation between self-leadership and dependent style was significantly negative (r=-.11, p=.044). Conscientiousness (β=.60, p<.001), extraversion (β=.28, p<.001), and rational style (β=.21, p<.001), openness to experience (β=.18, p<.001), and degree of leadership level (β=.10, p=.020) were identified as factors affecting self-leadership. The explanation power of this regression model was 50.0% and it was statistically significant (F=67.52, p<.001). CONCLUSION: The results of this study indicated that effective self-leadership programs should be developed by including conscientiousness, extraversion, openness to experience, and rational decision making.

A Study on Nursing Students' Self-leadership and Their Perception of Learning / 한국간호교육학회지

PURPOSE: The purpose of this study was to identify the relationship between self-leadership and the perception of learning in nursing students. METHODS: A descriptive research design was used in this study. The participants were 378 nursing students in M city and C city who were surveyed between June 1 and June 30, 2014 using self-report questionnaires. The data was analyzed using SPSS WIN 21.0 Program, which determined frequency, percentage, mean, standard deviation; a One-way ANOVA; a Scheffe test; a Pearson correlation coefficient; and a Stepwise multiple regression analysis. RESULTS: There were significant positive correlations between nursing students' self-leadership and their perception of learning. In the multiple regression analysis, self-leadership was the most significant predictor in explaining nursing students' perception of learning. CONCLUSION: Study findings suggest that nursing students' self-leadership is defined as having an important influence on nursing students' perception of learning. In order to strengthen nursing students' self-leadership, there is a need to develop education programs that increase nursing students' self-leadership.

Effects of Korean Enneagram Program on the Ego-identity, Interpersonal Relationship, and Self-leadership of Nursing College Students / 간호행정학회지

PURPOSE: This study was done to identify the effects of the Korean Enneagram program on college nursing students' ego-identity, interpersonal relationships and self-leadership. METHODS: A nonequivalent control group pre-posttest design was used. Twenty-nine students were in the experimental group receiving the Korean Enneagram program, and 28 were in the control group with no treatment. RESULTS: 'The experimental group will show higher scores for ego-identity (t=3.97, p<.001), interpersonal relationship (t=3.26, p=.002) and self-leadership (t=2.91, p=.007) compared to the control group 8 weeks after the program finished' was supported by significant differences in the scores between the two groups. CONCLUSION: The findings indicate that the Korean Enneagram Program has a significant effect on improving ego-identity, interpersonal skills and self-leadership in nursing college students and the program can be used as a tool to promote the ego-identity, interpersonal skills and self-leadership of nursing students.

Correlations Among Nursing Professionalism, Critical Thinking Disposition and Self-leadership in Nursing Students / 한국간호교육학회지

PURPOSE: The purpose of this study was to determine the relationship among the factors of nursing professionalism, critical thinking disposition and self-leadership in nursing students. METHODS: The participants were 715 nursing students in tertiary education. Data was collected from March 10 to 14, 2014 using self-report questionnaires and analyzed through descriptive statistics, t-test, ANOVA and Pearson correlation coefficient with SPSS/win 17.0. RESULTS: The mean scores for nursing professionalism (3.48+/-.50), critical thinking disposition (3.14+/-.27), self-leadership (3.44+/-.40) were above average. There was a positive correlation between nursing professionalism and self-leadership (r=.452, p<.01) and between critical thinking disposition and self-leadership (r=.405, p<.001). CONCLUSION: The result of this study indicates that developing nursing professionalism and critical thinking disposition in nursing students is significant for improving their self-leadership. Therefore the findings suggest meaningful basic data for nursing education.

Effects of Organizational Culture, Self-Leadership and Empowerment on Job Satisfaction and Turnover Intention in General Hospital Nurses / 간호행정학회지

PURPOSE: In this study factors affecting job satisfaction and turnover intention of nurses were explored in the context of organizational culture, self-leadership, and empowerment. METHODS: Participants were 286 nurses drawn from 3 general hospitals. Data were analyzed using t-test, one-way ANOVA, Pearson correlation, and hierarchial multiple regression with the SPSS/WIN 18.0 program. RESULTS: Significant differences in job satisfaction and turnover intention were found according to organizational culture types. Significant positive correlations were found between self-leadership, empowerment, task oriented organizational culture, relationship oriented organizational culture, innovation oriented organizational culture and job satisfaction. On the other hand, significant negative relationships were found between empowerment, relationship oriented organizational culture, innovation oriented organizational culture and turnover intention. The factors that enhance job satisfaction were found to be higher innovation-oriented organizational culture. Lower turnover intention was shown to be positively associated with relationship- or innovation oriented organization culture. CONCLUSION: Innovation oriented organizational culture is needed in order to raise job satisfaction and reduce turnover intention of nurses.

Effects of Self-leadership and Job Involvement on Clinical Competence in General Hospital Nurses / 간호행정학회지

PURPOSE: This study was performed to identify the effects of self-leadership and job involvement on clinical competence in general hospital nurses. METHODS: The participants in this study were 443 staff nurses working in general hospitals and having more than 6 months of nursing experience. Data were collected using self-administered questionnaires. RESULTS: There were significant positive correlations between nurses' self-leadership and job involvement, and between nurses' self-leadership and clinical competence. In the multiple regression analysis, clinical career, type of department and self-leadership were significant predictors in explaining nurses' clinical competence and accounted for 28% of the variance in nurses' clinical competence. CONCLUSION: Study findings suggest that nurses' self-leadership is defined as having an important influence on nurses' clinical competence. In order to strengthen nurses' clinical competence, there is a need to develop education programs to increase nurses' self-leadership.

A Review of Research on Self-leadership in Nurses' / 간호행정학회지

PURPOSE: The purpose of this study was to review journal articles, master's theses, and doctoral dissertations on self-leadership in nurses in order to identify overall trends in nursing self-leadership and to suggest strategies to improve self-leadership. METHODS: Twenty-six papers on self-leadership in nurses were reviewed. RESULTS: These papers were journal articles, master's theses, and doctoral dissertations regarding nurses who worked in general hospitals, university hospitals, and public health centers. Self-leadership was measured by using instruments developed by Manz (1983), Prussia, Anderson, & Manz (1998), and Houghton & Neck (2002). The instrument was composed of 18 items, with a 5-point Likert scale developed by Manz (1983) and modified by Kim (2002). Nurses' self-leadership was found to be related to job satisfaction, organizational commitment, nursing performance, and citizenship behavior. General characteristics of nurses, including age, education, marital status, position, and career, were also associated with self-leadership. CONCLUSION: The study findings provide data on recent trends in nurses' self-leadership. These results serve as basic data to provide a standard for developing self-leadership and indicate directions for further research.

The Effects of Preceptor Nurses' Self-leadership on Role Recognition and Job Satisfaction / 간호행정학회지

PURPOSE: The purpose of this study was to examine the effects of preceptor nurses' self-leadership on role recognition and job satisfaction. METHOD: The participants were 171 preceptor nurses worked in one of three general hospitals in Seoul. The data were collected from April 12 to May 12, 2011 and analyzed using descriptive statistics, t-test, ANOVA, pearson correlation, Scheffe, and regression with SPSS Win 19.0 program. RESULT: The results of the study were as followed. The average score for preceptor nurses' self-leadership was 3.55, for role recognition, 3.81 and for job satisfaction, 3.28. The factors of the preceptors' self-leadership affecting role recognition were self-expectation (beta=260, p=.002) and goal setting (beta=199, p=.030), and those factors accounted for 18.9% of explanatory power. The factors of self-leadership influencing job satisfaction were self-expectation (beta=18.3, p=.021), and rehearsal (beta=-168, p=.030), and those factors accounted for 31.3% of explanatory power. Among the factors of self-leadership, self-expectation influenced both role recognition and job satisfaction. CONCLUSIONS: The results of the study indicate that to improve preceptor's role recognition and job satisfaction, there should be special training programs to enhance preceptor's self leadership.