Adel Harb^1,, Zainab Althunian², Janette Silva³, Abdulrahman Alayed⁴, Saleh Aljarudi⁵, Abrar Barshaid⁶

The type of leadership style adopted by the manager and how it is perceived by nurses can play a critical role in influencing staff performance and healthcare outcomes. This study aims to examine nurses’ perceptions about the managers’ leadership and to determine whether the style used may play a role in determining the quality of patient care. Methodology: A cross-sectional quantitative study was conducted in Eastern Health Cluster was over a four- month period from April 5^th to July 30th 2021. A purposive sampling technique was used whereby all nurses and midwives working in EHC facilities, 8,699 staff, were invited to participate in the research adopting multifactor leadership questionnaire (MLQX5) to rate leadership styles and outcomes in relation to transformational, transactional, and passive avoidant leadership styles. The questionnaire was evaluated by a panel of expert nurse leaders against construct validity then piloted to test reliability. Data were collected after ethical approval was granted from King Fahad Specialist Hospital. Results: 577 nurses provided a 3.98% margin of error at the 95% confidence level. Statistical analysis was conducted using SPSS version 23.0. Results show that nurses perceive that their managers are using transformational and transactional leadership styles more often than passive avoidant leadership style. There was a positive and highly significant correlation between leadership and outcome factors. The analysis shows a positive correlation between leadership outcome factors (effectiveness, extra effort and satisfaction) and transformational and transactional leadership styles and a negative correlation with passive avoidant leadership style. A comparison of sociodemographic characteristics within the nursing workforce found that there are no significant differences in perceived leadership styles relating to gender although mean scores show that females had a higher perception of transformational and transactional styles compared to men who had a higher perception of passive avoidant style. Recommendations and Implication for Nursing: Transformational leadership appears to be best suited for nursing as it has positive nursing outcomes There is a strong need to implement leadership education and training amongst all nurses and to continuously train and educate nurse leaders and those potential leaders under succession planning programs about leadership skills and competencies and how to promote a culture for transformational leadership. Conclusion: The transformation of the healthcare system in Saudi Arabia, and challenges that are inherent, emphasize the importance of ensuring that nurses are effective leaders if organizational needs are to be met in the future. It is therefore important to conduct further qualitative and quantitative nursing researches amongst this nurse population to provide evidence about how leadership style is perceived and how it may influence outcomes within the nursing workforce and work environment.

nurses, perceptions, leadership styles, eastern healthcare cluster, Saudi Arabia