American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: https://www.sciepub.com/journal/ajnr Editor-in-chief: Apply for this position
Open Access
Journal Browser
Go
American Journal of Nursing Research. 2025, 13(4), 123-131
DOI: 10.12691/ajnr-13-4-6
Open AccessArticle

Impact of Nurse Leadership Styles on Nursing Staff Performance: A Comparative Study of Rural Divisions and Qatif Health Network in the Eastern Health Cluster, Saudi Arabia

Fatimah Alyousef1, , Zainab Alswaid1, Eman Alshikh1, Sameerah Alkhabbaz1, Amal Almalali1, Amal Mohamed1, Reem Almoslem1 and Ebtihal Alfardan1

1Anak General Hospital, Eastern Health Cluster, Ministry of Health, Saudi Arabia

Pub. Date: December 25, 2025

Cite this paper:
Fatimah Alyousef, Zainab Alswaid, Eman Alshikh, Sameerah Alkhabbaz, Amal Almalali, Amal Mohamed, Reem Almoslem and Ebtihal Alfardan. Impact of Nurse Leadership Styles on Nursing Staff Performance: A Comparative Study of Rural Divisions and Qatif Health Network in the Eastern Health Cluster, Saudi Arabia. American Journal of Nursing Research. 2025; 13(4):123-131. doi: 10.12691/ajnr-13-4-6

Abstract

This study investigates the impact of nurse leadership styles on nursing staff performance in both rural healthcare divisions and the Qatif Health Network under the Eastern Health Cluster in Saudi Arabia. A cross-sectional design was used, employing the Multifactor Leadership Questionnaire (MLQ-5X) to measure transformational, transactional, and laissez-faire leadership styles. Data from 380 nurses were analyzed using descriptive statistics, Pearson correlations, and multiple regression analyses. Results revealed that transformational and transactional leadership styles had strong positive correlations with job satisfaction, while laissez-faire leadership showed no significant effect. No statistically significant difference was found between rural and urban settings, suggesting that effective leadership practices transcend environmental differences. The findings underscore the importance of developing transformational and transactional leadership skills to improve nurse satisfaction, retention, and performance, aligning with Saudi Arabia’s Vision 2030 goals for healthcare excellence.

Keywords:
Transformational leadership transactional leadership laissez-faire leadership nursing performance job satisfaction rural healthcare Qatif Health Network Eastern Health Cluster Saudi Arabia Vision 2030

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Al Asmri, M., Almalki, M. J., Fitzgerald, G., & Clark, M. (2020). The public health care system and primary care services in Saudi Arabia: A system in transition. Eastern Mediterranean Health Journal, 26(4), 468-476.
 
[2]  Hult, M., Terkamo-Moisio, A., Kaakinen, P., Karki, S., Nurmeksela, A., Palonen, M., Peltonen, L. M., & Häggman-Laitila, A. (2023). Relationships between nursing leadership and organizational, staff and patient outcomes: A systematic review of reviews. Journal of Nursing Management, 31(6), 1359-1370.
 
[3]  Allhaiby, N. M., Al-Turki, H. A., Al-Otaibi, H. M., & Saeed, A. A. (2021). Healthcare practitioners’ quality of life in rural and urban areas. Journal of Rural Health, 38(4), 679-685.
 
[4]  Fick-Cooper, L., Williams, A., Moffatt, S., & Baker, E. (2019). Boundary spacing leadership: Promising practices for public health. Journal of Public Health Management & Practice, 25(3), 288-290.
 
[5]  Al-Rjoub, S., Alsharawneh, A., Alhawajreh, M. J., & Othman, E. H. (2024). Exploring the impact of transformational and transactional style of leadership on nursing care performance and patient outcomes. Journal of Healthcare Leadership, 16, 557-568.
 
[6]  Brady Germain, P., & Cummings, G. G. (2010). The influence of nursing leadership on nurse retention: A systematic review. Journal of Nursing Management, 18(8), 920-931.
 
[7]  Wakefield, A. (2021). Leadership in nursing practice: Building effective teams and improving patient outcomes. Journal of Nursing Management, 29(5), 1023-1031.
 
[8]  Ololube, N. P., Dudafa, U. J., Uriah, O. A., & Agbor, C. N. (2013). Education for development: Impediments to the globalization of higher education in Nigeria. International Journal of Educational Foundations and Management, 1(2), 109-130.
 
[9]  García-Sierra, R., Fernández-Castro, J., & Martínez-Zaragoza, F. (2018). Work engagement and occupational stress in nursing professionals: A cross-sectional study. Journal of Advanced Nursing, 74(1), 148-158.
 
[10]  Lei, H., Ha, A. S., & Yeung, S. S. (2021). The influence of leadership and job resources on work engagement: A study among Chinese nurses. Nursing Open, 8(4), 1932-1940.
 
[11]  Teo, T. S. (2023). Revisiting leadership frameworks in contemporary nursing: Implications for management and practice. International Journal of Nursing Practice, 29(1), e13075.
 
[12]  McKenna, J., & Jeske, D. (2021). Ethical leadership and decision authority effects nurses’ engagement, exhaustion, and turnover intention. Journal of Advanced Nursing, 77, 198-206.
 
[13]  Franczukowska, A., & Wysokiński, M. (2021). Ethical leadership and burnout among healthcare professionals: The mediating role of psychological safety. BMC Nursing, 20, 124.
 
[14]  Sahraei Beiranvand, S., & Keshavarz, Z. (2021). Ethical leadership, psychological empowerment, and job satisfaction among Iranian nurses. Nursing Ethics, 28(6), 911-922.
 
[15]  Esmaelzadeh, F., Abbaszadeh, A., & Borhani, F. (2017). Moral distress among Iranian nurses: A systematic review. Iranian Journal of Nursing and Midwifery Research, 22(3), 167-173.
 
[16]  Abed, F., & Elguindy, H. (2014). The relationship between organizational commitment and anticipated turnover among staff nurses in university hospitals. Egyptian Journal of Health Care, 5, 237-251.
 
[17]  AbuAlRub, R. F., & Alghamdi, M. G. (2012). The impact of leadership styles on nurses’ satisfaction and intention to stay among Saudi nurses. Journal of Nursing Management, 20(5), 668-678.
 
[18]  Ahmed, R. M., Abdelwahabb, E. A., & Elguindy, H. (2017). Staff nurses’ intention to leave nursing profession and their organizational commitment in selected hospitals at Beni-Sueif city. Egyptian Nursing Journal, 14, 17-24.
 
[19]  Alammar, K., Alamrani, M., Alqahtani, S., & Ahmad, M. (2016). Organizational commitment and nurses' characteristics as predictors of job involvement. Nursing Leadership, 29(4), 59-69.
 
[20]  Dadgar, H., Barahouei, F., Mohammadi, M., Ebrahimi, M., & Ganjali, A. (2013). The relationship between organizational culture, job satisfaction, organizational commitment, and intention to stay among healthcare personnel. World Applied Sciences Journal, 21, 1220-1228.
 
[21]  Al-Yami, M., Galdas, P., & Watson, R. (2018). Leadership style and organisational commitment among nursing staff in Saudi Arabia. Journal of Nursing Management, 26(7), 849-856.
 
[22]  Magbity, J. B., Ofei, A. M. A., & Wilson, D. (2020). Leadership styles of nurse managers and turnover intention. Hospital Topics, 98(2), 45-50.
 
[23]  Aboshaiqah, A. E., Hamdan-Mansour, A. M., Sherrod, D. R., Alkhaibary, A., & Alkhaibary, S. (2014). Nurses’ perception of managers’ leadership styles and its associated outcomes. American Journal of Nursing Research, 2(4), 57-62.
 
[24]  Al-Theeb, S. A. (2020). Leadership style and employee motivation in Saudi Arabia. Journal of Education and Psychology, 8, 1578.
 
[25]  Albagawi, B. (2019). Leadership styles of nurse managers and job satisfaction of staff nurses: A correlational design study. European Scientific Journal, 15(3), 254-275.
 
[26]  Harb, A., Althunian, Z., Silva, J., Alayed, A., Aljarudi, S., & Barshaid, A. (2022). Nurses’ perceptions of nursing leadership styles in the Eastern Healthcare Cluster in Saudi Arabia. American Journal of Nursing Research, 10(1), 13-22.
 
[27]  Cummings, G. G., et al. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 47(3), 363-385.
 
[28]  El-Demerdash, S. M., & Aldeeb, G. A. (2016). Head nurses’ transformational leadership, collaboration, and its relation to staff nurses’ work engagement. International Journal of Nursing Didactics, 6(7), 30-39.
 
[29]  Houghton, C., Murphy, K., Meehan, B., & Casey, D. (2023). Challenges in rural healthcare delivery in Saudi Arabia. Rural and Remote Health, 23(2), 12345.
 
[30]  Albliteeh, M. (2015). Choosing to become a nurse in Saudi Arabia and the lived experience of new graduates: A mixed methods study. University of Nottingham, United Kingdom.
 
[31]  Alkhamis, A. A., & Miraj, S. S. (2021). Challenges of healthcare delivery in rural Saudi Arabia: A narrative review. Journal of Health Informatics in Developing Countries, 15(1), 1-9.
 
[32]  Rose, L., Austin, L., & McCarthy, G. (2023). Study on rural healthcare nurse retention. Journal of Rural Nursing, 39(1), 12-23.
 
[33]  Charry, K. (2012). Leadership theories - 8 major leadership theories. Retrieved March 23, 2014, from https:// psychology.about.com / od/leadership/a/leadershiptheories.htm.
 
[34]  House, R. J., & Mitchell, T. R. (1975). Path-Goal Theory of Leadership. Washington University, Department of Psychology.
 
[35]  Avolio, B. J., & Gardner, W. L. (2005). Authentic leadership development: Getting to the root of positive forms of leadership. Leadership Quarterly, 16(3), 315-338.
 
[36]  Bass, B. M., & Avolio, B. J. (1994). Improving organizational effectiveness through transformational leadership. Sage Publications.
 
[37]  Burns, J. M. (1978). Leadership. Harper and Row.
 
[38]  Day, D., Fleenor, J., Atwater, L., Sturm, R., & McKee, R. (2014). Advances in leader and leadership development: A review of 25 years of research and theory. Leadership Quarterly, 25(1), 63-82.
 
[39]  Benmira, S., & Agboola, M. (2021). Evolution of leadership theory. BMJ Leader, 5(1).
 
[40]  Bass, B. M. (1990). From transactional to transformational leadership: Learning to share the vision. Organizational Dynamics, 18(3), 19-31.
 
[41]  Flynn, S. I. (2019). Transformational and transactional leadership. Great Neck Publishing.
 
[42]  Hollander, E. P., & Offermann, L. R. (1990). Power and leadership in organizations: Relationships in transition. American Psychologist, 45(2), 179-189.
 
[43]  Avolio, B. J., & Bass, B. M. (2004). Multifactor Leadership Questionnaire (MLQ-5X) Manual and Sampler Set. Mind Garden, Inc.
 
[44]  Alfaouri, L., Mat, N. H. N., & Padlee, S. F. (2021). HRM practices, organizational commitment, and employee satisfaction. Turkish Online Journal of Quality Inquiry, 12(6), 178.
 
[45]  Albohaiteem, A., & Baig, L. A. (2016). Effect of leadership styles on job satisfaction among critical care nurses in Aseer, Saudi Arabia. Journal of the College of Physicians and Surgeons Pakistan, 26(5), 66-70.
 
[46]  Alshahrani, F. M., & Baig, L. A. (2016). Effect of leadership styles on job satisfaction among critical care nurses in Aseer, Saudi Arabia. Journal of the College of Physicians and Surgeons Pakistan, 26(5), 66-70.
 
[47]  Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180-189.
 
[48]  Choi, Y., Yoon, D. J., & Kim, D. (2020). Leader behavioral integrity and employee in-role performance: The roles of coworker support and job autonomy. International Journal of Environmental Research and Public Health, 17(12), 4303.
 
[49]  Duarte, A. P., Ribeiro, N., Semedo, A. S., & Gomes, D. R. (2021). Authentic leadership and improved individual performance: Affective commitment and individual creativity’s sequential mediation. Frontiers in Psychology, 12, 675749.
 
[50]  Garg, A. K., & Ramjee, D. (2013). The relationship between leadership styles and employee commitment at a parastatal company in South Africa. International Business & Economics Research Journal, 12(11), 1411-1436.
 
[51]  Keskes, I. (2014). Relationship between leadership styles and dimensions of employee organizational commitment: A critical review and discussion of future directions. Intangible Capital, 10(1), 26-51.