Transformational Nurse Leaders and Nurse Well-Being: Examining Mediating Influences of Organisational Justice and Quality of Work-Life Mixed Methods Study.
Abstract
Background: Transformational leadership is recognised as a crucial factor influencing nurses' work experiences and well-being. However, the mechanisms through which transformational leadership affects nurse well-being, especially concerning organisational justice and quality of work life, are not fully understood. Aim: This study investigates the direct and indirect effects of transformational leadership on nurse well-being, focusing on the mediating roles of organisational justice and quality of work life. Methods: Using a sequential explanatory mixed methods design, quantitative data were collected from 580 nurses across five hospitals in Saudi Arabia with validated tools: the Global Transformational Leadership Scale, Organizational Justice Scale, Quality of Nursing Work Life Scale, Emotional Exhaustion subscale of the Maslach Burnout Inventory, Job Satisfaction Scale, and Perceived Stress Scale. Qualitative data were obtained from 25 focus group discussions using a validated semi-structured discussion guide. Quantitative analyses included hierarchical multiple regression and mediation analyses, while qualitative data were analysed thematically. Results: Transformational leadership significantly reduced emotional exhaustion (β=-0.48, p<0.001), increased job satisfaction (β=0.53, p<0.001), and lowered perceived stress (β=-0.46, p<0.001). Mediation analyses showed significant indirect effects through organisational justice and quality of work life (indirect effects: -0.34 to 0.38, p<0.001). Qualitative findings highlighted the importance of inspirational motivation, individualised consideration, intellectual stimulation, and idealised influence. Conclusions: Transformational leadership directly and indirectly enhances nurses' well-being through improved organisational justice and quality of work life. These findings emphasise the need for healthcare organisations to foster transformational leadership and promote fair, supportive work environments to enhance nurse well-being.