A Quantitative Analysis: Determining Key Leadership Traits and Their Impact on Healthcare Employee Retention and Job Satisfaction in Hospital Settings

Year 2025, Volume: 11 Issue: 22, 182 - 193, 31.10.2025

Matthew Trenholm

https://doi.org/10.48121/jihsam.1715283

Abstract

Objective: To examine the relationship between healthcare leadership traits and employee retention and job satisfaction among registered nurses.

Methods: A cross-sectional survey was conducted among registered nurses in Fraser Health Authority, British Columbia, utilizing the Leadership Trait Questionnaire (LTQ) alongside measures for job satisfaction and retention.

Results: Out of 928 distributed surveys, 176 complete responses were analyzed. Findings indicated a moderate-to-strong positive correlation between perceived leadership traits and both job satisfaction (r = 0.694, p < 0.001) and retention (r = 0.493, p < 0.001).

Conclusion: Effective leadership traits are significant predictors of job satisfaction and employee retention, underscoring the importance of leadership development in healthcare settings.

Keywords

Healthcare leadership , job satisfaction , employee retention , leadership traits , organizational behavior , leadership development

Ethical Statement

Approval to gain access to and contact participants was obtained from Fraser Health Authority. Ethical approval was obtained by the University of Liverpool Research Ethics Committee and by the Fraser Health Research, Ethics and Compliance Team.

Supporting Institution

University of Liverpool; Fraser Health Authority

Thanks

Acknowledgements: I am deeply grateful to the individuals who contributed to the successful completion of this research study. First and foremost, I would like to express my sincere gratitude to my primary dissertation advisor, Dr Omotayo Joan Olajide, who provided much needed advice, guidance and support. Her assistance and insights were instrumental throughout the various stages of the study. Thank you. I wish to extend my thanks to my other dissertation advisor, Dr Enis Elezi, who supported me through the early stages of the research process and offered much needed support and guidance. I also wish to offer my heartfelt thanks to the University of Liverpool for providing the necessary resources and support, without which this study would not have been possible. Additionally, I offer my appreciation to Fraser Health Authority for granting me the permission to conduct the study in their organization. Special thanks to the Research Services team for providing me with the necessary guidance to navigate the research ethics approval process. Lastly, I am thankful for the support and encouragement of my family and friends. Their unwavering support helped to provide me with the motivation and strength to persevere.

References

• Abdulmalik, P. P., & Pangandaman, H. (2024). Leadership traits of nurse managers and nurse staff commitment in the Philippines hospitals. Jurnal Administrasi Kesehatan Indonesia, 12(1), 49–61. https://doi.org/10.20473/jaki.v12i1.2024.49-61
• Abraham, T. H., Stewart, G. L., & Solimeo, S. L. (2021). The importance of soft skills development in a hard data world: learning from interviews with healthcare leaders. BMC Medical Education, 21(1). https://doi.org/10.1186/s12909-021-02567-1
• Agresti, A. (2010). Analysis of Ordinal Categorical Data. 2nd Edition. Newark: John Wiley & Sons, Incorporated. Google Books. https://books.google.ca/books?hl=en&lr=&id=VVIe4BPDR7kC&oi=fnd&pg=PR9&dq=Analysis+of+Ordinal+Categorical+Data&ots=cW85BcUAZK&sig=mkqVQczYse8dtgP8kPkAzXRZ4q8#v=onepage&q=Analysis%20of%20Ordinal%20Categorical%20Data&f=false
• Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. (2011). Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical care, 49(12), 1047–1053. https://doi.org/10.1097/MLR.0b013e3182330b6e
• Alkan, E., Cushen-Brewster, N., & Anyanwu, P. (2024). Organisational factors associated with healthcare workforce development, recruitment, and retention in the United Kingdom: a systematic review. BMC nursing, 23(1), pp. 604–14. https://doi.org/10.1186/s12912-024-02216-0.
• Andrade, C. (2021). The Inconvenient Truth About Convenience and Purposive Samples. Indian journal of psychological medicine, 43(1), pp. 86–88. https://doi.org/10.1177/0253717620977000.
• Ariss, M. (2021). The Impact of Leadership Style on Employee Satisfaction and Retention Among Nurses. (Doctoral dissertation, Graduate School). https://researchworks.creighton.edu/esploro/outputs/doctoral/The-Impact-of-Leadership-Style-on/991005931042402656
• Belias, D., & Koustelios, A. (2014). Leadership and job satisfaction--A review. European Scientific Journal, 10(8). https://www.researchgate.net/profile/Dimitrios-Belias/publication/261570285_LEADERSHIP_AND_JOB_SATISFACTION_-_A_REVIEW/links/00463534ba5443ec4a000000/LEADERSHIP-AND-JOB-SATISFACTION-A-REVIEW.pdf
• Boumans, N.P., & Landeweerd, J.A. (1993). Leadership in the nursing unit: relationships with nurses' well-being. Journal of advanced nursing, 18(5), pp. 767–775. https://doi.org/10.1046/j.1365-2648.1993.18050767.x.
• Brown, A. (2020). Communication and leadership in healthcare quality governance: Findings from comparative case studies of eight public hospitals in Australia. Journal of health organization and management, 34(2), pp. 144–161. https://doi.org/10.1108/JHOM-07-2019-0194
• Brown, R., & Michalowski, M. (2022). Nurses' Utilization of Information Resources for Patient Care Tasks: A Survey of Critical Care Nurses in an Urban Hospital Setting. Computers, Informatics, Nursing 40(10):p 691-698. https://doi.org/10.1097/cin.0000000000000908
• Cowden, T., Cummings, G., & Profetto-McGrath, J. (2011). Leadership practices and staff nurses' intent to stay: a systematic review: Leadership practices and staff nurses' intent to stay. Journal of nursing management, 19(4), pp. 461–477. https://doi.org/10.1111/j.1365-2834.2011.01209.x.
• Cram, N.B. (2013). The impact of nursing leadership characteristics and nursing work environment on nurses' intent to stay in dissimilar healthcare cultures. ProQuest Dissertations & Theses. https://www.proquest.com/openview/79cbe813a700c1a2b67662aa8066a294/1?pq-origsite=gscholar&cbl=18750
• Das, S., Mitra, K., & Mandal, M. (2016). Sample size calculation: Basic principles. Indian journal of anaesthesia, 60(9), 652–656. https://doi.org/10.4103/0019-5049.190621.
• De Vries, N., Lavreysen, O., Boone, A., Bouman, J., Szemik, S., Baranski, K., Godderis, L., & De Winter, P. (2023a). Retaining Healthcare Workers: A Systematic Review of Strategies for Sustaining Power in the Workplace. Healthcare, 11(13), 1887. https://doi.org/10.3390/healthcare11131887
• De Vries, N., Boone, A., Godderis, L., Bouman, J., Szemik, S., Matranga, D., & De Winter, P. (2023b). The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals. INQUIRY the Journal of Health Care Organization Provision and Financing, 60. https://doi.org/10.1177/00469580231159318
• Duffield, C., Roche, M., O'Brien-Pallas, L., Catling-Paull, C., & King, M. (2009). Staff satisfaction and retention and the role of the Nursing Unit Manager. Collegian Journal of the Royal College of Nursing Australia, 16(1), 11–17. https://doi.org/10.1016/j.colegn.2008.12.004
• Dzokoto, M. K., Mensah, B. T., Agbenu, I. A., Gatheru, P. M., Kwashie, M. D., & Boateng, K. A. (2024). Leadership, and management style and influence on healthcare worker's job satisfaction and productivity: a scoping review. International Journal of Community Medicine and Public Health, 11(7), 2926–2934. https://doi.org/10.18203/2394-6040.ijcmph20241859
• Einarsen, S., Schanke Aasland, M., & Skogstad, A. (2007). Destructive leadership behaviour: A definition and conceptual model. The Leadership Quarterly, Volume 18, Issue 3, pp 207-216, https://doi.org/10.1016/j.leaqua.2007.03.002.
• Fagerdal, B., Lyng, H. B., Guise, V., Anderson, J. E., Thornam, P. L., & Wiig, S. (2022). Exploring the role of leaders in enabling adaptive capacity in hospital teams - a multiple case study. BMC health services research, 22(1), 908. https://doi.org/10.1186/s12913-022-08296-5
• Field, A. (2024). Discovering statistics using IBM SPSS statistics. Sage publications limited. https://books.google.ca/books?hl=en&lr=&id=83L2EAAAQBAJ&oi=fnd&pg=PT8&dq=Discovering+statistics+using+IBM+SPSS+statistics&ots=UbMQxsDKEM&sig=nyfbjgPwvhSw5Daw2_R-JmY-ss8#v=onepage&q=Discovering%20statistics%20using%20IBM%20SPSS%20statistics&f=false
• Friman, S., Maijala, R., Eloranta, S., Suominen, S., & Ikonen, T. (2024). The characteristics of leadership and their effectiveness in quality management in healthcare-A systematic literature review and a content analysis. Health Services Management Research, https://journals.sagepub.com/doi/abs/10.1177/09514848241254921.
• Hayes, L. J., O'Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., Laschinger, H. K. S., & North, N. (2011). Nurse turnover: A literature review – An update. International Journal of Nursing Studies, 49(7), 887–905. https://doi.org/10.1016/j.ijnurstu.2011.10.001
• Joubert, S. (2024). Effective Leadership in Healthcare: 5 Essential Traits. Northeastern University. https://graduate.northeastern.edu/resources/leadership-in-healthcare/
• Kane, R. L., Shamliyan, T., Mueller, C., Duval, S., & Wilt, T. J. (2007). Nurse staffing and quality of patient care. Evidence report/technology assessment, (151), 1–115. https://pubmed.ncbi.nlm.nih.gov/17764206/#:~:text=Limited%20evidence%20suggests%20that%20the,units%20and%20in%20surgical%20patients.
• Laschinger, H.K.S., Wong, C.A., Cummings, G.G., Grau, A.L. (2014). Resonant leadership and workplace empowerment: the value of positive organizational cultures in reducing workplace incivility. Nursing economic, 32(1). https://neltoolkit.rnao.ca/sites/default/files/Resonant%20Leadership%20and%20Workplace%20Empowerment_The%20Value%20of%20Positive%20Organizational%20Cultures%20in%20Reducing%20Workplace%20Incivility%202014.pdf
• Landry, L. (2018). 6 Characteristics of an Effective Leader. Harvard Business School. https://online.hbs.edu/blog/post/characteristics-of-an-effective-leader
• Mah'd Alloubani, A., Almatari, M. & Almukhtar, M.M. (2014). Effects of leadership styles on quality of services in healthcare. European Scientific Journal, 10(18). https://DOI:10.19044/esj.2014.v10n18p%25p
• McCullagh, P. (1980). Regression Models for Ordinal Data. Journal of the Royal Statistical Society. Series B, Methodological, 42(2), pp. 109–142. https://doi.org/10.1111/j.2517-6161.1980.tb01109.x.
• Mosadeghrad, A.M. (2013). Occupational stress and turnover intention: implications for nursing management. International journal of health policy and management, 1(2), p.169. https://pmc.ncbi.nlm.nih.gov/articles/PMC3937923/
• Mosadeghrad, A.M. & Ferdosi, M. (2013). Leadership, job satisfaction and organizational commitment in healthcare sector: proposing and testing a model. Materia socio-medica, 25(2), pp. 121–126. https://doi.org/10.5455/msm.2013.25.121-126.
• Nelsey, L., & Brownie, S. (2012). Effective leadership, teamwork and mentoring – Essential elements in promoting generational cohesion in the nursing workforce and retaining nurses. Collegian (Royal College of Nursing, Australia), 19(4), pp. 197–202. https://doi.org/10.1016/j.colegn.2012.03.002.
• Northouse, P.G. (2025). Leadership: Theory and practice. 10th Edition. Sage publications. https://books.google.ca/books?hl=en&lr=&id=V6AwEQAAQBAJ&oi=fnd&pg=PT16&dq=Leadership:+theory+and+practices&ots=qNYCureKjI&sig=36B7x74V7uM2q60wSJ7DTQhFf8I#v=onepage&q=Leadership%3A%20theory%20and%20practices&f=false
• Onoyona, E.S. (2019). An Investigation of the Differences between Leadership Styles and Leadership Effectiveness by Generational Cohorts in Home Healthcare Management Agencies. ProQuest Dissertations Publishing. https://www.proquest.com/docview/2364192464/fulltextPDF/1E48CAD8CA5B4B3BPQ/1?accountid=12117&sourcetype=Dissertations%20&%20Theses.
• Orukwowu, U. (2022). Nursing leadership in healthcare: the impact of effective nurse leadership on quality healthcare outcomes. IPS Interdisciplinary Journal of Social Sciences, 1(1), pp.1-6. https://doi.org/10.54117/iijss.v1i1.1.
• Oskarsson, I.M.L., & Vik, E. (2024). Suggesting a holistic framework for understanding healthcare services leadership competence–a critical interpretive synthesis. Leadership in Health Services, 37(5), pp.99-129. https://www.emerald.com/insight/content/doi/10.1108/LHS-08-2023-0059/full/html.
• Robbins, B., & Davidhizar, R. (2020). Transformational Leadership in Health Care Today. The health care manager, 39(3), pp. 117–121. https://doi.org/10.1097/HCM.0000000000000296.
• Rosenman, R., Tennekoon, V., & Hill, L.G. (2011). Measuring bias in self-reported data. International Journal of Behavioural and Healthcare Research, 2(4), pp.320-332. https://doi.org/10.1504/IJBHR.2011.043414
• Sayed, N.M.I. (2021). Systematic analysis regarding leadership in healthcare. International Journal of Business Continuity and Risk Management, 11(2-3), pp.224-236. https://doi.org/10.1504/IJBCRM.2021.116281.
• Sheehan, M., McCarthy, P., Barker, M., & Henderson, M. (2001). A model for assessing the impacts and costs of workplace bullying. In Standing Conference on Organisational Symbolism (SCOS), Trinity College, Dublin (Vol. 30).
• Singh, P. K., Singh, S., Kumari, V., & Tiwari, M. (2024). Navigating healthcare leadership: Theories, challenges, and practical insights for the future. Journal of postgraduate medicine, 70(4), 232–241. https://doi.org/10.4103/jpgm.jpgm_533_24
• Sija, A. (2022). Determinants of employee retention in private healthcare. European Journal of Human Resource Management Studies, 5(4). https://doi.org/10.46827/ejhrms.v5i4.1220.
• Sonnino, R. E. (2016). Health care leadership development and training: progress and pitfalls. Journal of Healthcare Leadership, 8, pp. 19–29. https://pubmed.ncbi.nlm.nih.gov/29355187/
• Specchia, M.L., Cozzolino, M.R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses' Job Satisfaction. Results of a Systematic Review. International Journal of Environmental Research and Public Health, 18(4):1552. https://doi.org/10.3390/ijerph18041552
• Vilegi-Peters, D. (2010). The impact of effective leadership on quality: The role of leadership in managing quality initiatives in health care. Dissertations & Theses database (305245109).
• Whitman, G. R., Kim, Y., Davidson, L. J., Wolf, G. A., & Wang, S. (2002). The impact of staffing on patient outcomes across specialty units. JONA the Journal of Nursing Administration, 32(12), 633–639. https://doi.org/10.1097/00005110-200212000-0000
• Winston, B. E., & Patterson, K. (2006). An Integrative Definition of Leadership. International Journal of Leadership Studies, 1(2), pp.6-66. https://www.rodrigoselback.com.br/wp-content/uploads/2020/08/An-Integrative-Definition-of-Leadership.pdf
• Wong, C.A., Cummings, G.G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of nursing management, 21(5), pp. 709-. https://doi.org/10.1111/jonm.12116.
• Zboril-Benson L.R. (2002). Why nurses are calling in sick: the impact of health-care restructuring. Can J Nur Res. 33:89–107. https://pubmed.ncbi.nlm.nih.gov/11998199/
• Zhao, J., Liu, T., & Liu, Y. (2024). Leadership support and satisfaction of healthcare professionals in China's leading hospitals: a cross-sectional study. BMC health services research, 24(1), pp. 1016–10. https://doi.org/10.1186/s12913-024-11449-3.
• Ziegel, E.R., Johnson, R.A., & Wichern, D.W. (1999). Applied Multivariate Statistical Analysis. Technometrics, 41(1), pp. 81-. https://doi.org/10.2307/1271011.