The Influence of Managers’ Use of Leadership Behaviors on Staff Nurses in China and the United States

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TITLE The Influence of Managers’ Use of Leadership Behaviors on Staff Nurses in China and the United States
RESEARCHER Donna K. McNeese-Smith, Hu Yan & Ying-Hua Yang
UCLA School of Nursing
The Hong Kong Nursing Journal (2000), 46(3):7-17.

The purpose of this study was to determine whether the use of certain leadership behaviors by departmental managers made a difference in employee outcomes, and whether findings were similar across the United States and China.

The study involved comparisons between study in Seattle (McNeese-Smith, 1996) and Los Angeles (McNeese-Smith, 1995) with data collected in three of eight tertiary hospitals in Shanghai, China. These hospitals were all government funded and each had over 700 beds, providing both inpatient and outpatient services. All respondents completed the Leadership Practices Inventory (translated into Chinese for the Shanghai sample). Internal consistency for the LPI in these studies ranged between .78 to .92 for the Self version and between .53 and .85 for the Observer version. Respondents also completed the Job-in-General scale (Smith, Ironson, Brannick, Gibson & Paul, 1989), Productivity scale (McNeese-Smith, 1995, 1996), and Organizational Commitment Scale (Porter, et al., 1974). Demographic data were also collected.

In all three settings, managers rated themselves higher in each behavior than the staff nurses rated them. There were significant differences between manager scores for Shanghai compared to Seattle and LA for Modeling as rated by staff nurses. Staff nurses in Shanghai rated their managers higher. There were also significant differences between staff nurse ratings of managers in LA and Shanghai on Challenging and Inspiring. Los Angeles managers were rater higher, but Shanghai managers were rated very similarly to Seattle managers. “While there were significant differences between some scores, the effect score was quite small” (p. 12).

A highly positive, significant correlation was shown among leadership behaviors and employee outcomes across all three locations. A lower but significant positive correlation was also shown among the organizational outcomes. The Seattle, LA and Shanghai data show a positive, significantly significant correlation between each of the five leadership behaviors and Job Satisfaction and Organizational Commitment. On the dimension of Productivity, the U.S. sample showed positive significant correlations for all five leadership practices, while Encouraging was the only leadership practice to show a significant relationship in the Chinese sample.

In the China study, while all five leadership practices formed a model that predicted Job Satisfaction, none of the individual coefficients were significant in predicting Job Satisfaction. The full model was not significant in predicting Productivity, with Encouraging a significant predictor in a stepwise procedure. Organizational Commitment was predicted by the full model, with Inspiring and Encouraging showing significance as individual predictors.

“All three studies found that nurses rated their managers highest in Enabling and Modeling an lower in Challenging and Inspiring. Chinese nurse outcomes varied from US nurse outcomes in that job Satisfaction, productivity and organizational commitment were all significantly lower among nurses in China than among nurses in the US” (p.14). “Relationships between managers’ use of leadership behaviors and staff nurse outcomes of job satisfaction and organizational commitment were comparable across China and the US studies. These correlations indicate that nurses in China are strongly influenced by their managers’ use of leadership behaviors just as US nurses are” (p. 15).

“Clearly, leadership makes a difference to hospital nurses in both countries, particularly in times of rapid change. How managers behavior in leadership roles influences nurses, and probably other employees, to experience more job satisfaction, more productivity and increases in long term commitment to the employing organization. It is important for top administrators to use these five behaviors in successfully creating the standard for organizational leadership. Educators can use this model to teach nurse managers strategies for more efficacious leadership” (p. 15).