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Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review
Abstract
BACKGROUND Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. METHODS The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers. RESULTS A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. CONCLUSIONS The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to enhance nursing job satisfaction, retention, work environment factors and individual productivity within healthcare settings.
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“Leadership established on relationships is in line with a relational leadership style that focuses on persons and relationships [36], implying communication, and involving and empowering followers [43].”
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Lawal, A. D., Groulx, P. M., Bosak, J., Flood, P. C., Chênevert, D., & Bourgoin, A. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107486
Martins, P., do Nascimento, G., Fernandes, A. C., Moreira, A., & Vieira, P. A. (2026) · Administrative Sciences · doi:10.3390/admsci16080356
“…commitment, particularly affective commitment, as the key mechanism translating leadership into retention outcomes (Meyer & Allen, 1991; Meyer et al., 2002; Cummings et al., 2018; Wright & Pandey, 2010; Vandenabeele, 2009; Martins et al., 2023; Hom et al., 2017; Griffeth et al., 2000).”
InfluentialValidation and Application of the Chinese Integral Nursing Leadership Scale Among Clinical Nurses
Zhang, J., Jiang, W., He, X. Y., Hou, L., Dai, Y., Luo, N., Yang, Y., Lin, J., & Hu, C. (2026) · Journal of Nursing Management · doi:10.1155/jonm/3672064
“Transactional leadership emphasizes job performance and task completion, which may stife creativity and innovation within the team [11].”
InfluentialProfessional Segmentation as a Barrier to Reform in Turkish Nursing
Inceoz, Z., & Hughes, D. (2026) · Nursing Inquiry · doi:10.1111/nin.70156
Past, Present and Future: A Historical Analysis and Reflection of 100 Years of Nursing Leadership
Bolton, S. C., Byrne, A., Wirihana, L., Connor, J., & Cutmore, E. (2026) · Nursing Inquiry · doi:10.1111/nin.70152 · Cited by 1
“Emotional demands on nurse leaders can lead to burnout, and its reliance on idea-lised influence may suppress critical thinking (Cummings et al. 2018; Boamah 2022).”
Peer teaching: Leadership development in nursing students
Abdul-Rahim, H. Z., Lim, Z. Y., Asri, A. A. M., & Mumin, K. H. A. (2026) · Next research. · doi:10.1016/j.nexres.2026.102277
Duffy, A., & Connolly, M. (2026) · Journal of Advanced Nursing · doi:10.1111/jan.70707
Metadata
- Authors
- Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E.
- Affiliations
- University of Alberta (CA)
- Western University (CA)
- Corresponding author
- Cummings, Greta G.
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 85
- Pages
- 19-60
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W4233451756
- Semantic Scholar
- abb240e891ac6787579d92c4e1d6d3fdda213ec1
- Cited by
- 637
- References
- 378
- Citations by year
- 2026: 132 · 2025: 122 · 2024: 104 · 2023: 78 · 2022: 75 · 2021: 52 · 2020: 35 · 2019: 21 · 2018: 12
- FWCI
- 5.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- Funders
- University of Arizona (1 RO1-NU00908)
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Nursing › Leadership and Management › Healthcare Education and Workforce Issues
- Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Education, Practice, and Leadership
- Keywords
- leadership styles, relational leadership, nursing workforce, nursing work environment, nursing satisfaction, nurse retention, nurse well-being, staff relationships, organizational context, nursing productivity
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