The effects of leadership and ward factors on job satisfaction in nursing homes: a multilevel approach

Aims and objectives. To examine (1) the relationships between job satisfaction and task-and relationship-oriented leadership and (2) the direct and moderating effects on job satisfaction of three ward-level factors: workload, use of teams and staff stability. Background. Job satisfaction in nursing homes is vital to meeting the challenges related to recruitment and turnover. Design. Cross-sectional design. Method. A multilevel analysis approach was used to recognise a hierarchal structure of determined factors and to capture variation in job satisfaction at the individual and ward level. A questionnaire was sent to 444 registered nurses, auxiliary nurses and unskilled nursing assistants. Structured interviews were administered to 40 ward managers and 13 directors, and 900 hours of field observations was conducted in 40 nursing home wards throughout Norway. Results. We found a significant relationship between job satisfaction and task-oriented and relationship-oriented leadership styles, with a stronger effect for task orientation. The effect of the two leadership styles varied significantly across wards. Furthermore, staff stability had both a significant positive direct effect and a moderating effect on job satisfaction, whereas the two other ward-level predictors yielded no significant contributions. Conclusion. The relatively stronger effect of task-oriented leadership on job satisfaction, particularly in wards with low staff stability, is in contrast to most previous studies and suggests that there may be specific conditions in nursing homes that favour the use of this leadership style. The varying effect of both leadership styles indicates that staff in different nursing home wards could benefit from the use of different leadership styles. Relevance to clinical practice. The study highlights the importance of using different leadership behaviour and the importance of high staff stability to ensure job satisfaction among nursing home personnel.