Transformational leadership, psychological empowerment, work engagement and intensive care nurses’ job performance: a cross-sectional study using structural equation modeling

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BACKGROUND: The global nursing shortage has intensified the need for effective leadership strategies to enhance nurse performance and retain skilled staff, particularly in high-stress environments like intensive care units Transformational leadership has been recognized as a critical factor in improving nurses'job performance. However, the mechanisms underlying this relationship remain underexplored. This study investigates the direct impact of transformational leadership on ICU nurses'job performance and examines the mediating roles of psychological empowerment and work engagement. METHODS: A cross-sectional study was conducted. Between October to November 2024, a total of 584 intensive care nurses from China completed the survey, which included standard assessments on transformational leadership, psychological empowerment, work engagement, and job performance. Structural equation modeling was employed to analyze the direct and indirect effects of transformational leadership on job performance, with psychological empowerment and work engagement as mediators. RESULTS: The results indicated significant positive correlations among transformational leadership, psychological empowerment, work engagement, and job performance (all P < 0.01). Transformational leadership not only directly affected the job performance of intensive care nurses but also influenced it through the partial mediating roles of psychological empowerment and work engagement, with the mediating effects accounting for 24.64% and 21.74% of the total effect, respectively. Additionally, the analysis found that psychological empowerment and work engagement, played a chain mediating role in the relationship between transformational leadership and the job performance, with the mediating effect accounting for 15.94% of the total effect. CONCLUSIONS: This study highlights the association between transformational leadership and ICU nurses' job performance, both directly and indirectly through psychological empowerment and work engagement. The findings suggest that transformational leadership is related to key psychological and behavioral factors that may support better job performance. Fostering transformational leadership behaviors may serve as a valuable approach for nursing managers to enhance psychological empowerment and engagement among ICU nurses, with potential benefits for patient care outcomes. CLINICAL TRIAL NUMBER: Not applicable.

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