Understanding the Impact of Leadership Styles on Nurse

What are the experiences of leadership styles for nurses in the provision of essential nursing care to patients and job satisfaction

The style of leadership is critical for the provision of appropriate care to patients as well as job satisfaction. The quality of nurse work environments and leadership styles have been linked to patient safety outcomes as they can constrain or facilitate professional nursing practice (Olds et al. 2017). However, few studies have been conducted investigating mechanisms of leadership influences and subsequent outcomes (Boamah et al. 2018). An important component of the nurses’ lives is job satisfaction. This component significantly impacts performance and productivity, professional behaviour, commitment to organisation and patient safety (Olds et al. 2017). The study aims at identifying and describing the experiences of different leadership styles for nurses who work in government and private hospitals as they provide essential care to patients. For those who are seeking healthcare dissertation help, understanding the nuances of leadership styles in nursing environments can be the most valuable fact.

The methodological approach underpinning this proposal is the qualitative research design that focuses on a phenomenological approach. Qualitative research is beneficial as it takes into account the natural contexts in which groups and individuals function therefore making it possible to discover an in-depth understanding of real-world problems (Korstjens and Moser, 2017). Phenomenology aims at studying live human experiences and how things appear or are perceived in consciousness (Tuffour, 2017). This methodological design focuses on the commonality within a particular group. Its fundamental goal is to establish a description of the nature of an identified phenomenon. The utilization of phenomenology in nursing research is directly related to the ability of this approach to give answers to questions that are particularly relevant to practice (Moxham and Patterson, 2017). This approach provides an appropriate design in order to analyse the experiences of nurses in relation to leadership styles.

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Sampling and Recruitment

The participants of the study will be nurses working full-time in private and government hospitals in the country. Both female and male nurses will be included and the sample will incorporate Registered Nurses, Enrol Nurses, and Nurse Assistants working in ICU, ER, and OR wards. Recruitment of participants will be done through purposive sampling which is considered the most essential kind of non-probability sampling (Etikan et al. 2016). Non-probability sampling can be quite useful in instances where the researcher has limited resources, workforce and time. This method of identification of participants is also useful in instances where randomization is impossible; such as in cases where the population is huge. In some situations, the sample population may not be well defined. Non-probability sampling methods become much more effective and usable in these scenarios (Etikan et al. 2016).

The purposive sampling technique involves the deliberate selection of participants based on the qualities they possess. This technique is also known as judgment sampling (Etikan et al. 2016). Sample selection will be based on the judgement of the researcher and the purpose of the research. This technique does not need a set number of participants and any underlying theories. The research will have to identify participants willing to provide valuable and relevant information by virtue of experience or knowledge, or both (Etikan et al. 2016). The participants selected will foundationally have first-hand knowledge and must have experienced and understood the context of the phenomenon in the research. This primary involves the identifying and selecting participants or a group of participants who are well-informed and proficient with the phenomenon of interest.

Participant retention refers to holding on to enrolled participants during the entire duration of a particular research. In order to ensure valid statistical inferences on the results and empower the qualitative aspect of research, participant retention is an important aspect in clinical research (Daykin et al. 2018). Proper information prior to the qualitative aspect of the study is essential to the participants. In doing so, the researcher enables the participants to understand the benefits and risks associated with the research (Daykin et al. 2018).

Data Collection Method

In-depth interviews will be utilized as the data collection method. It is useful in phenomenological approaches as they enable studying of invisible processes, sensitive as well as personal and morally ambiguous issues (Faulkner and Trotter, 2017). They make it easy to acquire individual perspectives that cannot be obtained with other methods like textual analysis or observations. The objective of this research is to explore the experiences of leadership styles on nurses’ provision of care services and job satisfaction. The settings selected for the interviews will either be inside the hospital or outside based on the respective participant’s preference. The participants will also be offered coffee, lunch or dinner based on their preference.

In order to achieve data saturation, the interviews will begin with open-ended questions (Tan et al. 2016). The semi-structured interview guide developed will contribute directly to the trustworthiness and objectivity of the study. These will also make the results plausible (Kallio et al. 2016). There are five major phases that will be considered: the prerequisites involved in the using of semi-structured interviews, the use and retrieval of past knowledge, the formulation of preliminary semi-structured interview guide, pilot testing and presentation of the complete semi-structured interview guide (Kallio et al. 2016). The interviews will also be audio recorded and transcribed verbatim in data analysis.

However, one consideration in using this method is that they require high degrees of rapport building with the participants and they can cost a lot of money, time as well as emotional labour (Faulkner and Trotter, 2017). One advantage of this method is that it is highly adaptable where conversational and informal tactics can be utilized for filling in missing information and making clarifications. One disadvantage as noted above is that they can be quite expensive to implement in terms of time and resources.

Data Collection Process

The process will begin with developing an interview protocol, which are rules for guiding how interviews will be administered and implemented and the instructions to follow for each to ensure consistency and increase the reliability of findings (Thompson et al. 2019). The interviews will be conducted face to face with participants where open-ended questions will be asked and changes in word choice and tone will also be monitored. Probing techniques to be used include contradicting, faking puzzling, linking, encouraging, acknowledging, showing understanding, and procuring details (Thompson et al. 2019). They will be arranged at times and places convenient for the participants where ‘small talk’ will be used pre-interview to build rapport.

Whether within the hospital or outside its environs, the participants will be met at mutually agreed venues. This will provide them with an ambient, comfortable and private environment for the interview. Per session, groups involved in the interviews will range from five to eight participants so that homogeneity can be ensured (Guest et al. 2017). This will also capitalize on the shared experiences of the participants. There are some sensitive themes that occur as a result of the use of a focus group context. Person-to-person basis, however, is more effective in generating a wide range of items (Guest et al. 2017). The duration will be 60 minutes and notes as well as audiotapes will be utilized in recording data. This will enable the participants to easily share their stories and help solicit information from the participants (Castillo-Montoya, 2016).

Data Analysis

Data will be analysed simultaneous with data collection. It is beneficial to analyse data obtained from both interviews and literature (Holloway and Galvin, 2016). At the end of every session, digital recordings will be transcribed to create verbatim writing accounts. The transcripts will then be converted to rich text format and qualitatively imported to MAXQ 2007 software. The constant comparison analysis method will be used in analysing data from the in-depth interviews. It involves an inductive category coding for simultaneously comparing all units of meaning to be obtained (Memon et al. 2017).

The method is characterized by three stages. The first, often referred to as open coding, involves chunking the data into small units where a code or descriptor is attached to each unit. The second stage, termed as axial coding, will involve grouping the codes into categories where a ‘look-alike, feel alike’ criteria is advocated for in grouping (Memon, 2017). The third and final stage, termed as selective coding, will involve the development of one or more themes expressing the contents of each data group.

Cypress (2017) points out that validity and reliability need to be considered by qualitative inquirers during study design, analysis as well as when determining the study’s quality and not just after the completion of the research. In any scientific research, issues of reliability and validity present very significant instruments. Therefore, for the present study, to attain active validity and reliability, strategies to ensure the rigor of the study need to be built into the qualitative research process. Rigor involves the state or quality of being very careful, exact, or having strict precision, accuracy, or thoroughness (Cypress, 2017). This aspect is evaluated on the basis of thoroughness of the approach undertaken by the study (Cypress, 2017). In qualitative phenomenological studies like the present one, rigor will be operationalized through criteria of transferability, credibility, confirmability, and dependability. Credibility will be attained through prolonged and persistent engagement with participants to ensure a truthful and accurate depiction of their lived experiences (Cypress, 2017).

The method of purposive sampling will enhance transferability (Cypress, 2017). It will also be enhanced through a thorough and robust description and analysis of data from the detailed and accurate descriptions of the nurses being interviewed. In addition, while critically examining the information obtained from literature, the utilization of only the most recent sources; between 2015 and 2020; provides a rigorous and thorough approach. These literature will provide an in-depth understanding of relevant information and reflect the findings of the qualitative research that will be conducted.

On reliability, the study will undertake to prevent issues that may arise from aspects such as inclusion of leading questions, pilot interviews and speeding up the methodological process (Cypress, 2017). The research will also take steps to ensure its internal validity, which refers to the extent by which the methodological design actually evaluates what it is supposed to measure. Dependability will also be enhanced through the use of expert nursing research researchers who will review the data obtained from interviews for the validation of descriptors and themes identified.

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Ethics

Consent will be obtained from the participants by first providing them with all the information they need to know about the research study to enable them to make informed decisions about participation in the research. Ethical rules bind all researchers to obtain informed consent from their participants before they get involved in a study and to ensure they are adequately informed, competent, and not coerced (Cocanour, 2017). Ethical issues in qualitative research emanate from the nature of the study’s where there is an immersion in relationships and situations that are unpredictable and complex (Reid et al. 2018). They include maintaining altruism and integrity, upholding autonomy when acquiring access and consent, and managing power relations. They can be mitigated by using the principles of non-maleficence, beneficence, equity, and justice in guiding actions before, during, and after research.

Limitations

Qualitative research is concerned with real items that cannot be quantified, it should focus on providing explanations and understandings of the dynamics of social relations (Queros et al. 2017). The potential limitations point towards the research’s validity, reliability and biasness. Various errors and risks may arise that may limit the achievement of reliability and validity (Gunawan, 2015). One possible limitation is that the findings will be limited since the study will utilize purposive sampling in recruiting a small number of participants, therefore, meaning they will not be generalizable to nurses working in other healthcare settings or facilities (Efendi et al. 2016). Non-probability sampling is a process which involves unequal chances given to the participants or units of the population included in selection (Etikan, 2016).

There is need for further exploration and empirical research on leadership style and nurse satisfaction needs and comparisons made on the experiences of these nurses. This will enable better inferences and conclusions on these experiences.

References

Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing

Cocanour, C. S. (2017). Informed consent—It's more than a signature on a piece of paper. The American Journal of Surgery, 214(6), 993-997. Retrieved from

Cypress, B. S. (2017). Rigor or reliability and validity in qualitative research: Perspectives, strategies, reconceptualization, and recommendations. Dimensions of Critical Care

Efendi, F., Chen, C. M., Nursalam, N., Indarwati, R., & Ulfiana, E. (2016). Lived experience of Indonesian nurses in Japan: A phenomenological study. Japan Journal of Nursing

Faulkner, S. L., & Trotter, S. P. (2017). In‐Depth Interviews. The International Encyclopedia of Communication Research Methods, 1-2. Retrieved from DOI:

Gunawan, J. (2015). Ensuring trustworthiness in Qualitative Research. Belitung Nursing Journal,

Holloway, I. & Galvin, K. (2016). Qualitative Research in Nursing and Healthcare. WILEY Blackwell. Retrieved from ISBN: 978-1-118-87449-3

Kallio, H. M., Pietila, A. M., Johnson, M., Docent, M. K. (2016). Systematic methodological review: developing a framework for a qualitative semi-structured interview guide.

Memon, S., Umrani, S., & Pathan, H. (2017). Application of a constant comparison method in social sciences: a useful technique to analyze interviews. Grassroots, 51(1). Available at

Olds, D. M., Aiken, L. H., Cimiotti, J. P., & Lake, E. T. (2017). Association of the nurse work environment and safety climate on patient mortality: A cross-sectional study. International journal of nursing studies, 74, 155-161. Retrieved from

Queiros, A., Almeida, F., Faria, D. (2017). Strengths and Limitations of Qualitative and Quantitative Research Methods. Open Access Publishing Group, 3(9) 2017. Retrieved

Reid, A. M., Brown, J. M., Smith, J. M., Cope, A. C., & Jamieson, S. (2018). Ethical dilemmas and reflexivity in qualitative research. Perspectives on medical education, 7(2), 69-75. Retrieved

Tan, V., Porcher, R., Falissard, B., Ravaud, P. (2016). Point of Data Saturation Was Assessed Using Resampling Methods in a Survey with Open- Ended Questions. J Clin Epidemiol, 80, 88-96. Retrieved from doi: 10.1016/j.jclinepi.2016.07.014

Thompson, S., Marsh, P., Mond, J., & Brown, C. (2019, September). Applying participatory health research elements in rural end-of-life research: reflections on conducting in-depth Interviews with participants on sensitive topics. In Forum Qualitative

Tuffour, I. (2017). A critical overview of interpretative phenomenological analysis: a contemporary qualitative research approach. Journal of Healthcare

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