The purpose of this study was to examine the relationships between transformational leadership (TL), structural empowerment (SE), job satisfaction (JS), nurse-assessed adverse patient outcomes (APO), and the quality of care (QOC). The study further investigates the mediating effects of SE and JS on TL-APO and TL-QOC relationships. A total of 600 nurses working at 17 government hospitals in Pakistan completed the survey. The hypothesized model was tested using a confirmatory factor analysis and structural equation modeling. We found a positive relationship between TL, SE, JS, and QOC but negative relationships between TL and APO, SE and APO, and JS and APO. Our study further suggests that SE and JS strongly mediate both TL-APO and TL-QOC relationships.
This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and medical quality on the relationship between participative leadership and patient satisfaction. The data was obtained from 123 public sector hospitals in Pakistan. We employed confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques to test the structural model. From the study results, we found significant and positive relationships between participative, administrative quality, medical quality, and patient satisfaction. In addition, our research found administrative quality and medical quality as potential mediators on PL-PS relation. Adopting participative leadership as an exogenous factor, and both administrative and medical quality as potential mediators of patient satisfaction, provided new insights into MBNQA criteria.
This study examined various features of urban form, which promote sustainable development and provoke shoppers toward shopping malls. A field survey was conducted in shopping malls at Hangzhou, which is the capital city of the Zhejiang province, China. Structural equation modeling and a confirmatory factor analysis were used to measure the hypotheses. The results of this study showed that the built environment and entertainment completely mediated the relationship between ambiance and consumption, and they have a positive impact on the environment and shoppers. The built environment and entertainment are viewed as essential elements of physical and social sustainability. Real estate developers, urban planners, and shopping mall managers should consider the design features of urban form to meet sustainable development goals and to attract more shoppers. Testing these relationships via a mediating method is a novel contribution to the study of shopping malls.
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