Relationship Between Teams’ Leader–Member Exchange Characteristics and Psychological Outcomes for Nurses and Nurse Managers: A Cross-Sectional Study in Japan

Abstract

Introduction The Leader–Member Exchange (LMX) theory, based on the social exchange theory, relates to positive psychological states among nurses. However, the influence of various LMX qualities coexisting within a team on nurses or nurse managers is still uncleared. Objective This study examines the relationship of nurses and nurse managers’ psychological states with the average LMX and LMX dispersion among nurses in their units. Methods The study was conducted at two university hospitals in March 2017 using anonymous questionnaires. Nurses completed the LMX-7 scale and the subscales of job satisfaction, achievement, and growth from the Checklist on Commitments Related to Work. Nurse managers completed the subscales of management satisfaction, effectiveness, and extracting extra effort from the Multifactor Leadership Questionnaire. Both nurses and managers completed the Intention to Continue Working scale. The nurses’ data were analyzed using a multilevel analysis to clarify associations between nurses’ psychological states and LMX, average LMX, and LMX dispersion. Hierarchical multiple regression analysis tested to test the correlations of the psychological states of nurse managers with average LMX and LMX dispersion. Results Data from 586 nurses and 28 managers were analyzed. The LMX and average LMX of nurses were positively related to positive psychological states. Nurse managers displayed significant associations between high LMX dispersion and good psychological states. When average LMX was low, management effectiveness increased as LMX dispersion increased; when average LMX was high, management effectiveness was almost constant. Conclusion The unit’s LMX characteristics appear to be related to the psychological states of both nurses and nurse managers. Increasing the LMX of each nurse may lead to positive psychological states for not only that nurse but all nurses in the unit. When LMX with subordinates is low, increasing LMX with a portion of nurse managers should be a priority to improve their psychological states.

The association of leader–member exchange and team–member exchange with nurses' innovative behaviours: A cross‐sectional study

“…Meanwhile, LMX had a positive effect on TMX in this study. This result was similar to past findings (Du et al., 2022; Kawaguchi et al., 2021; Regt et al., 2018). SET pointed out that power differentiation leads to leadership in the dominant position of exchange, which will affect other exchange relationships of individuals (Blau, 1964).…”

“…The total score of the LMX was higher than that of nurses in Japan (Kawaguchi et al, 2021) and Korea (Kim & Yi, 2019). Compared with Chinese nurses, this research was similar to previous studies (Pan et al, 2021).…”

“…Chinese managers pay more attention to social exchange (i.e. showing respect, emotion and care) with employees, which helps improve the quality of LMX (Andersen et al., 2020; Kawaguchi et al., 2021). The mean score of the TMX was at an above‐moderate level in this research.…”

“…On the contrary, a significant time commitment may reduce the efficiency and experience of nurses (Yan et al., 2022). Higher levels of motivation, respect and trust in association with leaders can increase nurses' courage and confidence to take risks in innovation (Afsar & Masood, 2018; Kawaguchi et al., 2021). Meanwhile, high‐quality LMX makes employees feel supported and glad to use their best talent to complete work tasks (López‐Ibort et al., 2020).…”

Analysis of the Effect of Rational Emotional Intervention Combined with Hierarchical Management Mode on Improving the Psychological Stress of Emergency Nurses and Trainee Nurses

“…Based on scientific management and behavior management, hierarchical management mode implements hierarchical responsibility system, which can rationally allocate human resources and reduce unnecessary waste of nursing resources [14,15]. Kawaguchi et al believed that through hierarchical management, clarifying the job responsibilities of nurses at all levels, and through measures such as layer by layer supervision and guidance, it can give staff at all levels of work autonomy and enthusiasm, and reduce the pressure at work [16].…”