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

Saeka Kawaguchi; Yukie Takemura; Kimie Takehara; Keiko Kunie; Naoko Ichikawa; Kazunori Komagata; Koji Kobayashi; Mitsuyo Soma; Chieko Komiyama

doi:10.1177/23779608211025981

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

SAGE Open Nurs. 2021 Jun 30:7:23779608211025981. doi: 10.1177/23779608211025981. eCollection 2021 Jan-Dec.

Authors

Saeka Kawaguchi¹, Yukie Takemura¹, Kimie Takehara², Keiko Kunie³, Naoko Ichikawa¹, Kazunori Komagata⁴, Koji Kobayashi⁵, Mitsuyo Soma⁴, Chieko Komiyama⁴

Affiliations

¹ Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, The University of Tokyo, Tokyo, Japan.
² Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya University, Nagoya, Japan.
³ Department of Nursing Administration, School of Nursing, Tokyo Women's Medical University, Tokyo, Japan.
⁴ Department of Nursing, The University of Tokyo Hospital, The University of Tokyo Hospital, Tokyo, Japan.
⁵ Department of Labor Policy, Japanese Nursing Association, Tokyo, 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.

Keywords: Leader–Member Exchange; leadership; multilevel analysis; nurse; psychological state.