Sobre la implicació de la Comunitat Internacional i l’acumulació de forces polítiques

The literature is reviewed in two sections. The major section, reviews the literature under three headings: job satisfaction, nursing leadership and front-line managers’ competencies (Figure 2.1). The second section reviews nine leadership development programs, identifying the strengths and weaknesses of those programs.

2.3.1 Literature review strategy: nurses’ job satisfaction

In order to address the aims of the current study, this chapter reviews studies related to nurses’ job satisfaction, nursing leadership, and literature on the competencies of front-line managers. In relation to job satisfaction a search of the major databases (CINAHL, 1990 to 2007; Pre-CINAHL; MEDLINE, Cochrane; Pubmed) was undertaken to retrieve studies using the key words: ‘satisfaction; dissatisfaction; job satisfaction; factors associated with job satisfaction; measuring job satisfaction’. Lambert, Hogan, and Barton (2001) identified that job satisfaction has been extensively studied both as a dependent and independent variable. They estimate the number of articles and dissertations dealing in some manner with the subject of job satisfaction to be over 3300 in 1976 and over 12000 in 1996 (Lambert et al., 2001). The selection of studies was therefore restricted to the following studies: those that examined and measured nurses’ job satisfaction, those published in English, and those published after 1990 with the exception of one early study by Larson, Lee, Brown and Shorr (1984) that measured nurses’ job satisfaction using a tool that was developed for the study. This

study gives an historical insight to job satisfaction literature of the 80s. The often cited early work of Blegen and Mueller (1987) is also noted. The reference lists of relevant articles obtained were checked and additional potentially relevant articles retrieved.

The primary intent of the review was to examine the research in terms of how the evidence has advanced knowledge in the area of nurses’ job satisfaction. The use of studies that had undergone peer-review assured a high level of quality, thereby supporting the validity of the findings and the conclusions (Hayes et al., 2006).

Using these methods 19 studies were identified that measured job satisfaction (Larson et al., 1984; Blegen & Mueller, 1987; Blegen, 1993, McNeese-Smith, 1997; Kramer & Schmalenberg, 2003; Shader et al., 2001; Bartram, Joiner & Stanton, 2004; Goddard & Laschinger, 1997; Laschinger & Havens, 1997; Laschinger, Finegan, Shamian & Wilk, 2001; Manojlovich & Laschinger, 2002; Upenieks, 2003; Larabee et al., 2003; Aiken et al., 2000; Aiken & Patrician, 2000; Aiken et al., 2001; Aiken et al., 2002a; Irvine & Evans, 1995; Shields & Ward, 2001).

2.3.1.1 Four categories of job satisfaction findings

The job satisfaction material was critiqued, summarised and divided into four categories: (1) job satisfaction and general associated factors; (2) job satisfaction and empowerment; (3) job satisfaction and magnet hospital attributes; (4) job satisfaction and retention (Table 2.2: Appendix B). The literature was tabulated using the following headings: author/s, focus of the study, methodology and key findings. In category (1) the seven job satisfaction and general associated factors studies are: Larson et al. (1984); Blegen and Mueller (1987); Blegen (1993); McNeese-Smith (1997); Shader et al. (2001); Bartram et al. (2004); Kramer and Schmalenberg (2003). In category (2) the five job satisfaction and empowerment studies are: Goddard and Laschinger (1997); Laschinger and Havens (1997); Laschinger et al. (2001); Manojlovich and Laschinger (2002); Larabee et al. (2003). In category (3) the five job satisfaction and magnet hospital attributes studies are: Aiken et al. (2000); Aiken and Patrician (2000); Aiken et al. (2001);

Aiken et al. (2002a); Upenieks (2003). Finally in category (4) the two job satisfaction and retention studies are: Irvine and Evans (1995); Shields and Ward (2001).

2.3.2 Literature review strategy: nursing leadership

A similar method was used to retrieve studies from the major databases (CINAHL, 1990 to 2007; Pre-CINAHL; MEDLINE, Cochrane; Pubmed) using the key words: ‘nurse manager leadership; measuring nurse manager leadership, and nurse manager leadership and satisfaction’. Thirty- one articles were retrieved using this methodology however fourteen of these articles were excluded because they were in the main opinion – based and therefore offered limited assistance on how leadership could be measured. Only seventeen articles were identified that measured leadership (Dunham- Taylor & Klafehn, 1995; Medley & Larochelle 1995; Morrison et al., 1997; Gullo & Gerstle, 2004; Kleinman, 2004; McGuire & Kennerly, 2006; Garrett, 2001; Boumans & Landeweerd, 1993; McNeese-Smith, 1999; Bratt, Broome, Kelber & Lostocco, 2000; Fletcher, 2001; Sellgren, Ekvall & Tomson, 2006; Rosengren, Athlin & Segesten, 2007; Force, 2005; Volk & Lucas, 1991; Leveck & Jones, 1996; Boyle et al., 1999). Of these studies eleven also measured job satisfaction (Volk & Lucas, 1991; Garrett, 1991; Boumans & Landeweerd, 1993; Medley & Larochelle, 1995; Dunham- Taylor & Klafehn, 1995; Morrison et al., 1997; Gullo & Gerstle, 2004; McNeese-Smith, 1999; Bratt et al., 2000; Fletcher, 2001; Boyle et al., 1999). The 17 leadership studies were critiqued and summarised. They were then divided into three major categories, based on how leadership was measured; (1) transformational and transactional, (2) leaders’ characteristics, skills and behaviours, (3) leadership and retention (Table 2.3: Appendix B). The literature was tabulated using the following headings: author/s, focus of the study, methodology and key findings.

2.3.2.1 Three categories of leadership studies

In category (1) there are the six studies that measured transformational and transactional leadership: Dunham-Taylor and Klafehn (1995); Medley and Larochelle (1995); Morrison et al. (1997); Gullo and Gerstle (2004); Kleinman (2004); McGuire and Kennerly (2006). Contained

in category (2) are the eight studies that explored leaders’ characteristics, skills and behaviours: Garrett (1991); Boumans and Landeweerd (1993); Fletcher (2001); Sellgren et al. (2006); Rosengren et al. (2007); McNeese- Smith (1999); Bratt et al. (2000); Force (2005). Finally within category (3) are the three studies that measured leadership and its relationship with retention: Volk and Lucas (1991); Leveck and Jones (1996); Boyle et al. (1999).

Numerous other studies were examined on both job satisfaction and leadership. These provided further insights into both leadership and the factors that influence job satisfaction, however articles were excluded that were opinion based and provided no methodology for examining and measuring job satisfaction and/or leadership. Within the literature reviewed no randomised controlled trials were reported in relation to job satisfaction and/or leadership.

2.3.3 Literature review strategy: front-line managers’ competencies The same data bases were used to retrieve the studies on nurse managers’ competencies. The words used to search for studies were: ‘front- line managers’ business competencies, and front-line nurse managers’ competencies’. No studies were retrieved that addressed only the business competencies of nurse managers; however six studies were retrieved that explored front line nurse managers competencies (Duffield, 1991; Cameron- Buccheri & Ogier, 1994; Gould et al., 2001; Scoble & Russell, 2003; Kleinman, 2003; Anthony et al., 2005).

2.5 Nursing Leadership 2.5.1 Transformational and

transactional leadership 2.5.2 Leaders’ characteristics skills

and behaviours

2.5.3 Leadership and retention 2.5.4 Limited summary of effective

nurse managers’ style and retention

2.5.5 Summary of studies 2.5.6 Summary of leadership

findings

2.6 Front line manager competencies 2.6.1 Studies’ methodologies 2.6.2 Studies’ findings 2.6.2.1 Financial management 2.6.2.2 Human resource management & Operational management 2.6.3 Summary of findings 2.4 Job satisfaction

2.4.1 General factors associated with job satisfaction • 2.4.1.1Working conditions

• 2.4.1.2 Personal and job attributes • 2.4.1.3 Patient care and workloads • 2.4.1.4 Autonomy

• 2.4.1.5 Stress, group cohesion and scheduling 2.4.2 Job satisfaction and empowerment

2.4.3 Job Satisfaction and magnet hospital attributes 2.4.4 Job satisfaction and retention

2.4.5 Summary of studies

2.4.6 Summary of job satisfaction factors findings