Healthcare Top Management's Transformational Leadership Behaviors and Nurses' Occupational and Organizational Turnover Intention: On the Role of Work Engagement and Autonomous Motivation.

This study examines the contribution of top management's transformational leadership behaviors on two targets of nurses' turnover intention (organization and occupation) by focusing on the indirect (through vigor and dedication) and conditional indirect associations (involving autonomous motivation as a moderator). Although the issue of nurse turnover has received growing scientific attention, the research is currently silent about the specific targets of turnover intention and more importantly, the potential pathways through which top management's transformational leadership behaviors relate to each target. Cross-sectional data from a sample of 426 French-Canadian nurses and structural equation modeling were used to test the proposed model. Top management's transformational leadership behaviors distinctly predicted organizational and occupational turnover intention through specific nurses' states of engagement. While perceived transformational leadership positively predicted vigor, its indirect associations (via dedication) with organizational and occupational turnover intention depend on nurses' level of autonomous motivation at work. In times of nurse shortage, the present findings provide insights into how and when top management's transformational leadership behaviors relate to nurses' organizational and occupational turnover intention. Healthcare organizations are advised to foster top management transformational leadership behaviors and autonomous motivation to sustain the nursing workforce.