Wu Jijun, Li Yuxin, Lin Qin, Fan Yuting, Zhang Jiquan, Liu Zhenfan, Liu Xiaoli, Rong Xian, Zhong Xiaoli
Department of Nursing, Deyang People's Hospital, Deyang, China.
North Sichuan Medical College, Nanchong, Sichuan, China.
BMJ Open. 2025 Apr 29;15(4):e091462. doi: 10.1136/bmjopen-2024-091462.
This study aimed to investigate the relationship between transformational leadership and presenteeism among intensive care unit (ICU) nurses in tertiary hospitals and further investigate the chain-mediated role of perceived social support and occupational coping self-efficacy.
This is a cross-sectional survey study.
Six tertiary hospitals in Sichuan Province, China.
590 ICU nurses were recruited from six tertiary hospitals in China for the survey.
Presenteeism of ICU nurses was the primary outcome indicator. Transformational leadership, perceived social support and occupational coping self-efficacy were secondary outcome indicators. The transformational leadership scale, perceived social support, occupational coping self-efficacy and Stanford presenteeism scale were used to investigate ICU nurses through convenience sampling.
The presenteeism score of ICU nurses was 15.46±4.45 (mean±SD), in which the incidence of high presenteeism was 53.90%. Correlation analysis showed that presenteeism was negatively correlated with transformational leadership, perceived social support and occupational coping self-efficacy (=-0.412 to -0.486; p<0.05). Perceived social support partially mediated the relationship between transformational leadership and presenteeism, with an effect value of 0.055 (95%CI: -0.102 to -0.012; p<0.001); occupational coping self-efficacy partially mediated the relationship between transformational leadership and presenteeism, with an effect value of 0.042 (95% CI: -0.074 to -0.017; p<0.001); perceived social support and occupational coping self-efficacy chain-mediated between transformational leadership and presenteeism, with an effect value of 0.029 (95% CI: -0.046 to -0.016; p<0.001).
ICU nurses' perceived social support and occupational coping self-efficacy are chain-mediated between transformational leadership and presenteeism. Therefore, to reduce nurses' presenteeism, nursing managers should adopt targeted interventions based on the factors influencing them to improve transformational leadership and enhance their perceived social support and occupational coping self-efficacy.
本研究旨在探讨三级医院重症监护病房（ICU）护士的变革型领导与出勤主义之间的关系，并进一步探究感知社会支持和职业应对自我效能感的链式中介作用。
这是一项横断面调查研究。
中国四川省的六家三级医院。
从中国六家三级医院招募了590名ICU护士进行调查。
ICU护士的出勤主义是主要结局指标。变革型领导、感知社会支持和职业应对自我效能感是次要结局指标。采用变革型领导量表、感知社会支持量表、职业应对自我效能感量表和斯坦福出勤主义量表，通过便利抽样对ICU护士进行调查。
ICU护士的出勤主义得分为15.46±4.45（均值±标准差），其中高出勤主义发生率为53.90%。相关性分析表明，出勤主义与变革型领导、感知社会支持和职业应对自我效能感呈负相关（=-0.412至-0.486；p<0.05）。感知社会支持部分中介了变革型领导与出勤主义之间的关系，效应值为0.055（95%CI：-0.102至-0.012；p<0.001）；职业应对自我效能感部分中介了变革型领导与出勤主义之间的关系，效应值为0.042（95%CI：-0.074至-0.017；p<0.001）；感知社会支持和职业应对自我效能感在变革型领导与出勤主义之间起链式中介作用，效应值为0.029（95%CI：-0.046至-0.016；p<0.001）。
ICU护士的感知社会支持和职业应对自我效能感在变革型领导与出勤主义之间起链式中介作用。因此，为降低护士的出勤主义，护理管理者应基于影响因素采取针对性干预措施，以改善变革型领导，增强其感知社会支持和职业应对自我效能感。
