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Universiti Putra Malaysia
Leadership plays a crucial role in maximising employees' positive attitude, performance, and motivation in different situations in the workplace, including in the healthcare setting. In Saudi Arabia, health sector privatisation has been a key objective of the government in recent years to reform healthcare services. Throughout the ongoing internal organisational and external environmental changes in the sector to achieve this goal, leadership has been essential in addressing potential impacts on employee identification and performance. However, the healthcare system faces several challenges, such as a shortage of qualified employees, low productivity, a high turnover rate, and poor attitudes among the workforce. A review of the literature indicates limited examination of the directive, supportive, participative, and achievement-oriented leadership styles, as well as organisational identification in the regional literature. Little is known about uncertainty reduction and self-enhancement as situational factors affecting employees' work-related outcomes. Therefore, the general objective of this study is to examine the relationship between leadership styles and nurses' performance directly and through the mediating effect of organisational identification and the moderating effects of uncertainty reduction and self-enhancement in the Saudi healthcare sector. Most importantly, this study represents the first known empirical research to identify leadership styles in the Saudi healthcare sector. This quantitative study utilised the stratified sampling technique to select a sample of 371 permanent nurses working in five hospitals in Riyadh and Makkah, Saudi Arabia. Data was collected through a self-administrated questionnaire and analysed using structural equation modelling in the Smart-PLS version 3.0 software. The results demonstrated that only directive leadership directly influences employee performance, while the other leadership styles do not. Organisational identification was affected by directive, supportive, and achievement-oriented leadership but not by achievement-oriented leadership. The mediation test revealed that organisational identification significantly explains the effect of directive, supportive, and participative leadership on employee performance but not the effect of achievement-oriented leadership. In the moderation test, uncertainty reduction was shown to moderate the influence of directive and supportive leadership on organisational identification but not that of achievement-oriented and participative leadership. Finally, the moderating effect of self-enhancement was only significant in the relationship between participative leadership and organisational identification and insignificant for the other leadership styles. Theoretically, this study has expanded the current research on leadership styles and underlying mechanisms, apart from offering new insights into employees' identification processes. Practically, the findings of this study provide managers in the Saudi healthcare sector with a better understanding of the factors that influence employee performance. However, this study was limited to the studied variables. Future research might include other forms of leadership behaviours, such as the eight leadership styles of the newly formulated Path-Goal Theory and other forms of identification. This could help further develop the Path-Goal Theory and the SIT, as well as their applications.
Leadership, organisational identification, uncertainty reduction, self-enhancement, job performance, Saudi Hospital Sector