This study investigates (1) if communication with one's supervisor is related to empowerment through establishing perceptions of leader integrity, and (2) the extent to which the relationship between leader integrity and empowerment is moderated by intellectual stimulation. Due to the dynamic nature of today's organizational environment, understanding the nuances among these variables is vital to effective performance at the individual and organizational level. Hierarchical multiple regression tests were performed with a sample of 259 nurses in two regional healthcare facilities in the Midwestern United States. The results support a moderated-mediation relationship such that open communication with one's supervisor is positively related to empowerment through perceptions of leader integrity, but the relationship between leader integrity and empowerment varies across levels of intellectual stimulation. Specifically, while supervisor integrity mediates the relationship between patient safety communication and empowerment, this mediated relationship is only significant for followers who experience high intellectual stimulation, and is not significant for followers who report low intellectual stimulation. Thus, open communication and leader integrity will only empower followers if the leader is intellectually stimulating. This research clarifies how leaders in health care environments should communicate with their followers to empower them to think and act by their own initiative. Specifically, followers who communicate openly with their supervisor will feel more empowered, but only if they experience high intellectual stimulation which can improve their job performance and patient safety overall.
AikenL.S. and WestS.G. (1991). Multiple Regression: Testing and Interpreting Interactions, Sage, Thousand Oaks, CA.
2.
AvolioB. J., and YammarinoF. J. (2013). Transformational and charismatic leadership: The road ahead.2nd Edition. Oxford, UK: Elsevier Science.
3.
BagozziR.P. and YiY. (1988). On the evaluation of structural equation model. Journal of the Academy of Marketing Science, 16:74–94.
4.
BaronR.M. and KennyD.A. (1986), The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51:1173–1182.
5.
BassB. M., and AvolioB. J. (1997), Full range of leadership: Manual for the Multi-factor Leadership Questionaire.Palto Alto, CA: Mind Garden.
6.
BeckettC., and KipnisG. (2009). Collaborative Communication: Integrating SBAR To Improve Quality/Patient Safety Outcomes. Journal for Healthcare Quality, 31:19–28.
BolkanS., GoodboyA. K., and GriffinD. J. (2011). Teacher leadership and intellectual stimulation: Improving students' approaches to studying through intrinsic motivation. Communication Research Reports, 28:337–346.
9.
BurnsJ.M. (1978) Leadership. New York. Harper and Row.
10.
ChampouxJ.E. and PetersW.S. (1987), Form, effect size, and power in moderated regression analysis. Journal of Occupational Psychology, 60:243–255.
11.
CohenJ. and CohenP. (1983), Applied Multiple Regression/Correlation Analysis for Behavior Sciences, 2nd ed., Lawrence Erlbaum Associates, Mahwah, NJ.
12.
DineenB. R., LewickiR. J., and TomlinsonE. C. (2006). Supervisory guidance and behavioral integrity: Relationships with employee citizenship and deviant behavior. Journal of Applied Psychology, 91:622–635.
13.
DionneS.D., YammarinoF.J, AtwaterL.E. and SpanglerW.D. (2003). Transformational leadership and team performance.Journal of Organizational Change Management, 17:177–193.
14.
EchambadiR. and HessJ.D. (2007), Mean-centering does not alleviate collinearity problems in moderated multiple regression models. Marketing Science, 26:438–445.
15.
EdmondsonA. (1999). Psychological Safety and Learning Behavior in Work Teams. Administrative Science Quarterly, 44:350–350.
16.
FornellC. and LarkerD.F. (1981), Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18:39–50.
17.
GardnerW. L., CogliserC. C., DavisK. M., and DickensM. P. (2011). Authentic Leadership: A review of the literature and research agenda. The Leadership Quarterly, 22:1120–1145.
18.
HairJ. F., BlackW. C., BabinB. J., AndersonR. E. and TathamR. (2006). Multivariate Data Analaysis, 6th ed., Pearson, Upper Saddle River, NJ.
19.
HalbeslebenJ., LeroyH., DierynckB., SimonsT., SavageG., MccaugheyD., and LeonM. (2013). Living up to safety values in health care: The effect of leader behavioral integrity on occupational safety. Journal of Occupational Health Psychology, 18:395–405.
20.
HarrisC.T., PeeplesR, and MetzloffT.B. (2008). Does Being a Repeat Player Make a Difference? The Impact of Attorney Experience and Case-Picking on the Outcome of Medical Malpractice Lawsuits. Yale Journal of Health Policy, Law, and Ethics. 8:Article 1.
21.
HawksJ.H. (1992). Empowerment in nursing education: concept analysis and application to philosophy, learning and instruction. Journal of Advanced Nursing17:609–618.
LeeA., and KellyD. (2012). The Effect of Hospital Electronic Health Record Adoption on Nurse-Assessed Quality of Care and Patient Safety. JONA: The Journal of Nursing Administration, 41(11):466–472.
24.
LeonardM., GrahamS., and BonacumD. (2004). The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care, 13(Suppl 1), i85–i90. doi:10.1136/qshc.2004.010033.
25.
MayerR. C., DavisJ. H., and SchoormanF. D. (1995), An integrative model of organizational trust. Academy of Management Review20:709–734.
26.
MaynardM. T., GilsonL. L., and MathieuJ. E. (2012). Empowerment—Fad or Fab? A Multilevel Review of the Past Two Decades of Research. Journal of Management, 38(4), 1231–1281.
27.
PalanskiM.E., KahaiS.S., and YammarinoF.J. (2011). Team Virtues and Performance: An Examination of Transparency, Behavioral Integrity, and Trust. Journal of Business Ethics, 99(2):201–216.
28.
PardueS. (1987). Decision-making skills and critical thinking ability among associate degree, diploma, baccalaureate, and master's-prepared nurses. The Journal of Nursing Education, 26(9):354–361.
29.
PengA.C., LinH.E., McDonoughE., HuB., ZhangA. (2013). Work Meaningfulness: the Influences of CEO Intellectual Stimulation and Environmental Uncertainty. Academy of Management Proceedings. 2013:1 10282; doi:10.5465/AMBPP.2013.10282abstract.
30.
PeruginiM., and BagozziR. P. (2001). The Role of Desires and Anticipated Emotions in Goal-Directed Behaviours: Broadening and deepening the theory of planned behavior. British Journal of Social Psychology40:79–98.
31.
ReaderT., FlinR., LaucheK., and CuthbertsonB. (2006). Non-technical skills in intensive care. British Journal of Anaesthesia, 96:551–559.
32.
RuotsalainenJH, VerbeekJH, MarinéA, SerraC. (2014). Preventing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews, 12.
33.
SiegallM. and GardnerS. (2000). Contextual factors of psychological empowerment, Personnel Review, 29(6):703–722.
34.
SimmonsT. (2002). Behavioral Integrity: The Perceived Alignment between Managers' Words and Deeds as a Research Focus. Organization Science, 13(1):18–35.
35.
SimonsT. (2008). The integrity dividend: Leading by power of your word. San Francisco: Jossey-Bass.
36.
SpreitzerG. M. (1995). Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academy of Management Journal, 38(5):1442–1465.
37.
SpreitzerG. M. (1996). Social structural characteristics of psychological empowerment. Academy of Management Journal, 39(2):483–504.
38.
SyrekC., ApostelE., and AntoniC. (2013). Stress in highly demanding IT jobs: Transformational leadership moderates the impact of time pressure on exhaustion and work–life balance. Journal of Occupational Health Psychology, 18(3):252–261.
TuckeyM. R., BakkerA. B., and DollardM. F. (2012). Empowering leaders optimize working conditions for engagement: A multilevel study. Journal of Occupational Health Psychology, 17:15–27.
42.
TuckerA., and EdmondsonA. (2003). Why Hospitals Don't Learn from Failures: Organizational and Psychological Dynamics that Inhibit System Change. California Management Review, 45(2):55–72.
Van RyzinJ. (2005). Walking the Talk: Organizational Integrity Begins and Ends at the Top. FutureAge.
45.
VogelgesangG. R., LeroyH., and AvolioB. J. (2013). The mediating effects of leader integrity with transparency in communication and work engagement/performance. The Leadership Quarterly, 24(3):405–413.
46.
WalumbwaF., AvolioB., GardnerW., WernsingT., and PetersonS. (2008). Authentic Leadership: Development And Validation Of A Theory-Based Measure. Journal of Management, 34(1):89–126.
47.
WalumbwaF., and HartnellC. (2011). Understanding transformational leadership–employee performance links: The role of relational identification and self-efficacy. Journal of Occupational and Organizational Psychology, 84(1):153–172.
48.
WangG., OhI., CourtrightS., and ColbertA. (2011). Transformational Leadership and Performance Across Criteria and Levels: A Meta-Analytic Review of 25 Years of Research. Group & Organization Management, 36(2):223–270.
YasinG., NawabS., BhattiK. K., and NazirT. (2014). Relationship of Intellectual Stimulation, Innovations and SMEs Performance: Transformational Leadership a Source of Competitive Advantage in Smes. Middle-East. Journal of Scientific Research, 19(1): 74–81.
51.
ZhouQ., HirstG., and ShiptonH. (2012). Context matters: Combined influence of participation and intellectual stimulation on the promotion focus– employee creativity relationship. Journal of Organizational Behavior, 33, 894–909.
