Nurses’ Perspectives on Managerial Leadership Practices and Their Determinants

Abstract

Background: Managerial leadership is essential for maintaining safe patient care, supporting nursing staff, improving workplace engagement, and strengthening healthcare quality. Nurses’ perceptions of leadership are influenced by managerial behaviors and workplace conditions, yet evidence from hospital settings in Lahore remains limited. Objective: To assess nurses’ perceptions of managerial leadership practices and identify factors associated with these perceptions among registered nurses working in selected public and private hospitals of Lahore, Pakistan. Methods: A quantitative cross-sectional study was conducted among registered nurses with at least six months of clinical experience. A total of 422 nurses were approached, and 401 completed a standardized self-administered questionnaire. Data were analyzed using SPSS version 26. Descriptive statistics summarized demographic characteristics, perception levels, and leadership-related factors, while multivariable linear regression identified determinants of nurses’ perception scores. Results: The response rate was 95.0%. Most participants were female (58.9%), aged 20–29 years (55.1%), BSN/Post RN qualified (61.8%), and employed in public hospitals (61.3%). The mean perception score was 58.42 ± 11.63. Overall, 29.4% of nurses had low perception, 42.6% moderate perception, and 27.9% high perception. Leadership training (β = 4.92, p < 0.001), organizational support (β = 0.51, p < 0.001), and innovative work behavior (β = 0.97, p < 0.001) were positively associated with perception scores, whereas job-related stress (β = -0.18, p = 0.002) and heavy workload (β = -0.23, p = 0.001) were negatively associated. Conclusion: Nurses demonstrated moderate perceptions of managerial leadership practices. Strengthening leadership training, organizational support, innovation, workload management, and stress reduction may improve nursing leadership effectiveness and workplace outcomes