The role of leadership in nurses' wellbeing and performance: A cross-sectional survey using a dual motivational pathway model.

AIM: To examine the positive motivational paths from perceived autonomy-supportive leadership, and the negative motivational paths from perceived controlling leadership to satisfaction and frustration of basic psychological needs, work motivation, work performance, work engagement and somatic symptom burden among nurses using Self-Determination Theory. DESIGN: The study used a cross-sectional design mapping nurses' perceptions of the various study variables through a survey. METHODS: Nurses working in the municipal healthcare in Norway were recruited through an electronic questionnaire sent out via a link to their emails between 29th of August and 29th of September 2020. Of them, 219 nurses completed the questionnaire. Study hypotheses were tested using structural equation modelling. RESULTS: Higher levels of perceived autonomy-supportive leadership were associated with reduced levels of somatic symptom burden and increased levels of work performance and work engagement through the satisfaction of basic psychological needs and autonomous motivation, specifically identified regulation and intrinsic motivation. Perceptions of controlling leadership were associated with heightened levels of somatic symptom burden through basic psychological need frustration, amotivation and introjected motivation, along with lower levels of work engagement through need frustration and amotivation. CONCLUSION: This study underscores the positive motivational paths of perceived autonomy-supportive leadership on nurses' work performance and wellbeing through the facilitation of basic psychological need satisfaction and autonomous motivation. Conversely, the study highlights negative motivational paths of perceived controlling leadership on reduced work engagement and heightened ill-being through the basic psychological need frustration, controlled motivation and amotivation. IMPACT: This study provides insights and actionable recommendations for nurses and their leaders, emphasizing the significance of understanding the adverse impact associated with perceived controlling leadership. The findings underscore the importance of addressing these issues to mitigate detrimental effects on motivation and overall work functioning. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The Roles of Patients' Authenticity and Accepting External Influence, and Clinicians' Treatment Styles in Predicting Patients' Dental Anxiety and Avoidance of Dental Appointments.

A substantial proportion of adults suffer from high dental anxiety, which is related to poor oral health and functioning. Using authenticity theory and self-determination theory, we applied a model testing two moderated mediation hypotheses: (i) the negative indirect association between authenticity and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of autonomy support; and (ii) the indirect positive association between accepting external influence and avoiding dental appointments through dental anxiety would be more evident when clinicians provides higher levels of controllingness. Participants (N = 208) responded to a survey with validated questionnaires. The model with hypotheses were tested using Structural Equation Modeling (SEM) in LISREL and Conditional Process Modeling (moderated mediation). The results supported our hypotheses. The SEM model tested was found to fit the data well. Patient's personality and dental clinic treatment environments predicted 38% of the variance in dental anxiety, which explained 38% of avoidance of treatment.

Autonomy-supportive dental treatment, oral health-related eudaimonic well-being and oral health: a randomized clinical trial.

Objective: We tested the hypotheses that a dental intervention designed to promote oral care competence in an autonomy-supportive way, relative to standard care, would positively predict patients' perceived autonomy support from oral health-care professionals, increases in eudaimonic well-being (i.e. both personal growth and purposeful behaviour goals) and improved oral health (i.e. reduced dental bacterial plaque on tooth surface and reduced gingivitis) over 5.5 months. We also tested a self-determination theory model with the intervention positively predicting perceived autonomy support, which in turn would predict increases in eudemonic well-being, leading to improved oral health.Design: A randomised two-group experiment was conducted at a dental clinic with 138 patients (Mage = 23.31 yr, SD = 3.5). Variables were measured before and right after the intervention and 5.5 months later.Results: Overall, the experiment and hypothesised process models received strong support. The effect sizes were large for perceived autonomy support, change in personal growth, change in dental plaque and change in gingivitis, whereas the effect size for purposeful behaviour was moderate. The measurement and structural equation models for the SDT process model received good fit.Conclusions: The current field experiment extends previous knowledge by showing that promoting patient oral care competence in an autonomy-supportive way improves oral health through patients' eudaimonic well-being.