From leadership research to district action: Impact of Nursing Leadership Styles on the Staff Turnover Intention in Saudi Arabia: A Cross-Sectional Study

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Background and objectives The efficiency of healthcare systems and nursing care depends on appropriate leadership. The purpose of this study was to determine the association between leadership styles of nurse managers and the staff turnover intention in Saudi Arabia. The nurses' intention to quit their jobs was considered as indicative of staff turnover intention. Methods A quantitative cross-sectional questionnaire-based study was conducted among 279 nurses, employed in three hospitals in Hafar Al-Batin City, Saudi Arabia. The questionnaire comprised three parts to determine the association between leadership styles of nurse managers and staff turnover intention, and how they related to participants' demographic variables (gender/age/education/income/marital status/experience). The first part collected demographic data, and the second part was an adapted and validated version of the multifactor leadership questionnaire (MLQ-6S) used to assess the perceived leadership styles of nurse managers, based on 21 items. The third part, comprising seven items, was used to assess nurses’ turnover based on intention to quit. The second and third parts of the questionnaire were scored using a five-point Likert scale. Collected data were tabulated and analyzed using a statistical software package for descriptive and inferential statistics (t-test, one-way analysis of variance (ANOVA), and correlation), comparing dependent outcome variables against independent demographic variables. Statistical significance was assumed when p-value was less than 0.05. Results Based on leadership style scores, transactional (13.32 out of a maximum of 24; 55.48%) and transformational (26.58 out of a maximum of 48; 55.37%) leadership were the most frequently perceived leadership styles among nurse managers. Laissez-faire leadership (6.31 out of a maximum of 12; 52.57%) was the least frequently perceived style. Upon comparing perceived leadership styles of nurse managers against demographic variables, no significant differences were observed for transformational leadership. However, income and experience of nurses showed significant relationship with the perceived transactional and laissez-faire leadership style scores, respectively. Based on perceived "intention to quit" scores, majority of the nurses expressed uncertain intention to quit (n = 193; 69.2%) and there was a significant yet weak negative correlation between the perceived leadership styles and intention to quit. The correlation coefficient (Pearson’s-r) was lowest for laissez-faire leadership (-0.258) followed by transactional (-0.295) and transformational styles of leadership (-0.348). Conclusions The present study indicated a greater degree of transactional and transformational leadership styles among nurse managers than laissez-faire leadership style. While most of the nurses mentioned an uncertain intention to quit, correlating it with the perceived leadership styles it was found that transformational leadership among nurse managers indicated greater retention of nurses within their present jobs. The present research findings underline the importance of prioritizing and fostering healthy workplace environment by the nurse managers, through inculcation of transformational leadership practices. Furthermore, focused, multi-centric studies from around the world can help understand the leadership practices of nursing leaders and its relationship with the intention of nurses to quit their respective roles.

Study methods

Ethical approval for the present study was obtained from the Institutional Ethics Committee (IRB approval no.: H-05-FT-083, Ministry of Health, Hafar Al-Batin, Saudi Arabia). This research was designed as a quantitative cross-sectional questionnaire-based study to determine the association between nurses’ perceived leadership styles of their nurse managers and their self-perceived intention to quit the present job.

Limitations

First, the current study used the perceptions of nurses about leadership practices. It could be more beneficial to evaluate leadership practices based on a combination of nurses’ perceptions and assessments of the styles used by nurse managers. Second, convenience random sampling methodology was used in this study, and this could have limited the potential of the study to generalize findings. Third, while the effect of independent demographic variables was only used as a means for statistical comparison in the present study, their multifactorial confounding effect on the dependent variables (perceived leadership styles and intention to quit) was not evaluated. Nevertheless, this study is one among the first to be reported from Saudi Arabia, which determines the association between the nurses’ perceived ideas relating to the leadership styles of their nurse managers and their intent to remain or leave the job.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one recurring leadership practice described in the source. Map its participants, incentives and constraints to a district setting, then design a small reversible staff pilot with an accountable owner. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Record implementation fidelity, staff review time, task quality and unintended burdens against a baseline. Use a comparison team where feasible and document alternative explanations before expanding. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Sharifa M Alasiry; Fawzah S Alkhaldi. Impact of Nursing Leadership Styles on the Staff Turnover Intention in Saudi Arabia: A Cross-Sectional Study. Cureus (2024-10-02). https://doi.org/10.7759/cureus.70676

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.