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The Impact of Transformational Leadership on Nurses’ Organizational

Commitment: A Multiple Mediation Model

Article in European Journal of Investigation in Health Psychology and Education · December 2019
DOI: 10.3390/ejihpe10010021

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Article

The Impact of Transformational Leadership on

Nurses’ Organizational Commitment: A Multiple
Mediation Model
Kamran Iqbal 1,2,*, Tehreem Fatima 3 and Muhammad Naveed 4
1 Department of Management Sciences, University of Lahore, Sargodha 40100, Pakistan;
[email protected]
2 Department of Management Sciences, Bahria university Islamabad, Islamabad 44000, Pakistan

3 Department of Management Sciences, University of Lahore, Sargodha 40100, Pakistan;

[email protected]
4 Department of Management Sciences, University of Lahore, Sargodha 40100, Pakistan;

[email protected]
* Correspondence: [email protected]

Received: 13 October 2019; Accepted: 6 December 2019; Published: 9 December 2019

Abstract: This study proposed that the transformational style of nursing staff supervisors inculcate
commitment amongst nurses. Moreover, psychological empowerment and psychological well-
being were posited as multiple meditators in the above-mentioned association, based on the tenant
of conservation of resource (COR) theory. The authors have collected the survey data from the
sample of (n = 299) hospital nurses working in Sargodha district of Pakistan. The bootstrap results
have supported the direct, as well as indirect relationships. These findings imply that when the
nursing staff perceives their leader as transformational, their psychological empowerment is
enhanced, and they have higher well-being, which in turn increases their commitment to their
hospitals. This study offers a better understanding of psychological states that mediate
transformational leadership and organizational commitment linkage.

Keywords: transformational leadership; psychological empowerment; psychological well-being;

organizational commitment; nursing sector

1. Introduction
Nursing is considered as the central component of the healthcare sector in all parts of the world.
However, in a developing country like Pakistan, it has a significant contribution to health care.
Pakistan’s estimated population is over 200 million, making it the fifth most populated nation in the
world. More than half of the people do not have access to essential health and educational facilities.
The availability of nurses is insufficient to meet the requirement of healthcare. Although nurse to
population ratio improved from 1:32,000 in 1960 to 1:5199 by 1997 [1], it is still very low, compared
to developed nations. Improvement in quality of patient care is a primary goal of health care
organization [2]. Nurses’ commitment to their hospitals is critical for the maintenance of high-quality
safety and health care environment [3]. Because nurses work closely with patients in hospitals, their
commitment to their hospital is highly crucial for quality assurance. The term “organizational
commitment” refers to the attachment between employee and organization [4]. According to [5],
committed employees put more effort into achieving organizational goals and objectives. Also,
organizational commitment has been associated with several employee attitudes and behaviors, for
instance, job performance [6], job satisfaction [7] and job turnover [8].

Eur. J. Investig. Health Psychol. Educ. 2019, 1, 262-275; doi:10.3390/ejihpe10010021 www.mdpi.com/journal/ejihpe

Eur. J. Investig. Health Psychol. Educ. 2019, 1 263

Organizational commitment is believed to be an outcome of the positive exchange relationship

between an organization and its employees [9]. Research shows that increase in salary and monetary
benefits are not appropriate methods to resolve the issue of nurses’ shortage in hospitals; instead,
organizations should focus on non-monetary factors to motivate nursing staff [10]. Amongst these
non-monetary factors, leadership is found to be an antecedent of employee commitment.
Transformational leadership has surfaced as one of the most important leadership styles that foster
higher levels of commitment in employees [11]. It is defined as “a process through which leaders and
followers raise one another to higher levels of morality and motivation” [12] (pp. 20). According to
Bass [13], transformational leadership style leads to a higher level of motivation and performance in
employees than transactional leadership style. Shamir et al. [14] pointed out that these kinds of
leaders convey salient messages to their employees about the impact and importance of the group’s
task and how their efforts contribute toward a group success. A transformational leader is one who
“looks for the potential motives in followers, seeks to satisfy higher needs, and engages the full
person of the follower” [12] (pp. 4). Such leaders lead their employees through motivation,
inspiration, and inculcate valuable and positive changes in their workers. They inspire individuals to
perform at an unexpected level and produce exceptional outcomes. By doing so employee’s attitudes
are changed in ways that enhance their motivation to achieve organizational goals. Prior studies on
transformational leadership have linked it with employee well-being [15], project success [16], job
satisfaction [17], patient safety [17], job crafting [18,19], employee creativity [20], knowledge sharing
[21], performance outcomes [22], managerial performance [23], work engagement [24], proactive
work behavior [24], organizational performance [25], and organizational citizenship behavior [26]. In
nursing, this leadership concept has been linked with higher team performance and better patient
care [27]. Recently, transformational leadership style is found to be effective in leading nursing staff
and has proven to be a precursor of positive organizational outcomes. It is suggested as an
appropriate leadership style, to overcome the issue of nurse retention [17].
Even though there is a well-established empirical and conceptual association of transformational
leadership with organizational commitment [11], researchers are still in quest of clarifying the
mechanisms that link these two variables. In this study, we aim to depart from the use of single
mediators of, i.e., psychological empowerment [11] and leader-member exchange [28], and introduce
multiple explanatory paths linking transformational leadership to organizational commitment. One
is through psychological empowerment and the other is through the mechanism of psychological
well-being. For this purpose, we build on the CORperspective and argue that the transformational
leaders are able to inculcate higher psychological empowerment in the followers by escalating the
level of meaningfulness they attribute to their work, having necessary capabilities to perform the
assigned tasks, and having a sense of influence over one’s environment [11]. Moreover, they are also
capable of bringing a sense of higher psychological well-being in employees through support and
motivation, which enhances the satisfaction and feeling of accomplishment in the followers [29].
These positive psychological states, in turn, create a stronger bond and attachment to organization,
increasing the levels of organizational commitment.

2. Theoretical Background and Hypotheses Development

The tenant of the COR theory states that employees need resources for effective work
performance and retention. These resources may be physical, social, or psychological, derived from
the factors present in their work contexts [30]. Leaders are an important source of imparting resources
to their followers; a good quality association between leaders and followers results in more
resourceful employees [31]. Building on the theoretical conception of COR, it is argued that the
inspiration, motivation, support and individualized consideration given by the transformational
leader makes their followers more resourceful in terms of empowerment [32] and well-being [33]
which ultimately leads to positive organizational outcomes, i.e., organizational commitment.
Employees that feel psychologically independent and attribute more meaning to their work have a
higher level of involvement in organizational activities [34]. Similarly, the psychological well-being
Eur. J. Investig. Health Psychol. Educ. 2019, 1 264

at work is yet another important resource that employee’s value, and it enhances their capacity to be
retained and have a high attachment to the organization [35].
Our proposed model focuses on the examination of the nexus between transformational
leadership, psychological empowerment, and organizational commitment, described in Figure 1.
This study helps to understand the black box between transformational leadership and
organizational commitment in the nursing sector. The proposed model suggests that
transformational leadership stimulates psychological empowerment and psychological well-being,
which in turn influence nurses’ organizational commitment.

Figure 1. The hypothesized mediation model.

2.1. Transformational Leadership and Organizational Commitment

Organizational commitment is defined as “the relative strength of an individual’s identification
with and involvement in a particular organization” [4] (pp. 27). Organizational commitment (OC)
shows the degree of association that employees have with their organization [36]. Research has
uncovered that organizational commitment leads to many benefits for both employees and the
organization [37]. Rowden [38] found that higher levels of commitment lead to job security, career
advancement, and increased rewards for the employees. Prior studies proclaim the association
between transformational leadership and organizational commitment by using various contextual
settings [39–42] and obtain divergent findings [43,44]. Bushra et al. [45] advocate that
transformational leadership is a potential determinant of organizational commitment, having studied
banking sector employees in Pakistan. Transformational leaders induce the voice of their followers
in the policymaking process and help them to increase their potential [46]. When managers consider
the needs of their followers and appreciate their efforts to apply new approaches to solve work-
related problems, it motivates them to get more engaged in their job, and this results in the higher
commitment of staff to their organization [44]. Based on the substantive review, the following
hypothesis has been deduced:

H1. There is a positive relationship between transformational leadership and organizational commitment.
Eur. J. Investig. Health Psychol. Educ. 2019, 1 265

2.2 Transformational Leadership and Psychological Empowerment

The concept of employee empowerment has been extensively studied during the last two
decades in different settings and contexts, such as information technology organizations and
academics [47], social workers [48], banking managers [49], public welfare caseworkers [50],
manufacturing firms [51], hotel staff [52] and nurses [11]. Spreitzer [53] defined psychological
empowerment as “increased intrinsic task motivation manifested in a set of four cognitions reflecting
an individual’s orientation to his or her work role: competence, impact, meaning, and self-
determination” (pp. 1443). Organizations use empowerment as an import tool by delegating the
responsibility and freedom to their employees so that they use their creative ideas to add value in
products and services offered by these organizations [54]. Psychological empowerment is one of the
main factors that distinguishes the transformational leadership style from other leadership styles [55].
Therefore, it can be proposed that the transformational leadership style is a possible predictor of
psychological empowerment. Past studies proclaim a significantly positive nexus between
transformational leadership and psychological empowerment [47,56,57]. Therefore, we hypothesize
that:

H2. Transformational leadership is positively related to psychological empowerment.

2.3. Psychological Empowerment and Organizational Commitment

Empowered employees consider themselves to be more competent and influential in their
organizations and at their job. It is posited that when employees perceived that their organization is
empowering them, they are more likely to respond with a higher level of organizational commitment
[58]. Empowered employees perceive themselves to have an impact on their organizations and in
their jobs [11]. In this way, empowerment motivates employees to perform at the highest level, and
exhibit a higher organizational commitment to achieving organizational goals [59]. We, therefore,
hypothesize:

H3. Psychological empowerment is positively related to organizational commitment.

Based on the literature, it is evident that the transformational leadership style fosters a higher
level of psychological empowerment in employees that thrive from organizational commitment. So,
it is hypothesized that:

H4. Psychological empowerment mediates the link between transformational leadership and organizational
commitment.

2.4. Transformational Leadership and Psychological Well-Being

Psychological well-being is an essential dimension of the overall well-being of employees [60].
Psychological well-being is the state of happiness and satisfaction with experiences at work and life
in general, utility, sense of achievement, and belongingness. Psychological well-being has been
studied with several job-related variables, i.e., with the working environment [61,62], job insecurity
[63], job burnout [64], employee performance [65], and psychological capital [66]. Transformational
leaders can help employees to reduce stress levels through their mentoring function [67]. Bass and
Riggio [68] highlighted that transformational leaders help their subordinates to achieve challenging
goals through their continuous support and motivation. McVicar [33] suggested that
transformational leadership influences well-being of employees, especially in the health sector, where
the environment is highly stressful. We expect a definite link between transformational leadership
and psychological well-being. Hence, we hypothesize that:

H5. Transformational leadership has a positive impact on psychological well-being.

2.5. Psychological Well-Being and Organizational Commitment

Eur. J. Investig. Health Psychol. Educ. 2019, 1 266

Nielsen et al. [69] argue that transformational leaders enhance self-efficacy in employees and
increase trust in management, which results in higher psychological well-being. Also, researchers
have proclaimed a substantial positive link among well-being and employee outcomes, such as
organizational commitment [70]. Hence, we expect a positive relationship between psychological
well-being and organizational commitment. As a result, we hypothesize:

H6. Psychological well-being has a positive impact on organizational commitment.

We propose that transformational leadership is linked with psychological well-being and that
psychological well-being is positively related to organizational commitment. Thus, we also propose
a mediating hypothesis:

H7. Psychological well-being mediates the link between transformational leadership and organizational
commitment.

3. Methodology

3.1. Sample and Procedure

We focused on the nursing staff of private and public hospitals of Sargodha District, the 12th
largest city in Pakistan with a population of over two million. It consists of more than 30 big hospitals.
The collection of the data was self-administered, and participants were assured about the
confidentiality of their responses. Self-administration helps the researcher to make sure that
participants are giving their responses after proper clarification and understanding of the contents.
This study adopted the convenience sampling technique. A total of 618 questionnaires were
circulated, 330 were returned. Amongst the returned questionnaires, a few questionnaires were
partially filled and contained multiple responses, these were removed. Therefore, only 299 (48%)
were used for the final analysis. The surveys were conducted in English as it is the medium of
instruction in all higher education institutes in Pakistan, and English is well understood among the
nursing staff of hospitals in Pakistan. A cover letter showing the purpose of the visit was attached in
front of the questionnaire. Ethical approval was obtained from the district health authority. The
respondents were told about the aims and objectives of the study. The participation of the
respondents was voluntary, and they were assured data confidentiality Data were analyzed using
5000 bootstrapped samples and run though model 4 by using SPSS macro, which was developed by
Preacher and Hayes [71] to test all hypotheses. All measures were evaluated at five-point Likert scale
ranging from 1 = strongly disagree to 5 = strongly agree. The sample consisted of 52.5% males and
47.5% females. From the total respondents, 64% were married, and 36% were single. A total of 73%
were aged less than 35, 30% less than 25 years old, 17% between ages 36 to 50, while only 10% were
aged more than 50 years old.

3.2. Measures

3.2.1. Transformational Leadership

Transformational leadership was measured by using seven items taken from [72]. Sample items
were “my supervisor treats staff as individuals, supports and encourages their development”; “my
supervisor encourages thinking about problems in new ways and questions assumptions.” The
Cronbach’s alpha value for this variable was 0.703.

3.2.2. Organizational Commitment

The questionnaire of organizational commitment was adopted from Meyer et al. and Meyer and
Allen [73,74]. The scale consisted of 5 items. Sample items were “I would be happy to work at my
organization until I retire”; “I would be happy to work at my organization until I retire” The
Cronbach’s alpha value for this variable was reported as 0.766.
Eur. J. Investig. Health Psychol. Educ. 2019, 1 267

3.2.3. Psychological Empowerment

The psychological empowerment was measured by adopting a scale developed from Spreitzer
[53]. The questionnaire contains 12 items, for example, “I can decide on my own how to go about
doing my work”; “I have considerable opportunity for independence and freedom in how I do my
job” The Cronbach’s alpha value for this variable was 0.863.

3.2.4. Psychological Well-Being

The measure of psychological well-being was adapted from Diener et al. [75]. The measure
consisted of 8 items, for instance, “I am engaged and interested in my daily activities”; “I actively
contribute to the happiness and well-being of others.” The Cronbach’s alpha value for this variable
was 0.792.

4. Results

4.1. Descriptive Statistics and Correlation

Table 1 exhibits descriptive statistics (which include mean, standard deviation, and correlations)
of the demographical variables. Transformational leadership was found to be significantly correlated
to psychological empowerment (r = 0.575, p < 0.01), psychological well-being (r = 0.621, p < 0.01) and
organizational commitment (r = 0.529, p < 0.01). A significant correlation was found between and
psychological empowerment and organizational commitment (r = 0.674, p < 0.01), and between
psychological well-being and organizational commitment (r = 0.617, p < 0.01).

Table 1. Correlations and descriptive statistics.

Variables Mean S. D 1 2 3 4 5 6 7
1. Gender 1.475 0.500 1
2. Marital status 1.351 0.493 0.213** 1
3. Age 2.063 0.934 0.072 0.213** 1
4. Transformational
4.164 1.541 −0.043 0.018 −0.068 1(0.703)
leadership
5. Psychological
2.571 0.741 0.014 0.064 0.011 0.575** 1(.863)
empowerment
6. Psychological well-
2.555 0.691 −0.009 −0.019 −0.007 0.621** 0.696** 1(.792)
being
7. Organizational
2.570 0.783 0.010 0.019 0.019 0.529** 0.674** 0.617** 1(0.766)
commitment
Notes: ** Significant level. p < 0.01, N = 299.

4.2. Confirmatory Factor Analysis

Before testing the hypotheses, a series of confirmatory factor analyses were run to verify the best
suitable measurement model [76]. The result of the proposed model showed excellent model fit, χ2 =
842.52, CFI = 0.947, TLI = 0.931, and RMSEA= 0.057, as compared to another possible model. Also, the
factor loadings of all indicators loaded significantly, and their values were greater than 0.50. On the
whole, the confirmatory factor analysis results revealed that the proposed model has adequate
discriminant validity (Table 2).
 Eur. J. Investig. Health Psychol. Educ. 2019, 1 268

Table 2. Confirmatory factor analysis.

Model χ2 CFI TLI RMSEA

Four-factor model (TL, PE, PWB, OC) 842.52 0.947 0.931 0.057
Three-factor model (combining PE and PWB into a factor) 1207.24 0.857 0.828 0.079
Two-factor model (combining PE, PWB, and OC into a factor) 1663.43 0.746 0.721 0.094
Two-factor model (combining TL and PE into a factor and, PWB and OC into a
1684.22 0.727 0.701 0.112
factor)

Two-factor model (combining TL, PE and PWB) 1672.92 0.734 0.695 0.101

One factor model (combining all items into one factor) 1929.31 0.685 0.624 0.129
Notes: TL = Transformational leadership, PE = Psychological empowerment, PWB = Psychological
well-being, OC = Organizational commitment.

4.3. Mediation Analysis

4.3.1. Mediating Effect of Psychological Empowerment

Regression results have been used according to instructions given by Barron and Kenny and
preacher and Hayes [71,77]. Table 3 shows a significant total effect between the transformational
leader and organizational commitment (B = 0.2686, p < 0.001). Hence, the first condition of mediation
is fulfilled, as per Barron and Kenny [71]. Next, there is a significant positive relationship between
transformational leaders and psychological empowerment (B = 0.2764, p < 0.001). These results
support our second hypothesis, H2, and the second condition of mediation. Next, a significant and
positive effect of psychological empowerment and organizational commitment is observed (B =
0.5829, p < 0.001). Hence, our third hypothesis, H3, and the third condition of mediation are
supported. Fourth, a significant positive link between transformational leadership and
organizational commitment has been reduced substantially and has become B = 0.1075, p < 0.001. It
is still significant and supports our first hypothesis, H1. Finally, mediation was tested, based on the
significance of the indirect effect as directed by Preacher and Hayes [71]. In this study, the authors
first applied four conditions of Barron and Kenny [77], and then we examined the significance of the
indirect effect by bootstrapping the sampling distribution. The results revealed that indirect effect of
transformational leadership on organizational commitment is also found to be significant (Sobel Z =
0.1611, p < 0.001). The bootstrap result on a 95% level of confidence for all confidence intervals did
not contain zero (Lower levels of confidence interval (LLCI) = 0.1238, Upper levels of confidence
interval (ULCI) = 0.2036). Hence these results have also supported our fourth hypothesis, H4.

Table 3. Testing of mediation (psychological empowerment).

Variable B SE t P LLCI ULCI

Transformational leadership regressed
on organizational commitment: Total 0.2686 0.0250 10.7420 0.0000 0.2194 0.3178
effect
Transformational leadership regressed
0.2764 0.0228 12.1056 0.0000 0.2315 0.3213
on psychological empowerment
Psychological empowerment regressed
0.5829 0.0539 10.8139 0.0000 0.4768 0.6889
on organizational commitment
Transformational leadership regressed
on organizational commitment for
0.1075 0.0259 4.1490 0.0000 0.0565 0.1585
Psychological empowerment: Direct
effect
The indirect effect of transformational leadership on organizational commitment through psychological empowerment
Value Boot SE Boot LLCI Boot ULCI
0.1611 0.0203 0.1238 0.2036

4.3.2. Mediating Effect of Psychological Well-Being

Table 4 shows that the total effect of transformational leadership on organizational commitment
is significant (B = 0.2686, p < 0.001). Next, there is a significant positive relationship between
Eur. J. Investig. Health Psychol. Educ. 2019, 1 269

transformational leadership and psychological well-being (B = 0.2783, p < 0.001). Hence, the fifth
hypothesis, H5, is accepted. Next, significant and positive effects of psychological well-being and
organizational commitment were noticed (B = 0.5322, p < 0.001). This supports the sixth hypothesis
H6, and the third condition of mediation are supported. Fourth, a significant positive link between
transformational leadership and organizational commitment has been reduced substantially and has
become (B = 0.1205, p < 0.001). So H7 is partially supported. The indirect effect of transformational
leadership on organizational commitment was also found to be significant (Sobel Z = 0.1481, p <
0.001). As the bootstrap result on a 95% level of confidence for all confidence intervals did not contain
zero (LLCI = 0.0993, ULCI = 0.1930). Hence these results also support our seventh hypothesis, H7.

Table 4. Testing of mediation (psychological well-being).

Variable B SE t P LLCI ULCI

Transformational leadership regressed on organizational
0.2686 0.0250 10.7420 0.0000 0.2390 0.3375
commitment: Total effect
Transformational leadership regressed on psychological well-
0.2783 0.0204 13.6440 0.0000 0.2383 0.3185
being
Psychological well-being regressed on organizational
0.5322 0.0642 8.2915 0.0000 0.4059 0.6585
commitment
Transformational leadership regressed on organizational
0.1205 0.0288 4.1866 0.0000 0.0639 0.1771
commitment for psychological well-being: Direct effect
The indirect effect of transformational leadership on organizational commitment through psychological well-being
Value Boot SE Boot LLCI Boot ULCI
0.1481 0.0245 0.0993 0.1930

5. Discussion
The present study observed the link of transformational leadership with organizational
commitment through the underlying role of psychological empowerment and well-being. We aimed
to extend the general positive effect of the transformational leadership style of nursing staff
supervisors on the commitment of nurses working in the context of the targeted population. The
results of our study generated important findings based on the COR theoretical lens.
First of all, the direct association of transformational leadership and organizational commitment
was supported, based on the results. Leadership, in general, is considered as an antecedent of
organizational commitment. Specifically, transformational leadership is found to be a precursor of
organizational commitment in broad organizational and cultural settings [11]. The study found a
positive relationship between transformational leadership and organizational commitment, which is
consistent with previous findings [11,78,79]. Transformational leaders can induce commitment in
their followers by inspiring them, promoting and supporting innovation, giving individual
consideration, and modeling the desired behaviors. As per the COR perspective, leaders provide
resources to followers that are necessary to engage in positive organizational outcomes [31]. In this
way, transformational leadership results in a higher level of intrinsic value that the followers then
place on goal achievement, in turn, this fosters an overall commitment to the attainment of commonly
held organizational visions [28].
Though the connotation that transformational leadership and organizational commitment have
theoretical and empirical existence [11], researchers have increasingly called for the clarification of
the underlying factors that link these two constructs [28]. We have extended the direct association in
transformational leadership and organizational commitment through the role of psychological
empowerment. The results support this hypothesis, which confirms the study of Balaji and Krishnan
[80]. This is through the creation of higher psychological empowerment in the followers, by
increasing the level of meaningfulness they attribute to their work, having the necessary capabilities
to perform the assigned tasks, and having a sense of influence over their environment [11]. Moreover,
psychologically empowered employees are found to be more committed [81]. Based on COR,
transformational leaders provide their followers with the needed autonomy and meaningfulness at
Eur. J. Investig. Health Psychol. Educ. 2019, 1 270

work. This constitutes an important psychological resource to induce the state of organizational
commitment [11,31]. This kind of psychological empowerment persuades a higher level of employee
involvement and attachment to their organizations [82].
Another way that transformational leaders promote commitment in their followers is by
enhancing the level of psychological well-being. So, we proposed psychological well-being as an
explanatory mechanism in clarifying the transformational leadership and organizational
commitment relationship. The cohesive nature of transformational leadership and psychological
well-being was supported by the results, as well as aligned with studies expounded in the literature
[83]. The support and motivation imparted by the transformational leaders make the followers more
satisfied, accomplished, and positive at their work [29]. This positive psychological state, in turn,
creates a stronger bond and attachment to organization, increasing the levels of organizational
commitment that is supported by the notion of COR [31]. Our results supported the results of [70];
concluding a significant association between psychological well-being and organizational
commitment. Thus, the followers have higher psychological well-being when they are led by a
transformational leader that improves their organizational commitment.
The main thrust of this investigation was to test whether psychological empowerment and
psychological well-being were the routes through which transformational leadership determine the
commitment of nursing staff. Theoretically, this study is unique in the sense that it has identified
multiple mediating mechanisms linking transformational leadership to organizational commitment
through psychological empowerment and psychological well-being. This has extended the field by
moving beyond the use of a single mediator of psychological empowerment [11] and leader-member
exchange[28]. We have contributed to the literature by using a COR perspective to explain
transformational leadership relations with the follower outcomes. It is suggested that
transformational leadership has an indirect influence on commitment through the psychological
resources of empowerment and well-being [31]. Our results offer support to the notion that leaders’
actions have the capacity to shape employees’ behaviors and their work outcomes [84]. Thus, this
study, based on the theoretical lens of COR, shows that transformational leaders are an essential
source of imparting psychological resources to their followers [31]. It further emphasizes the
importance of psychological empowerment and well-being as valuable resources that cause
employees to have higher levels of organizational commitment [33,69]. A transformational leader
acknowledges the needs of their followers and facilitates the provision of needed psychological
resources to create a sense of empowerment and well-being in their followers [17]. These are much
needed psychological resources for creating a commitment to the organization [85].
We offer practical implications for hospital management and nursing staff supervisors to
practice transformational leadership style to foster a higher level of commitment amongst nurses.
This study shows that transformational leadership style creates better outcomes in nurses as
compared to overly-managed and inflexible authoritarian styles [86]. By using the transformational
leadership style, nursing supervisors offer support, inspiration, individual-focused attention, and act
as a role model for nurses, that fosters psychological empowerment and well-being. Nurses will have
more independence and will be mentally satisfied while performing their job duties. In high-stress
environments of hospitals, it is important that nurses have a higher level of empowerment and well-
being to impart their services. This will enable the hospital management to improve staff retention
[87] and create a sense of commitment among nurses that will not only reduce their turnover intention
but also consolidate their attachment and involvement to their work and organization.
Transformational leaders cultivate the feelings of empowerment and well-being in nursing staff that
ultimately increase their organizational commitment. Hospitals have working environments that
have a high prevalence of adverse circumstances, stress, and tension. Moreover, they face issues of
nursing staff retention and shortage [17]. So, psychological empowerment and well-being are
indispensable for boosting the organizational commitment of nursing staff that can be achieved
through the practice of transformational style by nursing staff supervisors.

6. Conclusions
Eur. J. Investig. Health Psychol. Educ. 2019, 1 271

The findings of this study suggest that transformational leadership, psychological well-being,
and psychological empowerment affect nurses’ organizational commitment. Specifically, this study
has determined the role of transformational leadership in nurses’ organizational commitment
through two routes of psychological well-being and empowerment. This study concludes that both
psychological mechanisms are significant, but the mechanism of psychological empowerment is
slightly better than the mechanism of psychological well-being. We conclude that supervisors should
have a good relationship with their subordinates to increase subordinates’ psychological
empowerment and well-being. Hospital’s management should also work on leadership skills of staff
members that are leading a team, so that they can positively impact their subordinate’s attitudes. We
hope that future researchers will extend this study by examining the potential moderators that link
transformational leadership to organizational commitment, i.e., occupational self-efficacy [88], social
support [89], and power distance [90]. The more explanatory mechanism can be examined beyond
psychological well-being and psychological empowerment, i.e., procedural justice [91], and the
dimensions of organizational commitment could be examined as outcomes [28]. Since, data were
collected from a single source and were collected at single time frame, there could be a problem of
common method variance. Therefore, the use of longitudinal designs and data from more sources
(i.e., supervisors) is suggested to further improve the rigor and authenticity of the findings in this
study.
Author Contributions: Conceptualization, K.I and T.F.; methodology, K.I.; software, K.I.; validation, K. I. , T.F.
and M.N.; formal analysis, K.I.; investigation, K.I. and T.F.; resources, K.I. and T.F.; data curation, K.I.; writing—
original draft preparation, K.I..; writing—review and editing, T.F. and M.N..; visualization, T.F. and M.N.;
supervision, K.I.; project administration, K.I.

Funding: This research received no external funding.

Conflicts of Interest: The author declares no conflict of interest.

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