Abstract
OBJECTIVE: This study aimed to investigate the relationship between transformational leadership and presenteeism among intensive care unit (ICU) nurses in tertiary hospitals and further investigate the chain-mediated role of perceived social support and occupational coping self-efficacy. DESIGN: This is a cross-sectional survey study. SETTING: Six tertiary hospitals in Sichuan Province, China. PARTICIPANTS: 590 ICU nurses were recruited from six tertiary hospitals in China for the survey. PRIMARY AND SECONDARY OUTCOME MEASURES: Presenteeism of ICU nurses was the primary outcome indicator. Transformational leadership, perceived social support and occupational coping self-efficacy were secondary outcome indicators. The transformational leadership scale, perceived social support, occupational coping self-efficacy and Stanford presenteeism scale were used to investigate ICU nurses through convenience sampling. RESULTS: The presenteeism score of ICU nurses was 15.46±4.45 (mean±SD), in which the incidence of high presenteeism was 53.90%. Correlation analysis showed that presenteeism was negatively correlated with transformational leadership, perceived social support and occupational coping self-efficacy (r=-0.412 to -0.486; p<0.05). Perceived social support partially mediated the relationship between transformational leadership and presenteeism, with an effect value of 0.055 (95%CI: -0.102 to -0.012; p<0.001); occupational coping self-efficacy partially mediated the relationship between transformational leadership and presenteeism, with an effect value of 0.042 (95% CI: -0.074 to -0.017; p<0.001); perceived social support and occupational coping self-efficacy chain-mediated between transformational leadership and presenteeism, with an effect value of 0.029 (95% CI: -0.046 to -0.016; p<0.001). CONCLUSION: ICU nurses' perceived social support and occupational coping self-efficacy are chain-mediated between transformational leadership and presenteeism. Therefore, to reduce nurses' presenteeism, nursing managers should adopt targeted interventions based on the factors influencing them to improve transformational leadership and enhance their perceived social support and occupational coping self-efficacy.