Concept Analysis Transformational Leadership

ConceptAnalysis: Transformational Leadership


Effectiveleadership is believed to the backbone of quality care in the modernhealth care facilities. However, different types of leadership havedifferent attributes, which frustrates the process of selecting thebest style. However, transformational leadership, which is increasingbecoming a common concept in the field of nursing, has key attributesthat benefit nurses and their clients. These attributes includeinspirational motivation, individualized consideration, idealizedinfluence, and intellectual stimulation. The concept oftransformational leadership is mainly used to describe the leadershipqualities of nurse leaders, hospital administrators, and team leaderswithin the field of nursing. The key antecedent of transformationalleadership is the ability of leaders to understand the significanceof the influence they have on their juniors. Consequences oftransformational leadership include the motivation of followers,enhanced patient outcome, and satisfaction of nurse as well as theirclients. Empirical indicators of transformational leadership are theability of an individual or teams of leaders to develop visions andinfluence their juniors to agree with those visions.

Keywords: Transformational leadership, defining attributes,consequences, antecedents, and empirical referents.

ConceptAnalysis: Transformational Leadership

Effectiveleadership in the field of nursing has become one of the essentialfactors that influence the treatment outcome and enhance theworkplace for nurses. The current research as well as writing in thefield of leadership in nursing is dominated by the conceptual theoryof transformational leadership. Although there are many leadershipstyles that have been researched on, many scholars believe thattransformational leadership is the most effective tool that can helphealth care organizations meet their customer demands and deliverhealth care services more effectively. Transformational leadership isachieved when leaders motivate their followers by appealing to highermoral values and ideas. Transformational leadership is defined as aleadership style that seeks to bring constant change with theobjective of improving systems and individuals (Doody, 2012). Thewidespread adoption of the concept of transformational leadership isbased on the notion that this type of leadership can help the chargenurses enhance job satisfaction, solving problems effectively,enhance staff performance, improve patient outcome, and achievedesired changes in the workplace.

Aimsof analysis

Leadershipin the field of nursing is believed to be among the most criticalfactors that determine the quality of care, satisfaction of patients,and the treatment outcome (Doody, 2012). However, the selection ofthe most suitable type of leadership is still confusing since eachleadership style has its unique attributes. The purpose of thisconcept analysis is to define the concept of transformationalleadership, describe of its uses that are relevant to the field ofnursing, identify its key attributes, antecedents, consequences, andempirical indicators.

Usesof the concept of transformational leadership

Theconcept of transformational leadership is used in nearly all fieldsof profession. In the present study, the concept can be used todescribe the leadership style adopted by the nurse leader, manager ofthe nursing unit, hospital administrators in charge of the nursingunit, and team leaders within the nursing unit. The ideal attributesof the concept can be compared with characteristics of individualleaders in order to determine whether they are transformational ornot.


Thetheory of transformational leadership was developed after combiningthe ideas, behavior, traits, and contingency approaches, whichresulted in an integrative leadership perspective. Scholars havegiven different characteristics of transformative leadership, butfour of them are quite common in several articles. First,transformative leadership is characterized by the possession ofinfluential behaviors and attributes that help leaders inspire theirfollowers (Sadeghi &amp Pihie, 2012). Secondly, transformationalleaders draw from inspirational motivation to develop and state theirvision that in turn encourages followers. Third, transformationalleadership involves the use of intellectual stimulation to encouragefollowers to become more creative and innovative. Lastly,transformative leaders tend to give individualized consideration totheir followers, which allows them to coach, support, and encouragefollowers (Sadeghi &amp Pihie, 2012). This implies thattransformational leaders are listening to individual followers andgive them some responsibilities with the objective of helping themachieve some growth through personal challenges.

Transformationalleadership is increasingly becoming the most preferred type ofleadership because it creates an environment for followers to achievemore than the basic requirements. In addition, transformationalleaders are considered to be proactive, which means that nurseleaders who adopt are able to encourage their followers to movebeyond their immediate interest (Sadeghi &amp Pihie, 2012). By beingproactive means that transformative leaders assess the currentsystems in the health care facilities and bring the necessary chancesbefore adverse effects occur. Transformational leaders achieve thisby collaborating with their juniors who are in the direct contactwith patients, understand the specific needs of patients served bythe health care facility, and are able to relate those needs with thecurrent practices used by the health facility. During thiscollaboration, transformational leaders, create room for criticismand reflection. These leaders inspire people by acting as models ofintegrity, setting clear goals, stirring emotions, providing support,and having higher expectations (Sadeghi &amp Pihie, 2012).

Transformationalstyle of leadership is associated with effectiveness in the deliveryof health care services. The relationship between effectiveness andthis style of leadership is based on the idea that transformationalleaders are able to integrate the opinions of their junior nurses,which culminates in quality decisions (Sadeghi &amp Pihie, 2012). Astudy conducted by Riaz &amp Hussain (2010) revealed thattransformational leadership is positively associated with jobsatisfaction among nurses and enhanced on-the-job performance. Thisis because transformational leaders use ideas, instead of force orrules, to motivate their juniors. The use of ideas to encouragejuniors involves showing people the reason to adopt certain practicesor take specific actions, instead of using coercion. Moreover,transformational leaders derive their motivation to lead from thefact that they are accepted by their juniors, and not because theyare senior leaders in their organizations. The acceptance by juniorscreates an atmosphere for team building, which enhances the qualityof care.

Theuse of transformational leadership in nursing has also beenassociated with enhanced quality of care, patient safety, andtreatment outcome. These are indirect benefits that patients enjoywhen they are served by nurses who have been motivated by theirtransformational nurse leaders (Middleton, 2015). Transformationalleaders encourage the juniors to their juniors to increase theirunderstanding of patient needs, which is associated with enhancedpatient-nurse relationship and patient satisfaction with thetreatment offered by nurses. Moreover, some studies have establishedthat motivated nurses have a higher tendency of embracingevidence-based practices than those who are not motivated (Middleton,2015). This means that nurses working under a transformative leaderare more informed and dedicated to meet organizational goals, whichinclude the delivery of services that match the specific needs of theclients. Additionally, giving nurses an opportunity to learn throughdifferent personal experiences enhances their competence and abilityto deliver quality care.

Definingattributes of the concept of transformational leadership

Fromthe literature review, the concept of transformational leadership hasfour key attributes. The first attribute is referred to as idealizedinfluence, which refers to the level of admiration and respect thattransformational leaders get from their followers (Sadeghi &ampPihie, 2012). Idealized influence is derived from the key attributesand behaviors that followers identify with their leaders and decideto adopt them. For example, followers of a transformational leadermay see pride and respect in their leaders, which in turn motivatesthem to adopt similar attributes since they are highly regarded, notonly by the hospital, but also by the society at large.

Thesecond attribute of transformational leadership is inspirationalmotivation. Transformational leaders are able to look into the futurein with hope and in optimistic ways, which enhances their capacity toinspire people around them (Sadeghi &amp Pihie, 2012). People in anyinstitution and in the society look up to people who can give themhope and a sense of direction in spite of the challenges affectingthem in their respective careers. This raises the confidence andenthusiasm of nurses regarding their future success.

Thethird attribute of the concept of transformational leadership isintellectual stimulation. Intellectual stimulation involves helpingthe followers think beyond the normal way of doing things.Transformational leaders achieve intellectual stimulation byencouraging their juniors to challenge their own assumptions andperceived capabilities in order to develop more viable solutions tothe challenges that they could be facing at a given time (Sadeghi &ampPihie, 2012). In addition, intellectual stimulation creates an openminded environment and encourages creativity in the nursing practice.

Thefourth attribute is known as individual consideration, which refersto the acknowledgement by the nursing leaders that followers havedifferent perception. These differences create the need for anindividualized consideration of the needs and desires of eachfollower when mentoring and coaching the followers (Sadeghi &ampPihie, 2012). Individualized consideration provides an opportunityfor personal growth of each follower.

Antecedentsand consequences

Antecedentsmay refer to events that are expected to take place before a givenconcept occurs (Doody, 2012). The first and the most basic antecedentof the concept of transformational leadership is the existence of aleader and a group of followers. These people should have a clearperception of the relationship that exists between them. For example,the nurse leaders should understand that the junior nurses look up tothem for direction and guidance in their daily practices. In otherwords, transformative leaders need to have established an identity aswell as the understanding of the influence that they have on othernurses before they can reflect the true attributes of transformativeleaders. In addition, nurse leaders should embrace the philosophythat focuses on enhancing the workplace, quality of care, andpatient-centered approach in delivering care.

Transformativeleadership is associated with numerous consequences that benefit thebody of nursing workforce, patients, and the health care facility.For example, transformational leadership is associated with forwardprogression in the nursing practice, which can be attributed to thetendency to encourage evidence-based practices, innovation, andcreating room for sharing ideas and criticism (Doody, 2012). Inaddition, transformational leadership enhances the self efficacy ofnurses since transformative leaders create opportunities that allownurses to learn from their own experiences. This is also achievedthrough the participation of nurses in team work and processes ofdecision making within the health care facility or the nursing unit.Giving nurses the opportunity to enhance their skills and properguidance in their daily activities leads to improved performance.Moreover, transformational leadership results in an increase in thepatient’s safety, treatment outcome, and the satisfaction ofpatients. This is because transformative leaders motivate nurses andgive them the support that they need to deliver quality care topatients.


Empiricalreferents are the indicators of the fact that a given concept hasoccurred. These referents may include classes of actual phenomenawhose existence demonstrates that the occurrence of the underlyingconcept (Doody, 2012). One of the key indicators of the qualities oftransformative leadership is the ability of individual nurse leadersto develop visions, influence other nurses to follow the vision andlead the nursing unit as well as the health care facility towardschange. Moreover, the transformative leadership skills of individualnurse leaders should be evaluated using the four attributed of theconcept of transformational leadership. For example, leaders can beconsidered as transformational if they incorporate the inspirationalinfluence, idealized influence, individual stimulation, andintellectual stimulation in their practices. Additionally,transformation leaders can be identified easily because they allowother nurses to criticize their ideas and make their suggestions. Acombination of any of the aforementioned empirical indicatorsconfirms the transformational qualities of a nurse leader.

Amodel case

Casesare used to provide a further illustration of a given concept. Inaddition, cases are used in the field of nursing to enhance theunderstanding of the underlying nursing concept. However, a case maynot include all attributes of the underlying concept.

Sally,a registered nurse has been actively perusing newspapers for jobadverts on a daily basis. She does not hide her intention to leaveher current job since she complains that the current employer doesnot compensate her according to her academic qualification. Claire,the nurse leader, calls Sally in her office and engages her in adiscussion that opens up her mind and helps her realize that staffmotivation goes beyond financial compensation. For example, Claireinforms Sally that her current employer does not have mandatoryovertime policy and give nurses free training opportunities annually,unlike most of the facilities that Sally has been applying for a job.Claire concludes the conversation by stating, “You only need tolike your job, give the best to the suffering patients, andcollaborate with other nurses since the success of our hospital and abetter compensation in the future depends on our current collectivecontribution”.

Thiscase demonstrates the attributes of inspirational motivation,individualized consideration, and idealized influence. Therefore,Claire can be considered as a transformational leader who is able todevelop a vision for the organization and influences other nurses atthe individual level.


Maryis the leader of the nursing unit who is liked by the hospitaladministrations for her ability to develop the vision and strategicgoals for her unit. The hospital manager congratulates her in everymeeting and attributes her current innovation, adoption oftechnology, and numerous research works within the nursing unit bythe nursing unit to her leadership. However, junior nurses dislikeMary and believe that she develops strategies and makes decisionsalone and later enforce those decisions for them.

Inthis case, there is an attribute of intellectual stimulation that canbe confirmed by research and innovation within the nursing. However,the attributes of idealized influence, inspirational motivation, andindividualized consideration are missing, which means that thehospital’s leadership cannot be considered to be transformational.


Sarais a registered nurse and she is interested in pursuing a diploma inleadership with the objective of increases her chances of pursuing acareer in leadership, but within the field of nursing. Her currentnurse manager, Clare, encourages and decides to make Sara herpersonal friend so that she can share leadership skills with her.Clare reminds Sara that she will succeed through academicqualification and having an open communication with other nurses whohave assumed leadership roles.

Thiscase illustrates the nursing concept of mentoring in leadership.Similar to the concept of transformational leadership, the concept ofmentorship encourages inspiration, charisma, and individualizedconsideration. However, the case does not include the attribute ofintellectual stimulation.


Kevinis a nurse leader, who is described by his juniors as being mean andconservative. Lately, he has refused to approve research projectswith a high budget, claiming that they are not cost effective. Healso placed a notice on his office door instructing junior nurses tovisit his office after the normal working hours only. He developsstrategies and visions for the nursing units and then places them onthe notice board in the form of memos for nurses to read.

Thiscase does not reflect any attribute of transformational leadership.Therefore, Kevin cannot be considered as a transformational leader.


Effectiveleadership is critical in the field of nursing because it determinesthe quality of care that patients are likely to receive. The conceptof transformational leadership has gained popularity becausetransformational leadership benefits nurses and patients. Some of thekey attributes that can be used to determine whether any health carefacility or an individual leader is a transformational leaderincludes the ability to incorporate idealized influence, intellectualmotivation, inspirational motivation, and individualizedconsideration. A successful use of transformational leadershipmotivates nurses and enhances their job satisfaction. This type ofleadership also benefits patients because motivated nurses offerquality services, which reduce medical errors, increase patientoutcome, and enhance patient satisfaction.


Doody,O. (2012). Transformational leadership in nursing practice. BritishJournal of Nursing,21 (20), 12-18.

Middleton,J. (2015). Leadership skills for nurses. NursingTimes.Retrieved December 2, 2015, from

Mwigboji,O. (2014). Transformational leadership in nursing: The case of Ebonyistate in Nigeria. InternationalResearch Journal of Public and Environmental Health,1 (10), 202-206.

Riaz,A., &amp Hussain, M. (2010). Role of transformational andtransactional leadership on job satisfaction and career satisfaction.Businessand Economic Horizon,1 (1), 29-38.

Sadeghi,A. &amp Pihie, Z. (2012). Transformational leadership and itspredictive effects on leadership effectiveness. InternationalJournal of Business and Social Science,3 (7), 186-197.


Transformational leadership

ppendix 1: Concept Map


Idealized influence

Individual consideration

Inspirational motivation

Intellectual consideration


Existence of a leader and followers

Understanding of leader’s influence on followers


Enhanced patient safety

Enhanced nurse satisfaction

Staff motivation

Empirical referents

Ability to develop vision

Ability to influence followers