Influence of Transformational Leadership Competence on Nurses' Intent to Stay: Cross-Sectional Study

Background/Objective: Transformational leadership (TL) by nurse managers is a modifiable organizational factor consistently linked to improved staff outcomes. However, evidence from the Arab Gulf region, particularly the Kingdom of Saudi Arabia (KSA), is limited. This study aimed to assess the relationship between nurse managers' TL and staff nurses' intent to stay and determine which TL dimensions predict intent to stay. Methods: A cross-sectional online survey was conducted among staff nurses at a three-hospital academic medical city in Riyadh, KSA. A total of 523 eligible respondents successfully completed the survey, utilizing probabilistic cluster sampling to guarantee representation from various nursing units within the medical city. Nurse managers' TL was assessed across five dimensions by using the multifactor leadership questionnaire, and staff nurses' intention to stay was measured using intent to stay scale. Descriptive statistics summarized the respondents' demographic profile, nurse managers' TL and staff nurses' intent to stay. Normality was evaluated using Shapiro-Wilk and Kolmogorov-Smirnov tests. Relationships were examined using Spearman's rank correlation, and multivariable ridge regression modeled the predictive contributions of the overall TL and its five dimensions to intent to stay. Results were considered significant if p < 0.05. Results: Nurse managers' TL exhibited a positive association with staff nurses' intention to stay in their current positions (r = 0.22, p < 0.001). Moreover, every dimension of TL demonstrated a strong positive relationship with the intent to stay (all p-values < 0.001). Multivariable ridge regression analysis revealed that the overall TL was a significant predictor of the intent to stay (β = 0.13, p < 0.001). Conclusions: The findings corroborate prior evidence linking TL to retention intentions. This underscores the practical salience of leadership competencies and attributes of nursing leaders, particularly TL, which recognizes the individual needs of staff nurses. This recognition subsequently fosters retention intentions, cultivates supportive nursing work environment, and enhances overall organizational success.