The internal structure of transformational leadership as perceived by clinical nurses: a network analysis

Transformational leadership, a proactive leadership style, is positively associated with increased nurses' job satisfaction, reduced occupational burnout, and enhanced retention intention. However, existing research has predominantly relied on conventional statistical methods, whereas network analysis-which examines the intrinsic connections among the dimensions of transformational leadership-remains underutilized. This study used network analysis to explore the interrelationships among dimensions of transformational leadership in clinical nursing. It addressed the research gap left by conventional statistical methods and provided empirical evidence to optimize nursing leadership practices and enhance clinical team management efficacy.

From October to December 2025, we recruited 948 clinical nurses from 10 hospitals using a convenience sampling method. A total of 836 nurses provided valid responses. Transformational leadership was assessed using the Transformational Leadership Questionnaire. The collected data were analyzed using network analysis.

Within the overall network structure, nodes D6 ("Demonstrate decisiveness and assertiveness in management, and be adept at resolving complex issues"), A7 ("Be willing to share both hardships and successes with the team"), C5 ("Show concern for team members' professional work, personal wellbeing, and career growth, and offer sincere developmental advice"), and C6 ("Focus on creating opportunities for team members to leverage their strengths") exhibit the highest strength and expected influence. Meanwhile, nodes C1 ("Consider individual circumstances when interacting with team members"), B6 ("Regularly collaborate with the team to analyze how your work aligns with and impacts departmental and hospital objectives"), B1 ("Facilitate an understanding of the hospital and department's developmental prospects"), and D1 ("Possess exceptional professional competence") are the core nodes with the highest bridge expected influence.

Network analysis revealed that transformational leadership in clinical nursing constitutes a complex, interconnected network. In nursing manager training, core nodes (D6, A7, C5, C6) and bridge nodes (C1, B6, B1, D1) may be prioritized to potentially enhance leadership competency, align nurses' career goals with hospital objectives, and foster synergistic leadership interactions.