STRADA Jurnal Ilmiah Kesehatan
DOI: 10.30994/sjik.v10i1.770
ISSN: 2252-3847 (print); 2614-350X (online)
Vol.10 No.1 May 2021 Page. 1017-1023
Influence of Autocratic, Democratic and Laissez-Faire
Leadership Styles Towards Nurse’s Job Satisfaction in
Inpatient Room of RSU Bhakti Rahayu Tabanan
Nina Rismawati Hakim*, I Gede Wirajaya
STIKES Bina Usada Bali, Indonesia
* Correspondent Author: ninakornalert99@gmail.com
ABSTRACT
Nursing services have always been the health services quality standard by community and
nursing being the largest workforce in a healthcare organization, therefore nurses are
required to have the ability to provide optimal and quality nursing care. Optimal and quality
nursing care cannot be separated from job satisfaction received by nurses. Satisfied nurses
are likely to exert more effort in their assigned tasks and achieveed organizational goals. An
effective leader motivates follower by its leadership style. Leadership style consists of
autocratic leadership style, democratic leadership style and laissez-faire leadership style.
The leadership of a nursing manager can create a work environment that decreases nurse
turnover, further increases nurse retention and increases patient satisfaction. This study
aimed at identifying the influence of the autocratic, democratic and laissez-faire leadership
style towards nurse’s job satisfaction in inpatients room at the RSU Bhakti Rahayu Tabanan.
Research design used cross sectional with quantitative approach. Data was collected through
filling questionnaire of 30 nurses in April 2018 in RSU Bhakti Rahayu Tabanan. Data
analysis is multiple linear regression and hypothesis testing using the F test and t test. The
results showed that autocratic, democratic and laissez-faire leadership style have a linear
influence to nurse’s job satisfaction with F test 86,99 and p value 0,000 was smaller than α
= 0,05 (p<0,05) and democratic is the most dominant leadership style that influences
towards the nurse’s job satisfaction in inpatient room of RSU Bhakti Rahayu Tabanan with
t test 4,228.
Keywords: Leadership Style, Job Satisfaction, Nurses
Received March 17, 2021; Revised April 10, 2021; Accepted April 29, 2021
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1017
STRADA Jurnal Ilmiah Kesehatan
DOI: 10.30994/sjik.v10i1.770
ISSN: 2252-3847 (print); 2614-350X (online)
Vol.10 No.1 May 2021 Page. 1017-1023
BACKGROUND
The development of knowledge and technology is as well impactful to the
development of the practice of nursing in hand with the effort to give the top-quality
nursing service. The quality of health service is dependent to the quality of the nurse. The
qualified nursing staff be identical to the professional nurse; owning the capability in
giving the nursing service in accordance with the standard - relevant to the ethical and
moral principles in order to protect the community. As for one of the efforts initiating to
fulfill the qualified nursing staff is to attend the higher education in nursing. Nursing
education is an important required process every nurse has to take. The minimum education
of professional nursing is to graduate from two stages of education program i.e. academic
stage (Bachelor of Nursing) and thus continued to the stage of professional education
(Professional Nurse). These previous stages are an obligatory regarding the integrated and
inseparable educational stages (Lestari, 2014).
The number of nurses taking further education in STIKES Bina Usada Bali in the
recent three years has increased moderately significant. In reference to the database, 159
nurses were recorded in the admission of first-year students of transfer program at STIKES
Bina Usada Bali in 2017, meanwhile 168 nurses were in the record of 2018, and in the year
of 2019 the admission increased to 202 nurses being enrolled (STIKES Bina Usada Bali,
2019). This particular condition indicates that the nursing staffs of hospital and public
health center are managing to enhance their competency. These nurses who take the further
education are defined as students with multiple roles. Multiple roles include two or more
different roles for domestic and public measure taken at simultaneous time (Afrida et al.,
2017).
Nursing students of transfer program indirectly take two or more roles in which the
importance and responsibility between one role and another are overlapping and thus the
performance of roles could be impacted. The students with multiple roles regularly
encounter difficulty and become excessed in maintaining all the roles. The capability of
adaptation in terms of the multiple roles i.e. student-profession-family is a requirement for
nursing students of transfer program. Any different responsibility burdened to each role
being taken is in the effort not to be neglected. This multiple state of roles tend to emerge
conflict between one role and another (Hidayah, 2015).
Should the students experience contradiction between their responsibility and the
duty they had to manage, the conflict between these roles emerges. This particular conflict
occurs in reference to the expectation of roles leading to a broken time-management and
the abandonment of a certain role caused by the presence of another role. The conflict of
roles happens to be encountered by either male or female. An existed research resulted in
the fact that female nurses experience a profession-family conflict, anxiety, depression,
and somatization significantly higher. The significant difference in terms of gender
emerges in relation between the profession-family conflict and the nurses’ psychological
health condition and moderating variable. A profession-family conflict is significantly
linked to anxiety and depression endured by the male nurses. The two genders experience
somatization (Zurlo et al., 2020).
A research on multiple roles (done by Khairiyah, Nur., Kusuma, Farida Halis Dyah;
Rahayu, 2017) showed that most of nursing grantee students at the University of
Tribhuwana Tunggadewi Malang are categorized as students with multiple roles. A
situation in which not only did a person take role as student, but they also take ones as
parent and nurse at once. Further stated that multiple roles are strongly related to the
occurrence of stress on nursing grantee students at the University of Tribhuwana
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STRADA Jurnal Ilmiah Kesehatan
DOI: 10.30994/sjik.v10i1.770
ISSN: 2252-3847 (print); 2614-350X (online)
Vol.10 No.1 May 2021 Page. 1017-1023
Tunggadewi Malang. (Batur & Nart, 2014) revealed in their research that a conflict of
multiple roles is potentially impactful to working stress on primary school teachers. It was
further declared that multiple roles conflict and working stress are moderately influential
to the commitment of primary school teacher organization. (Jamadin et al., 2015) as well
stated that a conflict of multiple roles becomes the predictor on working stress.
Students with multiple roles under a certain condition of stress can lead to the
degraded performance of nurse at the work place. Boles, Howard & Donofrio (2001) stated
that a domestic conflict emerged in a family would normally give impacts on a person’s
field of work. A home-problematic worker would influence the working performance
(Roboth, 2015). This certain situation threatens the organization for it causes distraction to
the working. Thus, this is contradictive to the organization’s objective in terms to allow the
nurses in enhancing their nursing competency in order to increase efficiency and
effectiveness of working in the organization.
A student among many of being interviewed found it difficult in managing time for
fulfilling the three roles being taken. Hospital nursing service is done with intact
responsibility, while in the other hand, taking the role as a student to attend university
major classes in the effort to get the academic duty well-finished. This current pandemic
of Covid-19 period has as well been impactful to nurses who fulfill the role as a parent, the
role of being a student builds up at home. This definite condition causes them exhaustion
in prioritizing the taken roles.
Based on the justification above, multiple roles could conclusively tend to trigger
individual conflict that becomes the source of exhaustion. Uncontrolled exhaustion leads
to stress on students with multiple roles, which seems appealing to the researchers to do
research entitled the correlation between multiple roles and stress on Students of Transfer
Program of 2019 STIKES Bina Usada Bali Nursing Study Program.
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STRADA Jurnal Ilmiah Kesehatan
DOI: 10.30994/sjik.v10i1.770
ISSN: 2252-3847 (print); 2614-350X (online)
Vol.10 No.1 May 2021 Page. 1017-1023
METHODS
a. Design of the Research
This research implemented a correlational designed research along with cross sectional
design of the research, which was a type of research emphasizing on observational
measurement time of the independent and dependent variable data only once at a time.
Of course, not all research subjects must have been observed on a same day and time, but
both the independent and dependent variable were assessed only once (Nursalam, 2013).
b. Population and Sample
The population used in this research was executive nurses at Bhakti Rahayu General
Hospital of Tabanan. Sampling was done the technique of total sampling. The amount of
sample in this research was exactly the same with the amount of the population. The
number of sample used in this research was 30 people.
c. Instrument of the Research
The instrument of this research was done to obtain information from the respondents,
while the researcher used a tool of data collection in the form of questionnaire. This
questionnaire consisted of a leadership-style-based questionnaire, contained with 9
questions and a job-satisfaction-based questionnaire, containing 5 questions, with the
usage of Likert scale for the score category of: 4=Strongly Agree (SA), 3=Agree (A),
2=Disagree (D), and 1=Strongly Disagree (SD). The amount of score from the item
question means X ≤ µ-0,5σ (low) and µ+0,5σ>X (high) (Azwar, 2009).
d. Procedure of Data Collection and Data Analysis
Data collection was done in April of 2018, located at Bhakti Rahayu General Hospital of
Tabanan.
The data analysis used in this research is Multiple Regression Analysis. This analysis was
crucial in identifying the correlation route between the independent and dependent
variable, whether each independent variable was positively or negatively correlated; and
in predicting the value of dependent variable in the event the value of the independent
variable increased or decreased.
RESULTS
The use of multiple linear regression analysis in this research was with the objective to prove
the hypothesis regarding the influence of the variable of autocratic leadership style (X1),
democratic leadership style (X2), and Laissez-Faire leadership style (X3), in a partial or
cooperative way towards the job satisfaction (Y). Statistic calculation resulted as figured in
the table below.
Table 1. Result of Multiple Regression Analysis
Unstandardized
Coefficients
Model
B
Std. Error
(Constant)
-.057
1.367
Autocratic
.115
.088
Demokratic
1.007
.238
Laissez-Faire
.900
.223
Dependent Variable: JOB_SATISFACTION
Standardized
Coefficients
Beta
.083
.514
.482
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t
Sig.
-.042
1.303
4.228
4.032
.967
.204
.000
.000
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STRADA Jurnal Ilmiah Kesehatan
DOI: 10.30994/sjik.v10i1.770
ISSN: 2252-3847 (print); 2614-350X (online)
Vol.10 No.1 May 2021 Page. 1017-1023
Based on the multiple linear regression test on the variable of autocratic, democratic, and
Laissez-Faire leadership style towards the job satisfaction, it is revealed that the three
leadership styles give linear influence to the executive nurses’ job satisfaction at the
inpatient rooms of Bhakti Rahayu General Hospital of Tabanan. The statistic calculation
resulted in the value of F = 86.99 with the significance of p<0.000..
DISCUSSION
This result is in line with the previous research done by Saputra (2015), which stated
that a leadership style gave positive and significant influence to the job satisfaction. Job
satisfaction of the employees would increase if there was a presence of an appropriate
leadership style experienced by those employees. Ugwa (2014) in his research declared that
there came a high level of job satisfaction among nurses at Aminu Kano Teaching Hospital,
related to the leadership style rather than the other socio-demographic variables.
Tjiptono (2001) revealed that a leadership style is a certain method used by leaders in
interacting with their subordinates (Baihaqi, 2010). On the other hand, Vesterinen (2012)
depicted that there was no correct leadership style, instead the similar result could still be
achieved with various methods. A nurse manager could have various leadership styles, but
they normally selected one style to be applied more than the rest styles. A nurse manager
must consider their leadership style from the employees’ point of views, situational factor,
and organizational goals to determine their leadership style with different employees in
different situations.
The most dominant leadership style in giving influence to job satisfaction of executive
nurses at the inpatient rooms of Bhakti Rahayu General Hospital of Tabanan, is the
democratic leadership style, being compared to the Laissez-Faire and autocratic leadership
style. The variable of democratic leadership style is known to gain the value of t count =
4.228 with the significance rate of 0.000, followed by the variable of Laissez-Faire
leadership style with the value of t count = 4.032 with the significance rate of 0.000, and the
variable of autocratic leadership style obtained the value of t count = 1.303 with the
significance rate of 0.204.
A democratic leadership style illustrates the leaders who tend to involve employees in
making decision, to delegate the authority, and to stimulate employees’ participation in
deciding the work methods and work goals, and to use feedback as the chance to train the
employees. In the world of nursing, leadership is a usage of a leader’s skills (nurse) in
influencing other nurses under their monitor for the division of duties and responsibility in
providing nursing care service to get the nursing’s goals achieved (Latif, 2008 as cited in
Maryanto 2013).
This research is in line with the previous research done by Ruslan (2014) which stated
the presence of influence of autocratic, democratic, and Laissez-Faire leadership style, to
the job satisfaction of the employees of PT. Bank Sulselbar Makassar, and the leadership
style variable which owned the most dominant influence to the job satisfaction was the
variable of democratic leadership style. In addition, Maryanto et al. (2013) concluded in
their research that there was a correlation between the leadership style of a leader and the
job satisfaction of nurses at Private Hospital in Demak. A room’s head of Private Hospital
in Demak applied the three styles of leadership i.e. democratic, autocratic, and Laissez-Faire.
The democratic leadership style was the most dominant style being applied by the room’s
head of Private Hospital in Demak.
In the style of democratic leadership, a leader is taking a role as a moderator or
coordinator, unlike as in the leadership style of an authoritarian. Leaders provide the
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STRADA Jurnal Ilmiah Kesehatan
DOI: 10.30994/sjik.v10i1.770
ISSN: 2252-3847 (print); 2614-350X (online)
Vol.10 No.1 May 2021 Page. 1017-1023
opportunity for their subordinates in filling or obtaining their egoistic needs as well as
motivate them in completing their duties, stimulate them to participate in the matter of goals
and methods, and lastly support the ideas and suggestions being aspired.
Leaders with the democratic style of leadership would prioritize a good “human
relation”. Executive nurses of Bhakti Rahayu General Hospital experienced a democratic
leadership style applied by their leaders in the hospital environment that gave job
satisfaction. Complete support, guidance, and direction were frequently provided by the
leaders in giving supreme nursing service to the patients.
CONCLUSION
There is a linear influence of autocratic, democratic, and Laissez-Faire leadership style
to the job satisfaction of the executive nurses of inpatient rooms at Bhakti Rahayu General
Hospital of Tabanan. The most dominantly influential style of leadership to the job
satisfaction of the executive nurses of inpatient rooms at Bhakti Rahayu General Hospital
of Tabanan is the democratic style of leadership compared to the Laissez-Faire and
autocratic leadership style.
Hospital’s management is expected to carry out a reevaluation for the fulfilment of
supporting factors of nurses’ job satisfaction to maintain or elevate the job satisfaction of
nurses which leads to the increasing level of those nurses’ working performance. The head
of the room is expected to serve guidance, development, and seminar for nurses in enhancing
a democratic style of leadership in accordance with standard service procedure to stimulate
nurses in doing certain activity or duty properly in order to achieve the desired goals.
The result regarding this research is expected to become a nursing educational material
for nursing students to bring them the comprehension of the importance of leadership style
in nursing environment, which later the head of the room would apply an art in a memberfriendly style of leadership, so any direction would lead the nurses properly in the effort to
give the nursing care.
The future researchers are expected to develop researches regarding leadership styles
applied by the head of the room, using the other theory of leadership style and add up the
other indicators of job satisfaction to measure the nurses’ job satisfaction. It is as well
expected that the future researchers would consider the usage of other method on data
collection namely qualitative method towards leaders and nurses to get a more objective and
accurate obtained data both on leadership and job satisfaction, in terms of the avoidance of
respondents’ subjectivity.
CONFLICTS OF INTEREST
The authors have no conflicts interest to disclose.
REFERENCES
Atefi, N., Lim Abdullah, K., Wong, L. P., & Mazlom, R. (2015). Factors influencing job
satisfaction among registered nurses: a questionnaire survey in Mashhad, Iran. Journal
of Nursing Management, 23(4), 448–458. https://doi.org/10.1111/jonm.12151
Baihaqi, M. F. (2010). Pengaruh Gaya Kepemimpinan Terhadap Kepuasan Kerja dan
Kinerja Dengan Komitmen Organisasi Sebagai Variabel Intervening (Studi pada PT.
Yudhistira Ghalia Indonesia Area Yogyakarta). Universitas Diponegoro.
Indrawati, A. D. (2013). Pengaruh Kepuasan Kerja terhadap Kinerja Karyawan dan
Kepuasan Pelanggan pada Rumah Sakit Swasta di Kota Denpasar. Jurnal Manajemen,
Strategi Bisnis, Dan Kewirausahaan, 7(2), 135–142.
Website: https://sjik.org/index.php/sjik | Email: publikasistrada@gmail.com
1022
STRADA Jurnal Ilmiah Kesehatan
DOI: 10.30994/sjik.v10i1.770
ISSN: 2252-3847 (print); 2614-350X (online)
Vol.10 No.1 May 2021 Page. 1017-1023
Ma, C.-C., Samuels, M. E., & Alexander, J. W. (2003). Factors That Influence Nurses???
Job Satisfaction. JONA: The Journal of Nursing Administration, 33(5), 293–299.
https://doi.org/10.1097/00005110-200305000-00005
Madeo, J. D., Welembuntu, M., & Tooy, G. C. (2015). Gambaran Kepuasan Kerja Perawat
Pelaksana di Ruang Rawat Inap RSUD Liun Kendage Tahuna. Jurnal Ilmiah
Tindalung, 1(2). https://doi.org/10.5281/jit.v1i2.70
Maryanto, Pujiyanto, T. I., & Setyono, S. (2013). Hubungan Gaya Kepemimpinan Kepala
Ruang dengan Kepuasan Kerja Perawat di Rumah Sakit Swasta di Demak. Jurnal
Managemen Keperawatan, 1(2).
Mawoli, M., & Haruna, M. (2013). Effect of Leadership Styles on Employees’ Job
Performance: Evidence from Federal Medical Centre in Niger State. Lapai Journal of
Management Science, 4(1), 2838.
Mousazadeh, S., Yektatalab, S., Momennasab, M., & Parvizy, S. (2019). Job Satisfaction
Challenges Of Nurses In The Intensive Care Unit: A Qualitative Study. Risk
Management
and
Healthcare
Policy,
12,
233–242.
https://doi.org/10.2147/RMHP.S218112
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The
Influence of Leader Empowering Behaviors, Work Conditions, and Demographic
Traits. INQUIRY: The Journal of Health Care Organization, Provision, and
Financing, 54, 004695801772494. https://doi.org/10.1177/0046958017724944
Nursalam. (2015). Manajemen Keperawatan Aplikasi dalam Praktik Keperawatan
Profesional (5th ed.). Jakarta: Salemba Medika.
Priyono, F. M. A. (2012). Pengaruh Gaya Kepemimpinan terhadap Kepuasan Kerja dan
Komitmen Manajemen pada Laboratorium Mawar. Journal of Business and Banking,
2(1), 113. https://doi.org/10.14414/jbb.v2i1.436
Robbins, S. P. (2005). Organizational Behavior. Upper Saddle River, New Jersey: Prentice
Hall.
Ruslan, R. (2014). Pengaruh Gaya Kepemimpinan Otokratis, Demokratis, dan Bebas
Terhadap Kepuasan Kerja Karyawan pada Kantor Pusat PT. Bank Sulselbar
Makassar. Universitas Hasanuddin.
Saputra, I. G. E. (2015). Hubungan Gaya Kepemimpinan Demokratis Kepala Ruang
dengan Kepuasan Kerja Perawat di Rumah Sakit Dr. RM. Soedjarwadi. STIKES
Kusuma Husada Surakarta.
Ugwa, E. A. (2014). A cross-sectional study of job satisfaction and leadership styles among
the nurses in Aminu Kano teaching hospital. Nigerian Journal of Basic and Clinical
Sciences, 11(2), 114. https://doi.org/10.4103/0331-8540.140363
Vesterinen, S., Suhonen, M., Isola, A., & Paasivaara, L. (2012). Nurse Managers’
Leadership Styles in Finland. Nursing Research and Practice, 2012, 1–8.
https://doi.org/10.1155/2012/605379
Website: https://sjik.org/index.php/sjik | Email: publikasistrada@gmail.com
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