Nursing education in Hong Kong has undergone major reform in recent year similar to that in some Western countries, involving the introduction of degree level preparation. This reform occurred just before Hong Kong was returned to the sovereignty of China. While a combination of complex factors contributed to the reform, the role of nurse leaders was instrumental in influencing policy development. This study investigated the role of nurse leaders in this reform and the factors influencing their effectiveness. A case study approach was used with multiple data collection methods that included a documentary search of report newspapers, newsletters and journal articles; semi-structured interviews (n=26) nurse leaders and policy makers; and a questionnaire survey of nurses from fh regional hospitals in Hong Kong (n=678). The period studied extended from the first proposal for a nursing degree programme in 1985, to 1995 when 180 nursing degree places were secured. An integrated leadership model is derived from this study that contains dimensions that influence leadership effectiveness: situational variables, leader power base, leaders' attributes and style, and leaders' reciprocal relationships with followers. Data analysis indicated that nursing education reform could be conceptualised as an evolution process. Nurse leaders' roles focused on the acquisition of power which involved: establishing goals, communicating directions, increasing power through unity, increasing power through influences empowering followers and preparing self. Situational variables that impacted on leadership effectiveness were categorised as inertia and facilitation. Though the findings indicated that nurse leaders had the ability to influence nursing education reform to some extent, the questionnaire survey suggested that frontline nurse did not regard nurse leaders as having good leadership skills. Their evaluation of nurse leaders' effectiveness was generally negative. Furthermore, a lack of experience in the political arena and lack of unity within nursing further weakened nurse leaders' power. Nurse leaders' potential had not been maximised This study expands the knowledge on leadership by providing a multidimensional framework to comprehend or predict leadership behaviour. The findings also highlight the problems associated with nursing leadership development in Hong Kong and suggest the importance of education, positive socialisation professionalisation and power base in promoting nursing leadership development Further studies, using a prospective design, of nurse leadership in other areas are needed to test the generalisability of these findings.
Permanent link to this resource: https://doi.org/10.24384/9a2h-4n80
Chan, Sally Wai Chi
Supervisors: Bartlett, Helen; Ross, Kath
Faculty of Health and Life Sciences
Year: 2001
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