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The self-organizing map clustered registered nurses' evaluations of their nurse leaders.

AIM
To characterize registered nurses' (RNs') perceptions of nurse leaders' transformational leadership (TL) qualities in Finnish university hospitals and identify predictors of positive and negative evaluations.


BACKGROUND
Transformational leadership can improve health care but requires development. Information on TL is typically derived from survey results, which are vulnerable to confounders.


METHOD
Cross-sectional survey. Registered nurses' perceptions of nurse leaders were measured with the TL scale. Kohonen's self-organizing map was used to cluster the data based on RNs' opinions and questionnaire items. Logistic regression explained background characteristics' effects on cluster formation.


RESULTS
A total of 1,970 RNs participated and evaluated their nurse leaders' TL qualities as moderate. Giving feedback and rewarding clustered separately from other TL qualities. Females and permanent workers evaluated nurse managers more negatively but nurse directors positively. Positive perceptions of nurse managers' TL predicted better TL among nurse directors. Vice nurse managers gave the most positive evaluations. A total of 197 RNs had no opinions about nurse directors' TL.


CONCLUSIONS
Registered nurses evaluated nurse managers' TL qualities as moderate and were unfamiliar with nurse directors. Background characteristics affecting evaluations differed between leader types.


IMPLICATIONS FOR NURSING MANAGEMENT
Giving feedback and rewarding should be more closely associated with other TL qualities. Transformational leadership requires transformational approaches from both nurse managers and directors.