The Association Between Transformational Leadership and Nurses' Clinical Performance in the Tabuk Health Cluster, Saudi Arabia.

AIM: This study examined the relationship between transformational leadership and clinical work performance among nursing professionals within the Tabuk Health Cluster. It focused specifically on the association of leadership behaviours with nursing performance. DESIGN: The study utilized a cross-sectional analytical quantitative research design. METHODS: Participants: A convenience sample of 280 nursing professionals (staff nurses and head nurses) from within the Tabuk Health Cluster was enrolled. MEASURES: Transformational leadership was measured with the Global Transformational Leadership (GTL) scale, and clinical performance through a 51-item scale derived from Yuxiu et al. (2011). DATA COLLECTION: This was a self-administered online questionnaire conducted over approximately 6 weeks, between November and January 2024. ANALYSIS: Data were analysed using SPSS version 26 with descriptive statistics, independent samples t-tests, ANOVA, and multiple linear regression to determine the predictive value of transformational leadership. RESULTS: Nurses perceived leadership positively (mean = 3.96/5). Overall clinical work performance was moderate (Mean = 2.70/4), with the leadership (2.75) and critical-care (2.79) subscales scoring highest. Transformational leadership significantly predicted clinical performance (p < 0.001), accounting for 26.9% of its variance. Nurses with 1-5 years of critical-care experience scored significantly higher than those with more than 5 years on both leadership perception and clinical performance (p < 0.001). CONCLUSION: Transformational leadership was positively associated with nurses' clinical performance and represents a modifiable target for improvement. The lower scores among more experienced nurses indicated a need to re-engage mid-to late-career staff. IMPLICATIONS FOR NURSING PRACTICE: The findings support investment in transformational leadership development, direct support for clinical performance, a stronger feedback culture, continuing professional development-particularly for mid- to late-career nurses-and quality-improvement efforts within the Health Cluster system. No patient or public contribution: While the study acknowledges the vital participation of nursing staff at the Tabuk Health Cluster, patients and members of the public were not involved in the design, conduct or reporting of this research.