Aim: The aim of this study was to analyse the relationships among structural empowerment, the leadership style of managers, and the engagement of nurses in a health organization of Spain.
Background: Transformational leadership has an impact on patient security and satisfaction as well as the well-being and engagement of healthcare workers. Empowerment is a management practice that is fundamental for professional growth and positively affects the quality of patient care.
Design: A cross-sectional study.
Methods: Randomized sample of 131 nurses recruited from 11 health centres with different levels of care was surveyed to assess managers' leadership style, nurse empowerment, and work engagement. The data were analysed by descriptive and correlational statistics and hierarchical mediated regression.
Results: The transformational leadership of the nurse manager directly and positively influences the structural empowerment of nurses. The structural empowerment of nurses directly and positively influences engagement. The transformational leadership of managers positively influences nurse engagement through the mediating effect of structural empowerment.
Conclusion: The structural empowerment of nurses acts as a mediator between the transformational leadership of nurse managers and nurse engagement.
Practical implication: The transformational leadership of nurse managers at the unit level has a double impact on staff nurses: first, increasing empowerment and second, increasing the engagement of the nurse staff.
Keywords: engagement; leadership; management; nurse; structural empowerment.
© 2018 John Wiley & Sons Ltd.