Institutionen för Lärande, Informatik, Management och Etik (LIME)

Frontiers in leadership research 5 poäng Examensarbete Vårterminen 2007

Managerial leadership and subordinate health, sickness absence, and sickness attendance

Författare: Anna Nyberg Introduction We still have limited knowledge about what behaviours and/or characteristics in leaders, or in the relationship between the manager and the employee, which are health promoting, or on the other hand constitute risk factors for the employees’ health. We also know very little about the role managerial leadership plays concerning the extent to which employees take sickness absence, or go to work while ill. Such knowledge could contribute to the education of managerial leaders to act in ways that are more beneficial to the health of the organization and the individual employee in a long term perspective.

After presenting some general aspects of leadership research, I will present a conceptual model of organisational- and work environment factors, and leadership in relation to subordinate health and patterns of sickness absence and attendance. In this model, I will present what relationships are and are not covered by research. However, the model and literature review is “under construction” and at present without any ambition of being complete.

What is leadership? Leadership is a general phenomena, and always an integrated part of the conceptions of the world of each particular time and culture. (Grint, 1997).

There are several questions to be asked, when trying to understand what leadership is, or could be (Grint, 1997).

1. Where does leadership take place? Does it take place within the leader, between the leader and the follower, or as representations in the followers’ minds? 2. What differs leadership from other processes of interpersonal influence? 3. How is leadership conducted, or performed? Through communication? 4. Why do we have leadership? Do we need leaders, and if so, why? 5. Who exerts the leadership? The leader, the followers, the media?

There is no one definition of leadership, agreed upon by scholars. Leadership has been defined according to the focus of the studies conducted, in terms of e.g. individual traits, leader behaviours, interaction patterns, or influence over followers (Yukl, 1989).

Yukl (1989) defines leadership as influencing task objectives and strategies, influencing commitment and compliance in task behaviour to achieve these

ii objectives, influencing group maintenance and identification, and influencing the culture of an organization.

Common leadership models tested in research Leadership research has traditionally been conducted quantitatively. Qualitative studies became more common in the 1980’s. The instruments used in most leadership research is self-administred questionnaires, most often the Ohio State LBDQ, Fiedler’s LPC scale, and the MLQ (Bryman, 2004).

Yukl (1989) concludes from the results of thousands of empirical studies conducted on leadership and effectiveness as contradictory and inconclusive. There is a disparity of approaches, a narrow focus of most researchers, and a lack of broad theories integrating the findings from different disciplines. The approaches are often classified according to whether they have a primary focus on power-influence, leader behaviour, leader traits, or situational factors interacting with behaviour, traits, or power. A short presentation of each approach follows below.

Power-influence approach: In the leadership literature, power is defined in different ways. It is defined either as potential influence over others, or as enacted and realized influence. It is defined as influence over attitudes and behaviours of people, or as influence over events. One accepted distinction is the one between personal power, stemming from attributes of the person, and position power, stemming from attributes of the situation. The two are, however, not mutually exclusive. McCall (1978) proposed that it is not enough for managers to have expertise or information; there must also be a situation in which followers need and are dependent of these resources. In social exchange theory (Hollander, 1978) greater status is given someone who demonstrates loyalty to the group, and competence in solving problems and making decisions. Leaders lose power if mistakes are made attributed to poor judgment, irresponsibility, or asserting self-interests in front of group interests. Research on the social exchange theory is limited, but supportive. There is some evidence in the literature that great power can corrupt a leader to misuse it (Zaleznik, 1970; Kipnis, 1972). It is therefore desirable to have organisational constraints on a leader’s use of power (Yukl, 1981).

Managerial behaviour: Except for task-oriented and relationship-oriented behaviour, researchers have not agreed upon meaningful categories of leader behaviours. The numerous studies of these behaviours in relation to satisfaction and performance are inconclusive in the US, except the positive relationship between consideration (relationship-orientation) and subordinate job satisfaction. In Japan, however, more consistent evidence shows that both task- and relationship- oriented behaviours are required for leadership effectiveness. There is, apparently, a situational factor present. A review by

iii Podsakoff, Todor, Grover, and Huber (1984) concludes that positive reward behaviours increase subordinate satisfaction and performance.

Trait approach: Trait studies were conducted in numerous amounts in the 1930´s and 1940´s. These early attempts aimed at finding extraordinary abilities in leaders, but failed to find any specific traits that were related to leadership success (Stogdill, 1974). More recent trait research is however slowly finding traits that are related to successful leadership behaviours. Traits found to relate most to managerial effectiveness is high self- confidence, energy, initiative, emotional maturity, stress tolerance, and belief in internal locus of control (Bass, 1981; Yukl, 1989).

Situational approaches: There are several theories applicable when trying to understand how the situation affects managerial behaviour. One of them is Role Theory (Kahn, Wolfe, Quinn, & Snoelk, 1964). Leaders adapt to role requirements by supervisors, peers and subordinates, and demands of the leadership situation. Managerial effectiveness further depends on how well the manager understands these expectations and demands, how they overcome constraints, and how they recognize possibilities (Kotter, 1982; Stewart, 1982). Situational theories emphasize that different behaviour or trait patterns are effective in different situations, and studies have tried to describe which situational factors moderate the relationship between leader behaviours and effectiveness. However, research on the impact of situational factors has not resulted in any conclusions about what behaviour patterns are successful in what situations (Yukl, 1989).

Transformational leadership: An interest in charismatic and transformational leadership arose in the 1980’s, coinciding with the need for American companies to make major changes in order to survive increasing competition from companies in other countries. The aim of the influence of transformational leaders is to empower subordinates to participate in the transformational process of the organization (Bass, 1985). Transformational leadership is therefore enacted at different levels in the organization, and viewed as a shared process (Burns, 1978).

Charismatic leadership involves the view of the leader as an idealized hero, in possession of qualities almost superhuman (Bass, 1985). This also involves a followership characterised by unquestioning acceptance and obedience (House, 1977).

Characteristic for the theories of transformational and charismatic leadership is that they encompass traits, behaviours, power, and situational factors at the same time. Bass (1997) summarises the research on the effects of transactional and transformational leadership on job satisfaction and

iv organisational outcomes in the following way: Transformational leaders are the most successful and laissez-faire leaders the least. In between are behaviours of more “conventional” character, such as putting demands on subordinates, rewarding and controlling them.

In his review of qualitative research, Bryman (2004) points out that quantitative and qualitative researchers have focused on somewhat different leader behaviours. Recent quantitative research puts emphasis on vision, charisma, and transformational leadership. Qualitative researchers, on the other hand, identify being a good communicator, and being someone who can be trusted frequently, as particularly important for successful leadership. Bryman writes that another contribution of qualitative research on leadership is that leaders are “depicted as people who draw upon their followers’ ideas, beliefs, and values and recycle them back to them in the form of a distinctive leadership framework”. This aspect of leadership is not recognized in quantitative research, where there is more of a focus on input – output, meaning what effects leadership has on various organizational outcomes.

Managerial leadership and employee stress, health, and behaviours related to sickness absence and sickness presenteeism The focus of interest in this paper is leader characteristics and behaviours creating a good working environment, healthy employees, and employees who go to work when healthy and stay home when sick. What do we know about a health promoting leadership?

Leadership and employee stress and health Working life research has, surprisingly enough, been rather neglecting of the contribution of leadership when studying work environment factors in relation to the health of employees. The few studies conducted are to a large extent based upon either task- and relationship oriented leadership, or transformational and transactional leadership.

Showing consideration for subordinates is, not surprisingly, associated with subordinates’ good health. Initiating structure is also a health promoting behaviour unless it is combined with low consideration. Low consideration in combination with high structure is associated with increased stress in subordinates. However, in more stressful situations, more structure is needed (Nyberg, Bernin & Theorell, 2005).

We also see that both transformational and transactional leadership are associated with good health among subordinates, the associations between transformational leadership and subordinate health being somewhat stronger. The situations detrimental to health are when the leader exerts no leadership at all, acts laissez-faire, or uses only transactional leadership (Nyberg, Bernin & Theorell, 2005).

v A few studies have been published recently, using other measures of leadership behaviours than the above mentioned. Gilbreath & Benson (2004), for example, developed a new instrument including 63 items describing leader behaviour. The instrument was created after interviewing subordinates and leaders and reviewing research on work, health and supervision. The questions were related to job control (e.g. Is flexible about how I accomplish my objectives); leadership (e.g. Makes me feel part of something useful, significant, and valuable); communication (e.g. Encourages employees to ask questions); consideration (e.g. Shows appreciation for a job well done); social support (e.g. Steps in when employees need help or support); group maintenance (e.g. Fails to properly monitor and manage group dynamics); organizing (e.g. Plans work to level out the load, reduce peaks and bottlenecks); and looking out for employee well-being (e.g. Strikes the proper balance between productivity and employee well-being). The instrument was developed to measure the overall effect of supervisor behaviour, rather than the effect of specific types of behaviours. The authors found that supervisor behaviour made a significant contribution to the prediction of GHQ (General Health Questionnaire) scores beyond the variables age, health practices, support from other people at work, support from home, stressful life events, and stressful work events. Fearing that their measure of leader behaviours were confounded with social support, they reproduced analyses without items closely related to supportive functions. They found that other leadership dimensions also made a statistically significant contribution to prediction of GHQ scores.

A study by Nyberg, Åkerblom, Bernin, Alderling et al (submitted 2007) investigated leader behaviours and characteristics as measured by the GLOBE questionnaire (Hanges & Dickson, 2004) in relation to subordinate stress/health, and working conditions. 10 subscales from the GLOBE questionnaire were used, exploring leadership in the hotel industry in Sweden, Poland, and Italy. Results showed that the leadership dimensions Integrity (just, trustworthy, sincere, and honest), and Team integrator (communicative, team-builder, informed, integrator) were associated with better working conditions (less iso-strain), which in turn were associated with more vitality and less behavioural stress in subordinates. Malevolent leadership (irritable, hostile, dishonest, vindictive) was directly associated with subordinate behavioural stress.

A longitudinal study of leadership and subordinate well-being, where staff in two community trusts participated four times in a 14-month period, concluded that leadership behaviour and subordinate responses were linked in a feedback loop, lending support for the proposition that the relationship between leader and subordinate is a two-way reciprocal process (van Dierendonck, Haynes, Borrill & Stride, 2004).

vi Leadership and group psychology Sy, Côté & Saavedra (2005) used an experimental design, exploring the effects on group members of the mood of leaders. The task given to the group members was to put up a tent, while blindfolded. The results showed that the mood of the leaders had important consequences in the groups. Individuals with leaders in a positive mood experienced more positive moods themselves. Leaders’ mood also had a direct influence on group effort. This relationship did not go through the affective tones of individual group members. Leaders’ mood also had both a direct and indirect (through group affective tone) influence on group coordination. The authors conclude that leaders’ moods can be powerful forces within groups. However, it can not be excluded that the relationship is mediated by leadership functions, meaning that leaders in positive moods could have been more successful in conducting their influence as leaders. An explorative study at Institutet för psykoterapeutisk psykoterapi (Ohlström, 1997) examined the effect of leadership styles on the group members in a group therapy. The researcher observed activity levels, and affective tones. Results indicated that being a passive, vague, unclear leader can make a group insecure. A leader who is too strict, dominant, and focused on rules, may decrease anxiety in group members, but on the other hand not allow them to develop as much as they possibly could. The group in which individuals seemed to function the best (were the most trusting, reflecting, active, and self-dependent) was the one where the leader was active, group oriented, democratic, participative, clear and fair.

Leadership and sickness absence, sickness attendance, and work attendance There is still little research on sickness absence and sickness attendance, and to my knowledge no robust studies putting these outcomes in relation to managerial leadership. A study of work place conflict resolution and the health of employees in Sweden and Finland, showed that employees who reported that differences were resolved through discussion were least likely to report stress, bad health and sickness absence. Those who reported that authority was used, or that no attempts were made to solve the problem, both reported worse health (Hyde, Jappinen, Theorell & Oxenstierna, 2006). Tollgerdt-Andersson (2005) studied differences in leadership in organizations with high and low rates of sickness absence. She came to the conclusion that managers in organizations with low rates of sickness absence had high self- esteem, felt secure as leaders, could “say no” and trust own judgements, put high and clear demands on subordinates, had clear rules and concrete goals, could delegate and give responsibility to subordinates, and followed up work efforts systematically. Dellve, Skagert & Wilhelmsson (2007) found leadership important for workplace health promotion, and work attendance. Leaders using rewards,

vii recognition, and respect, were associated with higher prevalence of work attendance. A higher proportion of employee work attendance was also seen in units whose leaders viewed the organization or the society (rather than the individual workers) as responsible for the high rate of sick leave.

Organizational and work environment factors in relation to employee health, sickness absence, and sickness attendance Organizational justice has over the past few years been extensively investigated, and in robust studies been found related to employee health (e.g. Elovainio, Kivimäki, & Vahtera, 2002; Kivimäki, Elovainio, Vahtera, & Ferrie, 2003). The relationship between organizational factors and managerial leadership at lower levels in the organization has, to my knowledge, not been investigated to the same extent. However, Elovainio, Kivimäki, Steen, & Vahtera (2004) found organizational justice and dicision latitude related to each other. Working conditions, measured by the demand-control-social support-model (Karasek & Theorell, 1990, Johnsson, 1986) have for decades been established having a relation to employee health outcomes, such as cardiovascular disease (Johnson, Hall & Theorell, 1989), psychiatric disorders (Sanne, Mykletun, Dahl, Moen & Tell, 2005), the metabolic syndrome (Chandola, Brunner & Marmot, 2006), and sickness absence (Christensen, Nielsen, Regulies, Smith-Hansen & Kristensen, 2005). The effort-reward-imbalance-model (Siegrist & Peter, 2000) explains about the same amount of ill health in subordinates, as has the demand-control-social support model been shown to do.

The three most commonly used models in working environment research (demand-control, effort-reward, organizational justice) were included in a presentation of working life research by Michael Marmot (American Psychosomatic Society, Budapest, 2007) and summarized as explaining approximately 30% of the ill health in the population.

This figure is a (first draft of a) conceptual model of how aspects of the organization, the managerial leadership, and the working conditions interplay with individuals´ affects, cognitions, stress, health, and behaviours regarding sickness absence, and attendance.

viii Organization: Justice Clarity …

Managerial leadership: Integrity, Communication, Autocracy Inspiration, Consideration, Structure, Transformational… Individual perceptions, interpretations, affects, cognitions, behaviours

Working conditions: Stress/Health Demands Control Social support Effort-reward … Sickness absence Sickness attendance

 There is substantial evidence of a relationship between working conditions (demand-control-social support, effort-reward) and subordinate health and sickness absence.  There is substantial evidence of a relationship between organizational justice and subordinate health and sickness absence.  There is a significant contribution of managerial leadership practice to the health of subordinates, over and above other work environment factors studied in relation to health. Studies of group psychology indicate that subordinates are susceptible to their leaders moods and behaviours, and that these are relevant for the level of trust within and performance by the group.  There are few studies investigating the contribution of leadership practice on well-known work environment factors (demand-control; effort-reward). The results from one study indicates that leader integrity and team-orientation contributes to a good work environment (less iso-strain).  There are, to my knowledge, no studies looking at how organizational justice is associated with managerial practices at lower levels.  There are, to my knowledge, no published studies looking specifically at managerial leader behaviour in relation to subordinate sickness absence and sickness attendance.

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