p ISSN 2723-6927-e ISSN 2723-4339
The Effect of
Leadership and Management Training in Nursing BasedMedeline Leininger
Selvyana Ta'dung
Nursing Master's Study Program, Faculty
of Nursing and Health Sciences, Karya Husada
University Semarang, Indonesia
Email: 2210077@unkaha.ac.id
ABSTRACT
This research
identifies the characteristics of respondents and evaluates the impact of
training on the implementation of managerial functions at the Lukas Enembe
Hospital - Central Memberamo. Findings show that the majority of respondents in
the treatment group were women (70.0%) and the majority were under 30 years old
or between 30-40 years old. In contrast, the control group was dominated by
women (65.0%) and most were aged 30-40 years. In terms of work experience, the
treatment group tended to have work experience of ≤5 years, while the
control group had work experience of >5-10 years. The implementation of
management functions in the treatment group showed a significant improvement
after training, with a decrease in the poor and moderate categories, and an
increase in the good category. Statistical analysis with Asymp.Sig value. 0.000
indicates a significant effect of training. Recommendations include the
implementation of ongoing training with follow-up sessions, the use of relevant
case studies, regular evaluations, as well as the integration of Leininger's
theory in the educational curriculum and collaboration between educational
institutions and RSUD. Researchers are advised to choose an appropriate
research design and conduct in-depth data analysis to evaluate the impact of
training in a statistically significant way.
Keywords: Managerial Training, Performance Improvement,
Statistical Evaluation
INTRODUCTION
Nursing management is an activity to improve
the quality, quality and quantity of health services comprehensively in
accordance with health standards set by the government, with a nursing
management process that runs in accordance with the nursing process to ensure
nursing care is carried out professionally and supports each other (Hasan &
Sri Musriniawati, 2023). The head of the room, as a first-line nursing manager,
is responsible for managing staff and carrying out management functions such as
planning, organizing, directing and supervising, which are universal and cover
all aspects of the management process (Rizal, 2016). As a driver of nursing
care services, the head of the room must have the skills to manage services
effectively in order to improve the quality of nursing services, as well as
overcome various problems in the room such as organizational structure and equipment distribution (Anwar,
2016).
Implementation of good management functions
by the head of the room can improve working conditions and the effectiveness of
nurses' performance through guidance, motivation and effective communication,
which is important for improving the quality of care services (Yuswardi et al,
2018). The managerial implementation of the head of the room plays a role in
improving the quality and safety of patients, by managing nursing services in
accordance with the demands of a dynamic health service system (Triana et al,
2020). Rahman and Tazkia's research (2020) shows that the management function
of the head of the room in the City Hospital is not implemented optimally,
which has an impact on the motivation of implementing nurses in providing
nursing care, with a p value of 0.009 which shows that there is a significant
relationship between the management function of the head of the room and the
motivation of nurses. .
Research conducted by Salakory and Nenny
Parinusa (2021) found a significant relationship between the implementation of
the management function of the head of the room and the job satisfaction of
nurses in the inpatient room at Sumber Hidup Ambon Hospital, with the test
results of the planning function variables (p = 0.001), organizing (p = 0.000),
direction (p = 0.001), and supervision (p = 0.000). Yusnilawati and Indah
Mawarti (2021) also reported that the planning and organizing function had a
significant effect on nurse performance with a value of p = 0.016 and p = 0.042
respectively. Research by Fuziyah, Nurida, et al. (2021) shows that there is a
significant relationship between the management function of the head of the
room and patient involvement in nursing care, with a p value <0.001.
Meanwhile, Monica and Thrisia (2018) noted that the competence of the head of
the room is related to the performance of nurses, especially in the functions
of organizing (p = 0.007) and directing (p = 0.014), in implementing
patient safety targets.
Meanwhile, the research results of Friandi,
Riris, and Emitra Fatriona (2023) showed that 50% of respondents rated the
management function of the head of the room as good, while the other 50% rated
it as poor, with a p value = 0.000 indicating a significant relationship
between the management function and the performance of the implementing nurse.
. Suci, Vauzyatari Tilawa, et al. (2023) reported variations in the assessment
of the management functions of room heads: the planning and supervision functions
were rated as poor by the majority of respondents, while the organizing and
directing functions were rated as good. These findings indicate that although
the organizing and directing functions are running well, the planning and
monitoring functions still require more attention in improving management in
inpatient rooms. Research conducted by Fithriyani et al. (2017) analyzed the
relationship between the managerial function of the head of the room and the
quality of nursing care documentation in the Pariaman Hospital inpatient room
using a descriptive analytical design with a cross-sectional approach, showing
that the majority of managerial functions such as planning, organizing,
directing and monitoring were in the good category, with a statistical test of the
correlation between the directing function and the quality of nursing care
documentation, it obtained p value = 0.042. Jakri, Yohanes, and Hildegardis
Timun (2019) used the Chi-square test in their research which found a
significant relationship between the management function of the head of the
room and the work performance of nurses with a p value of 0.046 < α =
0.05, recommending increasing the ability of the management
function through training.
Puspitasari (2017) examined the influence of
the managerial function of the head of the room on the performance of nurses at
Aji Muhammad Parikesit Regional Hospital, while Zulkarnain (2019) found that
all directing function variables such as motivation and communication had a
significant relationship with nurse performance, while confounding variables
did not affect nurse performance. Rizal and Alfi Ari F. (2015) reported that
the management function of the head of the room has a significant relationship
with the motivation of implementing nurses with a p value of 0.001 for each
management function. Research by Anggeria, Elis, and Maria (2017) found a
relationship between supervision and the implementation of nursing care with a
significance value of p = 0.401, which indicates there is
no significant relationship.
Pratiwi, Margareta (2019) show that the
quality leadership of the head of the room influences the implementation of the
quality management system with ρ = 0.024. Ana, Pratiwi et al. (2015)
reported that there is a significant influence between leadership on the
quality of nursing service quality management with ρ = 0.024. Teresa et
al. (2020) found that supervision provides support in documenting nursing care
with beneficial results for nursing service work programs. Finally, Fitriana,
Desi (2023) shows that a good leadership style has a positive effect on nurses'
performance in patient safety with 74.2% of respondents showing good
performance.
A preliminary study was conducted by
researchers on 5 executive nurses at Lukas Enembe Regional Hospital, Central
Mamberamo Regency in November 2023. The results of the interviews revealed that
3 out of 5 nurses said that the head of the room planned routine activities and
meetings, 4 out of 5 nurses said that if there were staff who violated the
rules some were given warnings, some were not, 4 out of 5 nurses said the head
of the room did not guide nurses in carrying out nursing care. Staff have never
received training, some SPOs are socialized, some are not. DP3 evaluation is
carried out every year. The implementation of management functions in the room
is not good, the head of the room gives a warning to any staff who violate the
rules. Incidental nursing care guidance is provided by the Head of the Room to
all staff, providing motivation to staff if they complete
their tasks well.
Interviews conducted by researchers with the
head of the room revealed that the head of the room planned routine activities
and meetings, there had been no management training for the head of the room.
Most nurses work as is, nurses have never been involved in room planning, room
planning is prepared by the head of the room. The head of the room's guidance
to staff is still temporary if there is a problem, in carrying out procedures
there are Standard Operating Procedures (SPO) and Nursing Care Standards (SAK)
but they have not been implemented properly. The provision of nursing care
carried out so far in the room is routine, the number of working hours for
nurses is 7 effective hours per shift, and meal breaks are 1 hour. To increase
the productivity, effectiveness and efficiency of nurses' working time, the
success and motivation of implementing nurses is greatly influenced by the
implementation of the managerial function of the head
of the room.
Based on this background description, researchers are interested
in investigating the influence of Leadership and Management in Nursing Training
based on Medeline Leininger Theory on the implementation of the managerial
functions of room heads and administrators at Lukas Enembe
Hospital - Central Memberamo. The formulation of the research problem is how
the Leininger Theory-based training influences the implementation of the
managerial function of the head of the hospital, considering the importance of
improving quality services related to the implementation of the management
function of the head of the room. The general objective of this research is to
provide an overview of the influence of the training, while the specific
objectives include identifying the characteristics of respondents, knowledge
about leadership and management in nursing, implementation of managerial
functions in the treatment room, as well as analysis of the influence of
training on managerial functions. The benefits of this research are expected to
contribute to educational institutions as a scientific reference, to hospitals
as evaluation material, and to nurses in developing knowledge and practice of
leadership and management in nursing based on Leininger's theory.
RESEARCH METHODS
The method used in this research
is a quasi-experimental method, which according to Sugiyono (2019) is a
research method to find the effect of certain treatments on other variables
under conditions that can be controlled, using all subjects in the study group
(intact group). who were given the treatment, not random subjects. This
research aims to evaluate the influence of Leininger theory-based leadership
and management in nursing training on the managerial function of room heads and
executors. The research design used was a quasi-experimental design in the form
of a nonequivalent control group design, where the experimental and control
groups were not randomly selected, with each group undergoing a pretest,
treatment and posttest. This design includes three stages: (1) Pre-experiment
measurement, namely measurements before treatment in both groups; (2)
Treatment, where the experimental group was given treatment in the form of
special learning while the control group was given conventional learning; and (3)
Post-experiment measurement, namely measurement after treatment to assess the
treatment effect. This research was carried out from November to July 2024 at
Lukas Enembe Regional Hospital, Central Memberamo Regency, Papua Mountains.
The population in this study were
all nurses at Lukas Enembe Regional Hospital who
worked in the Outpatient and Inpatient Installations, totaling
40 people, in accordance with the definition of population as a generalized
area consisting of objects or subjects with certain characteristics.(Sugiyono, 2019). The sample
consisted of 20 respondents for the experimental group who received Leadership
and Management in Nursing training based on Medeline Leininger Theory, and 20
respondents for the control group who received conventional learning, using
total sampling techniques. Inclusion criteria included nurses who were willing
to be respondents, worked directly with patients, and participated in training
programs, while exclusion criteria included nurses in structural positions or
who were not present during the study. The operational definition, which is
based on observable characteristics (Sugiyono, 2019), includes Leadership and
Management in Nursing training and implementation of managerial functions with
measurement using observation and questionnaires. The data collection tool is
an online form distributed via WhatsApp, with a grid of instruments including
training modules and questionnaires. Validity was tested by comparing the
calculated r value with r table (Sugiyono, 2019), while reliability was tested using
the Cronbach Alpha technique. Data collection procedures involve questionnaires
and informed consent, with data collection techniques in the form of formative
tests carried out before and after learning. Data processing includes editing,
coding, scoring, entry and tabulation, with analysis using SPSS 29.0 for
univariate, bivariate and multivariate analysis, including the chi square test
and multiple logistic regression. Research ethics involves informed consent,
anonymity, confidentiality, and voluntary, following ethical principles to
avoid unethical actions (Sugiyono, 2019).
RESULTS AND DISCUSSION
A.
Research result
1.
Data Validity and Reliability Test
Results
1.
Validity test
The validity test is used to determine whether or not
the questionnaire used by researchers is valid in obtaining research data from
respondents. This validity test uses correlation analysis with the SPSS version
29 program where the researcher uses the Sig score. (2- Tailed) when running
pearson-correlated in SPSS 29. If the correlation coefficient value of the
statement items being tested is greater than r table, namely 0.468 (df = n-2 =
20-2, n = 18 with significance α= 0 .05).
Table 1. Validity
test
|
Question |
r table |
r count |
Results |
|
Planning |
|||
|
P.1 |
0.468 |
0.899 |
Valid |
|
P.2 |
0.468 |
0.705 |
Valid |
|
P.3 |
0.468 |
0.801 |
Valid |
|
P.4 |
0.468 |
0.827 |
Valid |
|
P.5 |
0.468 |
0.512 |
Valid |
|
P.6 |
0.468 |
0.721 |
Valid |
|
P.7 |
0.468 |
0.873 |
Valid |
|
P.8 |
0.468 |
0.796 |
Valid |
|
P.9 |
0.468 |
0.859 |
Valid |
|
P.10 |
0.468 |
0.578 |
Valid |
|
Organizing |
|||
|
O.1 |
0.468 |
0.913 |
Valid |
|
O.2 |
0.468 |
0.818 |
Valid |
|
O.3 |
0.468 |
0.790 |
Valid |
|
O.4 |
0.468 |
0.653 |
Valid |
|
O.5 |
0.468 |
0.814 |
Valid |
|
O.6 |
0.468 |
0.734 |
Valid |
|
O.7 |
0.468 |
0.513 |
Valid |
|
O.8 |
0.468 |
0.882 |
Valid |
|
O.9 |
0.468 |
0.789 |
Valid |
|
O.10 |
0.468 |
0.796 |
Valid |
|
Staffing |
|||
|
S.1 |
0.468 |
0.763 |
Valid |
|
S.2 |
0.468 |
0.777 |
Valid |
|
S.3 |
0.468 |
0.761 |
Valid |
|
S.4 |
0.468 |
0.779 |
Valid |
|
S.5 |
0.468 |
0.516 |
Valid |
|
S.6 |
0.468 |
0.888 |
Valid |
|
S.7 |
0.468 |
0.816 |
Valid |
|
S.8 |
0.468 |
0.742 |
Valid |
|
S.9 |
0.468 |
0.729 |
Valid |
|
S.10 |
0.468 |
0.873 |
Valid |
|
Controlling |
|||
|
C.1 |
0.468 |
0.869 |
Valid |
|
C.2 |
0.468 |
0.850 |
Valid |
|
C.3 |
0.468 |
0.564 |
Valid |
|
C.4 |
0.468 |
0.909 |
Valid |
|
C.5 |
0.468 |
0.883 |
Valid |
|
C.6 |
0.468 |
0.803 |
Valid |
|
C.7 |
0.468 |
0.886 |
Valid |
|
C.8 |
0.468 |
0.802 |
Valid |
|
C.9 |
0.468 |
0.802 |
Valid |
|
C.10 |
0.468 |
0.868 |
Valid |
Source: Data inprocessing
with SPSS 29.0 (2024).
Based on the results in table 1 above, it shows that all the
questions in the questionnaire obtained a value of r calculated > r table,
because r calculated is greater than r table, namely 0.468, all items are
declared valid.
2.
Reliability Test
Reliability tests are carried out to measure the
extent of consistency or stability of research instruments. Reliability testing
was carried out using Cronbach Alpha statistical testing. A research instrument
is said to be reliable if the Cronbach Alpha value is above 0.468.
Table 2. Reliability
Test
|
Question |
r table |
r count |
Results |
|
Planning |
|||
|
P.1 |
0.468 |
0.938 |
Reliable |
|
P.2 |
0.468 |
0.938 |
Reliable |
|
P.3 |
0.468 |
0.937 |
Reliable |
|
P.4 |
0.468 |
0.937 |
Reliable |
|
P.5 |
0.468 |
0.940 |
Reliable |
|
P.6 |
0.468 |
0.938 |
Reliable |
|
P.7 |
0.468 |
0.938 |
Reliable |
|
P.8 |
0.468 |
0.937 |
Reliable |
|
P.9 |
0.468 |
0.937 |
Reliable |
|
P.10 |
0.468 |
0.939 |
Reliable |
|
Organizing |
|||
|
O.1 |
0.468 |
0.937 |
Reliable |
|
O.2 |
0.468 |
0.938 |
Reliable |
|
O.3 |
0.468 |
0.937 |
Reliable |
|
O.4 |
0.468 |
0.939 |
Reliable |
|
O.5 |
0.468 |
0.938 |
Reliable |
|
O.6 |
0.468 |
0.938 |
Reliable |
|
O.7 |
0.468 |
0.939 |
Reliable |
|
O.8 |
0.468 |
0.937 |
Reliable |
|
O.9 |
0.468 |
0.938 |
Reliable |
|
O.10 |
0.468 |
0.938 |
Reliable |
|
Staffing |
|||
|
S.1 |
0.468 |
0.938 |
Reliable |
|
S.2 |
0.468 |
0.938 |
Reliable |
|
S.3 |
0.468 |
0.938 |
Reliable |
|
S.4 |
0.468 |
0.937 |
Reliable |
|
S.5 |
0.468 |
0.939 |
Reliable |
|
S.6 |
0.468 |
0.936 |
Reliable |
|
S.7 |
0.468 |
0.938 |
Reliable |
|
S.8 |
0.468 |
0.938 |
Reliable |
|
S.9 |
0.468 |
0.938 |
Reliable |
|
S.10 |
0.468 |
0.938 |
Reliable |
|
Controlling |
|||
|
C.1 |
0.468 |
0.937 |
Reliable |
|
C.2 |
0.468 |
0.937 |
Reliable |
|
C.3 |
0.468 |
0.939 |
Reliable |
|
C.4 |
0.468 |
0.937 |
Reliable |
|
C.5 |
0.468 |
0.940 |
Reliable |
|
C.6 |
0.468 |
0.937 |
Reliable |
|
C.7 |
0.468 |
0.937 |
Reliable |
|
C.8 |
0.468 |
0.984 |
Reliable |
|
C.9 |
0.468 |
0.937 |
Reliable |
|
C.10 |
0.468 |
0.938 |
Reliable |
Data sourceprocessed
with SPSS 29.0 (2024).
Based on the results of table 2 above, it shows that
the Cronbach's Alpha value is greater than 0.468. Therefore, it can be
concluded that each statement item in the questionnaire used is able to obtain
consistent data, which means that if the statement is submitted again, an
answer that is relatively the same as the previous answer will be obtained.
2.
Data Normality Test Results
Table 3. Shapiro Wilk Data Normality Test
|
Variable |
P |
Information |
|
Pre-Test
Intervention Group |
0.752 |
Normal |
|
Post-Test Intervention Group |
0.001 |
Abnormal |
|
Pre-Test Control Group |
0.517 |
Normal |
|
Post-Test Control Group |
0.971 |
Normal |
Source: Data processed with SPSS 29.0 (2024).
TestnormalityIn
this study, the Shapiro Wilk test was used because the sample size was < 50.
Data is said to be normally distributed if the significance value (p value) is
> 0.05. The results of the normality test can be seen in table 4.3 above.
Table 4.3 shows that the research results show that there is data that is not
normal because it has a p value <0.05. After it was discovered that there
was data that was not normally distributed, the researcher carried out a
hypothesis test using the Wilcoxon test.
3.
Data Analysis Results
Table 4. Respondent Characteristics
|
Variable |
Intervention |
Control |
||
|
n |
% |
n |
% |
|
|
Gender Man Woman |
6 14 |
30.0 70.0 |
7 13 |
35.0 65.0 |
|
Age <
30 years 30
– 40 years >
40 years |
9 9 2 |
45.0 45.0 10.0 |
7 11 2 |
35.0 55.0 10.0 |
|
Years of service ≤
5 years >
5 – 10 years >
10 – 20 years >
20 years |
10 7 1 2 |
50.0 35.0 5.0 10.0 |
6 9 4 1 |
30.0 45.0 20.0 5.0 |
Source: Data processed with SPSS 29.0 (2024).
Based on table 4 above, it is known that the characteristics of respondents
in the treatment group were mostly female, namely 14 respondents or 70.0% and
in the control group, the majority were also female, namely 13 respondents or
65.0%.
The age
characteristics of respondents in the treatment group were divided into three,
namely the age category < 30 years as many as 9 respondents or 45.0%, the
age 30 - 40 years as many as 9 respondents or 45.0%, the age category > 40
years as many as 2 respondents or 10, 0%. The control group was divided into
three, namely the age category < 30 years with 7 respondents or 35.0%, the
age category 30 - 40 years with 11 respondents or 55.0%, the age category >
40 years with 2 respondents or 10.0%.
The characteristics of the work period of respondents in the
treatment group were divided into four, namely the work period category ≤
5 years as many as 10 respondents or 50.0%, the work period > 5 - 10 years
as many as 7 respondents or 35.0%, the work period category > 10 - 20 years
old as many as 1 respondent or 5.0%, and aged > 20 years as many as 2
respondents or 10.0%. The control group was divided into four, namely the work
period category ≤ 5 years as many as 6 respondents or 30.0%, work period
> 5 - 10 years as many as 9 respondents or 45.0%, work period > 10 - 20
years category as many as 4 respondents or 20.0%, and age > 20 years was 1
respondent or 5.0%.
Table 5. Management Function
Implementation Category
|
Implementation of Management Functions |
Intervention |
Control |
||||||
|
Pre-Test |
Post-Test |
Pre-Test |
Post-Test |
|||||
|
n |
% |
n |
% |
n |
% |
n |
% |
|
|
Planning Good Enough Not enough |
0 9 11 |
0.0 45.0 55.0 |
15 4 1 |
75.0 20.0 5.0 |
0 8 12 |
0.0 40.0 60.0 |
0.0 5 15 |
0.0 25.0 75.0 |
|
Organizing Good Enough Not enough |
0 7 13 |
0.0 35.0 65.0 |
15 4 1 |
75.0 20.0 5.0 |
0 5 15 |
0.0 25.0 75.0 |
0.0 5 15 |
0.0 25.0 75.0 |
|
Staffing Good Enough Not enough |
0 8 12 |
0.0 40.0 60.0 |
17 2 1 |
85.0 10.0 5.0 |
0 7 13 |
0.0 35.0 65.0 |
0.0 8 12 |
0.0 40.0 60.0 |
|
Controlling Good Enough Not enough |
0 7 13 |
0.0 35.0 65.0 |
16 3 1 |
80.0 15.0 5.0 |
0 8 12 |
0.0 40.0 60.0 |
0.0 7 13 |
0.0 35.0 65.0 |
Source: Data
processed with SPSS 29.0 (2024).
Based on the implementation of pre- and post-test management
functions in the treatment group, seen from table 5, it shows that the
implementation of management functions regarding Planning, the least category
has decreased, namely from 55.0% to 5.0%, likewise the moderate category has
experienced a decrease from 45.0 % became 20% and the good category appeared in
the post-test treatment group at 75.0%, whereas previously the good category
had not appeared in all the categories described above. In the implementation
of the management function regarding Organizing, the poor category decreased
from 65.0% to 5.0%, likewise the medium category experienced a decrease from
35.0% to 20% and the good category appeared in the post-test treatment group at
75, The 0% previously in the good category have not appeared in all the
categories described above. Implementation of management functions regarding
Staffing, the poor category experienced a decrease, namely from 60.0% to 5.0%,
likewise the moderate category experienced a decrease from 40.0% to 10% and the
good category appeared in the post-test treatment group at 85, The 0% previously
in the good category have not appeared in all the categories described above.
Implementation of the management function regarding Controlling, the poor
category experienced a decrease, namely from 65.0% to 5.0%, likewise the medium
category experienced a decrease from 35.0% to 15% and the good category
appeared in the post-test treatment group at 80, The 0% previously in the good
category have not appeared in all the categories described above.
Based on the characteristics of the implementation of pre and post test management functions in the control group, seen
from table 5, it shows that the implementation of management functions
regarding Planning, the category has not experienced an increase, namely from
60.0% to 75.0%, likewise the moderate category has experienced a decrease from
40, 0% to 25.0% and the good category did not appear in the control group
during the pre and post-test. Implementation of the management function
regarding Organizing, the less settled category is from 75.0% to 75.0%,
likewise the moderately settled category from 25.0% to 25% and the good category
does not appear in the control group during the pre and post-test.
Implementation of management functions regarding Staffing, the poor category
experienced a decrease, namely from 65.0% to 60.0%, the medium category
experienced an increase from 35.0% to 40.0% and the good category did not
appear in the control group during pre and post- test. Implementation of the
management function regarding Controlling, the poor category has increased from
60.0% to 65.0%, while the medium category has decreased from 40.0% to 35.0% and
the good category does not appear in the control group during pre and post
-test.
Table 6. Category Total Implementation of Management Functions
|
Implementation
of Management Functions |
Intervention |
Control |
||||||
|
Pre-Test |
Post-Test |
Pre-Test |
Post-Test |
|||||
|
|
n |
% |
n |
% |
n |
% |
n |
% |
|
Good Enough Not enough |
0 5 15 |
0.0 25.0 75.0 |
17 2 1 |
85.0 10.0 5.0 |
0 2 18 |
0.0 10.0 90.0 |
0.0 3 17 |
0.0 15.0 85.0 |
|
Total |
20 |
100 |
20 |
100 |
20 |
100 |
20 |
100 |
Source: Data processed with SPSS 29.0 (2024).
Based on the overall implementation of pre and post
test management functions in the treatment group, seen from table 4.6,
it shows that the implementation of management functions in the low category
has decreased, namely from 75.0% to 5.0%, likewise in the medium category has
decreased from 25.0 % became 10% and the good category appeared in the
post-test treatment group at 85.0%, whereas previously the good category had
not appeared in all the categories described above.
Table
7. Results of the Implementation of Management Functions in the Group
Treatment Before and After Intervention Wilcoxon
Signed Ranks
|
|
N |
Mean Rank |
Sum Rank |
Asymp.Sig |
|
Negative Ranking |
0 |
0.00 |
0.00 |
0,000 |
|
Positive Rank |
19 |
10 |
190.00 |
|
|
Ties |
1 |
|
|
|
|
Total |
20 |
|
|
|
Source:
Data processed with SPSS 29.0 (2024).
Wilcoxon Signed RanksThe overall
results of the implementation of management functions in the treatment group
before and after the intervention showed that the negative difference or
negative rank between the training results for the pre-test and post-test was
0, both in the N value, mean rank, and sum rank. This value shows that there is
no decrease (reduction) from the pre-test score to the post-test score. The
positive difference or positive rank between the pre test and post test was 19
positive data in N, which means that 19 respondents experienced an increase in
training scores from pre test scores to post test scores, the average increase
was 10, while the number of positive ranks or sum of rank is 190.00. Ties is
the similarity of the pre-test and post-test scores. In the Wilcoxon analysis
results above, the Ties value is 1, which means there is 1 respondent who has
the same score between the pre-test and the post-test. Based on the test
statistics output, it is known that Asymp.Sig. worth 0.000. Because the value
of 0.000 is smaller than <0.05, it can be concluded that Ha is accepted,
which means there is a significant influence on the implementation of the
respondent's management function before the training is carried out and after
the training is carried out.
Table
8. Results of the Implementation of Management Functions in the Group Control
Before and After Intervention Wilcoxon Signed Ranks
|
|
N |
Mean Rank |
Sum Rank |
Asymp.Sig |
|
Negative Ranking |
5 |
13.40 |
67.00 |
0.155 |
|
Positive Rank |
15 |
9.53 |
143.00 |
|
|
Ties |
0 |
|
|
|
|
Total |
20 |
|
|
|
Source: Data processed with SPSS 29.0 (2024).
Wilcoxon Signed RanksThe results
of the implementation of management functions in the control group before and
after the intervention showed that the negative difference or negative rank
between the training results for the pre-test and post-test was 5 in N. This
value indicates a decrease (reduction) from the pre-test value to the post-test
value of 5. respondents, with an average decrease in mean rank of 13.40, while
the number of negative rankings or sum rank was 67.00. The positive difference
or positive rank between the pre test and post test was 15 positive data in N,
which means that 15 respondents experienced an increase in training scores from
the pre test score to the post test score, the average increase was 9.53, while
the number of positive rankings or sum of rank is 143.00. Ties is the
similarity of the pre-test and post-test scores. In the results of the Wilcoxon
analysis above, the Ties value is 0, which means that there were no respondents
who had the same score between the pre-test and post-test in the control group.
Based on the test statistics output, it is known that Asymp.Sig. worth 0.155.
Because the value of 0.155 is greater than > 0.05, it can be concluded that
Ha is rejected, which means there is no significant influence between the
implementation of the respondent's management function before the training is
carried out and after the training is carried out in the control group.
B.
Discussion
This research was conducted to determine the effect of providing
Leadership and Management in Nursing Training based on Leininger Theory on the
Implementation of Managerial Functions of Heads of Rooms with Executives at
Lukas Enembe Hospital - Central Memberamo. The research results for each group
are as follows:
1.
The influence of providing
Leadership and Management in Nursing Training based on Leininger Theory on the
Implementation of Managerial Functions of Room Heads with Executives at Lukas Enembe Hospital - Central Memberamo in the treatment group
The results of the study showed that there were significant
differences in the implementation of the managerial functions of the head of
the room at Lukas Enembe Regional Hospital - Central Memberamo before and after
providing Leadership and Management in Nursing Training based on Leininger's
Theory. An increase in the post-test mean score that is greater than the
pre-test mean indicates significant improvement. The management function
implementation category in the poor category decreased from 75.0% to 5.0%,
while the moderate category decreased from 25.0% to 10%, and the good category
appeared in the post-test treatment group at 85.0%, which previously not in
that category. Wilcoxon Signed Ranks shows that the negative difference between
the pre-test and post-test is 0, indicating there is no decrease in value.
However, there were 19 positive data showing an increase in value, with an
average increase of 10 and a total positive ranking of 190.00. Ties shows that
there is 1 respondent with the same score between the pre-test and post-test.
Leininger's theory, or Cultural Care Diversity and Universality
Theory, focuses on the importance of understanding culture in nursing practice,
emphasizing that effective care must take into account the patient's cultural
values (Kusnanto, 2019). This theory-based training is designed
to improve nurses' leadership and managerial skills with a focus on effective
communication, decision making, problem solving, and team management. This
training has been proven to have a significant influence on the implementation
of managerial functions, with improved interpersonal skills, decision making,
conflict management, as well as better motivation and leadership. Research by
Yusnilawati and Indah Mawarti (2021) shows the significant influence of
planning and organizing functions on nurse performance, while research by Abdul
and Majid (2016) highlights the influence of training and supervision on nurse
performance. Sutriyani (2014) also showed that there was a significant
difference in nurses' commitment after leadership training. For better
implementation, some practical steps include integrating culture in the
training curriculum, providing ongoing training, and establishing mentorship
programs. Further research is recommended to evaluate long-term impacts,
compare with other training methods, as well as obtain patient perspectives to
optimize Leininger Theory-based training.
2.
The influence of providing
Leadership and Management in Nursing Training based on Leininger Theory on the
Implementation of Managerial Functions of Heads of Rooms with Executives at
Lukas Enembe Hospital - Central Memberamo in the
control group
The results of the research showed that there was no difference in
the implementation of the managerial functions of room heads and executors at
Lukas Enembe Regional Hospital - Central Memberamo in the control group before
and after providing Leadership and Management in Nursing Training based on
Leininger Theory. The Wilcoxon Signed Ranks test showed a negative difference
between the pre-test and post-test for 5 respondents, with an average decrease
in mean rank of 13.40 and the number of negative rankings of 67.00. On the
other hand, there are 15 positive data showing an increase in value with an
average increase of 9.53 and a number of positive rankings of 143.00. The Ties
value is 0, indicating there are no respondents with the same score between the
pre-test and post-test in the control group. Based on Asymp.Sig. which has a
value of 0.155, which is greater than 0.05, it can be concluded that there is
no significant influence between the implementation of managerial functions
before and after training in the control group, so the alternative hypothesis
is rejected.
The control group in this study did not receive the training
intervention, serving to provide a comparison to the experimental group that
received training. The goal is to ensure that the changes observed in the
experimental group are truly caused by the training intervention and not by
other external factors. With no significant changes in the control group, these
results underscore the importance of training interventions in improving
managerial competence. This study suggested that the changing effects in the
experimental group were most likely caused by Leininger's Theory-based
"Leadership and Management in Nursing" training. This is in
accordance with research by Safitra (2019), which
shows that the inquiry learning method influences critical thinking skills, and
Sutam Tomi (2022), which reveals the effectiveness of
positive thinking training on reducing stress levels, showing that investment
in relevant training can produce significant changes. significant in managerial
practice and nursing services.
In this study, the absence of differences in the implementation of
managerial functions in the control group confirms that any changes that will
be observed in the experimental group after training can be directly attributed
to Leininger Theory-based Leadership and Management in Nursing training. The
control group served as a valid comparison to assess the effectiveness of the
training intervention. Research using a control group in the "Leadership
and Management in Nursing based on Leininger Theory" training study at
Lukas Enembe Hospital - Central Memberamo provides strong evidence of the
positive influence of the training on managerial abilities.
The group without treatment (control group) had no effect on
training indicating that the differences observed in the group receiving
training were indeed caused by the training itself, not by other factors. This
conclusion supports the internal validity of the study, indicating that the
changes measured in the group that received the training were due to the
training itself. The control group did not show significant changes while the
training group showed improvements, this strengthens the argument that the
training was effective, indicating that other variables that may have
influenced the results have been successfully controlled or did not have a
significant impact. Based on these findings, the training provided can be
recommended for wider application with the assumption that the training will
provide the same positive results. These findings also provide a strong basis
for continued research, including further development of training programs or
exploration of variations in training methods for improved outcomes.
CONCLUSION
Based on the research results, it can be
concluded that the characteristics of the respondents show that in the
treatment group, the majority were female (70.0%), while in the control group,
65.0% were also female. In terms of age, in the treatment group, the majority
were aged <30 years and 30-40 years (45.0% respectively), while in the
control group, the majority were aged 30-40 years (55.0%) . Based on work
experience, in the treatment group, 50.0% had work experience of ≤5
years, while in the control group, 45.0% had work experience of >5-10 years.
The implementation of management functions in the treatment group showed a
decrease in the less than 75.0% category to 5.0%, and the moderate category
from 25.0% to 10%, with the good category increasing significantly to 85.0%
after training. Statistical analysis shows the value of Asymp.Sig.
0.000, which means there is a significant influence of training on the
implementation of managerial functions. The suggestion for Lukas Enembe Hospital – Central Memberamo is that training be
carried out on an ongoing basis with follow-up sessions and using relevant case
studies to increase practical understanding. Periodic evaluations need to be
carried out to measure and improve the quality of training with full support
from management. For educational institutions, it is important to integrate
Leininger's theory in the curriculum and collaborate with RSUD for field
practice. Institutions are also advised to organize workshops and research
projects involving students and nursing staff. For researchers, it is advisable
to choose an appropriate research design, such as a comparative or longitudinal
study, and conduct in-depth data analysis to evaluate the impact of training in
a statistically significant way.
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