Leadership behaviours and organisational commitment in Greek healthcare, 2023–2024

Background

Health workforce shortages and turnover threaten health-system resilience. Leadership is a modifiable organisational lever, yet evidence from Southern Europe on how specific leadership behaviours relate to different components of organisational commitment is limited. We assessed whether ‘initiating structure’ (role clarity, task planning) and ‘consideration’ (support, respect) predict affective, continuance and normative commitment among healthcare professionals in Greece.

Methods

Cross-sectional survey (2023–2024) of 80 healthcare professionals from two tertiary hospitals and four primary-care units in Greece. Validated Greek versions of the Leadership Behaviour Description Questionnaire (LBDQ) and the Meyer–Allen Organisational Commitment scale were administered. Hierarchical linear regressions estimated associations between leadership behaviours and each commitment component, adjusting for socio-demographic and work characteristics.

Results

Commitment levels were moderate (mean±SD; scale 6–36): affective 20.8±7.5, continuance 19.8±6.5, normative 17.5±7.1. Initiating structure was independently associated with higher affective (β = 0.17, p = 0.039) and normative commitment (β = 0.23, p = 0.004). Consideration was associated with lower continuance commitment (β = −0.21, p < 0.001). Models explained 29% (affective), 25% (continuance) and 32% (normative) of variance. Age and years in the health sector were positively associated with affective commitment.

Conclusions

In Greek healthcare, leadership that strengthens role clarity and goal setting may build the forms of commitment most relevant to retention and discretionary effort, while supportive behaviours may reduce “staying because I must” commitment. Leadership development that combines structured management with supportive practice could be a pragmatic workforce policy to improve engagement and resilience in resource-constrained health systems.

Key messages

• Leadership behaviours are a modifiable, system-level lever that can strengthen workforce commitment and support service resilience.

• Leadership development should balance role clarity/goal setting with supportive practice to improve retention-relevant commitment profiles.