title: Self-perception of leadership styles and behaviour in primary health care.
abstract: The concept of leadership has been studied in various disciplines and from different theoretical approaches. It is a dynamic concept that evolves over time. There are few studies in our field on managers' self-perception of their leadership style. There are no pure styles, but one or another style is generally favoured to a greater or lesser degree. In the primary health care (PHC) setting, managers' leadership style is defined as a set of attitudes, behaviours, beliefs and values. The objectives of this study were to describe and learn about the self-perception of behaviours and leadership styles among PHC managers; to determine the influence of the leadership style on job satisfaction, efficiency, and willingness to work in a team; and to determine the relationship between transformational and transactional styles according age, gender, profession, type of manager years of management experience, and the type of organization.
  
  
  
  To describe leadership styles as perceived by PHC managers, a cross sectional study was performed using an 82 items-self-administered Multifactor Leadership Questionnaire (MLQ). This questionnaire measures leadership styles, attitudes and behaviour of managers. The items are grouped into three first order variables (transformational, transactional and laissez-faire) and ten second order variables (which discriminate leader behaviours). Additionally, the questionnaire evaluates organizational consequences such as extra-effort, efficiency and satisfaction.
  
  
  
  One hundred forty responses from 258 managers of 133 PHC teams in the Barcelona Health Area (response rate: 54.26 %). Most participants were nurses (61.4 %), average age was 49 years and the gender predominantly female (75 %). Globally, managers assessed themselves as equally transactional and transformational leaders (average: 3.30 points). Grouped by profession, nurses (28.57 % of participants) showed a higher transactional leadership style, over transformational leadership style, compared to physicians (3.38 points, p < 0.003). Considering gender, men obtained the lowest results in transactional style (p < 0.015). Both transactional and transformational styles correlate with efficiency and job satisfaction (r = 0.724 and r = 0.710, respectively).
  
  
  
  PHC managers' self-perception of their leadership style was transactional, focused on the maintenance of the status quo, although there was a trend in some scores towards the transformational style, mainly among nurse managers. Both styles correlate with satisfaction and willingness to strive to work better.
authors.affiliation: Public Health Nursing, Mental, and Maternal and Infant Health, Universidad de Barcelona, Campus Bellvitge, c/Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain. gloria.jodar@gmail.com.
authors.forename: Glòria
authors.initials: G
authors.lastname: Jodar I Solà
authors.affiliation: Public Health Departament, Consorci d'Atenció Primària de Salut de l'Eixample (CAPSE), Barcelona University, Roselló 161, 08036, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Gené I Badia
authors.affiliation: Fundamental and Surgical-Medical Department, Universidad de Barcelona, Campus Bellvitge, c/Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Pilar Delgado
authors.initials: PD
authors.lastname: Hito
authors.affiliation: Institut Universitari d'Investigación en Atenció Primària (IDIAP) Jordi Gol Unidad de investigación de Barcelona, Gran Via de les Corts Catalanes 587, àtic, 08007, Barcelona, Spain.
authors.forename: M Antonia Campo
authors.initials: MA
authors.lastname: Osaba
authors.affiliation: Barcelona's Primary Health Care Research, Evaluation and Quality Unit Institut Català de la Salut, Numància n° 23, 08029, Barcelona, Spain.
authors.forename: Jose Luís
authors.initials: JL
authors.lastname: Del Val García
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators / Q000523:psychology; D008486:Physician Executives / Q000523:psychology; D011320:Primary Health Care / Q000458:organization & administration*; D012649:Self Concept; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Job satisfaction; Leadership; MLQ; Managers; Primary health care; Self-concept