Followership of Nurses in Saudi Arabia: A Mixed Methods Study

Abstract

Introduction: This thesis presents a mixed-methods study of a sequential explanatory design aimed at exploring the current state of followership research in relation to health care clinicians, with a particular focus on understanding followership among nurses in the context of Saudi Arabia. Recognising the critical but often overlooked role of followership in the healthcare sector, this research explores the various dimensions, styles, impacts, and perceptions of followership. Scoping Review: The study begins with a scoping review to identify and map the existing body of research on followership in healthcare. The review examines studies across a range of methodologies, including quantitative, qualitative, and mixed methods, as well as systematic reviews and metaanalyses. This phase sets the stage for understanding the current state of followership research, identifying gaps, and establishing a context for the subsequent phases. Quantitative Phase: The quantitative section of the study focuses on nurses in Saudi Arabia. It aims to explore the prevalent followership styles among nurses and how these styles correlate with their sociodemographic profiles. This phase employs a cross-sectional design and the Kelley followership questionnaire-revised, providing valuable statistical insights into the nature and distribution of followership styles within this specific demographic. Qualitative Phase: Complementing the quantitative analysis, the qualitative phase delves into the personal perceptions and experiences of nurses regarding followership in Saudi Arabia. Through semistructured interviews with seven registered nurses, this phase uncovers themes related to the understanding of followership, involvement in decision-making, and the barriers and facilitators to effective followership. This in-depth exploration offers a nuanced view of how followership is perceived and enacted in the healthcare setting. Integration Phase: The final phase of the study integrates the findings from the scoping review, quantitative, and qualitative research. Using a sequential explanatory mixed methods approach and a joint display analysis, this phase synthesizes the data to draw comprehensive conclusions. The integration phase offers a holistic view of followership among healthcare clinicians, particularly nurses in Saudi Arabia, identifying key themes and implications. Conclusions and Implications: The research reveals that while followership is a crucial element in healthcare, it remains under-researched and often misunderstood. The study highlights the importance of effective followership in improving clinical team performance and patient safety. It also identifies the need for more research in areas such as the impact of followership on clinical practice and the development of practical followership interventions. Recommendations include the integration of followership concepts into healthcare education and training, and the promotion of environments that value and enhance followership skills. This thesis contributes to the understanding of followership in healthcare and provides a foundation for future research in this critical area.