1. Franziska Günzel-Jensen

  1. Department of Management, Aarhus University, Denmark
  1. Franziska Günzel-Jensen, Department of Management, School of Business and Social Sciences, Aarhus University, Bartholins Allé
    10, DK-8000 Aarhus C, Denmark. Email: frang{at}mgmt.au.dk
  1. Ajay K Jain

  1. Department of Human Behaviour and Organization Development, Management Development Institute Gurgaon, India


Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related
leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal,
i.e. transformational, transactional and empowering, leadership styles affect employees’ perceived agency in distributed leadership,
and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data
from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show that all leadership styles had
a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related
negatively to employees’ perceived agency in distributed leadership; however, a mediatory impact of this on the formal leadership
styles-distributed leadership relationship was not detected. These results emphasize the importance of formal leaders to enhance
employee involvement in various leadership functions; still, employees might prefer to participate in leadership functions
when they perceive that the organization is struggling to achieve its goals.

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Distributed leadership in health care: The role of formal leadership styles and organizational efficacy