Are Australian healthcare managers hardy: exploring relationships among hardiness and identified demographic and leadership constructs?

Submission note: A Thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Public Health to the School of Public Health, Faculty of Health Sciences, La Trobe University, Bundoora.

This thesis relays the outcomes of research that was designed to identify if Australian healthcare managers are hardy, and if there is an association between hardiness and demographic, individual and organisational leadership constructs that have been linked with organisational performance. The demographic characteristics include age, gender, education level, occupation, organisational role, organisational type, organisational size and whether the organisation was located within Australia. The leadership constructs include empowerment, commitment, emotional well-being, contingent reward behaviours, loyalty, follower satisfaction, organisational citizenship behaviours and transformational leadership. The three concepts that make up hardiness are control, challenge and commitment, and hardiness is known to provide a buffering effect against the negative impacts of stress. This definition is based on the work of Dr Susan Kobasa who studied this area in the 1970s. Hardiness could be used as a gauge of suitability for healthcare management roles that are known to be challenging enabling healthcare organisations to develop organisational policies, organisational structures and individualised support aimed at recognising and enhancing hardiness where it exists. This area is based on the work undertaken that is described in Chapter 3 and is the subject of the 2010 publication by Hague and Leggat. Data were obtained from practicing health service managers collected through an online questionnaire using validated scales. The opportunity to participate was introduced with an invitation and online survey link, sent to the membership of the Australasian College of Health Services Managers via a regular Newsletter. While the survey response rate was low (n = 44), data analysis comprised descriptive summaries and regression analysis including the use of the Bootstrapping function to mitigate the limitations of the small sample size. Despite the small sample size, investigation of the association between hardiness and the demographic, individual and organisational constructs identified that there are some consistencies arising from the analysis which are supported by, and contribute to the field. In particular this study found that managers in the Australian healthcare sector report hardy personalities and that hardiness and contingent reward have a significant relationship. This research suggests that healthcare organisations should focus on identifying hardiness among management staff. Matching hardy managers to challenging positions may ensure these managers are supported to continue to develop, rather than be overcome by the pressures of the position. Measuring hardiness will assist healthcare organisations in recruitment, staff development and staff support processes. Once hardiness is recognised in an individual, the investment in and development of these emerging leaders can be specifically targeted.