Healthcare organisations are social systems in which human resources are the most important factor. Leadership plays a key role, affecting outcomes for professionals, patients and work environment. The aim of this research was to identify and analyse the knowledge present to date concerning the correlation between leadership styles and nurses’ job satisfaction. A systematic review was carried out on PubMed, CINAHL and Embase using the following inclusion criteria: impact of different leadership styles on nurses’ job satisfaction; secondary care; nursing setting; full-text available; English or Italian language. From 11,813 initial titles, 12 studies were selected. Of these, 88% showed a significant correlation between leadership style and nurses’ job satisfaction. Transformational style had the highest number of positive correlations followed by authentic, resonant and servant styles. Passive-avoidant and laissez-faire styles, instead, showed a negative correlation with job satisfaction in all cases. Only the transactional style showed both positive and negative correlation. In this challenging environment, leaders need to promote technical and professional competencies, but also act to improve staff satisfaction and morale. It is necessary to identify and fill the gaps in leadership knowledge as a future objective to positively affect health professionals’ job satisfaction and therefore healthcare quality indicators.

Breast cancer is the most common malignancy in women, with a complex clinical path that involves several professionals and that requires a multidisciplinary approach. However, the effectiveness of breast cancer multidisciplinary care and the processes that contribute to its effectiveness have not yet been firmly determined. This study aims to evaluate the impact of multidisciplinary tumor boards on breast cancer care outcomes. A systematic literature review was carried out through Scopus, Web of Science and Pubmed databases. The search was restricted to articles assessing the impact of MTB implementation on breast cancer care. Fourteen studies were included in the review. The most analyzed outcomes were diagnosis, therapy and survival. Four out of four studies showed that, with implementation of an MTB, there was a change in diagnosis, and all reported changes in the treatment plan after MTB implementation. A pooled analysis of three studies reporting results on the outcome “mortality” showed a statistically significant 14% reduction in mortality relative risk for patients enrolled versus not enrolled in an MTB. This study shows that MTB implementation is a valuable approach to deliver appropriate and effective care to patients affected by breast cancer and to improve their outcomes.

BackgroundBreast cancer is the most common malignancy in women, with a complex clinical path that involves several professionals. A multidisciplinary approach is therefore essential and there is a growing emphasis on its application to breast cancer care. However, the effectiveness of breast cancer multidisciplinary care and the processes that contribute to its effectiveness have not yet been firmly determined. This study aims to evaluate the impact of MTBs on breast cancer care outcomes.MethodsA systematic literature review was carried out through Scopus, Web of Science and Pubmed databases. The search was restricted to articles assessing the impact of MTB implementation on breast cancer care, written in English and Italian language, published between 1995 and 2021.The quality of the included articles was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group from National Heart, Lung and Blood Institute Study Quality Assessment Tools. To combine not homogeneous results, when appropriate, meta-analysis was performed.ResultsFourteen studies, published between 2006 and 2021, were included in the review. From the quality assessment, seven studies were found to be of FAIR and seven of GOOD quality. The most analysed outcomes were: diagnosis, therapy and survival. Four out of four studies showed that with the implementation of the MTB there was a change in diagnosis, and seven out of seven studies reported changes in the treatment plan after MTB implementation. In terms of survival, results were not unanimous. A pooled analysis of three studies reporting results on the outcome “mortality” showed, in the fixed-effects model (p=0.43), a statistically significant 14% reduction of mortality relative risk for patients enrolled versus not enrolled in MTBs (pooled HR = 0.86; 95%CI: 0.81- 0.97). ConclusionsThis study shows that the implementation of the MTBs is a valuable approach to deliver appropriate and effective care to patients affected by breast cancer and to improve their outcomes. Further studies are needed to enrich the evidences available to date concerning especially the outcomes less investigated, but important to improve clinical care and care processes.

Background Healthcare organizations are social systems in which human resources are generally the most important factor for the provision of care. In these contexts, leadership plays a key role in providing effective and efficient care and results in positive outcomes for professionals, patients and work environment. The aim of this review was to identify and analyze the knowledge present to date in literature concerning the correlation between leadership styles and nurses' job satisfaction. Methods A systematic review of the literature was carried out on Medline and CINAHL databases between June and October 2019 by using a specific search algorithm. The following inclusion criteria were set: focus on the impact of different leadership styles on nurses' job satisfaction; secondary care; nursing setting; full-text available; English or Italian language. Results 6681 titles, 410 abstracts and 57 full texts were analyzed. The 12 selected studies considered 7 leadership styles: Transformational, Transactional, Passive-Avoidant, Laissez-Faire, Resonant, Authentic and Servant. Four studies (33%) considered only 1 style, 3 studies (25%) 2 styles, 4 studies (33%) 3 styles and only one study (9%) considered 4 styles. Transformational and Transactional styles were the most represented (75% and 67% respectively). Most of the studies conducted (88%) showed a significant correlation, both positive and negative, between the adopted Leadership style and the nurses' job satisfaction. Conclusions In a complex and constantly evolving context, healthcare organizations need to guarantee not only technical and professional competence, but also satisfaction as a motivational lever for health workers. It is therefore necessary to identify and fill the gaps in leadership abilities as a present and future objective in order to positively affect health professionals' job satisfaction and therefore healthcare quality indicators. Key messages Job satisfaction plays a key role in healthcare and nursing as a motivational lever for health workers. Leadership styles directly impact on nurses' job satisfaction which in turn affects healthcare quality and patient outcomes.