Methods
Data collection and participants
Data were collected at the end of September 2010 from nursing staff from four hospitals from Eastern Finland serving population of over 350 000 inhabitants. A total of 5692 structured electronic questionnaires were sent to the hospitals and 1497 returns were made, representing a 26.3% response rate. Analysis was based on 1497 nursing staff who returned their completed questionnaire majority of them being registered nurses.
Leadership instrument and its reliability
The questionnaire Transformational Leadership Scale was used for measuring nursing leadership practices and were grouped in five subheadings; nurse managers leadership ethics, managing nursing process, feedback and rewards, professional development and nursing director. (It contains 66 questions, including background information of nursing staff.) Nursing staff were asked to evaluate their nursing mangers and director. Answers were scaled 1–5 (5, fully agree; 4, partly agree; 3, cannot say; 2, partly agree; 1, fully disagree). The leadership questionnaire was developed within Attractive and Safety Hospital Project including researchers from the University of Eastern Finland and Kuopio University Hospital.