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The Impact of Different Leadership Styles on Motivation (NHS) Staff Case of Surrey Hospital. MBA Dissertation The Impact of Different Leadership Styles on Motivation (NHS) Staff Case of Surrey Hospital. (MBA) Master of Business Administration Author: Michael Dlamini Registration No: 209207121 Supervisor: Mr Azmat Firdous Academic Year: 2020-21 University of Sunderland London Campus Copyright University of Sunderland London Campus, No part of this publication may be reproduced without the prior written permission of the copy right owner Abstract   This research study will explore the importance of leadership style and the impact that motivation has on staff within the NHS.   I have chosen specifically Surrey county council, due to it being in the area in which I reside, and wanted to explore more intimately, leadership and motivation and how it may affect me as a future service user. This research report will explore the theories and strategies, within leadership and motivation and how effective these strategies are, in providing quality services. Leadership capabilities are known in all fields in healthcare organisations. The strong leader is essential to support the leadership position of any organisation and to be kept in mind in the field of health care. To gain leadership qualities, the leader requires a range of things to develop his/her skills. Efficient contact between group members and subordinates even among customers requires skills (In this scenario, patient is the customer) Issues can be resolved when we recognise our own, and other management style as it may overcome disputes between team members as well as administrators which in turn could resolve conflict. (Shrestha, 2019) highlights three types of management styles, autocratic, bureaucratic and laissez faire. These styles will be explored in depth within this research report as we unpick its benefits and disadvantages. In addition, motivation theories have several variables which changes within various external factors. The leader who motivates an individual or group of people needs to analyse the situation properly to understand which motivation theories to be applied (Gopalan et al., 2017). This analysis becomes the most essential thing and the whole motivation and motivating procedure solely depends on the analysis. This means, to accurately motivate people, a leader is expected to be good at analysis and must have a clear understanding of the whole situation (Gopalan et al., 2017). This research report will explore how motivation and its key features play a significant role in quality service.       APPENDIX 7 – DISSERTATION (PGBM161) DECLARATION  Statement of Originality and Authenticity I confirm that the dissertation I am submitting is an original and authentic piece of work written by myself that satisfies the University rules and regulations with respect to Plagiarism and Collusion. I further confirm that I have fully referenced and acknowledged all material incorporated as secondary resources in accordance with the Harvard system. I also certify that I have taken a copy of the dissertation, which I will retain until after the Board of Examiners has published the results, and which I will make available on request in pursuance of any appropriate aspect of the marking and moderation of the work within the University Regulations. Name:  Michael Dlamini Registration Number: 209207121 Programme: MBA Study Centre: University of Sunderland London Campus Date: 03/02/2021 Acknowledgements •       List of Figures and Tables Figure 1……………………………………………………………………………………………….4 Figure 2……………………………………………………………………………………………….6 Figure 3……………………………………………………………………………………………….9 Figure 4……………………………………………………………………………………………….12 Figure 5……………………………………………………………………………………………….13 Figure 6……………………………………………………………………………………………….15 Figure 7……………………………………………………………………………………………….18 Figure 8……………………………………………………………………………………………….20 Figure 9……………………………………………………………………………………………….21 Figure 10………………………………………………………………………………………………23 Figure 11………………………………………………………………………………………………26 •       List of Abbreviations Table of Contents Abstract………………………………………………………………………………………………………. i APPENDIX 7 – DISSERTATION (PGBM161) DECLARATION………………. ii Acknowledgements……………………………………………………………………………………. iii List of Figures and Tables……………………………………………………………………… ivList of Abbreviations………………………………………………………………………………. v Table of Contents………………………………………………………………………………………. vi Introduction……………………………………………………………………………………………. 1Background and Context…………………………………………………………………. 1Aims and Objectives……………………………………………………………………….. 1Scope and Importance…………………………………………………………………….. 1Research Rationale…………………………………………………………………………. 1Overview of Dissertation…………………………………………………………………. 1Literature Review………………………………………………………………………………….. 2Research Methodology………………………………………………………………………….. 3Data Presentation and Analysis……………………………………………………………… 4Results and Discussions………………………………………………………………………… 5Conclusion and Recommendations……………………………………………………….. 6Summary………………………………………………………………………………………… 6Evaluation of Results………………………………………………………………………. 6Recommendations based on Evaluation………………………………………….. 6Recommendation for future research work……………………………………… 6 References………………………………………………………………………………………………… 8 Bibliography………………………………………………………………………………………………. 9 Appendix 1………………………………………………………………………………………………. 10 Proposal………………………………………………………………………………………………….. 11 Chapter 1 Introduction   This chapter will explore the relationship and styles of leadership within Surrey hospital, NHS staff. The aim of this chapter is to determine whether different leadership styles. It will also explore the quality of care in healthcare settings and critically evaluate motivating factors that promotes a positive feedback from customers. The impact of how different leadership styles can promote staff moral through incentives such as pay increase, staff`s breaks, staff feeling valued and appreciated. Therefore, the complexities and challenges due to poor management. The advantages and disadvantages of high employee turnover. Leadership styles is known to be linked to quality treatment and associated behaviour. Leadership is viewed as a core supplement to the care of patients and health practitioners in a structured and synchronized manner. Factors that strengthen the quality and integration of treatment, effective leadership of healthcare professionals and its importance.   Context Just like other sectors, leadership styles play an essential role in health and social care services as well. Health care leaders and managers work hard to ensure that care users receive the best services on one hand, and they even check across how efficiently staff is performing within the organization. Health leaders even must check if staff is adequately motivated or not. This dissertation will concentrate into different leadership styles adopted by the health care leaders or managers and what impact can be led on the motivation of staff in the NHS. Therefore, there would be specific introspection of Surrey hospital to check for these essential aspects (Wu et al., 2020). This research aims to examine the relationship between various types of leadership and measures of quality of care in Health Care Settings. To explore and critically analyse the leadership styles practiced currently in Surrey hospital.To assess and critically evaluate the motivating factors in NHS especially in surrey hospital (Wu et al., 2020).To critically evaluate the impact of different leadership styles on the motivation of staff in Surrey hospital  Research questions The study must be able to answer the following questions for the research to meet all its aims and objectives: Does the leadership style in healthcare environments contribute to quality of the care?Is there any kind of relation between leadership styles in Healthcare Settings?What is the impact of leadership style towards quality of care and Healthcare Settings?To evaluate the benefits of the leadership styles towards quality of care in Healthcare Settings. 1.4 Scope and importance of the research This topic of this dissertation is extremely important in the present day because most of the staff leave health care organizations due to lack of motivation, poor moral, or being unable to communicate well with their leaders/managers and be able to express their workplace challenges and complexities. Staff feels reluctant to work as they face extreme pressure to handle tasks, or the absence of intrinsic and extrinsic rewards or at least motivational words from their seniors or leaders, against their hard-hearted efforts.  The scope of this research is therefore to check about why different leadership styles are so important to influence (positively or negatively) other staff and bring motivation within them, and their care delivery. There would be specific analysis on surrey hospital to identify the status of conditions (Wu et al., 2020). 1.5   Rational The rationale of this research is to find out why and how can leadership styles influence on motivation level of other staff working within health and social care services (specific reference to Surrey hospital). It would even check about how leaders can work in different aspects to ensure that they can bring motivation among the other staff. For example, the leaders need to explain to other staff how their job roles can help them to meet personal and professional goals, prevent burn out, and whether staff can perform well or are still lagging. The leaders should be able to keep on doing different things by which the staff can stay motivated in the long run. This would help them to take care of patients better (Alharbi, 2017). 1.6 Overview of Dissertation The dissertation is focusing on six chapters. Chapter one gives an introduction of the topic, leadership styles in NHS staff. The first chapter evaluates the objective of the research, the importance of the research considering leadership styles and the rational or justification of the research of investigating different types of leadership within NHS. In chapter two the literature review analyses the different types of leadership and theories relating to the subject and how some theories distinguish themselves from each other, leadership theories, motivational theories, goal-setting theories and cognitive theories, the relationship between of theories delivering quality of care and   a good feedback from customers. In the third chapter, research methodology is used which evaluates the research methods   used in the research paper including the explanatory and descriptive research methods. The research methodology also evaluates the data collection techniques out of the given number of participants in this research, different ages, cultural groups, sample, and the ethical and moral perspective of conducting the research work on leadership styles. In chapter four, data analysis techniques are identified like descriptive statistics, regression analysed and factor analysis.  The results are analysed and the discussed and it is evaluated how effective good leadership is dependent on core factors of a leader who has strong leadership skills and a role model to her/her employees. In fifth chapter, the results collected and analysed are discussed mand the justification of conducting the research work is presented. Finally, in the sixth chapter, the main objection of investigating the research was again presented, results are analysed, and the recommendations are presented considering the how to make a good leader in healthcare settings. Chapter 2 Literature Review 2.1. Leadership Styles and Theories Leadership is a skill of a particular individual who is responsible for leading a group of people or organization towards a well-defined goal. The individual who shows the ability to lead is known as a leader. A good leader should have the ability to motivate people, have excellent critical thinking and cognitive skills, know how to manage a group of people, and the know-how to delegate tasks. A leader can influence people and guide them towards success in life. They can build individuals up at a personal level. A leader will normally have the experience, wisdom, and knowledge that are required to go forward and achieve goals. Therefore, it can be said that leadership is a wide spectrum that involves the presence of various characters within individuals. This is a personality trait and is perceived differently by individuals; this leads to the development of various leadership styles. (Xu, 2017). Sometimes, the leader works as he or she pleases without thinking of all the technical nuances so that the followers or the people whom the leader is influencing are benefitted properly (Abasilim 2019). Various kinds of leadership have been developed over the years. None of them can be identified as perfect. But most leaders use the combination of two or more styles to get good results. The different leadership theories are as follows: Figure 1, Great Man Theory, Source: (www.floridatechonline.com) This theory has been formulated by Thomas Carlyle. In this theory, Carlyle argues that the leaders are born with certain traits that they are later responsible for making them great. Right from birth, they possess the potential to do great deeds and to influence people. He made such a conclusion after observing the traits and the characters of great leaders in the past. The proper showcase of these traits occurs due to some events, or it can be said that the leadership capacity of the leader is unfolded due to some event that may change the course of life of the leader (Xu, 2017). However, as the name suggest, is that it involves a gender-based prejudice (Spector, 2016). In theory, male characteristics are often emphasized therefore, masculine elements (Grint, 2011) are frequently included. There is a view that females can also be a leader and it is neglected in the theory. This may be a critical point of view, but it should not be ignored that the theory has a fair share. The origin of the theory coincided with the late 19th and early 20th centuries. As a matter of fact, women were not at the forefront in areas such as business, politics, faith organisations and state administration in these years (Kirkpatrick and Locke, 1991). Trait theory This theory suggests that the leader can be easily distinguished from a common person or a non-leader due to the presence of some traits or characteristics. These characters help shape and define the leader. The traits can be either genetic, meaning the leader is born with it or acquired which means the leader learns of possessing those characters due to the lessons he or she learned from some event in life. The nature of the traits that compose the trait theory can range from physical traits to psychological traits. It can be anything that defines an individual (Salehzadeh, 2017). However, similar ways as the great men theory. First, it is emphasized that the assumptions of the theory are speculative, and the theory lacks empirical tests and research (Harrison, 2018). For instance, the theory cannot give a clear descriptive answer to the question of who the leader is. On the other hand, as in the great men theory, the trait theory is also criticized for having a narrow perspective. At this point, only leadership characteristics have been put forward in theory, but other environmental factors (Robbins, 2001)   such as group values affecting the leadership and the structure of the tasks have not been taken into consideration. However, leadership is not a superficial phenomenon that can only be explained by characteristics. In addition to the lack of empirical tests and research (Harrison, 2018), there is also inconsistency between the characteristics set forth in the limited studies in trait theory (Judge et al., 2002). The contingency theory has been constructed and formulated in the 1960s. This theory speaks about the leadership style that is to be applied by the leader. According to the theory, it can be said that the style of leadership depends on the situation on which the leadership is to be applied. It says that the external factors of the environment hugely affect the nature of the leadership. These factors can also be considered as variables and can change from time to time. Understanding the needs and necessities of the situation is the most essential thing for the leader while applying this theory. If the leader can understand it then the nature of leadership applied by the leader will be successful and will show good results (Xu, 2017). However, the lack of adequate research fails to account for how certain demographic characteristics (e.g. education, experience, age and gender) influence the leader-subordinate relations. Figure 2, Fiedler’s Contingency Theory Source: (www.expertprogrammanagement.com) Style and Behaviour theory The style and behaviour theory suggests that the style of leadership that a leader will be following depends majorly on two factors. They are as follows: The demand of the situation: this relates to physical, time, and psychological stresses.The specific traits of the leader: integrity, ability to delegate, ability to communicate and self-awareness. Therefore, this suggests that it can be said that this theory also suggested that a leader shares great wealth of creativity and enthusiasm to make sure that he/she can lead effectively. The factors that are mentioned before should be well versed to the leader because this will directly influence the quality of output from the people the leader is inspiring or motivating (Xu, 2017). Process Leadership theory The theory of process leadership came into being from another theory which is known as the Servant’s theory which was constructed by Greenleaf in the 1900s. The servant’s theory focuses on the fact that a leader will be kind and generous towards the people he or she is leading due to their poor conditions. This means that the leader sympathizes with the subject and helps them by taking care of them and making sure that all their necessities are fulfilled. The leader also nurtures the people they are leading. The theory was formulated keeping the people in mind who are by profession a servant and hence the name. A similar kind of theory emerged from the servant’s theory which is known as the process leadership. meanwhile, it can be said that this theory of leadership also focuses on the leader who is working hard to make sure that the welfare of his or her followers is maintained. This kind of leader wants to do good for all the people who are following him and has taken on a social responsibility to do the same. The primary focus of the leader according to the theory of process leadership is to develop the person’s morale and make sure that he or she is growing up to become a different individual who will have a positive impact on society (Xu, 2017). Transactional theory The transactional theory is a major theory of leadership that came into being around the 1970s. According to this theory, there is a healthy amount of exchange between the leader and the subject who is following the leader. In all the previous theories it was seen that the flow of ideologies and thoughts was unidirectional i.e., from the leader to the follower. In this case, it is seen that the flow is bidirectional. This leaves a huge space for the learning of the leader as well. Personal development and learning are always static and never stagnant. This belief is true in this case. The leader can learn from the experience and the followers throughout his or her lifetime if the leader chooses to work according to this theory. It can also be identified as a give and take relationship if the reader wishes to view it in that manner. The leader is motivating and leading the followers and in return is learning from them (Xu, 2017). Transformational Theory The leaders who wish to follow the transformational theory make sure that their thoughts, goals, and beliefs are in alignment with their followers. This means they share a common ground in this aspect. The leader leads the followers in such a way that the morale and the motivation of both the leader and the follower are increased abundantly. And therefore, both the leader and the follower work towards the same goal and make sure that both sides benefits. The leader also sees that the follower is putting in the right kind of effort and the goal benefits the interest of the follower. (Xu, 2017) argues that this kind of approach increases productivity greatly and is the primary theory that is followed by most of the contemporary leaders around the world. The different leadership styles are as follows: Transactional Leadership style This is a kind of leadership style where the leader sets small goals for the followers and motivated the follower every step of the way. The small goals add up to a big one and once the follower fulfils all the goals a big achievement is gained by the follower. Another thing that can be identified as a key characteristic of this kind of leadership style is rewarding the follower. Here once the follower is fulfilling each small goal, the leader rewards the individual. Therefore, in terms of critical analysis, the interest for the follower to bear through the process of completing the goal becomes much easier for the follower. And the follower can retain the interest of completing the big goal till the very end. (Xu, 2017) suggests that the leader who is willing to follow this style will have to possess a high degree of expertise, knowledge, and most importantly should share the same goal as the follower. Transformational leadership style The transformational leadership style is another style of leadership that is followed by several leaders around the globe. In this style, the leader develops a personalized relationship with every individual follower and should empower the followers. A leader should empower the followers and develop them as a person. The lives of the followers transform into something different which benefits the individual and the people around the individual. The leader proves to act as a role model for the followers and the leader gives them stability. Additionally, the leader teaches the followers the different ways by which they can gain control over their lives and the situation around them. The application of this style as per (Rahbi et al., 2017) indicates that leadership in the practical field has shown drastic changes in the individual level and organizational level as well. Moreover, all these development or changes is in the positive direction. Figure 3, Transformational Leadership vs Transactional Leadership Source:(www.customessaymeister.com)     2.2 Motivation theories or styles Just like the different leadership theories that have been discussed previously, there are several motivation theories as well. Motivation can be Identified as a process where a person or a group of people are Inspired in such a way that they become goal-oriented or in other words, it can be said that the people show action and a song desire to fulfil a certain goal or a task. It can be identified as one of the main reasons for a person to achieve of goal and to become successful (Koenka, 2020). Also, motivation can be the prime reason for a person to overcome tough times and challenges. However, it can be said that “Motivation can come from a certain source which can be a culture, a person, or another source of influence. Motivation can come from external sources or internal sources when viewed concerning a person or an individual. For the sake of this discussion, only the external source of motivation is considered. The extent and the success of motivation can be understood by the results and on the fact that whether a person can reach the designated goal or not as per (Gopalan et al., 2017). There are several factors upon which the motivation theory depends on. These factors are variables and change with situation and other external factors. The leader who will be motivating an individual or group of people needs to analyze the situation properly to understand which motivation theories to be applied as per (Gopalan et al., 2017). This analysis becomes the most essential thing and the whole motivation and motivating procedure solely depends on the analysis. This means, to accurately motivate people, a leader is expected to be good at analysis and must have a clear understanding of the whole situation as per (Gopalan et al., 2017). He or she should also know the places the factors will work on and how they will influence the person. Over the years there have been the developments of different theories of motivation. These theories are different from one another but, their application will lead to a common goal. For any organization, it is essential to apply some of these motivation theories or styles as per (Gopalan et al., 2017). This is because employees tend to lose interest and get de-motivated a lot. Having a steady source of motivation is beneficial for the employees as it enables them to work harder consistently throughout the year and benefits the organization by getting positive results and high productivity from the employees (Kovach, 2018). The different theories are as follows: Motives and needs This theory helps the organization by giving them a few things that are primary and requirement to any employee (or an individual). These factors (placed in hierarchies) are arranged in a way so that the necessities of the employees are fulfilled, and this will help the organization to gain success. The different needs are as follows: Physiological needs: many of them will require enough time to rest after long hours of work, Safety needs: the staff will require PPE to protect themselves against infections, Love and Belonging: many of staff will have at established friendships at work, Esteem: promotions for better pay, Self-actualizing: many of the staff will want to pursue education/training to better themselves. Maslow, who formulated this motivation style, gone deeper explaining all the needs of the employees. In terms of critical analysis, it appears that he had arranged all the needs in a hierarchy and gave it different levels (Kovach, 2018). This hierarchy is often represented in a pictorial format in the shape of a triangle. Maslow said that each of these needs is to be fulfilled but the employee the most satisfaction when the lower level of the hierarchy is fulfilled first. The more the lower levels are satisfied the better the employee will function and get motivated (Badubi, 2017). Figure 4, Motives and Needs, Source: (www.simplypsychology.org) Expectancy Theory In this theory of motivation formulated by Vroom in 1964, it has been mentioned that people get motivated very easily if they know that on the completion of the goal, a good reward is waiting. This reward can be in any form and the presence of this tends to reduce the pain and suffering that a person is expected to achieve something. Expecting getting a good reward at the end of the task supports the person throughout the journey and keeps them motivated. It is also seen through several experiments that the results are very well at an individual level when this theory is applied (Kovach, 2018). Equity and justice Theory In 1963, Adams developed the theory of equity of justice. The theory is detailed but if it is summarized it can be said that the people work hard and stay motivated so that the resources available are shared equally amongst everyone. Inequity, it is said that the more a person works hard the better facility and reward the individual will receive. Justice is important at an organizational level so that the higher authorities stay unbiased and help in the process of maintenance of equity. Their thoughts and actions must be transparent and therefore will reduce the tension between the different people who are working for the organization (Kovach, 2018). Figure 5, Equity Theory of Motivation, Source: (www.iedunote.com) Goal-Setting Theory The goal-setting theory has been developed by Locke and Latham. According to this theory, people who are working for an organization are made to set difficult and easy goals. The mixture of these goals keeps the employees motivated and they work harder. The goal-setting theory has also said that having such kind of goals is beneficial for the development of the employee and is better than having only one kind of goal (either easy or difficult) or having no goal at all. Also, once the employees start working towards achieving the goals, they should be given constructive criticism in the form of feedbacks. This ensures that the employee can work efficiently in the right direction and can gain success (Kovach, 2018). Cognitive Evaluation Theory This theory of cognitive evaluation has been first mentioned by a researcher named Deci. In this theory, it has been said by the researcher that the employees need to undergo a cognitive evaluation. This cognitive evaluation will help the authorities to have a clear understanding of the individual’s nature and the needs of the individual.  This will also help the authorities understand the specific external elements which will help to fulfil all the needs of the person. It was evaluated critically that the fulfilment of needs helps the person stay motivated. It also helps them to have the feeling of being competent and achieving something. When this theory of motivation is applied it is seen that the employees are better satisfied with their life and work (Kovach, 2018). Work Design Theory For every working individual, there are certain job characteristics, they are as follows: Skill variety: involves the use of number of different skills and talents of a person.Task identity: is an important component of job satisfaction.Task significance: It shows how a piece of employee work relates to other work piece that are either done or in progress.Feedback: tends to produce stability and resistance to change.Autonomy: suggests that people are able to become self-determined when their needs for competence and connection. According to the theory of work design developed based on the job characteristic model of Hackman and Oldham, it is said that when all these five elements that are mentioned above are fully satisfied, then the employee gets high job satisfaction. This means the employee can also stay motivated while performing the tasks that are given to the employee from the job. The application of this theory of motivation also involves the higher authorities when considered at an organizational level. They are involved when delegating tasks to the employees. They must make sure that the appropriate task is being given to the appropriate person or else the growth of motivation will not be possible (Kovach, 2018). Reinforcement Theory The reinforcement theory of motivation talks about the reinforcement of positive behaviours. Doing such kind of action helps keep the employees stay motivated throughout the task and they can also expect a positive outcome from the organization. Also, in terms of critical analysis, it can be said that we need to keep in mind that this theory does not talk about paying attention to bad behaviour that is received from the employee. This kind of behaviour is called a negative one. It can lead to negative outcomes from the managers of the organization the employee is working for. The theory does not aim to change the personality or the inner ideologies of the person. Generally, people try to avoid facing any negative outcome and thus they work hard to get positive results (Kovach, 2018). Figure 6, Reinforcement Theory, Source: (www.tutorialspoint.com) 2.3. NHS Literature   The NHS is a publicly funded healthcare system founded in the United Kingdom, whereby, the citizens pay for their healthcare services through taxes and is overseen by the Department of Health. The NHS is approximately 70 years old and pays for the health care of people irrespective of their economic background. Most of the medical expenses for critical diseases are mainly covered through this system (Anandaciua et al., 2018). The NHS aims to reduce inequality within society regarding the important aspects of life and focus on the social wellbeing of its citizens. In terms of critical analysis, it is highlighted that, they strive to make the whole society free from many deadly diseases and the citizens remain healthy and have a long fulfilling life. Also, they aim to sustain the future generation and make sure they also live a long and healthy life. It has been founded around the Second World War era and has continued to be an important part of the lives of the people of the country. The patients as well as their relatives get immense benefits from the system. It is because of this reason the NHS has a significant place in literature as well. The people of the country are very loyal to this system and the system pays them back by rewarding their loyalty with the different services as per (Sallis et al., 2019). The NHS is an age-old system and has been around for many decades; many generations have grown up with the system and have received benefits throughout their lives. Therefore, NHS has almost become a part of the British culture and has well integrated with the common lives. As literature is generally derived from the common lives of the people, this system has also found its mention in the literature. In books like Country Doctor by A.J. Cronin, My Brother Jonathan by Francis Brett Young, are classic examples of books that contain mention of the NHS within them. There is mention about the staff members of NHS, their quest to find appropriate medicine for a disease, and other daily activities of the system are present in literature (Pope, 2019). It helps us get a clear insight into the nuances of the system through the lens of literature as per (Sallis et al., 2019). The literature also serves as a source of information for the NHS to understand the extent of service that they are providing from the perspective of an outsider or a common person who is a citizen of the country. Literature also acts as a source of historical knowledge (Marjanovic et al., 2019). The authors generally write their work concerning the society they are currently part of. So, in terms of critical analysis, it can be said that the NHS literature also helps them understand how the services provided by them have changed and evolved over the years of operation and how society has been impacted due to that (Pope, 2019). This is essential because generally the system tackles empirical or numerical data and does not go to the nuances of lives of common people and literature helps them to understand that as per Sallis et al., (2019). 2.4. Leadership styles in the NHS Figure 7, Leadership Qualities Framework Source: (www.yumpu.com) The leadership style of the NHS is unique. As demonstrated in the above illustration, the Healthcare Leadership Model, is used to structure the services and qualities required within the healthcare system. The model ensures that the patients are receiving valuable healthcare also to assists in the individual development of the healthcare professionals. This also provides an understanding of the importance of leadership and how it can be used in a clinical or service setting (Cabral et al., 2019). This is essential as evidence has suggested that leadership has been an area of neglect with professionals within the healthcare setting. Therefore, it should be kept in mind that leadership is an imperative part of providing effective care that will improve the quality of care received the patients. According to the NHS, positive leadership should show the following: Employees who are satisfied, productive, and engaged in the job they love.Care of top quality.Complete patient satisfaction.Valuable care services.Highly regarded services.An extremely successful organisation that is involved in providing healthcare to the common mass (Cabral et al., 2019). These mentioned outcomes can be considered as goals for a leader that needs to be achieved to get appropriate results from leadership (Lumbers, 2018). In the model, the NHS has incorporated nine leadership dimensions that can be utilised in this field. Each dimension represents the character or behaviour of the leader. Having these behaviours and applying them properly will make the achievement of the above goals easier and faster. Again, in contrast, if these behaviours are naturally not present then the NHS suggests certain ways by which these behaviours can be developed (Konstantinou and Prezerakos, 2018). Therefore, there is development in the personal and professional front as well. The nine dimensions are inspiring shared purpose, leading with care, evaluating information, connecting our services, sharing the vision, engaging the team, holding to account, developing, capability and influencing for results. For the well-being of the healthcare professionals, these nine dimensions are arranged in a pictorial format. Each element of that structure represents each element of behaviour that should be present inside a leader (Cabral et al., 2019). 2.5. Motivating factors in NHS Figure 8, Motivational Theory Source: (www.semanticscholar.org) The staff and healthcare professionals who are working for this public healthcare service are doing well for society. They are working hard to make sure that the people are treated equally and can get a high-quality healthcare system irrespective of their economic and societal background. However, it is imperative to highlight that the work can become repetitive on a daily basis which could create some demotivation within the staff who work closely with the public, (Cunningham et al., 2019). Therefore, motivation is essential in increasing the quality of care to enable productivity. In addition, motivation helps built the morale of staff and increases their self-esteem. Below are some suggestions that would assist in the morale of staff and their motivation: Praise– Praising staff for the acknowledged hard work will assist in them remaining focused on the job at hand and in turn improve the quality.Pay– it is evident that healthcare professionals do not receive the desired pay for the work that they do and are often underpaid. For motivation to be achieved, pay should be reviewed regularly with incentives to improve the morale and longevity of staff.  Job satisfaction– if staff are not satisfied with the job they are doing, they tend to lose motivation and start forcing themselves to do the job. This may affect their mental wellbeing and quality of care provided to patients.Availability of resources– Providing appropriate healthcare is challenging and this becomes even more difficult with the absence of resources. There is a requirement for high-quality equipment, medication, and other tools, However, without any one of these, staff may become incapable of providing quality care. As quality care is the most important aspect when it comes to the field of healthcare, the absence of the necessities increases challenges. Staff, therefore, are motivated when all resources are available. This includes functioning equipment which will only improve the quality of care received.Recognition– staff are doing excellent work with a high degree of precision every single day. They are working around the clock just to make sure that the patient does not become deprived of the care they need and deserve. After receiving quality care, if the patient praises them, it becomes a source of great motivation. This recognition lights up their passion all over again. (Chey et al., 2021). 2.6. Impact of different leadership styles on the motivation of staff in NHS. Figure 9 Motivational Theory Source: (www.europepmc.org) Motivation increases the level of loyalty shown by staff towards the organisation they are working with and this therefore requires good leadership. Leadership is an essential aspect, in focusing a team, towards common goal of providing quality care and high productivity (Lumbers, 2018). Among the different styles of motivation that have been discussed, almost all of them can be utilised within the staff of the NHS. Their impact can be different and everlasting. It can also help change the course of life of a few healthcare professionals. They also help to build organisational culture which ensures that staff are keeping their differences aside and working as a team. In addition, this supports a good relationship with the team and teaches them how to tackle a new challenge together by brainstorming ideas, analysing them, and understanding the nuances of these challenges (Lumbers, 2018). The development of organisational culture ensures a smooth and steady workflow. Therefore, this theory if applied to the NHS will encourage safety and maintain equity of the healthcare provided by their staff (Lumbers, 2018). The illustration below identifies 5 leadership styles within nursing which could be adapted throughout the various levels with the health care sector. Figure 10, Leadership Styles in Nursing Source: (www.relias.com) Having made the effort to apply different styles of motivation within the staff of the NHS this has increased the overall patient outcome by a huge number, therefore patient mortality has reduced. Also, the patients are more satisfied with the kind of care that they receive within the different settings like clinical and societal settings. During clinical care, there have been reported cases of unintentional injuries by staff to the patient which at a bad case can cause death. (Sfantou et al., 2017). In contrast, by applying different motivational styles or theories within the system of the NHS this has also reduced significantly (Fernandez, 2017). The application of the goal-setting theory along with the reinforcement theory has shown the best results. This is because small goals often mask the fact that staff work long hours (Sfantou et al., 2017). Completing small goals and getting positive reinforcement from them motivates staff and enables them to work harder and provide quality healthcare. This also helps staff to avoid the fact that they work long hours while on duty. Sometimes in emergency cases, employees stay after their duty is over for an extended period (Thusini and Mingay, 2019). During these long hours if the whole task of the day is divided into small goals then they seem easier to complete (Sfantou et al., 2017). In addition, they stay satisfied with their job, and the productivity increases. Here, the expectancy theory can also be applied. In this, staff tend to work more efficiently to achieve the goal and are likely to focus on the reward when their task is complete. (Konstantinou and Prezerakos, 2018). Chapter 3 Research Methodology 3.1 Research Framework Through this section, the researcher validates his or her ideologies and makes sure that the research remains scientifically accurate (Konstantinou and Prezerakos, 2018). Saunders et al. (2019) mentioned that a research can be divided and classified in to six different stages and it is important to follow this structure to ensure that all aspects of research are evaluated before actual conducting the research the different stages of the research are discussed below to provide an overview of the methodology and the approach that need to be adopted for the study. Figure 11, Research Onion Source: (www.15writers.com) 3.2 Research Philosophies: Saunders et al. (2019) have identified several philosophies, i.e. pragmatism, positivism, realism, objectivism and interpretivism. Some research need pragmatism to gather more ideas about truth that is currently in practice, and in its absolute form. Other than that, the employees and healthcare personnel that are involved with the organization will be satisfied with their work and show dedication and higher levels of productivity within the organization (Alharahsheh and Pius, 2020). Alharahsheh and Pius, 2020) said that Researchers of traditional scientific natural opinions (positivism) use a deductive approach, while a phenomenological approach is typically inductive (interpretivism).For this research I will choose positivism approach, contributing to predictive analysis rely on observable observations. Positivism as philosophy refers to the scientific conviction that knowledge is a product of human experience. 3.3 Research Approaches: Saunders et al. (2019) suggest that a research approach can be inductive or deductive. It`s selection completely depends on the earlier research aims, personal opinions, limitations, choices and more. A proper research approach helps the researcher to understand the ways preliminary data can be collected, the ways it can be analysed and interpreted (Woiceshyn and Daellenbach, 2018). All these are done so that the research can be concluded (Rahi, 2017). The primary knowledge that was required for understanding the different styles of leadership, the history and role of NHS in society, and the current leadership style that is being implemented. Qualitative Approach is used that produces results not obtained through quantifying methods or statistical results. This study is based on deductive modes of thought. 3.4 Research Strategies: The research strategy describes how the researcher intends to carry out the work (Saunders et al., 2019). The strategy can include number of different approaches, such as experimental research, action research, case study research, interviews, surveys, or a systematic literature review. Sampling is another technique that is equally important when it comes to any research.  This generally involves the collection of data that are required for the research. Over the years, there has been the development of an enumerable number of data sampling while they have been used in various aspects of research. In the research work under consideration, there has been the utilization of surveys and interviews for the sake of the collection of data. In all research, sampling is a critical technique. This includes generally collecting the data (Spens, 2006). 3.4.1 Surveys Punch (2003) suggest that surveys are one of the commonly used in research strategies because it helps in gathering information from a large group of people and the information that is collected via survey can be quantified and used for establishing results that are reliable and have been proven by the data. 3.4.2 Interviews Gubriem and Holstein (2002) explains that the use of interviews with surveys helps in enhancing the reliability of the findings. According to Gubriem and Holstein (2002), interviews can be conducted in person, over the telephone or also via email. The biggest benefit of using interview as a research strategy is that it can be used for expanding the scope of the research because the researcher can even ask additional questions, thus getting a better understanding of the subject and being able to expand the overall scope. 3.5 Research Choice: Saunders et al. (2019) highlighted three methods of the research and they are as follows: mono, mixed, and multi methods to select while working on this forth layer of the research onion. Generally, primary or secondary i.e. primary quantitative or secondary quantitative and mixed methods are used for data collection and analysis. Qualitative research also provides rich descriptive and exploratory data. Based on the time limitations and availability of resources, the quantitative method was the best option for researchers to conduct a single study. The term “mixed” refers to emerging research methodology which advances or “mixes” quantitative and qualitative data within a single investigation or ongoing research project. (Creswell and Clark, 2011). The research has been based on a mixed approach and has recently been extended to include areas such as nursing, family medicine, social work, mental health, pharmacy, allied health, etc. 3.6 Time Horizon: The research design requires time horizons regardless of the methods used for research. The Longitudinal and the Cross Sectional are two kinds of time horizons. Over a long time, longitudinal experiments are replicated. Cross-sectional trials are confined to a certain timeframe. The Cross and the Longitudinal are two kinds of horizons. Longitudinal trials are repeated over a long period of time. Cross-sectional experiments are limited to certain time (Andrew el at, 2019). Longitudinal research is required in that an adequate infrastructure is required to survive the time test for the actual study period. It is important that data collection and recording procedures are similar across different locations and that they are standardized and reliable over time.The method of data generation lies in quality longitudinal studies (QL). This procedure entails a cyclical and cumulative path over time, a journey that culminates in the development, management and review of a data set as well as its portrayal in the results of a report, in line with the nature of the QL investigation in general. 3.7 Techniques and procedures: 3.7.1 Data collection: The data obtained through the survey can be quantified and used to determine accurate and proven data outcomes. The major advantage of interviews as a study strategy is that they can be used to extend the research scope. Direct personnel inspection during site meetings, phone calls, emails, or routine and periodic analyses of data files to find anomalies, severe values, or incorrect codes are also examples of detection and tracking. Although site visits will not be necessary for all fields, investigators may find it impossible to ensure that data collection is continuing according to the manual’s protocols if documents are not audited on a routine basis, whether quantitative or quantitative. Furthermore, if the contact system is not specifically defined in the procedures manual, the delivery of any changes to team members can be jeopardized (Nicholas, el at., 2019). 3.7.2 Primary Data Collection Within a group of 100 participants, the surveys and interviews were carried out (on online means) to obtain the primary data for this research work. At least three senior managers were contacted via, emails, video call teams and they all agreed to avail themselves for half an hour each to answer question per person and their answers are set to be used for their annual staff meetings. Again, seventy staff members were also contacted via telephone after agreeing to remain anonymous for safety reasons and their responses were marked anonymous. During this research, further thirty individuals agreed to participate in the research by filling in the survey forms, questionnaires, and posting their answers. 3.7.3 Secondary data. The secondary data for this research has been accumulated from multiple sources, including online journal articles, newspaper articles, books, and other educational material from various online libraries available on the Internet. The literature review presents the secondary data on the subject and has given a comprehensive understanding and overview of the existing cultural diversity and challenges in the health and social care sector. The secondary data obtained via literature review can be for this reason, combined with the primary research findings to answer all the research questions. 3.7.4 Sampling strategy: Sampling is another equally critical technique which includes the general collection of data needed for research (Hanington el at, 2019). I have considered using Probability Sampling techniques; For example, out of 1000 people who may work in the hospital this specific sampling technique, is likely to achieve a fairer response. My sample size will be 100 respondents and 3 managers for interview. I have considered a survey of 100 out of the 1000 population as a reasonable sample size. My reasoning for this is due to the time constraints and less than that will not produce meaningful or reliable results. I will interview 3 managers; this is because of the likeliness of the demands of their job and them being busy. Therefore, this would be a reasonable size for interview. 3.7.5 Tools for data presentation and analysis: Quantitative data is quantitative statistics, i.e. information that can be calculated and recorded using numbers. Quantitative data will be presented using charts, tables, and graphs, on the hand interview data will be analysed in different themes. They are as follows: Personal interview method; Self-administered questionnaires method, and. Telephone interviewing method (Downe-Wamboldt, 1992; Morgan, 1993). In thematic analysis, both data coding and its understanding of quantitative code counts are descriptive on the contrary, thematic analysis offers a strictly qualitative, informative, and complex data account (Braun & Clarke, 2006).  3.8 Research Ethics This research was carried out ethically without violating any concern. All the respondents that were involved in the research had their free will to take part in the research and opt out of it, as per their own will. No questions were asked that could hurt their sentiments or emotions. The research utilised all tangible and intangible means of resources. It was carried out within time. There was no case of copyright infringement or plagiarism of any kind. All the materials used to gain preliminary information were true to their facts and knowledge. The research even adopted online and offline means, and there was the use of virtual mediums like zoom video conferencing tools to coordinate with the respondents. 3.9 Limitations Due to the pandemic, the research took some time to conduct. This is because contacting the professionals became harder on online or offline means.Face-to-face interviews were not possible due to social distancing protocols initially. The number of people who participated in the survey was less due to the lockdown of the nation. Survey questionnaires and interview questions: Questionnaires should be about 15 Leadership Style Questionnaire: Purpose This questionnaire is formed to conduct a survey to ask and help people assess their abilities to learn and understand their weaknesses and strengths to recognize a style of leadership in their personality. These questions are set in an order to help people check their capability to lead a team. The person who helps to understand the company with which he/she is associated is said to be a good leader. Name: Age: Gender: Ethnicity: Nationality: Directions For self-assessment, below is the form of questions given: S. NoStatementsStrongly DisagreeDisagreeNeutralAgreeStrongly AgreeLeadership Style: Does the leadership styles in healthcare environment contribute to the quality of care?      Is there any kind of relation between leadership styles in healthcare settings?      Is the impact of leadership style towards quality of care and healthcare settings?      Does the management embrace diversity, equality, and inclusion?      I do not think myself as a leader, but I can take over the role if the situation needs it     Staff Motivation:6.The members of staff need a close monitoring or else they will not perform their work     7.In critical times, leaders must let their staff work out difficulties on their own     8.I think most of the staff members in general are lazy     9.It must be a rule that staff member can appraise their performance     10.Most staff members feel insecure about their job and they are required to give directions     Leadership traits:11.Leader must motivate staff to take full credibility for their performance     12.I think I can organise people in a better way     13.I believe that formal decisions should be made by all staff members, provided that we observe appropriate procedures.     14.I am used to make my benchmark high and expect that the staff members should do this practice as well     15.It is good to leave staff members on their own generally.      Scoring 1. Sum the responses on items 4, 6, 12, 14, and 10 (authoritarian leadership). 2. Sum the responses on items 1, 3, 8, 11, and 13 (democratic leadership). 3. Sum the responses on items 2, 5, 7, 9, and 15 (laissez-faire leadership). Total Scores Authoritarian Leadership: ____ Democratic Leadership: _____ Laissez-Faire Leadership: ______ Score Interpretation This questionnaire is designed to measure three common leadership styles including, authoritarian, democratic, and laissez-faire. Once you have got your score, then you can decide which style of leadership you possess most of the times. Open-ended questions: What would your leader need to stop doing to be effective as a manager/leader? ____________________________________ What would the leader need to start doing to be effective as a manager/leader? ____________________________________ What should the leader continue doing to be effective as a manager/leader? ____________________________________ Does the leader have any needed strengths that might be overplayed at times? If so, please describe these and the impact they have when over-used. ____________________________________ What should the leader do less of? ____________________________________ Interview about 15-20 questions 1. How long have you worked here? 2. What qualifications and skills are required of a Team Leader in the NHS? 2. How can you cope with a team member that isn’t connected? 4.  What adjustments would you make when you start functioning as a team leader if you get the job? 5.  What would you do if a part of your healthcare staff was underperforming? 6. Does the leadership style in healthcare environments contribute to quality of the care? 7. Is there any kind of relation between leadership styles in Healthcare Settings? 8. What is the impact of leadership style towards quality of care and Healthcare Settings? 9. What is the benefits of the leadership styles towards quality of care in Healthcare Settings? 10.  How do you deal with staff conflict? 11. How do you deal with last minute cancelation? 12. How is your relationship with other professionals? 13. What is your relationship with your staff? 14. What motivates you? 15. What motivates your staff? 16. What are your main strengths? 17. What are your hobbies outside work? (Should be relevant to your research objectives. Questionnaires and  interview questions. Chapter 4 Data Presentation and Analysis Graphical presentation of Results of questionnaires or Interview Graphs Tables  Pie charts Bar charts Chapter 5 Results and Discussions Cross reference with theory and practice Identify gaps Your own contribution to knowledge or solution to problem 1         Conclusion and Recommendations 6.1                     Summary Summarise what you have achieved. of Results Explain any limitations in your results and how things might be improved based on Evaluation . Discuss how your work might be developed further. Work Discuss how your work might be developed further or related issues which you identified for further research. 2         Personal Development Skills before this project Skills after this project References Use the Harvard Reference style Books, Reports, Journal articles, conference papers and web pages are conventionally presented in slightly different ways. References Alharbi, A.Y., 2017. 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