Cent Eur J Nurs Midw. X:X

The quality of communication between nursing leaders and employees and its association with employee participation in change implementation

Andreja Gradišek, Ljiljana Leskovic

Faculty of Health Sciences, University of Novo Mesto, Slovenia

Aim: The aim of the study was to examine the association between the perceived quality of communication between nursing leaders and employees and employee participation in change implementation, and to determine whether these perceptions differ according to job position.

Design: A quantitative, cross-sectional, non-experimental study was conducted among nursing staff in nine Slovenian general hospitals.

Methods: The sample included 837 employees, of whom 131 were leaders and 706 were non-managerial staff. A structured questionnaire addressing communication during change and employees’ readiness for change implementation was used. Data were analyzed using principal component analysis, Spearman’s correlation coefficient, and the Mann-Whitney U test.

Results: The communication quality scale yielded a single-factor solution, whereas the readiness-for-change scale yielded two dimensions: active involvement in change implementation and organizational support for change implementation. Statistically significant positive associations were found between communication quality and active employee involvement in change implementation (ρ = 0.546; p < 0.001), as well as between communication quality and organizational support for change implementation (ρ = 0.616; p < 0.001). A statistically significant positive association was also found between active involvement and organizational support for change implementation (ρ = 0.498; p < 0.001). Leaders reported significantly higher scores than non-managerial employees across all three examined dimensions.

Conclusion: The findings indicate that communication quality is an important organizational factor associated with employee participation in change implementation in nursing. Its association with perceived organizational support and active employee involvement is particularly relevant. The results also highlight perceptual differences between leaders and non-managerial staff that should be considered when planning and implementing change in healthcare organizations.

Keywords: employee involvement, leader communication, nursing, organizational change, organizational support

Received: March 27, 2026; Revised: August 18, 2026; Accepted: October 29, 2026; Prepublished online: November 11, 2026