The mediating impact of job satisfaction, organisational commitment and perceived organisational support on the relationship between leadership styles and organisational culture with intention to leave: the case of expatriates in public health care in Saudi Arabia

Employees’ turnover has always been the main concern and interest of both academics and practitioners in the healthcare sector. Also, both leadership styles and organisational culture as the main contributors to employees’ intention to leave have always been the central focus of most scholars in different disciplines including healthcare and organisational studies. Although, there are numerous studies that have investigated the impact of both leadership styles and organisational culture on employees’ intention to leave, almost all of this research has only explored the direct relationships between these variables. As a result there is limited and inadequate attention on the indirect relationships among these variables through other major factors such as job satisfaction, organisational commitment and perceived organisational support. Therefore, this study argues that there is an absence of a comprehensive conceptual framework in this area that has explored both direct and indirect relationships among these variables. As a result, the main purpose of this study is to provide a comprehensive conceptual framework that enables researchers to investigate the mediating impact of job satisfaction, organisational commitment, perceived organisational support on the relationship between leadership styles and organisational culture with the intention to leave in public healthcare in Saudi Arabia. In the first instance and in order to achieve this study’s aim and objectives, a systematic literature review was carried out that helped and enabled the researcher to develop a conceptual framework that clearly shows these relationships. After developing a conceptual framework and hypotheses related to the relationships, a questionnaire was designed based on the existing literature in these areas and was distributed among 850 employees working in one public hospital in Saudi Arabia. Out of 850 questionnaires distributed 354 usable questionnaires were returned which provided around 40 percent response rate. The results of this study were interesting and in some respects unexpected in some areas. The findings show that transactional leadership style has no direct or indirect relationship with the intention to leave which was surprising and requires further investigation. Furthermore, job satisfaction does not act as a mediator on the relationship between transformational leadership style and intention to leave which was also unexpected and requires further investigation. On the other hand, the results of this study confirm the importance of both transformational leadership style and organisational culture on the intention to leave among expatriates in the public sector as well as the major influence of job satisfaction, organisational commitment and perceived organisational support on these relationships. This study makes several major contributions both from an academic and practitioners’ point of view. The most important contribution of this study lies in the roots of this study with the presentation of a conceptual framework that shows both direct and indirect relationships among all variables explored. Furthermore, this study also contributes to the growing literature in the area of leadership-culture-intention to leave in public healthcare systems in developing countries.