




































AGORA International Journal of Economical Sciences, http://univagora.ro/jour/index.php/aijes 

ISSN 2067-3310, E-ISSN 2067-7669 

No. 1 (2023), pp. 115-125 

 

115 
 

THE DIGITAL LEADERSHIP BEHAVIOURS OF X, Y, Z GENERATION 

NURSES IN THE DELIVERY OF HEALTH SERVICES 

 

S. ÜSTGÖRÜL, B. AKKAYA 

 

Sema Üstgörül¹, Bulent Akkaya² 

¹ Faculty of Health Sciences, Manisa Celal Bayar University, Turkey (orcid.org/ 0000-0002-

8163-726X), E-mail: sema84car@hotmail.com  

² Ahmetli VHS, Manisa Celal Bayar University, Turkey (orcid.org/ 0000-0003-1252-9334) 

 

Abstract. Younger nurses are more active and agile in nursing leadership comparing to 

as senior nurses are about to retirement. Digital era and technology forces nurses to be more 

dynamic and adaptive. Thus, they try to behave as digital leaders. The aim of this study to 

link the relationship between young digital nurse leaders’ organizational resilience and 

commitment in hospitals. To test this relationship, the data were collected from nurses in 

three groups: X, Y and Z generation. The data were collected by four scales and analysed by 

SPSS program. The results show that digital leadership has a positive effect on both 

organizational resilience and organizational commitment. Moreover, organizational 

resilience and organizational commitment is positively correlated. The young nurses have 

more digital leadership skills and behaviours comparing senior ones. But the perception of 

organizational resilience and commitment of the X generation nurses was higher than the Y 

and Z generations. The results of this study may guide to the managers of healthcare 

organization to pay attention young nurses in adapting technology and guide to senior 

nurses through applying digital leadership behaviours. 

Keywords: Nurses, X, Y and Z generation, digital leadership, organizational resilience, 

organizational commitment 

 

INTRODUCTION  

In today's competitive environment brought by globalization, the expectations and wishes 

of managers and employees have led to the emergence of new approaches in the field of 

leadership. One of them is digital leadership that provides active use of technology. Digital 

leaders are people who know technology well and are open to continuous learning, apply 

digital, reflect on company goals and business results in the most positive way, and combine 

strategy, culture, communication, technology and data to achieve all these (Eberl &  Drews, 

2021). It will certainly be digital leaders who lead and drive transformation in the New Digital 

Age. This understanding, which proceeds with the power of persuasion, attaches importance to 

continuous communication and dialogue, accepts change, can shape its business strategy 

accordingly, is fed from an agile, inclusive and egalitarian culture based on cooperation rather 

than hierarchies, and is accountable in the most transparent way when necessary, will also 

provide important developments in the field of health care (Lapão, 2020). 

Cross - generational work stress puts high-risk employment environments in healthcare 

organizations and hospitals. This causes decreasing productivity and negative organizational 

climate.  There are X, Y, and Z generations in almost all organizations as in hospitals and 

mailto:sema84car@hotmail.com


THE DIGITAL LEADERSHIP BEHAVIOURS OF X, Y, Z GENERATION NURSES IN 

THE DELIVERY OF HEALTH SERVICES 

 

116 
 

healthcare organizations.  Researches shows that perceived behaviours across generations 

contribute to misunderstanding and conflict (Kaifi et al., 2012; Paros et al., 2022; Easton & 

Steyn, 2022). Intergenerational, conflict in the health care context is exacerbated by the 

promotion of younger nurses to leadership positions, requiring them to oversee senior and more 

experienced nurses. Because nurses serve in a high dynamic environment due to technology 

and Industry 4.0. Day by day they need to learn new technology and adapt them to sustain their 

work quality and the hospital they serve in. 

  

I. Theoretical Background and Literature  

Digital leadership theory sees technological learning as part of a social transfer, in which 

corporate practices are taught to new members through selective reinforcement. For this reason, 

nursing is a profession that requires manager and leader nurses, student nurses and nurses who 

have just started their profession, to learn and direct them in hospital environments (Mthiyane 

& Habedi, 2018). Therefore, nurses new to the profession and student nurses learn high-quality 

digital nursing skills with the help of supplements such as clinical supervision, post-clinical 

conferences, and clinical training. 

The continuous implementation of technological innovations with digital leadership 

capabilities (Massaro, 2021) is crucial for the development of many organizations, including 

those in the healthcare industry, during the COVID-19 pandemic and future health crises 

(Basile et.al, 2022; Drago et.al, 2021). 

As a result of technological innovations in the healthcare industry, robotic medical devices 

are widely applied to provide many types of medical services, including monitoring patients, 

performing surgeries, and managing vital functions such as nursing care (Guntur et al., 2019). 

Nurses with high digital knowledge who will provide these services, manage technology and 

adapt the changes in technology to health institutions are more needed today. These can be 

expressed as young and dynamic nurses with digital leadership characteristics. In other words, 

Generation Z can be defined as a nurse. Constantly and rapidly changing technology reveals 

sharp differences in knowledge, perception and management between generations. In this 

context, the aim of this study is to determine the digital leadership perceptions of X, Y, Z 

generations nurses in the digital age and to examine the relationship between these digital 

leadership perceptions, implicit resilience and commitment. 

 

I.1. The link between digital leadership, organizational resilience and commitment  

Organizational commitment is defined as the desire of employees to stay in the 

organization, their identification with all the effectiveness and success of the organization, the 

loyalty and attitude of the employee to the organization, and the interest shown in order for the 

organization to be successful (Yiing & Ahmad, 2009). In this context, organizational resilience 

and agility are important concepts for nurses to serve to adapt to technology and hospital 

environment. Moreover, despite the intense job stress, this adaptability can only be overcome 

by highly resilient nurses. The concept of digital leadership is an important variable for nurses' 

organizational commitment and resilience. 

Due to the critical role digital technologies play in patient care, their use in 

nursing practices is increasing. In general, nurses recognize the significant benefits such 



Sema ÜSTGÖRÜL, Bulent AKKAYA 

 

117 
 

technologies provide for patients and their families. These range from timely assessment 

information to patient monitoring, family information to nurses' workload and working 

conditions. For example, digital technologies can offer opportunities to tackle current problems 

and challenges in the healthcare industry. Many healthcare systems are facing challenges due 

to the lack of skilled nurses with technology knowledge and the growing demand for long-term 

care. Because X and Y generations may be insufficient in adapting to this technology, 

managing it and transferring it to other people. Therefore, generation Z nurses born into the 

world of technology play a critical role in this process. In this process, having only digital 

leadership knowledge and behaviors is often not enough. At the same time, nurses' 

organizational resilience and organizational commitment should be high in order to ensure the 

sustainability of institutions and hospitals. So which generation of nurse can provide this? X? 

Y? Or is it Z? This research will have a unique value in answering these questions not explained 

in the literature and will contribute to the literature by testing the following hypotheses. 

 

I.2. Research Model and Hypotheses 

 

Figure 1. Research Model 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hypotheses 

H1: Digital leadership impacts organizational commitment in healthcare organizations.  

H2: Digital leadership impacts organizational resilience in healthcare organizations. 

H3: Organizational commitment relates with organizational resilience in healthcare 

organizations.  

 

II. Methodology  

II.1. Population and Sample  

Data were collected from 136 nurses of Turkish healthcare organizations by three different 

scales. The questionnaire had 4 sections: the first section was regarding sample characteristics 

of the participants, such as gender, age, level of education, etc. The second scale was about 

Digital Leadership 
 

Organizational 

Resilience  

Organizational 

Commitment 



THE DIGITAL LEADERSHIP BEHAVIOURS OF X, Y, Z GENERATION NURSES IN 

THE DELIVERY OF HEALTH SERVICES 

 

118 
 

digital leadership developed by Zeike et al. (2019) and adapted to Turkish by Sürücü e al. 

(2022). It included 6 statements. The third section is about organizational commitment 

developed by Meyer et al. (1993) and adapted to Turkish by Bağcı & Akbaş (2016). It consisted 

of 15 statements. The forth scale is organizational agility developed by Sharifi & Zhang (1999) 

and adapted to Turkish by Akkaya & Tabak (2018). It consisted of 15 statements. The tool for 

collecting data was chosen to be a five-point Likert scale ranging from 1 (Strongly Disagree) 

to 5 (Strongly Agree). 

Characteristics of participants are as follows:  77.9% (106) of respondents was female 

while 22.1% (30) was male. 67.6% (92) of the respondents was graduated from health 

vocational high school, the rest were graduated from other high schools (32.4%). Moreover, 

we asked their current education level.  82.4% (112) had bachelor’s degrees, while 17.6%(24) 

had a master’s or Ph.D. degree.  37.5% (51) participants was Z generation that means they were 

born between 1996-2015, 40.4% (55) participants was Y generation that means they were born 

between 1980-1995 while 22.1% (30) participants was X generation that means they were born 

before 1980s.  

 

II.2. Statistical Analysis 

The analysis was executed using structural equation modelling with the SPSS 26 program.  

Before testing Hypotheses, we checked data normal distribution and reliability analysis.  

Cronbach Alpha (α) was used to measure internal consistency for reliability and the Skewness 

and Kurtosis were used to check the data normality distribution. Cronbach Alpha was found 

higher than 0.70 for each scale that showed the data is high reliable.   

The Skewness and Kurtosis values should be between +2 and -2 that presents data has normal 

distribution (George, 2011). Table 1 presents the skewness and kurtosis has normal 

distribution. Thus, we applied parametric analysis methods such as regression, ANOVA and 

correlation in current research. 

 

 

Table 1. Normal Distribution Analysis (N=136) 

Scale Min. Max. Mean 
Std. 

D. 
(α) 

Skewness Kurtosis  

Statistics SE Statistics SE p value 

Digital 

Leadership 
1.00 5.0 3.84 0.48 0.92 -0.108 0.21 0.439 0.43 

 

0.183 

Organizational 

Commitment 
1.00 5.00 3.16 0.86 0.93 0.719 0.21 0.906 0.43 

 

0.256 

Organizational 

Resilience 
1.00 5.00 3.86 0.85 0.93 0.326 0.21 -0.455 0.43 

 

0.192 

 

 

 

 



Sema ÜSTGÖRÜL, Bulent AKKAYA 

 

119 
 

III. Results 

Characteristics of participants are as follows: the mean of age is 28.4; 40.9% (192) of the 

respondents were above 28 years, while 59.1% (277) were less than 28 years. 64.4% (302) of 

respondents were female, 35.6% (167) identified themselves as male. 39.0% (183) had high 

school degrees, 43.9% (206) had bachelor’s degrees, while 17.1% had a master’s or Ph.D. 

degree. 

R value showing the positive and significant relationship between digital leadership and 

organizational commitment is 0.607. It can be stated that 36% (R2) of organizational 

commitment depends on digital leadership behaviours. In other words, there is a positive and 

significant relationship between digital leadership and organizational commitments (p<0.001) 

(Table 2). Thus, Hypothesis 1(H1) is supported (Digital leadership impacts organizational 

commitment in healthcare organizations).  

 

 Table 2 : Model Summary 

Mod

el R 

R 

Square 

Adjust

ed R Square 

Std. 

Error of 

the 

Estimate 

 Change Statistics 

 

t value  

    F value  

df

1 

df

2 

Sig

.  

1 ,60

7a 

,36

8 

,364 ,6891

5 

8,83

8 

78,11

1 

1 13

4 

,00

0 

 a. Predictors: (Constant), Digital Leadership     

  

 

 

R value between digital leadership and organizational resilience is 0.607. It can be stated 

that 61% (R2) of organizational resilience depends on digital leadership behaviours. In other 

words, Regression test proved that there is a positive and significant relationship between 

digital leadership and organizational resilience (p<0.001) (Table 3). Thus, Hypothesis 2 (H2) 

is also supported (Digital leadership impacts organizational resilience in healthcare 

organizations).  

 Table 3: Model Summary 

Mod

el R 

R 

Square 

Adjust

ed R Square 

Std. 

Error of 

the 

Estimate 

 Change Statistics 

 

t value F  

value 

df

1 

df

2 

Si

g.  

1 ,78

1a 

,61

0 

,607 ,680

24 

14,4

75 

209,5

14 

1 13

4 

,00

0 

 a. Predictors: (Constant), Digital Leadership     

  

 

 

We also applied Pearson correlation to test the relationship between both independent 

(digital leadership) and dependents variables (organizational commitment and organizational 



THE DIGITAL LEADERSHIP BEHAVIOURS OF X, Y, Z GENERATION NURSES IN 

THE DELIVERY OF HEALTH SERVICES 

 

120 
 

resilience). The findings of the study indicate that the digital leadership outcome has a strong 

positive correlation with organizational resilience (r=781; p=.000) and organizational 

commitment (r=607; p=.000).  Organizational resilience has a positive correlation with 

organizational commitments (r=345; p=.000). This correlation supports Hypothesis 3 (H3): 

Organizational commitment correlates with organizational resilience in healthcare 

organizations. 

 

Table 4. Correlations 

Variables  

Digital 

Leadership 

Organizational 

Commitment 

Organizational 

Resilience 

Digital Leadership Pearson Correlation 1   

 Sig. (2-tailed)    

 N 136   

Organizational 

Commitment Pearson Correlation ,607** 1  

 Sig. (2-tailed) 0   

 N 136 136  

Organizational 

Resilience Pearson Correlation ,781** ,345** 1 

 Sig. (2-tailed) 0 0  

 N 136 136 136 

Correlation is significant at the 0.01 level (2-tailed).     

 

We applied ANOVA Post Hoc test to compare generations (X, Y, Z) perceived digital 

leadership organizational resilience and organizational commitment.  

As seen on Table 5, the model is significant(p=.000). In other words, digital leadership 

has a positive and significant impact on the organizational commitment and organizational 

resilience.  

 

Table 5. ANOVA 

 

Sum of 

Squares df 

Mean 

Square F Sig. 

Organizational 

Commitment 

Between 

Groups 

63,680 44 1,447 3,554 ,000 

Within 

Groups 

37,058 91 ,407 
  

Total 100,738 135    

Organizational 

Resilience 

Between 

Groups 

117,858 44 2,679 5,932 ,000 

Within 

Groups 

41,093 91 ,452 
  

Total 158,951 135    



Sema ÜSTGÖRÜL, Bulent AKKAYA 

 

121 
 

Post hoc test showed that the digital leadership mean scores were higher in the Z 

generation than the X generation (p=0.025); however, there was no statistically significant 

difference between "X and Y generation" and "Y and Z generation" (p>0.05).  

While the mean of organizational resilience scores was higher in the X generation than in 

the Y generation (p=0.016); however, there was no statistically significant difference between 

"X and Z generation" and "Y and Z generation" (p>0.05). 

The mean of organizational commitment scores was higher in the X generation than in the 

Z generation (p=0.011); however, there was no statistically significant difference between “X 

and Y generation” and “Y and Z generation” (p>0.05). 

 

Table 5: Multiple Comparisons 

Bonferroni   

 

Dependent Variable 

(I) 

Generation 

(J) 

Generation 

Mean 

Difference 

(I-J) 

Std. 

Error Sig. 

95% Confidence 

Interval 

Lower 

Bound 

Upper 

Bound 

Digital Leadership Y X ,168 ,218 1,000 -,36 ,70 

Z -,524 ,254 ,124 -1,14 ,09 

Z Y ,524 ,254 ,124 -,09 1,14 

X ,692* ,258 ,025 ,07 1,32 

X 

 

Y -,168 ,218 1,000 -,70 ,36 

Z -,692* ,258 ,025 -1,32 -,07 

Organizational 

Resilience 

Y Z -,111 ,213 1,000 -,63 ,40 

X -,703* ,248 ,016 -1,31 -,10 

Z Y ,111 ,213 1,000 -,40 ,63 

X -,592 ,252 ,060 -1,20 ,02 

X Y ,703* ,248 ,016 ,10 1,31 

Z ,592 ,252 ,060 -,02 1,20 

Organizational 

Commitment 

Y Z ,471 ,211 ,082 -,04 ,98 

X -,267 ,246 ,842 -,86 ,33 

Z Y -,471 ,211 ,082 -,98 ,04 

X -,737* ,250 ,011 -1,34 -,13 

X Y ,267 ,246 ,842 -,33 ,86 

Z ,737* ,250 ,011 ,13 1,34 

*. The mean difference is significant at the 0.05 level. 

 

CONCLUSIONS 

One of the most important factors that lead a company or firm to success is to have a 

successful and digital leader in digital age during Industry 4.0. Although leadership is a concept 

that is in our lives, digital leadership is a concept that has recently come to the fore and 

wondered. Digitalization has a positive effect on the individual performance of the personnel 



THE DIGITAL LEADERSHIP BEHAVIOURS OF X, Y, Z GENERATION NURSES IN 

THE DELIVERY OF HEALTH SERVICES 

 

122 
 

by increasing the quality of business life, increasing the speed of work of the personnel, 

completing the tasks on time, reducing the rate of mistakes made in the works and ultimately 

affecting the motivation of the personnel. The presence of digital leaders in companies in the 

digitalization process also increases the individual performance of employees (Benitez et al., 

2022; Abbasov & Tolay, 2021). 

In literature, researches from the perspective of leadership and digitalism is generally 

related to organizational commitment and resilience in the field of health. For example, the 

innovative leadership practices are more conducive innovative work behaviour and work 

performance of the company (Purwonta et al., 2020; Zuraik & Kelly, 2019; Asbari et al., 2019). 

The more positive the employee’s innovation practices are, the better employee's performance 

and organizational commitment will be. These findings are similar to our research result. And 

there are some other studies that support the result of current research, for instance, it has been 

found that transformational and digital leadership styles affect the performance of the 

organization positively and significantly (Madanchian et al., 2020; Al Khajeh, 2019). The 

organizational commitment is higher in organizations with digital competence (Yu & Moon, 

2021). Cho, et al., (2019) found that transformational leadership increases organizational 

commitment, Puliwarna et al., (2023) found that digital competence has direct positive and 

significant effect on organization performance. Hack-Polay et al. (2022) conducted research 

on guiding flexibility in nursing practice and examined the impact of digital innovations and 

enhanced emotional education on nursing competencies. They found that nurses could develop 

more outstanding modern capabilities with exposure to increasingly used technologies in the 

healthcare sector. AI and digital technology and health-related engineering equipment can help 

reduce stress in the profession. Therefore, technology is not a threat. It is a necessary 

complement that can upskill nurses.  

Health literacy, in particular, plays an important role in the delivery of health services by 

nurses. This is closely related to the digital leadership behaviours of nurses. The more effective 

the digital leadership behaviours are, the higher the sexual health and literacy levels will be. 

This is also important in the distribution of health services (Üstgörül, 2022). Lapão (2020) 

emphasized the importance of combining digital health with the leadership of nurses. A 

positive relationship was observed between transformational leadership and organizational 

commitment.  

In local literature, there are some studies supports the results of current research. Aymaz 

(2014) found the positive the relationship between the perception of leadership behaviours and 

organizational commitment of nurses. Yağız (2022), on the other hand, examined the 

relationship between the behaviours of nurses in the pandemic process and their organizational 

resilience, and resulted the positive relationship between those variables. Canpolat (2012) 

evaluated the leadership and organizational commitment of nurses.  

As seen in literature, there are different studies in the literature for organizational 

resilience, digital leadership and organizational commitment. However, the relationship 

between organizational resilience and organizational commitment, which defines nurses' 

digital leadership characteristics, has not been studied yet. This provides the originality of 

current research. For this reason, it is necessary to conduct research on the effects of 

organizational resilience and organizational commitment for nurses operating and working in 



Sema ÜSTGÖRÜL, Bulent AKKAYA 

 

123 
 

the digital age. Therefore, we examined the relationship between digital leadership, 

organizational resilience and organizational commitment of the perception of X, Y and Z 

generation nurses. 

 The results show that digital leadership has a positive effect on both organizational 

resilience and organizational commitment. Moreover, organizational resilience and 

organizational commitment is positively correlated. The young nurses have more digital 

leadership skills and behaviours comparing senior ones. But The perception of organizational 

resilience and commitment of the X generation nurses was higher than the Y and Z generations. 

The results of this study may guide to the managers of healthcare organization to pay attention 

young nurses in adapting technology and guide to senior nurses through applying digital 

leadership behaviours. 

Study Limitations and Future Research 

The sample population at this academic research hospital in Turkey did not represent the 

national nursing population. Therefore, the study’s findings should be not generalized to the 

population. We reached just 136 nurses and analysed the data with parametric tests and a 

quantitate method. 

For future studies, here are several opportunities for more study on the issue of digital 

leadership among different generations of nurses. First, a deeper assessment of the linkages 

between leadership style and organizational commitment in the concept of X, Y and Z 

generations leadership in nursing would provide data that can help in new and digital leadership 

development programming. Additional study employing a qualitative or mixed method should 

be undertaken to understand why digital leadership results in organizational commitment and 

resilience. Finally, while this study investigated the links between digital leadership and 

organizational commitment and quiet, it may be applied to a large sample. 

 

REFERENCES 

1. Abbasov, A., & Tolay, E. (2021). The Impact of Digital Leadership on Individual 

Performance: Research in a Firm Implementing Industry 4.0 Technologies in 

Azerbaijan. İzmir Journal of Management, 2(1), 59-74. 

2. Akkaya, B., & Tabak, A. (2018). Adaptation to Turkish of Organizational Agility 

Questionnaire: Reliability and Validity Study. Journal of Human and Work, 5(2), 185-206. 

3. Akkaya, B., Kayalıdere, U. K., Aktaş, R., & Karğın, S. (2020). Agile Leadership Approach 

and Development of A Scale For Measuring Agile Leader’s Behaviours. Journal of 

Business Research, 12(2), 1605-1621 

4. Al Khajeh, EH (2019). Impacts of leadership styles on organizational performance. New 

Trends in Management Studies, 99–114. https://doi.org/10.5171/2018.687849 

5. Asbari, M., Santoso, P., & Purwanto, A. (2019). Pengaruh Iklim Organisasi dan 

Kepemimpinan Transformasional Terhadap Produktivitas Kerja Inovatif Pada Industri 

Manufaktur di Pati Jawa Tengah. Jurnal Produktivitas Universitas Muhammadiyah 

Pontianak, 7(1 2020), 62-69. 

6. Aymaz, D. (2014). Examining the relationships between leadership behavior, 

organizational commitment and organizational creativity in nurses (Master's thesis, Health 

Sciences Institute). 



THE DIGITAL LEADERSHIP BEHAVIOURS OF X, Y, Z GENERATION NURSES IN 

THE DELIVERY OF HEALTH SERVICES 

 

124 
 

7. Bağcı, Z., & Akbaş, T. T. (2016). An investigation of the effect of nurses’ perceptions of 

organizational trust on their organizational commitment. MANAS Journal of Social 

Studies, 5(5), 155-170. 

8. Benitez, J., Arenas, A., Castillo, A., & Esteves, J. (2022). Impact of digital leadership 

capability on innovation performance: The role of platform digitization 

capability. Information & Management, 59(2), 103590. 

9. Canpolat, Z. (2012). Evaluation of leadership and organizational commitment in nurses 

(Master's thesis, İstanbul Science Bilim University). 

10. Cho, Y., Shin, M., Billing, T. K. & Bhagat, R.S. (2019). Transformational Leadership, 

Transactional Leadership and Affective Organizational Commitment: A Closer Look at 

Their Relationships in Two Distinct National Contexts. Asian Business & Management, 

18, 187-210.  

11. Drago, C., Gatto, A., & Ruggeri, M. (2021). Telemedicine as technoinnovation to tackle 

COVID-19: A bibliometric analysis. Technovation, 102417. 

12. Easton, C., & Steyn, R. (2022). Leadership styles and effectiveness in the workplace: A 

perspective of the millennial generation. South African Journal of Economic and 

Management Sciences, 25(1), 1-10. 

13. Eberl, J. K., & Drews, P. (2021). Digital Leadership‒Mountain or molehill? A literature 

review. Innovation Through Information Systems: Volume III: A Collection of Latest 

Research on Management Issues, 223-237. 

14. Mthiyane, G. N., & Habedi, D. S. (2018). The experiences of nurse educators in 

implementing evidence-based practice in teaching and learning. Health SA gesondheid, 

23(1), 1-9.  

15. Hack-Polay, D., Mahmoud, A. B., Ikafa, I., Rahman, M., Kordowicz, M., & Verde, J. M. 

(2022). Steering resilience in nursing practice: Examining the impact of digital innovations 

and enhanced emotional training on nurse competencies. Technovation, 102549.  

16. Kaifi, B. A., Nafei, W. A., Khanfar, N. M., & Kaifi, M. M. (2012). A multi-generational 

workforce: Managing and understanding millennials. International journal of business and 

management, 7(24), 88. 

17. Basile, L. J., Carbonara, N., Pellegrino, R., & Panniello, U. (2023). Business intelligence 

in the healthcare industry: The utilization of a data-driven approach to support clinical 

decision making. Technovation, 120, 102482.  

18. Lapão, L. V. (2020). The nursing of the future: Combining digital health and the leadership 

of nurses. Revista Latino-Americana de Enfermagem, 28. 

19. Lee, J. S. (2016). Effect of self-leadership and resilience on college adjustment in nursing 

students. Journal of the Korea Academia-Industrial cooperation Society, 17(10), 253-260. 

20. Massaro, M. (2021). Digital transformation in the healthcare sector through blockchain 

technology. Insights from academic research and business developments. Technovation, 

102386.  

21. Madanchian, M., Hussein, N., Noordin, F., & Taherdoost, H. (2020). Effects of virtuous 

leadership on organizational performance. Positive Psychological Science: Improving 

Everyday Life, Well Being, Work, Education, and Societies Across the Globe, 145–158.  



Sema ÜSTGÖRÜL, Bulent AKKAYA 

 

125 
 

22. Meyer, J. P., Allen, N. J., & Smith, C. A. (1993). Commitment to organizations and 

occupations: Extension and test of a three-component conceptualization. Journal of 

applied psychology, 78(4), 538.  

23. Paros, A., Kelly, P.S. and Sprinkle, T.A. (2022), "Enhancing project team outcomes 

despite provisional work: a discussion to leverage cross-generational advantages", Team 

Performance Management, 28,  3(4),191-204.  

24. Puliwarna T, S. Djati, S, P., & Elisabeth Tanti P. (2023). The Effect of Digital Leadership, 

organizational culture, digital competence and organization's commitment on 

Organizational Performance: Information Technology System in Indonesian Navy. 

International Journal of Scientific Research and Management,  11 (04), 4833-4846. 

25. Purwanto, A., Asbari, M., & Santoso, P. (2020). Effect of Integrated Management System 

of ISO 9001:2015 and ISO 22000:2018 Implementation To Packaging Industries Quality 

Performance at Banten Indonesia. Jurnal Ilmiah MEA (Manajemen, Ekonomi, & 

Akuntansi), 4(1), 17-31.  

26. Purwonta, A., Bernarto, I., Asbari, M., Wijayanti, L. M., & Hyun, C. C. (2020). The 

impacts of leadership and culture on work performance in service company and innovative 

work behavior as mediating effects. Journal of Reseacrh in Business, Economics, and 

Education, 2(1), 283- 291.  

27. Guntur, S.R., Gorrepati, R.R., & Dirisala V.R. Chapter 12 - robotics in healthcare: an 

internet of medical robotic things (IoMRT) perspective N. Dey, S. Borra, A.S. Ashour, F. 

Shi (Eds.), Machine Learning in Bio-Signal Analysis and Diagnostic Imaging, Academic 

Press (2019), pp. 293-318, 10.1016/B978-0-12-816086-2.00012-6. 

28. Sharifi, H., & Zhang, Z. (1999). A methodology for achieving agility in manufacturing 

organisations: An introduction. International journal of production economics, 62(1-2), 7-

22. 

29. Sürücü, L., Yikilmaz, İ., & Maşlakçi, A. (2022) Digital Leadership: A Scale Adaptation 

Study. Journal of Abant Social Sciences, 22(3), 1038-1050 

30. ÜSTGÖRÜL, S. (2022). Cinsel Sağlık Okuryazarlık Ölçeğinin Geliştirilmesi: Geçerlik ve 

Güvenirlik Çalışması. Ankara Sağlık Bilimleri Dergisi, 11(2), 164-176. (Development of 

the Sexual Health Literacy Scale: Validity and Reliability Study). 

31. Yağiz, F. N. S. (2022). Crisis Leadership During The Covid-19 Pandemic: Systematic 

Review. The Journal of Selcuk University Social Sciences Institute, (47), 388-401. 

32. Yu, J., & Moon, T. (2021). Impact of digital strategic orientation on organizational 

performance through digital transformation capability. ICIC Express Letters, Part B: 

Applications, 12(9), 847– 856. 

33. Zeike, S., Bradbury, K., Lindert, L. & Pfaff, H. (2019). Digital leadership skills and 

associations with psychological well-being. International Journal of Environmental 

Research and Public Health, 16(14), 2628-2641 

34. Zeike, S., Bradbury, K., Lindert, L. & Pfaff, H. (2019). Digital leadership skills and 

associations with psychological well-being. International Journal of Environmental 

Research and Public Health, 16(14), 2628-2641. 

35. Zuraik, A., & Kelly, L. (2019). The Role of CEO Transformational Leadership and 

Innovation Climate in Exploration and Exploitation. European Journal of Innovation 

Management, 22(1): 84-104. 


