THE RELATIONSHIP BETWEEN TRANSFORMATIONAL LEADERSHIP AND JOB CRAFTING AMONG INTENSIVE CARE NURSES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Transformational leadership has been attributed with proactive behaviors of nurses like job crafting; this gives staff a chance to re-invent roles in order to enhance patient care. Limited evidence on this relationship in intensive care unit (ICU) settings was found. The systematic review and meta-analysis were conducted to evaluate how transformational leadership results in job crafting in nurses, with a specific focus on the situation in ICUs and discussing mediating and moderating factors. Empirical studies published by December 2025 were located in the systematic search of PubMed, Scopus, Web of science, CINAHL, and Google Scholar. The number of studies that were included was twenty five, with a total of 12846 nurses (4982 in the ICU). Pooling of effect sizes was done through the use of data extraction, quality appraisal and random-effects meta-analysis. Job crafting was moderately related to transformational leadership (r = 0.41, 95% CI: 0.33 0.48) and it had a stronger influence in the ICU nurses (r=0.46, 95% CI: 0.37 0.53). The most reported mediators were psychological empowerment (44%) and work engagement (36%). The relationship was moderated by organizational identification, grit and culture in 22, 10 and 8 percent of the studies respectively. The sensitivity analyses helped to confirm the strength of findings with the effect (r = 0.38) slightly smaller with publication bias adjustment, without any changes in the conclusions. Transformational leadership positively affects job crafting by nurses, especially in ICU, and the strength of this effect is mediated and moderated by the same. It is suggested that leadership development and job-crafting interventions should be done to enhance patient outcomes and nurse performance.