Liderazgo y clima organizacional en hospitales: una revisión narrativa de mediadores, moderadores y diseños metodológicos
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https://doi.org/10.5281/zenodo.23984004Palabras clave:
liderazgo, clima organizacional, hospitales, mediación, moderación, enfermería, análisis multinivelResumen
El clima organizacional hospitalario desempeña un papel especialmente importante en las instituciones sanitarias, dada su naturaleza intensiva en recursos humanos. Se relaciona con la satisfacción, la permanencia y el bienestar del personal, así como con la seguridad del paciente. El liderazgo, por su parte, constituye uno de sus antecedentes más ampliamente estudiados. Sin embargo, los mecanismos que explican la relación entre ambos constructos y las condiciones que la determinan aún no se han sintetizado dentro de un marco integrador. El presente estudio tiene como objetivo sintetizar la evidencia sobre la relación entre los estilos de liderazgo y el clima organizacional en los hospitales. La revisión examina los mediadores, los moderadores, los marcos teóricos y los diseños metodológicos empleados para investigar esta relación. Para alcanzar este objetivo, se llevó a cabo una revisión narrativa de la literatura indexada en Scopus.
Los resultados indican que los estilos de liderazgo transformacional, de apoyo, participativo, auténtico y servidor se asocian con climas organizacionales más favorables. Por el contrario, los estilos laissez-faire, autoritario y tóxico se relacionan con el deterioro del clima organizacional. El liderazgo transaccional, sin embargo, presenta resultados mixtos. Los mediadores identificados con mayor frecuencia incluyen la comunicación, el apoyo organizacional percibido, la justicia organizacional, el empoderamiento y la autonomía, la seguridad psicológica y el burnout. Por su parte, los moderadores más frecuentes en la literatura incluyen la cultura organizacional, los subclimas de las unidades, el tamaño del hospital, la disponibilidad de recursos y la rigidez jerárquica. No obstante, estos efectos moderadores solo se han evaluado formalmente en un número limitado de estudios. Predominan los diseños transversales de fuente única, cuyos análisis se apoyan principalmente en técnicas de regresión o en modelos de ecuaciones estructurales (SEM). En conjunto, la evidencia respalda la existencia de una asociación entre el liderazgo y el clima organizacional, mediada por las condiciones cotidianas de trabajo y condicionada por el contexto hospitalario. Las investigaciones futuras deberían priorizar los diseños longitudinales y multinivel, las pruebas explícitas de moderación y mediación moderada, y los estudios empíricos realizados en hospitales latinoamericanos.
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Derechos de autor 2026 Juan Carlos Quispe-Cuba
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