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This study develops and tests an integrated framework that explains how transformational leadership relates to service performance in elderly care settings, with a focus on the serial mediating roles of psychological empowerment and emotional labor, as well as the moderating role of perceived organizational support. Drawing on survey data from 312 employees in elderly care institutions in Guangxi, China, we employed structural equation modeling (SEM) with bootstrapping procedures to examine both direct and indirect pathways. The results indicate that transformational leadership is positively associated with service performance through a dual-pathway mechanism. Specifically, transformational leadership enhances employees’ psychological empowerment, which not only directly predicts performance but also shapes emotional labor strategies, thereby facilitating more effective service delivery. More importantly, we found a significant serial mediation effect, suggesting that leadership influences performance through interconnected psychological and emotional processes. Additionally, perceived organizational support emerged as a significant contextual factor that reinforces employee performance. By integrating psychological empowerment and emotional labor into a unified sequential model, this study advances theoretical understanding of leadership effectiveness in high-contact service environments. It also extends transformational leadership research to the underexplored context of elderly care in developing regions of China, where demographic pressures and service demands are rapidly intensifying. Practically, our findings highlight the necessity for elderly care institutions to simultaneously foster empowering leadership, support employees” emotional regulation, and strengthen organizational support systems to improve service quality.
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Yang¹ et al. (2026) studied this question.
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