Association between democratic leadership and nurse performance in an Indonesian hospital: A cross-sectional study

Introduction: Leadership style is an important organizational factor influencing nurse performance and the quality of healthcare services in hospital settings. Effective leadership from nurse managers may improve work motivation, communication, collaboration, and professional responsibility among nurses. This study aimed to examine the relationship between authoritarian, democratic, and laissez-faire leadership styles and nurse performance at Setio Husodo Hospital Kisaran, Indonesia. Research Methodology: A quantitative cross-sectional analytical design was employed between November and December 2025. The study involved 95 nurses selected using purposive sampling from a total population of 125 nurses. Data were collected using validated questionnaires assessing leadership styles and nurse performance. Statistical analyses included univariate analysis, Chi-square tests, and ordinal logistic regression using SPSS software with a significance level of p < 0.05. Results: Most respondents were aged 26–35 years (69.5%), held diploma-level nursing education (90.5%), and had more than five years of work experience (55.8%). Democratic leadership style showed a significant relationship with nurse performance (p = 0.002), while authoritarian leadership (p = 0.294) and laissez-faire leadership (p = 0.605) demonstrated no significant association. Multivariate analysis confirmed democratic leadership as the strongest predictor of nurse performance (β = -1.869; 95% CI: -3.308 to -0.429; p = 0.011). Conclusion: Democratic leadership was significantly associated with improved nurse performance and may contribute to better nursing service quality in hospital environments. Strengthening participatory and communicative leadership approaches among nurse managers is recommended to optimize workforce performance and healthcare outcomes.