THE EFFECT OF LEADERSHIP AUTONOMY SUPPORT, WORK- LIFE BALANCE, AND PSYCHOLOGICAL CAPITAL ON THE INNOVATIVE BEHAVIOR OF HOSPITAL EMPLOYEES
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Abstract
Indonesia’s healthcare sector continues to advance through initiatives such as the National Health Insurance (JKN). However, major challenges persist, including unequal access to services, shortages of medical professionals, and heavy workloads. However, limited empirical research has examined how leadership support and work-life balance jointly influence employees’ innovative behaviour through psychological resources, particularly in public hospitals in Indonesia. This study addresses this gap by examining the effects of Leadership Autonomy Support (LAS), Work-Life Balance (WLB), and Psychological Capital (PsyCap) on Innovative Behaviour (IB) among employees at RSUD dr. Soegiri Lamongan. Using a quantitative approach with PLS-SEM and data from 200 respondents, the findings show that LAS and WLB positively affect PsyCap. LAS and PsyCap significantly enhance IB, whereas WLB has a positive but non-significant direct effect on IB. PsyCap also mediates the relationships between LAS and IB as well as WLB and IB. These findings indicate that LAS and PsyCap are key drivers of innovative behaviour, while WLB contributes to innovation indirectly by strengthening employees’ psychological resources. Practically, hospital management should foster autonomy-supportive leadership and strengthen employees’ psychological capital through supportive work environments and employee development initiatives to encourage innovation and improve organizational responsiveness.
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Copyright (c) 2026 Budi Himawan, Wendra Hartono

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References
Abdelhay, E. S., Taha, S. M., El-Sayed, M. M., Helaly, S. H., & Abdelhay, I. S. (2025). Nurses retention: the impact of transformational leadership, career growth, work well-being, and work-life Balance. BMC Nursing, 24(1), 148.
Afsar, B., & Umrani, W. A. (2020). Transformational leadership and innovative work behavior: The role of motivation to learn, task complexity and innovation climate. European Journal of Innovation Management, 23(3), 402–428.
Ajayi, V. O. (2023). A review on primary sources of data and secondary sources of data. Research Gate Preprint. https://www.researchgate.net/publication/370608670_A_Review_on_Primary_Sourc es_of_Data_and_Secondary_Sources_of_Data
Al-Romeedy, B. S., Khairy, H. A., Abdelrahman Farrag, D., Alhemimah, A., Salameh, A. A., Gharib, M. N., & Fathy Agina, M. (2025). Green Inclusive Leadership and Employees’ Green Behavior in Tourism and Hospitality Businesses: Do Green Psychological Climate and Green Psychological Empowerment Matter? Journal of Quality Assurance in Hospitality & Tourism, 1–38.
Ali, H., Li, M., & Qiu, X. (2022). Employee engagement and innovative work behavior among Chinese millennials: mediating and moderating role of work-life balance and psychological empowerment. Frontiers in Psychology, 13, 942580.
Allen, T. D., French, K. A., Dumani, S., & Shockley, K. M. (2020). A cross-national meta- analytic examination of predictors and outcomes associated with work–family conflict. Journal of Applied Psychology, 105(6), 539.
Alolayyan, M. N., & Alyahya, M. S. (2023). Operational flexibility impact on hospital performance through the roles of employee engagement and management capability. BMC Health Services Research, 23(1), 19.
Althubaiti, A. (2022). Sample size determination: A practical guide for health researchers. Journal of General and Family Medicine, 24(2), 72–78. https://doi.org/10.1002/jgf2.600
Amabile, T. M., Schatzel, E. A., Moneta, G. B., & Kramer, S. J. (2004). Leader behaviors and the work environment for creativity: Perceived leader support. The Leadership Quarterly, 15(1), 5–32.
Andrade, C. (2020). Sample size and its importance in research. Indian Journal of Psychological Medicine, 42(1), 102–103.
Anindita, R., & Lestari, D. A. (2024). The Influence of Transformational Leadership on Innovative Work Behavior through Psychological Capital and Job Involvement as Intervening Variables. Eduvest-Journal of Universal Studies, 4(8), 7516–7532.
Bahagia, R., Daulay, R., Arianty, N., & Astuti, R. (2024). Transformational leadership, emotional intelligence, and innovative work behavior: Mediating roles of knowledge sharing at public hospitals in Indonesia. Problems and Perspectives in Management, 22(1), 103.
Barroga, E., Matanguihan, G. J., Furuta, A., Arima, M., Tsuchiya, S., Kawahara, C., Takamiya, Y., & Izumi, M. (2023). Conducting and writing quantitative and qualitative research. Journal of Korean Medical Science, 38(37).
Bell, E., Harley, B., & Bryman, A. (2022). Business research methods. Oxford university press.
Berry, L. L., & Seltman, K. D. (2014). The enduring culture of Mayo Clinic. Mayo Clinic Proceedings, 89(2), 144–147.
Blasco-Giner, C., Battistelli, A., Meneghel, I., & Salanova, M. (2025). Psychological capital, autonomous motivation and innovative behavior: a study aimed at employees in social networks. Psychological Reports, 128(4), 2620–2648.
Bougie, R., & Sekaran, U. (2019). Research methods for business: A skill building approach. john wiley & sons.
Bryman, A., & Bell, E. (2015). Business research methods (4th ed.). Oxford University Press.
Chakkaravarthy, M., & Bhaumik, A. (2025). Impact of Emotional Intelligence and Leadership Styles on Employees’ Job Performance: A Review Paper. Journal of Multidisciplinary Research for SMET (JMR-SMET), 1(1), 40–57.
Cheraghi, R., Ebrahimi, H., Kheibar, N., & Sahebihagh, M. H. (2023). Reasons for resistance to change in nursing: an integrative review. BMC Nursing, 22(1), 310.
Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Sage.
De Jong, J., & Den Hartog, D. (2010). Measuring innovative work behaviour. Creativity and Innovation Management, 19(1), 23–36.
Deci, E. L., Olafsen, A. H., & Ryan, R. M. (2017). Self-determination theory in work organizations: The state of a science. Annual Review of Organizational Psychology and Organizational Behavior, 4, 19–43.
Deci, E. L., & Ryan, R. M. (2013). Intrinsic motivation and self-determination in human behavior. Springer Science & Business Media.
Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W. B. (2001). The job demands- resources model of burnout. Journal of Applied Psychology, 86(3), 499.
Digital Scientists. (2023). 4 barriers to implementing new technology in healthcare.
Digital Scientists. https://digitalscientists.com/blog/implementing-new- technology-in- healthcare/
Dong, X., & Yuan, P. (2018). Psychological Capital and Innovative Behavior: A Moderated Mediation Model. Argos, 35(68), 56–66.
Ekmekcioglu, E. B., & Öner, K. (2024). Servant leadership, innovative work behavior and innovative organizational culture: the mediating role of perceived organizational support. European Journal of Management and Business Economics, 33(3), 272–288.
Fotiadis, A., Abdulrahman, K., & Spyridou, A. (2019). The mediating roles of psychological autonomy, competence and relatedness on work-life balance and well-being. Frontiers in Psychology, 10, 1267.
Fuchs, H., Petkova, T., Fishbein, A., Galily, D., & Fuchs, A. (2023). Psychological Flexibility in Human Leadership-Facing the Challenges and Needs of the 21st Century Working Social Spaces. Economics, Management & Business 2023-Contemporary Issues, Insights and New Challenges, 8, 1021–1038.
Garg, V., Attree, A. K., & Kumar, V. (2023). The mediating role of psychological empowerment on the transformational Leadership-Innovative work behaviour relationship: A study of Indian banking sector. South Asian Journal of Human Resources Management, 10(1), 130–151.
Gillet, N., Gagné, M., Sauvagère, S., & Fouquereau, E. (2013). The role of supervisor autonomy support, organizational support, and autonomous and controlled motivation in predicting employees’ satisfaction and turnover intentions. European Journal of Work and Organizational Psychology, 22(4), 450–460.
Gomes, G., Seman, L. O., & De Montreuil Carmona, L. J. (2021). Service innovation through transformational leadership, work-life balance, and organisational learning capability. Technology Analysis & Strategic Management, 33(4), 365–378.
Haas, D. A., Jellinek, M. S., & Kaplan, R. S. (2018). Hospital budget systems are holding back innovation. Special Issue on HBR insight center: Health care’s new frontier. Harvard Business Review,(Website).
Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2022). A primer on partial least squares structural equation modeling (PLS-SEM) (3rd ed.).
Sage.Hair, HealthManagement.org. (2023). Influence of leadership styles on job satisfaction and organisational commitment in healthcare.
Herron, A. (2025). 8 Surprising Benefits of Work-Life Balance You Might Not Expect. https://www.webmdhealthservices.com/blog/benefits-work-life- balance/
Hetland, J., Hetland, H., Bakker, A. B., & Demerouti, E. (2018). Daily transformational leadership and employee job crafting: The role of promotion focus. European Management Journal, 36(6), 746–756.
Huynh, T., & Torquati, J. C. (2019). Examining connection to nature and mindfulness at promoting psychological well-being. Journal of Environmental Psychology, 66, 101370.
Indrayani, I. G. A. P. W., & Sari, D. M. F. P. (2025). Psychological Capital, Work Happiness, and Innovative Behaviour: Evidence from Millennials Worker of Star-Rated Hotels. Jurnal Ilmiah Manajemen Dan Bisnis, 10(1), 1–14.
J. F., Risher, J. J., Sarstedt, M., & Ringle, C. M. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31(1), 2–24.
Jebb, A. T., Ng, V., & Tay, L. (2021). A review of Likert scale development, analysis, and reporting. Journal of Personality Assessment, 103(3), 293–305. https://doi.org/10.1080/00223891.2020.1807318
Junior, J. T., Gomes, G., De Montreuil Carmona, L. J., & Tambosi, S. S. V. (2021). Organisational culture and work–life balance as facilitators of service innovation: study in a technology knowledge-intensive business services firm. International Journal of Innovation Management, 25(07), 2130002.
Kaplan, O., & Rhoads, E. P. (2025). How Insider-led Processes Lead to Localization: The Case of Digital Technology and Humanitarian Protection. Global Studies Quarterly, 5(1), ksaf018.
Kludacz-Alessandri, M., Hawrysz, L., Żak, K., & Zhang, W. (2025). The impact of digital transformational leadership on digital intensity among primary healthcare entities: a moderated mediation model. BMC Health Services Research, 25(1), 117.
Koroglu, Ş., & Ozmen, O. (2022). The mediating effect of work engagement on innovative work behavior and the role of psychological well-being in the job demands–resources (JD-R) model. Asia-Pacific Journal of Business Administration, 14(1), 124–144.
Lakens, D. (2022). Sample size justification. Collabra: Psychology, 8(1), 33267. Lichtman,
M. (2023). Qualitative research in education: A user’s guide. Routledge. Linzer, M., Jin, J. O., Shah, P., Stillman, M., Brown, R., Poplau, S., Nankivil, N.,
Cappelucci, K., & Sinsky, C. A. (2022). Trends in clinician burnout with associated mitigating and aggravating factors during the COVID-19 pandemic. JAMA Health Forum, 3(11), e224163–e224163.
Lorenz, T., et al. (2022). Validation of the revised Compound Psychological Capital Scale (CPC-12R) and measurement invariance across samples. Frontiers in Psychology, 13, 1075031.
Luthans, F., & Youssef-Morgan, C. M. (2017). Psychological capital: An evidence- based positive approach. Annual Review of Organizational Psychology and Organizational Behavior, 4(1), 339–366.
Luthans, F., Youssef, C. M., & Avolio, B. J. (2006). Psychological capital: Developing the human competitive edge. Oxford university press.
Mahmood, A., & Khan, M. M. (2024). The effect of work-family conflicts on employee well- being: the mediating role of work-life balance and the moderating role of psychological resources. Pakistan Social Sciences Review, 8(4), 592–609.
Makwana, D., Engineer, P., Dabhi, A., & Chudasama, H. (2023). Sampling methods in research: A review. International Journal of Trend in Scientific Research and Development, 7(3), 762–768.
May, T., & Perry, B. (2022). Social research: Issues, methods and process. McGraw-Hill Education (UK).
Mukti, A. (2025). Sample size determination: Principles and applications for health research. Healthcare Studies & Innovations Journal, 3(1). https://doi.org/10.71357/hsij.v3i1.63 Mutonyi, B. R., González-Piñero, M., Slåtten, T., & Lien, G. (2024). Driving innovation in health care: exploring the impact of ambidextrous leadership on creative performance among frontline health professionals in Norway. BMC Health Services Research, 24(1), 268.
Newman, A., Ucbasaran, D., Zhu, F. E. I., & Hirst, G. (2014). Psychological capital: A review and synthesis. Journal of Organizational Behavior, 35(S1), S120– S138.
Ntoumanis, N., Ng, J. Y. Y., Prestwich, A., Quested, E., Hancox, J. E., Thøgersen- Ntoumani, C., Deci, E. L., Ryan, R. M., Lonsdale, C., & Williams, G. C. (2021). A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health. Health Psychology Review, 15(2), 214– 244.
Osazuwa, M. O., & Nwokorie, R. M. (2025). Maintaining Work-life Balance through Career Transitions.
Pardiman, P. (2025). The Effect of Green Job Design on Employee Behavior in Indonesian Hospitals: A Mediation Model. Available at SSRN 5151668.
Park, R., & Kang, S. (2025). Effects of autonomy support on innovation: resolving the dilemma of participation in innovation with trust. International Journal of Manpower, 46(1), 150–167.
Park, S., & Kim, H. (2023). Optimizing survey design: Effects of scale length on response reliability and validity. Frontiers in Psychology, 14, 1122334. https://doi.org/10.3389/fpsyg.2023.1122334
Prasad, K. D. V., Vaidya, R. W., & Anil Kumar, V. (2025). Relationship between work–life balance and psychological well-being: The mediating role of occupational stress in the IT sector. Frontiers in Psychology, 15, 1472885.
Prasad, K., McLoughlin, C., Stillman, M., Poplau, S., Goelz, E., Taylor, S., Nankivil, N., Brown, R., Linzer, M., & Cappelucci, K. (2021). Prevalence and correlates of stress and burnout among US healthcare workers during the COVID-19 pandemic: a national cross-sectionalsurvey study. EClinicalMedicine, 35.
Rahmadani, V. G., Schaufeli, W. B., Stouten, J., Zhang, Z., & Zulkarnain, Z. (2020). Engaging leadership and its implication for work engagement and job outcomes: The role of psychological empowerment. Journal of Leadership & Organizational Studies, 27(4), 373–388.
Reeve, J., & Cheon, S. H. (2021). Autonomy-supportive teaching: Its malleability, benefits, and potential to improve educational practice. Educational Psychologist, 56(1), 54–77.
Rigdon, E. E., Becker, J. M., & Sarstedt, M. (2022). Factor indeterminacy as metrological uncertainty: Implications for advancing psychological measurement using PLS- SEM. Behavior Research Methods, 54(2), 964– 981.
Salazar Jr, D. (2022). The American correctional healthcare system is ailing: Technology innovation as a prescription for penal system healthcare delivery. Monterey, CA; Naval Postgraduate School.
Samroodh, M., Anwar, I., Ahmad, A., Akhtar, S., Bino, E., & Ali, M. A. (2022). The indirect effect of job resources on employees’ intention to stay: A serial mediation model with psychological capital and work–life balance as the mediators. Sustainability, 15(1), 551.
Sarstedt, M., Ringle, C. M., & Hair, J. F. (2021). Partial least squares structural equation modeling. In Handbook of market research (pp. 587–632). Springer.
Saunders, M., Lewis, P., & Thornhill, A. (2009). Research methods for business students. Pearson education.
Senbursa, N., & Dunder, E. (2024). The mediating effect of well-being, happiness, and trust in the relationship between work-life balance and work effectiveness in seafarers.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 61, 00469580241254745.
Sekaran, U., & Bougie, R. (2019). Research methods for business: A skill-building approach (8th ed.). Wiley.
Sitompul, P., Soelistya, D., Simanihuruk, P., Purwati, T., & Efendi, E. (2024). Impact of Work-Life Balance and Work Engagement on Innovative Work Behavior. International Journal of Supply and Operations Management, 11(4), 448–461.
Slåtten, T., Mutonyi, B. R., & Lien, G. (2020). The impact of individual creativity, psychological capital, and leadership autonomy support on hospital employees’ innovative behaviour. BMC Health Services Research, 20(1), 1096.
Slemp, G. R., Lee, M. A., & Mossman, L. H. (2021). Autonomy-supportive interventions in the workplace: A systematic review and meta-analysis. Motivation and Emotion, 45(6), 710–731. https://doi.org/10.1007/s11031-021-09902-3
Tay, L., Jebb, A. T., & Scotney, V. S. (2021). Assessments of Societal Subjective Well- Being. Measuring Well-Being: Interdisciplinary Perspectives from the Social Sciences and the Humanities; Lee, MT, Kubzansky, LD, VanderWeele, TJ, Eds, 70–92.
Van Wingerden, J., & Poell, R. F. (2019). Meaningful work and resilience among teachers: The mediating role of work engagement and job crafting. PloS One, 14(9), e0222518.
Walliman, N. (2021). Research methods: The basics. Routledge.
Wang, Y., Chen, Y., & Zhu, Y. (2021). Promoting innovative behavior in employees: The mechanism of leader psychological capital. Frontiers in Psychology, 11, 598090.
Xue, Y., Li, X., Liang, H., & Li, Y. (2020). How does paradoxical leadership affect employees’ voice behaviors in workplace? A leader-member exchange perspective. International Journal of Environmental Research and Public Health, 17(4), 1162.
Zhang, B., Luo, J., & Li, J. (2024). Moving beyond Likert and traditional forced- choice scales: A comprehensive investigation of the graded forced-choice format. Multivariate Behavioral Research, 59(3), 434–460.
Zhao, X., & Ke, Y. (2022). Examining the impact of response formats on Likert- type scale data quality. Social Science Research, 102, 102684. https://doi.org/10.1016/j.ssresearch.2021.1026
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