Leadership Style, Quality of Work Life, and Job Performance among BPO Nurses in Metro Manila: Basis for the CARE Action Plan

This study examined the relationships among leadership styles, quality of work life (QWL), and perceived job performance among registered nurses working in healthcare business process outsourcing (BPO) companies in Metro Manila. Using a descriptive–correlational design, data were gathered from 235 purposively selected Utilization Management nurses who completed validated instruments measuring leadership preferences, QWL, and job performance. Data were analyzed using descriptive statistics, Kendall's tau correlation, and path analysis. Findings revealed that most participants were aged 30–39 years (65.5%), female (73.2%), and married (55.7%), with a slightly higher proportion of US-licensed nurses (53.2%) compared to Philippine Registered nurses (46.8%). The workforce was largely composed of early-career professionals, with 46.8% having less than one year of experience, and was predominantly engaged in work-from-home arrangements (97.0%), reflecting the continued shift toward remote healthcare delivery in BPO settings. Among the leadership styles assessed, democratic leadership was the most preferred (M = 4.45), followed by laissez-faire (M = 3.50) and authoritative leadership (M = 3.33). Democratic leadership showed significant positive associations with job performance (τ = 0.252, p < .001) and QWL (τ = 0.291, p < .001). Path analysis further confirmed that democratic leadership significantly predicted both job performance (β = 0.252, p < .001) and QWL (β = 0.291, p < .001), while QWL had a significant positive effect on job performance (β = 0.397, p < .001). Job performance was rated as fair overall, indicating areas for improvement despite generally favorable perceptions of leadership and QWL. Based on these findings, the study proposes the CARE Model Action Plan as a framework to strengthen participatory leadership, enhance work–life balance, and improve nurse performance in healthcare BPO settings. Keywords: Democratic leadership, Healthcare business process outsourcing, Job performance, Quality of work life, Registered nurses