Research Project
J. Basic. Appl. Sci. Res., 2(9)8833-8842, 2012
© 2012, TextRoad Publication
ISSN 2090-4304 Journal of Basic and Applied
Scientific Research www.textroad.com
*Corresponding Author: Agusthina Risambessy, Department of Buisness Administrative, Faculty of Administrative Science, University of Brawijaya, Malang of Indonesia. Email: austhin_r@yahoo.com
The Influence of Transformational Leadership Style, Motivation, Burnout
towards Job Satisfaction and Employee Performance
Agusthina Risambessy1*, Bambang Swasto2, Armanu Thoyib3, Endang Siti Astuti2
1Department of Management, Faculty of Economic, University of Pattimura, Indonesia 2Department of Business Administration, Faculty of Administrative Science,
University of Brawijaya, Malang, East Java of Indonesia 3Faculty of Economic and Business, University of Brawijaya, Malang, East Java of Indonesia
ABSTRACT Changes in organizational structure, vision and changes leadership is inevitable in any institution. Leadership style is a special characteristic that distinguishes a leader from one another and this is a powerful force to move the employee or employees in completing work toward the achievement of maximum results, especially in improving public health services in environment compete. This research aimed to describe and analyze the influence of transformational leadership styles, motivation, burnout, and job satisfaction and employee performance. The unit of analysis is nursing paramedic at a hospital in Malang Raya. Data collection techniques: conduct interviews using questionnaires and observation techniques as well as using SEM analysis tool with 105 respondents in a hospital. The research proves that: Transformational leadership style with ideal, indicator: the influence of leader behavior, intellectual stimulation, a consideration of the individual has a significant and positive influence towards motivation. Transformational leadership style had a significant and negative influence on burnout. And directly influence is stronger than the influence of indirect. This proves that the intervening variables mediated transformational leadership style with burnout cannot be ignored. Transformational leadership style has significant influence and positive toward job satisfaction. Transformational leadership style has significant and positive influence toward employee performance. This indicates that transformational leadership has a direct role to increase motivation, pressing the occurrence of burnout among nursing paramedic, improving job satisfaction, and performance of a paramedic nursing hospital. Motivation with an indicator: the need for existence; the need for relation and the need for growth have leverage significant negative and burnout against. Motivation has significant and positive influence toward job satisfaction. Motivation has significant and positive toward employee performance. This gives the meaning that motivation has a very important role to improve the performance of employees. Prevent the occurrence of burnout among the paramedics nursing as well as the improved employee of Malang Hospitals. Burnout with indicators: mental, physical and emotional exhaustions have significant influence and negative towards job satisfaction. Burnout has a significant negative influence on performance and employees. This shows that burnout has influence directly to lower job satisfaction and performance of employees within the hospital nursing paramedic of Malang Raya. The satisfaction of working with indicators: the work itself, a chance to be promoted, supervise, rewards and support a co-worker has a positive and significant effect on the performance of employees. This gives the meaning that job satisfaction was instrumental to increase employee performance. Keywords: Transformational Leadership Style, Motivation, Burnout, Job Satisfaction and Employee Performance
INTRODUCTION
The company as a forum and process of various activities that are planned and organized in the framework of the achievements of objectives is thus an important element of the Organization management wheel. Human resources are the most important asset in a company or organization. Employees can become potential if managed properly and right, but will be burdens if improper manage. Quality of human resources will be a power for management and support the performance of a company or organization that achieve good purpose. General Hospital is an institution for social service activities where public health is provide public health services, and it open 24 hours, porvide services to patient whether it impatient, emergancy treated or outpatient, both has severe disease or a light disease. Lack of paramedics and rising of arrival patient is the problem that faced by the hospital, on the other side, the paramedics has to provide maximum service that becomes focus in this research.
A style of transformational leadership can provide a positive influence toward performance and attitude of followers [1]. Granting of work motivation is a raises morale or motivation of working individuals are influenced by the needs system. Therefore, any organization is required to plan, organize, and provision a
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facility that is needed to meet the needs of employees. The form of worries facing a worker, for example, the threat of dismissal, the mutation of position is incompatible with desire, lack of welfare, moreover , it is often flow to the path of emotional sadness. The lack of that feelings will be show psychology discipline as emotional exhaustion. According to Babakus et al., [2], based on the emotional exhaution is Burnout, but Burnout is not the only one form of emotional exhaution.
Research problems is: Whether leadership style has significant influence toward motivation, Burnout, job satisfaction and employee performance? Whether motivation has significant influence toward Burnout, job satisfaction and employe performance? Whether Burnout has significant influence toward job satisfaction and employee performance? Whether job satisfaction significant influence toward employee performance?
Research Purpose: Analysis and explain the influence of transformational leadership style toward motivation, Burnout, job satisfaction, employee performance. Analysis and explain the influence of motivation toward Burnout, job satisfaction, employee performance. Analysis and explain the influence of Burnout toward job satisfaction of employee and employee performance. Analysis and explain the influence of job satisfaction toward employee performance.
MATERIALS AND METHODS Empirical Research
Alan J. Dubinsky, et al., [3] research result found that: 1). Role conflict has positive relationship with role of ambiguity, 2). Role conflict has no significant influence toward performances. 3). Role of ambiguity decrease performance and organization comitment, 4). Role of ambiguity has no relationship with job satisfaction, 5). Performance has positive relationship with job satisfaction, 6). Job satisfaction has positive relationship with organization comitment.
Daniel C. M. et. al, [4] result showed that: 1). Salesperson that overload level has high role, also has high level of job presure, 2). Salesperson that has highest feedback from its manager has low role of ambiguity, and them which obtaint high otonomy of conflict has low role , 3). Salesperson that has high atitude type A realized role conflict and also has high overload role.
Low and Cravens [5] proved that higher intrinsic motivation, lower role conflict in salesperso,. higher intrinsic motivation level, lower ambiguity role of salesperson. Higher intrinsic motivation level, lower Burnout in salesperson ground, Alf Crossman [6] “ job satisfaction and official performance on staff of Lebanon banks” research result show that all of job satisfaction has significant relationship with official performance. Elencov [7], research result found there had positive significant among tranformational leadership bahavior with organization performance than transactional leadership behavior.
Hypothesis H1: Transformationnel leadership style has signifiant influence to motivation. H2 : Transformationnel leadership style has signifiant influence to Burnout H3 : Transformationnel leadership style has signifiant influence to job satisfaction. H4 : Transformationnel leadership style has signifiant influence to employée performance. H5: Motivation has significant influence to Burnout. H6: Motivation has significant influence to job satisfaction. H7: Motivation has signifiant influence to employée performance. H8: Burnout has significant influence and negative to job satisfaction. H9: Burnout has signifiant and négative influence to employée performance. H10: Job satisfaction has significant influence to employee performance. Research Methodology This explanatory research is a kind of resarch that try to explain relationship among variables through hypothesis test. Unit of analysis in this research is paramedics of Malang hospitals. Research population is Malang hospitals that consist of Malang Regency, Malang City and Batu Malang City. It takes 6 hospitals at Malang Raya area.Sampel of this research is nurse paramedics that use as responden. Sample size using Slovin formula with 5% of galad precision. Base on calculation with Slovin formula get 105 people as sample size.
Data Collection Techniques
Data collection techniques use: a) Questionaire, it become main instrument in this research that address to respondent. b) Interview, is a technic to collect data with direct interview to respondent. c) Documentation is a technic to learn exist company document that related with reasearch problem.
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Reliability of research instrument and validity test show that all research instrument is valid and reliable. Where, alpha coefficient value bigger than 0.6. Method of data analysis devided into two group, that is analysis of statistic descriptive and analysis of statistic inferential. Analysis of statistic descriptive is use to know frequency distribution answer of respondent from questionaire result. Descriptive measurement is provision point, better in respondent ammount with average rate answer of respondent or it precentage.
Analysis of Statistic Inferential
Analysis of statistic inferential used to test influence of every variables. Using Structure Equation Mode (SEM) as a technic of statistic analysis. Structural equation, is a formula to show causality relationship among every construct. Endogen Variable = Exogen Variable + Endogen Variable + Error Y2 = X1 + X2 + X3 + Y11 + ℰ Y1 = X1 + X2 + X3 + ℰ X3 = X1 + X2 + ℰ X2 = X2 + ℰ Operational Definition and Measurement Variable
Operational definition is meant to explain every variables as construct indicator or laten variable in this research. In order that there is no misunderstanding or different opinion.
Transformational leadership style is an approach way that used by leader to influence staff to reach organization purpose, Subbak [8]. Leadership that will be research is installation leader, room leader, and unit leader. Operational variable that used to measure is transformational leadership, absorb from Wood et al, [9] as follows:
1. Ideal influencio becarme as the example and a proud leader. 2. Leader behaviour is as independent leader with motivated people that stays arround
by giving the meaning and challenge to employee work which covers to unite the vision and mission.
3. Intelectual stimulation that is leader stimulate staff being more: giving reward to employee, and develop new idea.
4. Individual consideration that is leader giving atency to individual need by focused on abilty, where leader become trainer, and direct communication.
Motivation is the potential power that inside a person that can be developed by some outside
force/essentially revolves around the monetary or non-monetary rewards that can influence the results of the performance of both positive and negative, and it really depends on the situation and condition of the person. In this research, indicator and variable adopted from Clayton Alderfer ERG teory, that is:
1. Need of existence that is a need which related with directly life which covers the needs about fulfilled monetary.
2. Relation need or relatedness, is to emphasize the important of social relationship and relationship among individual that cover relationship of the leader with subordinate, subordinate with the leader, relationship of the leader with the leader, and work partner relationship.
3. Need of growth, is a need that related with intrinsic desire, individual toward personal development as a chance to follow education and training. Burnout is an exhaustion that unite according to physic, mental and emotional. This measurement of
Burnout variable is physical exhaustion, mental exhaustion and emotional exhaustion. 1. Physical exhaustion is the helplessness to face work situation like feel exhaust and isolated. 2. Mental exhaustion is the helplessness to work situation as consequence of job tension that
influence someone psychology like: Feel depression and worried. 3. Emotional exhaustion is the helplessness to control emotion when facing work situation that influence
someone emotion like feel priceless and rejected [9]. Job satisfaction that is an attitude of someone toward things that related with occupation [10].
Measurement of job satisfaction variable in this research adopted from Lock in Robbins [11] that is job satisfaction aspects that consist of:
1. The work itself, to which it gives to the individuals: every interesting work, the value of the work itself is a source of satisfaction
2. The opportunity to be promoted is opportunities to occupy the higher level of the hierarchy are available within an organization, namely, the opportunity to excel and aspects of fairness.
3. Supervision is the ability of leadership to provide technical assistance and support to implementation of work behavior employees provide support, the degree of freedom.
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4. Rewards that are a number of financial rewards received by employee who was seen more as justice to the workers in accordance with salary expectations, to a fair salary, awards and benefits.
5. Support partners, other employees are working in a job that shows the friendly attitude and encourage an increase in achievement through each other, provide support.
Performance is the result of work achieved by one employee/subordinate in carrying out the work in accordance with the criteria set for the work. [12]. The performance of the work even of quantity as well as quality based on standard work which has been determined. [13]. The performance of employees in this research is paramedic nursing. Intended with paramedics nursing are employee that deals / in direct contact provide good care services to hospital patients, nurse emergency and outpatient. [13]. Six primary criteria that can be used to measure employee performance. Those criteria will be used in this research for measuring employee performance as follows:
1. Quality that is the result of the implementation of the activities of accomplished service by giving priority to quality and accuracy.
2. Quality that is the result of accomplished services by responsibility that provided according to working time or exceed working time.
3. Timeliness that is the lenght of an activity are resolved fast and influenceive. 4. Cost efectiveness that is the influenceivelly and efficiently magnitude of organization
resources. 5. Need for supervision that is the ability of the employee to perform job functions that
require supervision of a supervisor to prevent unintended actions. 6. Interpersonal impact That is the ability of an employee to maintain self-esteem, good
name in building working relationships of work environment and society.
RESULTS AND DISCUSSION The results of hypothesis test can be seen in the table as follows: Table 1 Loading Factor () Test Model Relationship Of Variable Leadership Style, Motivation, Burnout Toward Job Satisfaction and The Final Stage Of Employee Performance.
H
Independent Variable Dependent Variable Loading Factor
t count
p value Decisions
H1 TLS Motivation 0.670 6.537 0.000 Acceptable H2 TLS Burnout -0.323 -2.685 0.007 Acceptable H3 TLS Job Satisfaction 0.204 2.089 0.037 Acceptable H4 TLS Employee Performance 0.184 3.100 0.002 Acceptable H5 Motivation Burnout -0.277 -2.222 0.026 Acceptable H6 Motivation Job Satisfaction 0.548 5.324 0.000 Acceptable H7 Motivation Employee Performance 0.582 6.200 0.000 Acceptable H8 Burnout Job Satisfaction -0.084 -3.168 0.003 Acceptable H9 Burnout Employee Performance -0.087 -2.620 0.009 Acceptable H10 Job Satisfaction Employee Performance 0.255 4.130 0.000 Acceptable
Source: Processed Data Primer on (2010)
Based on the results of the calculations can be known that all significant influence is visible from t count is below 1.96 and p value ≥ 0.05. Can be explaining as follows:
1. Transformational leadership Style significantly influence toward motivation of the rate of t count = 6.537 and rate of p value = 0.000, and loading factor as big as 0.670. These coefficients showed that transformational leadership style will result in high motivation.
2. Transformational leadership style significantly influence toward Burnout, seen from the rate of t count = (-2.685) and rate of p value = 0.007, and loading factor as big as (-0.323). These coefficients showed that by applying the transformational leadership style will improve the paramedic nursing.
3. Motivation significantly influence toward Burnout seen from the rate of t count = (-2.222) and rate of p value = 0.026, and loading factor as big as -0.277. These coefficients showed that by having motivation will prevent Burnout.
4. Motivation significantly influence toward job satisfaction seen from the rate of t count = 0.5324 and rate of p value = 0.000, and loading factor as big as 0.548. These coefficients showed that by having motivation will produce job satisfaction.
5. Motivation significantly influence toward employee performance, seen from the rate of t count = 6.200, and the rate of p value = 0.000 and loading factor as big as 0.582. These coefficients showed that by having motivation will produce high performance in paramedics nursing.
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6. Burnout significantly influence and negative toward job satisfaction seen from the rate of t count = (- 3.168), and the rate of p value = 0.003 and loading factor as big as -0.084. This showed that job satisfaction felt by the paramedic nursing depends greatly on the conditions of work and the workplace environment.
7. Burnout significantly influence and negative toward employee performance, seen from the rate of t count = (-2.620) and the rate of p value = 0.009, and loading factor as big as 0.087. These coefficient shows that weigh pressure of hard work and some work can influence level performance that will be produce by paramedics nursing.
8. Job satisfaction significantly influence toward employee performance, seen from the rate of t count = 4.130 and the rate of p value = 0.000, and loading factor as big as 0.255. These coefficients showed that by having complacence work will influence employee performance.
Thus, the hypothesis results test shows that: H1: Transformational leadership significantly influence toward motivation has significant level as big as p
= 0.000 (acceptable hypothesis). H2: Transformational leadership style significantly influence to Burnout, significant level of p = 0.007
(acceptable hypothesis). H3: Transformational leadership significantly influence toward job satisfaction. Significant level as big as p
= 0.037 (acceptable hypothesis) H4: Transformational leadership style significantly influence toward employee performance. Significant
level as big as p = 0.002 (acceptable hypothesis). H5: Motivation significantly influence toward Burnout. Significant level as big as p = 0.026 (acceptable
hypothesis). H6: Motivation significantly influence toward job satisfaction, significant level as big as p = 0.000
(acceptable hypothesis). H7: Motivation significantly influence toward employee performance, significant level as big as p = 0.000
(acceptable hypothesis). H8: Burnout significantly influence and negative toward job satisfaction, significant level as big as p =
0.003 (acceptable hypothesis). H9: Burnout significantly influence and negative toward employee performance, significant level as big as
p = 0.009 (acceptable hypothesis). H10: Job satisfaction significantly influence toward employee performance, significant level as big as p =
0.000 (acceptable hypothesis). Overall result test can be described in the following model as in Figure 1
Figure 1 Overall result test
Source: Processed Data on 2011
This discussion will attempt to answer the formulated problem, by using the method of SEM (structural equation modelling) in aid of AMOS 16.0 program and coefficients and the standards of significance will be discussed whether a hypothesis that is supported and formulated by accepted fact or rejected based with necessary explanations.
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The Influence of Transformational Leadership Style of Motivation Base on the results of through testing of structural equation modeling showed tranformational leadership
style significantnly positive and significantly toward motivation with P = 0.000 (<0.05), and the rate of standardized regression weights/loading factor as big as = 0.670 and the rate of t count (critical ratio) = 6.537. This findings support the research results from Mehta et al., (2003). However, researches results of Mehta et al., (2003) with significant level are 0.051, if seen from reliable degrees 0.95%, then the result has strength influence from this research. Based on result test, shows that transformational leadership style significantly influence and positive toward motivation. This give sense that a leader who implement transformational leadership could increase highes motivation to paramedics environment. This findings make strong Mehta research et al., (2003), that study about relationship among different leadership style that can be used as another strategy to increase other partner motivation, and to know the different of leadership style among several countries, and to know other partner motivation toward performance. The truth of leadership style is the main element of one leader to determine attitude into formulated doctrine, institution program, and to direct the activity in institution relationship with its environments [14]. When organization is fluctuated and uncertainty, role of the leader is needed. The leader who has mision surely will be able to manage organization and every resources which support leader.
In this leadership style, the leader comunicate its desire to concrete organization purpose by vision, mision and ask other people to be allied to reach purpose with using resources and energy in efficiently [14].
The Influence of Transformational Leadership Style Toward Burnout
Result test by structural equation modeling showed transformational leadership style influence negative and significant toward motivation with P = 0.007 (<0.05), and the rate of standardized regression weights/loading factor as big as = -0.323 and the rate of t count (critical ratio) = -2.685. Based on that result test, showed that transformational leadership style significantly influence and positive toward Burnout, this give meaning that a leader who implemented transformational leadership style can prevent burnout in paramedics environment.
According to complexity resource in hospital needed leadership to activate source by four factor [15] that is 1). Leadership hospital, 2). Coordination that developed by every vice directur and instalation leader 3). Comitment and professionalism of paramedics and non medic sources 4). Understanding of sevices user as services type that available at hospital.
The Influence of Transformational Leadership Style Toward Job Satisfaction The result test by structural equation modeling showed transformational leadership style influence positive and significant toward job satisfaction with P = 0.037 (<0.05), and the rate of standardized regression weights/loading factor as big as = -0.204 and the rate of t count (critical ratio) = 2.089. This research showed that significantly influence among transformational leadership with job satisfaction signed by path coefficient. That things seen from the rate of standardized regression weight as big as = 0.138.
This findings support research result of Mitzi N. Stumpf [16], Peter Lok and John Crawford [17], Griffith James [18] says that Headmaster who implement transformational leadership style produce strong relationship, positive and significant toward job satisfaction, and produce negative relationship that significant toward employee turnover level, and toward student value achievements (output produce by student).
The Influence of Transformational Leadership Style Toward Employee Performance
To answer research problem (H4) as partial can be notice from SEM analysis result showed that transformational leadership influence toward motivation. This can be proved with tha rate of t count (critical ratio) = 3.869 bigger than the rate of t tabel 1.96, the rate of p = 0.000 more insignificant than = 0.05. This research also showed positive significant founded among transformational leadership style with employee performance, that indicated with path positive coefficient. That can be seen from value ofstandardized regression weight as big as = 0.185.
This findings make strong research of Emmanuel Ogbonna and Llyoyd C. Harris [19], Darwis A. Yousef [20], Griffith James [21], Elencov [22]. Based on result test, indicate that tranformational leadership style significantly influence and positive toward employee performance. This mean that a leader who implement transformational leadership style can increase employee performance.
Every capability inside of leadership must inherent tight to every loaded space of a leader, and leader responsibility because without more capabilities of human resources management, impossible the leader has goog succeed to do leader resposibility. Transformational leadership style has big affet toward organization that leader lead.
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Motivation Influence toward Burnout To answer research problem (H5) as partial can be seen from SEM analysis result. Showed that the rate
of t count (critical ratio) = 3.934 bigger than t tabel = 1.96 or the rate of p = 0.000 more insignificant than = 0.05. This research also showed that there is positive influence among motivation with Burnout, that signs with coefficient of positive path. This can be seen from the rate of standardized regression weight = 0.414.
Result test signs that motivation give direct role toward Burnout. There are three main characteristics of motivation that belongs by paramedic person, that is: 1) Effort, that is showed someone strength of job attitude or total effort that shown by someone in their works, 2) strong willingness, that showed strong willingness which demonstrated by someone in implemented his effort to job tasks, and 3) Direction or purpose, that related with direction by strong effort and willingness of someone, that basically is benefit things. This research support previous research of Low and Cravens [23]. Thus can be conclude that H5 state that motivation significantly influence toward Burnout. Motivation Influence toward Job Satisfaction
To answer the problem of (H6) as partial, can be notice from SEM analysis result, showed that motivation influence toward job satisfaction. This thing proved by the rate of t count (critical ratio) = 2.620 bigger than the rate of t tabel 1.96 or the rate of p = 0.009 more insignificant than = 0.05. This research also showed positive relationship among motivation with job satisfaction which signs with positive path coefficient. It can be seen from the rate of standardized regression weight as big as = 0.305.
Base on result test signs that motivation directly significant influence and positive toward job satisfaction. According to Robbins [11], Gibson et al. [10], and Porter & Lawler says that motivation significantly influence toward job satisfaction. Igalens & Roussel [24] also says that flexible pay that give to employee not motivate and not increase job satisfaction, and benefit that give to permanent and not permanent employee do not make employee motivated and do not increase job satisfaction. Thus H6 hypothesis state that, motivation significantly influences toward job satisfaction, it can prove and support by empirical and fact.
Motivation Influence Toward Employee Performance
To answer research problem of (H7) as partial, can be seen from SEM analysis showed that motivation significantly influence toward employee performance. This things can be proved by the rate of t count (critical ratio) = 6.247 bigger than the rate of t tabel 1.96 or the rate of p = 0.000 more insignificant than = 0.05. This research also showed positive relationship among motivation with employee performance that signs with positive path coefficient. It can be seen from the rate of standardized regression weight as big as = 0.294.
Based on the results of tests indicating that motivation influential significant and positive directly against employee performance. This provides meaning that with giving motivate to the employee will increase employees’ performance. Thus this finding supported previous research and supported by several theories stating that motivation effect on employee performance [25][26].
Burnout Influence toward Job Satisfaction
The result of testing through structural equation unified showing significant and positive motivational influence on the performance by employees P = 0.000 (<0.05) and the rate of standardized regression weights/loading factor as big as = -0.582 and the rate of t count (critical ratio) = 6.200. Based on that testing, signifying that burnout that effect toward employees satisfaction work.
The result of this research is to support research [23][27]. Researchers formerly found that fatigue emotional is Burnout root formation that negative influential significant with objects research teachers and the lecturer, institution sales with a pressure indicator work, and burden family. This organizations is quite different from other public service organization that in the public service organization, such as private or government hospitals, employee who ready to work already has professionalism soul, Alfonso and Korten into Tangkilisan [14] says that profesionalism that is fitness among bureaucratic competence with task requirement. Fulfilling fitness among employee competence with task requirement become rule to construct professionalism employee. This mean, skill and competence of employee reflected direction and purpose that want to reach by an organization. professionalism soul formed when follow education and training on education place.
Burnout Influence Toward Employee Performance
Result test of structural equation modeling showed Burnout berpengaruh signifikan significant influence and negative toward nursing paramedics performance with P = 0.009 (>0.05) and the rate of standardized regression weights/loading factor as big as = -0.087 and the rate of t count (critical ratio) = -2.620. that things can be seen from the rate of standardized regression weight as big as 0.117, Burnout significant influence and negative toward employee performance which is proved and acceptable in hypothesis 9. This findings support result research of Alan Dubinsky et al.[3], Low and Cravens [23], Zagladi [27].
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Maslach [28] state that low personal accomplishment is a feeling of guilt, because it has been treating client negatively [29]. The guilt it appears because they are always realizes that he had undergone chance to the poor quality toward others. Burnout arises from the most emotional sources in, example is feeling frustrated, despond, sad, helpless, depressed, apathy to work, sceptical of the environment, feel bound by duties in work, so that someone feels doesn't give psychologically services. Besides that looked is individual related easily offended, easy angry without reasons and easy disappointed [29].
A wide range of feelings do not believe because of experiencing emotional exhaustion, is certainly decrease work productivity. Company which profit oriented and nonprofit institutions, such as schools and university, usually facing Burnout problems which came upon employees.
The Influence of Job Satisfaction Toward Employee Performance
Based on these test results, indicating that job satisfaction is represented by an indicator of the work itself, a chance to be promoted, supervise, properly rewards and support colleagues can give direct influence toward employee performance. It means that the higher satisfaction employees of work will be more producing high performance by employees.
Thus this finding supported previous study and supported by several theories stating that performance in form of quantity work, and quality work influence on work satisfaction. Robbins [11] state that influence from job satisfaction toward employee performance is: 1) productivity; 2) absent; and 3) the level of output. Besides that, job satisfaction gives influence toward employee performance, according to Handoko [30] is: 1) work achievement; 2) rolling employee and attendance; 3) the age and level of work; and 4) large organization. Alf Crossman (2000) research showed that job satisfaction in overall has significant relationship with employee [31][32][33].Tthe results show that job satisfaction significantly positive influence on performance of employees formed by indicator 1) attitude towards work, 2) partners, 3) supervisor, 4) support and policy organizations, 5) salary, 6) promotion and progress, and7) customer.
CONCLUSION Several conclusions were as follows:
1) Transformational leadership style with its indicator which used are: the influence of ideal, intellectual stimulation, leader behavior, consideration of individual has significant influence and positively to motivation. With significant stage (0.000). Transformational leadership style has direct role to increase motivation that will produce by employees to organization.
2) Transformational leadership style has significant influence and negative towards Burnout. With significantly stage of (0.007). This thing showed that transformational leadership style has great capability to prevent Burnout. Direct influence more strong than indirect influence. This proved that variable intervening that mediates variable transformational leadership style with burnout cannot neglect.
3) Transformational leadership style has significantly influence the job satisfaction. This indicates that transformational leadership style has a direct role to generate job satisfaction for the nurses and midwives in the hospital of Malang Raya. Indirectly influence is stronger than direct influence. Thus proving that variable intervening mediated variable transformational leadership style with job satisfaction to note in measurement, because it has a strong contribution.
4) Transformational leadership style has significant influence and positive toward employee performance. This gives the meaning that transformational leadership style has a direct role to improve performance to be generated at organization.
5) Motivation with indicator: the need for the existence/ of the existence has significant influence and negative toward Burnout. This gives the meaning that motivation has a very important role directly to prevent the occurrence of Burnout amongst paramedics nursing of Malang Raya hospitals.
6) Motivation has significant influence and positive toward job satisfaction. This gives the meaning that motivation has a very important role to increase the work of employees through the fulfillment needs that organization gives to employees.
7) Motivation has significant influence and positive toward employee performance. This thing gives the meaning that motivation has a very important role to increase employee performance.
8) Burnout using indicators: mental, physical and emotional exhaustions have significant influence and negative towards job satisfaction. This shows that Burnout has important influence to paramedics nursing to decrease job satisfaction.
9) Burnout has significant influence and negative toward employee performance. This shows that the indicators of emotional exhaustion as a shaper of Burnout have an influence directly and meant for paramedic nursing in decreasing employee performance.
10) Job satisfaction using these aspects of job satisfaction as an indicator: the work itself, a chance to be promoted, supervise, rewards and support a co-worker has a positive and significant influence on
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performance of employees. This give meaning that job satisfaction give meaning to increase performance by giving assessment that appropriate with job and rewards appreciation achievement.
SUGGESTION Based on the results of this research and some suggestions may be given to: Hospital 1. Job satisfaction is one of the forming variables of employees attitude work that possibility of the creation
of bigger spoke positively about the Organization, performing beyond normal estimates, as well as obedient to the call of duty. Therefore, it is advisable for the Manager to be able to pay attention to hospital policies and procedures relating to the granting of rewards, whether it be rewarded oriented to performance or oriented to giving right. Policies and procedures if it is run with a sense of Justice will provide a level of satisfaction.
2. Research results prove paramedics nursing never experienced burnout one factor supporting is have souls professionalism thus suggested to hospital management continue to fertilize soul professionalism to employees and give attention to employees, Even give the opportunity to employees revealed what was facing task that given to employees as a friend and can make friend discussion.
4. In order for the summit leadership and the manager can give you wide opportunity to next researcher to get actual data of access information, so that scientific activities like this will not stop at a certain point.
Regional Government
1. Regional Government of East Java Province or District of Regional Government of Malang have removed the system use labor honorary paramedics nursing, therefore need to pay attention to the appointment of a civil servant's candidate almost 29-30 r paramedics MPP/ year and patients number even nurse emergency ambulatory, inpatient that still increase.
2. In order to implement the task of health care service that professional to embody the hospital services are global standard, Regional government as a steward public service in public health should be more continuous optimize leadership role work unit healthcare proactive to support excellent service, with training exercise that focus on the aspect of management and executes program benchmarking as a means to evaluate the development of an organization.
3. To increase services, need to state policy of giving intensivitation as organization care toward paramedics nursing untill paramedics nursing still exist in job.
Next research works 1. Using any objects remain at hospital but is more directed to the various types hospital in east java or on other
provinces in Indonesia. With a sample of research that is paramedics nursing and non-paramedic nursing and non-paramedics.
2. This research not fills variable stage of turnover/ attention to leave or attention to stay. In suggested that next research can learn that variables.
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