Work Engagement Mediates Perceived Organisational Support, Leader–Member Exchange and Employee Performance
Abstract
ABSTRACT
Purpose—This study aims to examine the effects of Perceived Organisational Support (POS) and Leader-Member Exchange (LMX) on employee performance, with work engagement serving as a mediating variable among health workers in public health facilities in Medan.
Method – This study employed a quantitative approach. The population consisted of health workers from 41 public health facilities in Medan. A total of 180 respondents were selected using a convenience sampling technique. Data were collected through questionnaires, interviews, and documentation. The data were analysed using Structural Equation Modelling (SEM) with SmartPLS 3.0.
Results – The findings reveal that Perceived Organisational Support (POS) has a significant positive effect on employee performance and work engagement. Likewise, Leader-Member Exchange (LMX) significantly influences employee performance and work engagement. In addition, work engagement has a significant positive effect on employee performance. The mediation analysis further indicates that work engagement significantly mediates the relationships between POS and employee performance, and between LMX and employee performance.
Originality/Novelty – This study offers a research model that integrates POS, LMX, work engagement, and employee performance in the context of public health services. It also highlights the mediating role of work engagement in explaining how organisational support and leader-member relationships contribute to better employee performance.
Implications – theoretically, this study contributes to the employee performance literature by highlighting work engagement as a mediating mechanism linking perceived organisational support and leader-member exchange to employee performance. Practically, the findings suggest that public health institutions can improve human resource effectiveness and service quality by strengthening organisational support and fostering high-quality leader-employee relationships.
Keywords
Full Text:
PDFReferences
Aggarwal, A., Chand, P. K., Jhamb, D., & Mittal, A. (2020). Leader–Member Exchange, Work Engagement, and Psychological Withdrawal Behavior: The Mediating Role of Psychological Empowerment. Frontiers in Psychology, 11(March), 1–17. https://doi.org/10.3389/fpsyg.2020.00423
Al Badi, F. M., Cherian, J., Farouk, S., & Al Nahyan, M. (2023). Work engagement and job performance among nurses in the public healthcare sector in the United Arab Emirates. Journal of Asia Business Studies, 17(5), 1019–1041. https://doi.org/10.1108/JABS-06-2022-0216
Al Otaibi, S. M., Amin, M., Winterton, J., Bolt, E. E. T., & Cafferkey, K. (2023). The role of empowering leadership and psychological empowerment on nurses’ work engagement and affective commitment. International Journal of Organizational Analysis, 31(6), 2536–2560. https://doi.org/10.1108/IJOA-11-2021-3049
Aldabbas, H., Pinnington, A., Lahrech, A., & Blaique, L. (2025). Extrinsic rewards for employee creativity? The role of perceived organisational support, work engagement and intrinsic motivation. International Journal of Innovation Science, 17(2), 237–260. https://doi.org/10.1108/IJIS-08-2022-0165
Ashfaq, F., Abid, G., Ilyas, S., & Binte Mansoor, K. (2023). Perceived organisational support and work engagement among health sector workers during the COVID-19 pandemic: A multicentre, time-lagged, cross-sectional study among clinical hospital staff in Pakistan. BMJ Open, 13(6). https://doi.org/10.1136/bmjopen-2022-065678
Awan, S. H., Habib, N., Shoaib Akhtar, C., & Naveed, S. (2020). Effectiveness of Performance Management System for Employee Performance Through Engagement. SAGE Open, 10(4), 1–15. https://doi.org/10.1177/2158244020969383
Bakker, A. B., Demerouti, E., & Sanz-Vergel, A. (2023). Annual Review of Organizational Psychology and Organizational Behavior Job Demands-Resources Theory: Ten Years Later. Annu. Rev. Organ. Psychol. Organ. Behav. 2023, 10, 25–53. https://doi.org/10.1146/annurev-orgpsych-120920-053933
Baş, M., Ayaz, M. Q., & Ağin, K. (2024). The mediating role of knowledge sharing in the relationship between leader-member exchange and work integration. Ekonomski Vjesnik, 37(2), 209–221. https://doi.org/10.51680/ev.37.2.1
Bennouna, A., Boughaba, A., Mouda, M., & Djabou, S. (2023). Examining the mediating effect of job satisfaction on the relationship between leader-member exchange and safety behavior among Algerian healthcare workers. Leadership in Health Services, 37(1), 112–129. https://doi.org/10.1108/LHS-05-2023-0031
Bernales-Turpo, D., Quispe-Velasquez, R., Flores-Ticona, D., Saintila, J., Ruiz Mamani, P. G., Huancahuire-Vega, S., Morales-García, M., & Morales-García, W. C. (2022). Burnout, Professional Self-Efficacy, and Life Satisfaction as Predictors of Job Performance in Health Care Workers: The Mediating Role of Work Engagement. Journal of Primary Care and Community Health, 13. https://doi.org/10.1177/21501319221101845
Bonaiuto, F., Fantinelli, S., Milani, A., Cortini, M., Vitiello, M. C., & Bonaiuto, M. (2022). Perceived organizational support and work engagement: the role of psychosocial variables. Journal of Workplace Learning, 34(5), 418–436. https://doi.org/10.1108/JWL-11-2021-0140
Borst, R. T., Kruyen, P. M., Lako, C. J., & de Vries, M. S. (2020). The Attitudinal, Behavioral, and Performance Outcomes of Work Engagement: A Comparative Meta-Analysis Across the Public, Semipublic, and Private Sector. Review of Public Personnel Administration, 40(4), 613–640. https://doi.org/10.1177/0734371X19840399
Cabrera, W., & Estacio, D. (2022). Job Attitude as a Factor on Employees Performance. International Journal of Economics Development Research (IJEDR), 3(1), 13–35. https://doi.org/10.37385/ijedr.v3i1.254
Caesens, G., & Stinglhamber, F. (2020). Toward a More Nuanced View on Organizational Support Theory. Frontiers in Psychology, 11(March), 10–12. https://doi.org/10.3389/fpsyg.2020.00476
Chatzittofis, A., Constantinidou, A., Artemiadis, A., Michailidou, K., & Karanikola, M. N. K. (2021). The Role of Perceived Organizational Support in Mental Health of Healthcare Workers During the COVID-19 Pandemic: A Cross-Sectional Study. Frontiers in Psychiatry, 12(November), 1–6. https://doi.org/10.3389/fpsyt.2021.707293
Che, X., Guo, Z., & Chen, Q. (2021). The Relationship Between K-Workers’ Leader–Member Exchange, Organizational Citizenship Behavior and Task Performance—Evidence From Chinese Hospitals. Frontiers in Psychology, 12(July), 1–12. https://doi.org/10.3389/fpsyg.2021.625584
Cheng, L., Wei, W., Zhang, J., Yao, Y., Zhang, Y., & Zhu, W. (2024). The association of leader-member exchange and team-member exchange with nurses’ innovative behaviours: A cross-sectional study. Journal of Advanced Nursing, 80(7), 2813–2821. https://doi.org/10.1111/jan.16121
Cho, E. (2020). A comprehensive review of so-called Cronbach’s alpha. Journal of Product Research, 58(13), 81–122. https://doi.org/10.1108/ijwbr-03-2022-0011
Corbeanu, A., & Iliescu, D. (2023). The Link between Work Engagement and Job Performance: A Meta-Analysis. Journal of Personnel Psychology, 22(3), 111–122. https://doi.org/10.1027/1866-5888/a000316
Dhynianti, L., Darmawan, E. S., Nadjib, M., & Soewondo, P. (2025). Readiness of community health centers to implement integrated primary health care services in Jakarta, Indonesia: a 2024 study. Journal of Integrated Care, 33(3), 260–271. https://doi.org/10.1108/JICA-11-2024-0065
Du, B., He, B., Zhang, L., Luo, N., Yu, X., & Wang, A. (2022). From subordinate moqi to work engagement: The role of leader-member exchange in the sustainability context. Sustainability, 15(1), 170. https://doi.org/10.3390/su15010170
Eisenberger, R., Rhoades Shanock, L., & Wen, X. (2020). Perceived Organizational Support: Why Caring about Employees Counts. Annual Review of Organizational Psychology and Organizational Behavior, 7, 101–124. https://doi.org/10.1146/annurev-orgpsych-012119-044917
Elrehail, H., Harazneh, I., Abuhjeeleh, M., Alzghoul, A., Alnajdawi, S., & Ibrahim, H. M. H. (2020). Employee satisfaction, human resource management practices and competitive advantage: The case of Northern Cyprus. European Journal of Management and Business Economics, 29(2), 125–149. https://doi.org/10.1108/EJMBE-01-2019-0001
Eshete, B. A., & Kassahun, T. (2025). The mediating role of employees engagement in the relationship between adaptive leadership and service quality in the health sector. Leadership in Health Services, 38(5), 82–100. https://doi.org/10.1108/LHS-03-2025-0056
Garengo, P., Sardi, A., & Nudurupati, S. S. (2022). Human resource management (HRM) in the performance measurement and management (PMM) domain: a bibliometric review. International Journal of Productivity and Performance Management, 71(7), 3056–3077. https://doi.org/10.1108/IJPPM-04-2020-0177
Gün, İ., Söyük, S., & Özsari, S. H. (2021). Effects of Job Satisfaction, Affective Commitment, and Organizational Support on Job Performance and Turnover Intention in Healthcare Workers. Archives of Health Science and Research, 8(2), 89–95. https://doi.org/10.5152/ArcHealthSciRes.2021.21044
Hair Jr., J. F., Howard, M. C., & Nitzl, C. (2020). Assessing measurement model quality in PLS-SEM using confirmatory composite analysis. Journal of Business Research, 109, 101–110. https://doi.org/10.1016/j.jbusres.2019.11.069
Hair, J F, Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2021). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) (3rd ed.). SAGE Publications.
Hair, Joseph F, Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2024). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) (3 (ed.)). Sage Publications.
Hasan, A. A., Ahmad, S. Z., & Osman, A. (2023). Transformational leadership and work engagement as mediators on nurses’ job performance in healthcare clinics: work environment as a moderator. Leadership in Health Services, 36(4), 537–561. https://doi.org/10.1108/LHS-10-2022-0097
Henseler, J., Ringle, C. M., & Sarstedt, M. (2023). Assessing discriminant validity in variance-based structural equation modeling: Updated guidelines. Journal of the Academy of Marketing Science, 43(1).
Imran, M. Y., Elahi, N. S., Abid, G., Ashfaq, F., & Ilyas, S. (2020). Impact of perceived organizational support on work engagement: Mediating mechanism of thriving and flourishing. Journal of Open Innovation: Technology, Market, and Complexity, 6(3), 1–18. https://doi.org/10.3390/JOITMC6030082
Jankelová, N., Joniaková, Z., & Skorková, Z. (2021). Perceived organizational support and work engagement of first-line managers in healthcare – The mediation role of feedback seeking behavior. Journal of Multidisciplinary Healthcare, 14(July), 3109–3123. https://doi.org/10.2147/JMDH.S326563
Jeong, Y., & Kim, M. (2022). Effects of perceived organizational support and perceived organizational politics on organizational performance: Mediating role of differential treatment. Asia Pacific Management Review, 27(3), 190–199. https://doi.org/10.1016/j.apmrv.2021.08.002
Ji, H., Zhao, X., & Dang, J. (2023). Relationship between leadership-member exchange (LMX) and flow at work among medical workers during the COVID-19: the mediating role of job crafting. BMC Psychology, 11(1), 162. https://doi.org/10.1186/s40359-023-01194-3
Jufrizen, J., Harahap, D. S., & Khair, H. (2024). Leader-Member Exchange and Employee Performance: Mediating Roles of Work Engagement and Job Satisfaction. Journal of Economics, Business, & Accountancy Ventura, 26(3). https://doi.org/10.14414/jebav.v26i3.3591
Juliansyah, R., Aqid, B. M., Salsabila, A. P., & Nurfiyanti, K. (2024). Implementation of EMR System in Indonesian Health Facilities: Benefits and Constraints. Journal of Indonesian Health Policy and Administration, 10(1), 31–38. https://doi.org/10.7454/ihpa.v10i1.1140
Kananu, K. M., Ambrose, K., & Joel, T. (2020). The effect of employee engagement on the relationship between leader-member exchange and innovative work behaviour in Kenya. Journal of Business and Economic Development, 5(3), 113–120. https://doi.org/10.11648/j.jbed.20200503.11
Kapil, K., & Rastogi, R. (2020). The relationship between leader-member exchange, work engagement and organizational citizenship behaviour. Journal of Indian Business Research, 12(2), 191–214. https://doi.org/10.1108/JIBR-08-2018-0202
Khan, H. G. A., Khan, M. A., Ali, M. I., Salem, S., Rashid, S., & Zahur, H. (2022). Does authentic leadership influences performance of individuals in presence of trust and leader member exchange: an evidence from health care sector. Cogent Business and Management, 9(1). https://doi.org/10.1080/23311975.2022.2119539
Kim, J. H., & Han, J. W. (2022). Relationship of Hospital Nurse LMX, Emotional Immersion, and Turnover Intention. Journal for ReAttach Therapy and Developmental Diversities, 5(SpecialIssue2), 433–442.
Kirilmaz, S. K. (2022). Mediating Role of Positive Psychological Capital in The Effect of Perceived Organizational Support on Work Engagement. Journal of Organizational Behavior Research, 7(1), 72–85. https://doi.org/10.51847/xNeqENPv4Y
Li, P., Sun, J.-M., Taris, T. W., Xing, L., & Peeters, M. C. W. (2021). Country differences in the relationship between leadership and employee engagement: A meta-analysis. The Leadership Quarterly, 32(1), 101458. https://doi.org/10.1016/j.leaqua.2020.101458
Li, Q., Mohamed, R., Mahomed, A., & Khan, H. (2022). The Effect of Perceived Organizational Support and Employee Care on Turnover Intention and Work Engagement: A Mediated Moderation Model Using Age in the Post Pandemic Period. Sustainability (Switzerland), 14(15). https://doi.org/10.3390/su14159125
Limato, R., Tumbelaka, P., Ahmed, R., Nasir, S., Syafruddin, D., Ormel, H., & Kok, M. (2023). What factors do make quality improvement work in primary health care? Experiences of maternal health quality improvement teams in three Puskesmas in Indonesia. International Journal of Environmental Research and Public Health, 20(1), 44. https://doi.org/10.1371/journal.pone.0226804
Liu, H., Song, Z., Xu, Y., Xu, X., & Li, J. (2023). Exploring Explanatory Mechanisms of Adjustment-Specific Resources Underlying the Relationship between Leader–Member Exchange and Work Engagement: A Lens of Conservation of Resources Theory. Sustainability (Switzerland), 15(2). https://doi.org/10.3390/su15021561
Liu, X., Jing, Y., & Sheng, Y. (2023). Work from home or office during the COVID-19 pandemic: The different chain mediation models of perceived organizational support to the job performance. Frontiers in Public Health, 11(3). https://doi.org/10.3389/fpubh.2023.1139013
Ma, H., Zhu, X., Huang, J., Zhang, S., Tan, J., & Luo, Y. (2023). Assessing the effects of organizational support, psychological capital, organizational identification on job performance among nurses: a structural equation modeling approach. BMC Health Services Research, 23(1), 806. https://doi.org/10.1186/s12913-023-09705-z
Maan, A. T., Abid, G., Butt, T. H., Ashfaq, F., & Ahmed, S. (2020). Perceived organizational support and job satisfaction: a moderated mediation model of proactive personality and psychological empowerment. Future Business Journal, 6(1), 1–10. https://doi.org/10.1186/s43093-020-00027-8
Mazzetti, G., Robledo, E., Vignoli, M., Topa, G., Guglielmi, D., & Schaufeli, W. B. (2023). Work Engagement: A Meta-Analysis Using the Job Demands-Resources Model. Psychological Reports, 126(3), 1069–1107. https://doi.org/10.1177/00332941211051988
Mitchell, R., Gu, J., & Boyle, B. (2024). The impact of leader member exchange quality and differentiation on counterproductive and citizenship behavior in health care teams. Health Care Management Review, 49(2), 86–93. https://doi.org/10.1097/HMR.0000000000000394
Muharram, F. R., Sulistya, H. A., Swannjo, J. B., Firmansyah, F. F., Rizal, M. M., Izza, A., Isfandiari, M. A., Ariningtyas, N. D., & Romdhoni, A. C. (2024). Adequacy and Distribution of the Health Workforce in Indonesia. WHO South-East Asia Journal of Public Health, 13(2), 45–55. https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_28_24
Mulligan, R., Ramos, J., Martín, P., & Zornoza, A. (2021). Inspiriting innovation: The effects of leader-member exchange (lmx) on innovative behavior as mediated by mindfulness and work engagement. Sustainability (Switzerland), 13(10), 1–18. https://doi.org/10.3390/su13105409
Musenze, I. A., Mayende, T. S., Kalenzi, A., & Namono, R. (2021). Perceived organizational support, self-efficacy and work engagement: testing for the interaction effects. Journal of Economic and Administrative Sciences, 38(2), 201–228. https://doi.org/10.1108/JEAS-08-2020-0141
Muslih, M., & Hardani, R. T. S. (2022). Effect of Work Environment And Workload on Employee Performance. International Journal of Economics, Social Science, Entrepreneurshipand Technology (IJESET), 1(1), 23–35.
Muslih, M., & Pratama, M. D. (2022). Kepuasan Kerja sebagai Variabel Intervening pada pengaruh Kepemimpinan Terhadap Kinerja Pegawai. Inovatif: Jurnal Ekonomi, Manajemen, Akuntansi, Bisnis Digital Dan Kewirusahaan, 1(1), 16–28.
Ni, Y., Wu, D., Bao, Y., Li, J., & You, G. (2023). The mediating role of psychological needs on the relationship between perceived organizational support and work engagement. International Nursing Review, 70(2), 204–210. https://doi.org/10.1111/inr.12797
Ortiz-Isabeles, C. J., & García-Avitia, C. A. (2021). Relationship between perceived organizational support and work engagement in Mexican workers. Psicogente, 24(45). https://doi.org/10.17081/psico.24.45.4084
Praveen, S., Parmar, J., Chandio, N., & Arora, A. (2021). A Systematic Review of Cross-Cultural Adaptation and Psychometric Properties of Oral Health Literacy Tools. International Journal of Environmental Research and Public Health, 18(19), 10422. https://doi.org/10.3390/ijerph181910422
Rubel, M. R. B., Hung Kee, D. M., & Rimi, N. N. (2021). High-performance work practices and medical professionals’ work outcomes: the mediating effect of perceived organizational support. Journal of Advances in Management Research, 18(3), 368–391. https://doi.org/10.1108/JAMR-05-2020-0076
Saadeh, I. M., & Suifan, T. S. (2019). Job stress and organizational commitment in hospitals: The mediating role of perceived organizational support. International Journal of Organizational Analysis, 28(1), 226–242. https://doi.org/10.1108/IJOA-11-2018-1597
Sadovyy, M., Sánchez-Gómez, M., & Bresó, E. (2021). COVID-19: How the stress generated by the pandemic may affect work performance through the moderating role of emotional intelligence. Personality and Individual Differences, 180, 110986. https://doi.org/10.1016/j.paid.2021.110986
Şahin, S., & Yozgat, U. (2024). Work–family conflict and job performance: mediating role of work engagement in healthcare employees. Journal of Management & Organization, 30(4), 931–950. https://doi.org/10.1017/jmo.2021.13
Şanliöz, E., Sağbaş, M., & Sürücü, L. (2023). The Mediating Role of Perceived Organizational Support in the Impact of Work Engagement on Job Performance. Hospital Topics, 101(4), 305–318. https://doi.org/10.1080/00185868.2022.2049024
Santalla-Banderali, Z., & Alvarado, J. M. (2022). Incidence of Leader–Member Exchange Quality, Communication Satisfaction, and Employee Work Engagement on Self-Evaluated Work Performance. International Journal of Environmental Research and Public Health, 19(14), 1–22. https://doi.org/10.3390/ijerph19148761
Saygili, M., Hikmet, N., & Yorgancioglu Tarcan, G. (2025). The effect of leader-member exchange on turnover intention in healthcare employees. Journal of Health Organization and Management. https://doi.org/10.1108/JHOM-09-2024-0394
Schuh, S. C., Cai, Y., Kaluza, A. J., Steffens, N. K., David, E. M., & Haslam, S. A. (2021). Do leaders condone unethical pro-organizational employee behaviors? The complex interplay between leader organizational identification and moral disengagement. Human Resource Management, 60(6), 969–989. https://doi.org/10.1002/hrm.22060
Song, R., Hao, Y., Li, J., Yang, X., Liu, J., & Chen, L. (2023). Mediating Effect of Perceived Organizational Support on the Resilience and Mental Health of ICU Nurses. Journal of Clinical and Nursing Research, 7(4), 69–78. https://doi.org/10.26689/jcnr.v7i4.5018
Szilvassy, P., & Širok, K. (2022). Importance of work engagement in primary healthcare. BMC Health Services Research, 22(1), 1–11. https://doi.org/10.1186/s12913-022-08402-7
Tóth-Király, I., Gillet, N., Inhaber, J., Houle, S. A., Vandenberghe, C., & Morin, A. J. S. (2023). Job engagement trajectories: Their associations with leader–member exchange and their implications for employees. Journal of Occupational and Organizational Psychology, 96(3), 545–574. https://doi.org/10.1111/joop.12433
Voorhees, C. M., Brady, M. K., Calantone, R., & Ramirez, E. (2020). Discriminant validity testing in marketing: An analysis, causes for concern, and proposed remedies. Journal of the Academy of Marketing Science, 48(1), 20–44. https://doi.org/10.1007/s11747-019-00656-1
Wagner, B., & Koob, C. (2022). The relationship between leader-member exchange and work engagement in social work: A mediation analysis of job resources. Heliyon, 8(1), e08793. https://doi.org/10.1016/j.heliyon.2022.e08793
DOI: https://doi.org/10.30596/ijbe.v8i1.29987
Refbacks
- There are currently no refbacks.
International Journal of Business Economics (IJBE)is abstracting & indexing in the following databases:
View My Stats IJBE



