LEADERSHIP ROLE AND EMPLOYEE INTENTION TO STAY: NEW EVIDENCE FROM HEALTHCARE SECTOR IN EMERGING ECONOMIES

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JAM

J u r n a l A p l i k a s i M a n a j e m e n J o u r n a l o f A p p l i e d M a n a g e m e n t

V o l u m e 2 1 I s s u e 1 M a r c h 2 0 2 3

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R e c e i v e d N o v e m b e r ‘ 2 2 R e v i s e d J a n u a r y ‘ 2 3 M a rc h ‘ 2 3 A c c e p t e d M a rc h ‘ 2 3

LEADERSHIP ROLE AND EMPLOYEE INTENTION TO STAY: NEW EVIDENCE FROM

HEALTHCARE SECTOR IN EMERGING ECONOMIES

Retno Purwani Setyaningrum

Magister of Management, Universitas Pelita Bangsa, Cikarang, Indonesia

Jamailah Said

Accounting Research Institute (HICoE), Universiti Teknology MARA, Shah Alam, Malaysia

Djoko Soelistya

Universitas Muhammadiyah Gresik, Indonesia

Abstract: The report shows that healthcare employees experience more stress, emotional exhaustion, and burnout prevail during and post covid 19 and force employees to leave the profession. However, there are many more who take the challenge by staying on. This research investigates whether servant leadership, work-life balance, and behavior engagement play roles in employee intention to stay. This study surveyed 200 employees of 10 big healthcare companies in Indonesia. The number of respondents who filled out the questionnai- reviagoogleformwas137.DatawereanalyzedusingSmartPartialLeastSqu- are (PLS). The findings of the study showed that servant leadership has a positive effect on work-life balance, servant leadership has a positive effect on a leader's needs to trust, work-life balance has a positive effect on behavior engagement,work-lifebalancehasapositiveeffectonleaderneedstotrusthissu- bordinates,behavioralengagementhasapositiveeffectontheintentiontostay, empowerment leader moderates the positive effect of behavior engagement on intention to stay, and leader needs to trust his subordinates has a positive effect on the intention to stay. However, service leadership has no effect on the intention to stay, behavioral engagement has no effect on the leader's need to trust his subordinates, and behavioral engagement has no effect on the leader's need to trust his subordinates. The implication of this research is to retain employees in the company. Although the leadership style is not very supportive, it is still necessary to ensure that the employees feel comfortable at work, trusted by their superiors, and empowered by their abilities.

Keywords: Behavior Engagement, Empowerment Leader, Healthcare Com- panies, Intention to Stay, Servant Leadership, Trust, Work-Life Balance

CITATION

Setyaningrum, R. P. and Said, J. 2023. Leadership Role and Employee Intention to Stay: New Evidence from Healthcare Sector in Emerging Economies. Jurnal Aplikasi Manajemen, Volume 21, Issue 1, Pages 112-127. DOI: http://dx.doi.org/10.21776/ub.jam.2022.021.1.08.

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113 INTRODUCTION

The spread of Covid-19 in Indonesia has an impact on employees in healthcare companies due to high job demands (King and Iba, 2021). Serving the community's needs during a pandemic is noble and hard work, especially in a country like Indone- sia which does not yet have a good enough health infrastructurelikeinotherdevelopedcountries(Fa- culty of Medicine, University of Indonesia, 2020).

Leadership in healthcare companies is the central issue of the company's strategy in dealing with ch- anging circumstances caused by the spread of Co- vid-19 (Fahlevi et al, 2022). Indonesia's healthcare industry is affected due to direct interaction with public health. Servant leadership is one form of leadership needed by healthcare companies at this criticaltime. Poorhealthcarecompanyservicesnot only cause disappointment as in the past, but during the Covid-19 pandemic, it can cause someone to lose their life (Adams and Walls, 2020). Excel- lent service for healthcare companies can be start- ed from a leadership role to be ready to serve, especially in critical times (Stoller, 2020). Ahmad et al. (2021) argued that servant leaders foster a positive and supportive work environment through the modest use of power that nurtures trust and deve- lops healthy relationships among followers. Raya- tin et al. (2018) researched leadership styles which include servant, visionary, situational, transaction- al, and transformational leadership. This research found that servant leadership is the most dominant leadership style affecting employee performance.

Very few studies have attempted to investi- gate the effect of servant leadership on intention to stay (Asencio, 2016; Hoch et al., 2018). In this study, it is necessary to understand how servant leadership affects employee turnover or can retain employees' intention to stay. There is positive relationship between servant leadership and intention to stay. Amah and Oyetuunde (2020) stated that the servant leadership style is negatively related to the desire to resign, which means that employees pre- fer the intention to stay as stated. Siew (2017) stated that the servant leadership style effectively re- duces turnover intention. Servant leadership is significantly related to trust in the leader and trust in the leader contained in the leader's role in ethics (Haq et al., 2021). Trust must be the focus that company leaders must pay attention to, especially when Covid-19 has pushed many leaders into re-

mote management, which requires different skills from face-to-face management, which requires trust (Parker et al., 2020). Most managers have had to manage staff remotely since the lockdown. The majority (54.7%) of managers reported that now more than 80% of employees have Worked from Home (WFH) (Forbes et al., 2020). Since the lockdown, managers have had much more confidence in their teams (Forbes et al., 2020). Many studies show that managers who cannot directly "see" their subordinates (when WFH) sometimes have dif- ficulty trusting whether their employees are working (Parker et al., 2020). Many studies always em- phasize that employees need to trust their leaders (Kohlmeyer et al., 2017; Asencio, 2016; Burke et al., 2009). However, research on leaders who trust their employees is still rare when leaders and employees play an essential role in creating and main- taining trusting relationships (Dorman, 2014). Ef- fective leadership is not only about trusting subordinates but also about learning how to let subordinates feel trusted (Kim et al., 2018; Brower et al., 2009).However,researchbyKnollandGill(2011) stated that there is a tendency to trust, which is related to trust in supervisors and peers, but not to trust in subordinates. During the Covid 19 pandemic, leaders need to believe in their employees, like when employees have to work from home. In addition, leaders still have to trust the performance of their subordinates, even if they are not meeting them face to face. These things are interesting to be further researched.

Work-life balance has recently attracted the attention of researchers. The purpose of life is to work, while a career is the core of life. However, people have limited time and have to do many other activities besides their work (Felstead et al., 2002). This research is strengthened by Bataineh (2019), which stated that a balance is needed between work life, happiness, and employee performance. In this time of covid 19, work-life balance is highly expected by employees, and this requires support from the leadership. Research from various theoretical perspectives on job design prepared by leaders shows that when work is designed in such a way as to produce specific "job characteris- tics," it will also result in well-being, job satisfaction, performance, and other aspects that have a positive effect on employees (Bélanger et al., 2013;

Parker and Grote, 2020; Wang et al., 2020). Work-

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life balance positively affects employees' perceptions of their managers' ethical behavior. The relationship between work-life balance and managerial nature makes employees feel trusted by their leaders (Cowart et al., 2014). Employees view leaders as a party who has to balance their professional a- nd personal lives more, allowing employees to achieve a positive work-life balance and ultimately making the employees feel satisfied in their work (Braun and Peus, 2018). It is similar to the effect of work-life balance on behavior engagement. The ability of employees to achieve work-life balance with an organizational support must lead to higher work engagement (Jaharuddin and Zainol, 2019).

The presence of better performance charac- terizes behavioral engagement, which can increase employee work productivity (Blanco-González et al., 2021). Employees who are engaged will perce- ive their work as a meaningful activity and who careaboutthecommunity,andthusemployeescan increase cooperation for the common good (Afsar et al, 2020). The respect that employees receive fromtheleadersandtrustthatemployeesfeelposi-

tively affect their work, resulting in engagement (Melhem and Al Qudah, 2019). Nevertheless, many researchers have concerns about the differences in work engagement from other constructs and their theoretical benefits. When employees have confidence in their leaders, they will be more willing to invest themselves in their work (Christian et al., 2011). The behavioral engagement has been pro- posed to increase employee retention (Ashraf and Siddiqui, 2020; Shibiti, 2020). However, Bailey et al. (2015) identified engagement behavior negatively related to employee intention to change jobs.

Based on the inconsistency of the results, this research adds empowerment leader as a moderating variable. Empowerment leader behavior is closely related to behavior engagement because when leaders often provide opportunities for employees to empower their skills and ensure that their work is meaningful, employees will show an intention to stay (Mendes and Stander, 2011). The psychologi- calempowermentaffectsworkengagementandca- uses high innovation and lower turnover intentions (Bhatnagar, 2012).

HYPOTHESIS DEVELOPMENT

Figure 1. The Research Model

This research investigates whether servant leadership, work-life balance, and behavior engagement play roles in employee intention to stay.

This research is interesting to be conducted because there are inconsistent results between the researchers, namely positive and negative, between ser-

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115 vant leadership and intention to stay. This research

gap is interesting to be investigated further by incl- udingemployeeempowermentasmoderation.The research model is summarized in Figure 1.

Servant Leadership and Work-Life Balance In this COVID-19 pandemic, the effect of servant leadership, workplace (WFH and WFO), as well as supportive supervision will help employees not to feel the symptoms of work burnout and maintain a better balance between their professional and personal lives (Ahmad et al., 2021; Lamp- rinou et al., 2021). Servant leadership affects the work-life balance for remote workers and non-re- moteworkers. Servantleadershiphighlightsthevi- tal role work-life balance may play in achieving higher work engagement. Setyaningrum and Paw- ar (2020) stated that the greatest result in a quality work life exists when employees are faced with a comfortable workplace and work atmosphere. Th- is condition occurs when servant leadership focuses on listening, empathy, communication, and personal development. Barbuto and Wheeler (2006) stated that employees would feel comfortable working and being treated fairly in this situation. Chu- ghtai (2018) stated that servant leadership is positively related to work engagement and life satisfaction, with life satisfaction and positive emotion as the indicators.

H1 : Servant leadership had an effect on work-life balance.

Servant Leadership and Intention to stay Employees are an asset to the organization, and they can determine the success or failure of an organization in an industry. In the current situation, leaders must be able to predict and detect early employee intentions to stay and not leave for other organizations by giving them a competitive advantage (Rozsa et al., 2019). Employees will be committed and stay with the organization if they feel that the leader acts positively toward them (Perry- er and Jordan, 2010). In this case, servant leadership that can increase employee psychological clo- seness, which directly affects employee intention to quit, is needed (Ghosh et al., 2013). Several indicators of leadership style make employees intend tostay, namelygivingorderswithrationalcommu- nication, replacing bureaucracy with friendly support, learning to listen to subordinates' concerns,

and helping subordinates find meaning and work goals (Yao and Huang, 2018). Servant leadership efforts to develop a sense of belonging, build community, forge deep bonds, and deepen social capital can positively affect employees (Huning et al., 2020; Islam et al., 2022). A positive relationship exists between the leader's emotional intelligence and employee retention (Alzyoud et al., 2019).

H2 : Servant leadership had an effect on the inten- tion to stay.

Servant Leadership and A Leader Needs to Trust His Subordinates

Leadership trust is a must-have for managers and other leaders. Working in a high-trust work environment improves the employee engagement, well-being, and psychological safety, impacting employee turnover (Reddington, 2022). Servant leadership is significantly related to trust in the leader (Haq et al., 2021). Servant leadership can acc- ept, empathize, support, and foster a sense of trust insubordinates(Khanetal.,2020).Servantleader- ship places the interests of subordinates above the- irownsothatastrongsocialexchangerelationship will develop between the leaders and subordinates (Khattak and O'Connor, 2021).

H3 : Servant leadership has an effect on a leader's need to trust his subordinates.

Work-Life Balance and Behavior Engagement DuringthisCOVID-19pandemic,organizations will increasingly strive to create the right environment where employees experience work-life balance. At the same time, organizations concern- edwithorganizationaloutcomeswillencouragein-

creased employee work engagement (Wood et al., 2020). Work-lifebalanceisessentialtoengageand retain employees (Parkes and Langford, 2008). T- his research is also reinforced by De Kort (2017), which stated that work-life balance and work involvement are significant. Servant leadership builds work-life balance, leading to higher work engagement (Haar et al., 2017). A decrease in employee productivity and performance occurs when an organization does not think about the work balance of employees properly and is not managed properly (Wolor et al., 2020). Work and family demands, as well as life balance, will encourage employees to have work engagement. Lee (2016) found that an employee will have a lower absenteeism, work

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longer hours, and feel more satisfied at work if the health, work, and life of employees are taken into consideration by the leaders (work-life balance), and this research is strengthened by (Bunderson and Jeffery, 2009; Islam et al., 2014).

H4 : Work-life balance had an effect on behavior engagement.

Work-life Balance and A Leader Needs to Trust His Subordinates

Managers are a crucial factor in establishing work-life balance. Managerial support includes m- anagerialtrustwithcommunicationandunderstan- ding of subordinates, which is very important for achieving employee work or family balance (Co- wartetal., 2014). Work-lifebalancecanaffectem- ployee behavior, beliefs, and attitudes, which positively impacts the organization (De Kort, 2017).

The supervisor-subordinate relationship shows that the supervisor's support and trust in subordinates are exemplary and have a strong impact on the work-life balance of subordinates (Kishino, 2015).

Perceivedtrustinleadersexistswhenmanagersbe- haveethically,positivelyaffectorganizationalcul- ture, and treat employees fairly and consistently.

It can build managers' trust in employees and encourage employee work-life balance (Gordon et al., 2014). Work-life balance makes appropriate positive adjustments for employee well-being so that employees can respond positively to organizational goals because of their managers' trust (Oladele et al., 2016).

H5 : Work-life balance had an effect on the leader's need to trust his subordinates.

Behavior Engagement and Intention to Stay One of the most dominant concerns today is retention. It is widely recognized that there is a hi- ghturnoverofemployees,whichorganizationsne- ed to pay attention to by taking proactive steps to positively influence employees so that they remain intent on staying (Hughes and Rog, 2008). Bailey et al. (2017) stated that organizations experience lower voluntary turnover or intention to stay when employees feel involved in their work. Bellamko- nda et al. (2021) stated that behavior engagement fully mediates the relationship between goal clarity, trust in management, and intention to stay. Em- ployees with behavior engagement show high-quality performance and positive work, but employe-

es with low levels of engagement result in organizational losses (Albrecht et al., 2014). Intention to stay is an essential determinant of turnover behavior and is influenced by many employees' job attitudes, including job satisfaction, which has been linked to employee engagement (Milliman et al., 2018). Finally, employees who have a sense of w- ork engagement show higher participation levels and the intention to stay (Kim and Gatling, 2018).

A sense of work engagement will improve employee performance and reduce the intention to change jobs (Zia et al., 2021).

H6 : Behavior engagement had an effect on the in- tention to stay.

Behavior Engagement and A Leader Needs to Trust His Subordinates

Behavioral engagement will arise if employees are seen as making a total effort to involve themselves in their work, are responsible for their main work, and fully involve themselves in work following their work experience (Milliman et al., 2018). Behavioralengagementisconsideredauni- que motivation and is conceptualized as utilizing the organization's members for their work roles in terms of physical, cognitive, and emotional energy. It is secure and leads to behavioral engagement of their subordinates (Rich et al., 2010). Employ- ees tend to be involved in their work to the extent that they believe their leaders will appreciate the energy, time, effort, or personal resources they de- vote to work (Liu et al., 2018).

H7 : Behavior engagement had an effect on the lea- der's need to trust his subordinates.

The Moderate Role of Empowerment Leader Empowerment leader behavior is closely related to behavior engagement because when leaders often provide opportunities for employees to empower their skills and ensure that their work is meaningful, employees will show an intention to stay (Mendes and Stander, 2011). Psychological empowerment affects work engagement and causes high innovation and lower turnover intentions (Bhatnagar, 2012). Rude leadership will moderate behavior engagement on intention to stay, which means rude leadership weakens relations with employees. It is because rude leadership further weakens employee engagement behavior, which impacts employees not feeling at home (Jha, 2019).

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117 Employees do not want to be in a work environme-

nt that is psychologically unsafe and less empowered (Bhatnagar, 2012).

H8 : Empowerment leader moderates the effect of behavior engagement on the intention to stay.

A Leader's Needs to Trust His Subordinate's and Intention to Stay

Working in a high-trust work environment improves employee engagement, well-being, and psychological safety, impacting employee turnover (Reddington, 2022). Organizational leaders mu- stfosteracooperativeenvironmenttoavoidemplo- yee retention, for that leadership trust will be thre- atened when leaders ignore time and cultural vari- ations across team members (Shahid, 2018). Lead- ers who can develop trust between employees and the organization will strengthen the organization's effectiveness. Bibb and Kourdi (2004) asserted that various outcomes could be achieved when trust persists in an organization. Trust in subordinates hasuniqueconsequencesbeyondtrustinmanagers, and this will discourage subordinates' intention to stop working because there is high mutual trust (Brower et al., 2009). Companies can develop trust by incorporating their approach into their orga-

nizationalgoalsandimplementingthemconsisten- tly across the company. Trust can shape the behavior and views of workers towards the values built by the company and the environment of the company in which people want to work.

H9 : Leader needs to trust his subordinates has an effect on the intention to stay.

Empowerment Leaders and Intention to Stay Leadership that empowers employee empowerment, in turn, affects employee engagement so that it affects affective commitment and has an impact on the absence of a desire to move or on the intention to stay (Albrecht and Andreetta, 2011).

Empowering leadership directly affects psychological empowerment. Leaders need to encourage and allow followers to lead themselves actively.

Empowering leadership will indirectly affect the intention to move. The indicators are work attitud- esandbehavior,motivation,andcommitment.Em- powermenthasimplicationsfortheindividual'sin- tention to remain in the job (Albrecht and Andreet- ta, 2011). The indicators are the network of collea- gues and subordinate relationships.

H10 : Empowerment leaders had an effect on the intention to stay.

METHOD

Table 1. The Operational Definition of the Variables

Variables Indicators Item

Intention to Stay (Bhatnagar, 2012)

1. Passion 2. Enthusiasm 3. Toughness 4. Dedication 5. Motivation

6. Fully engaged with work

3 2 2 3 3 3 Servant Leadership

(Lamprinou et al., 2021)

1. Command with rational communication 2. Replace bureaucracy with friendly support 3. Learn to listen to the concerns of subordinates

4. Assist subordinates in finding the meaning and purpose of work

4 3 3 3 Work-life balance

(Cowart et al., 2014)

1. Self-efficacy

2. Role demands, enthusiasm 3. Inspiration, pride, and challenge 4. Dedication

5. Motivation

3 2 3 3 3

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Variables Indicators Item

Behavior Engagement (Milliman et al., 2018)

1. Spirit 2. Enthusiasm 3. Toughness

1 2 3 Leader Needs to Trust His

Subordinates (Haq et al., 2021)

1. Commitment 2. Motivation

3. Leadership trustworthy behavior

6 4 5 Empowerment Leader

(Albrecht and Andreetta, 2011)

1. Integrity 2. Meaningfulness

3. Supportive manager and co-works 4. Empowering behavior

5. Psychological empowerment

3 2 2 3 3

This study is a quantitative study that colle- cted data using a survey technique through a questionnaire because this type of research enables researchers to use either large or small populations.

Still,thedataobtainedaredatafromsamplestaken from the population. The population of this study was employees of 10 big healthcare companies in Indonesia (Jakarta, Bekasi, Surabaya). Based on calculations using the Slovin Test, the results of thecriteriafortheminimumsamplesizeof192res- pondents were found. In this study, it was determined to obtain more precise results, and the precau- tionary principle was determined that the number of samples used was 200 respondents. The sampling was done using Judgment Sampling Method, whichdeterminesresponsesbasedonspecificcon- siderations. We adapted instruments from publish- ed studies to develop the survey questions using a 5-point Likert scale ranging from 1 strongly disag-

ree to 5 strongly agree. The variables in this study consisted of an intention to stay (Y), servant leadership (X1), work-life balance (X2), behavior engagement (X3), the leader need to trust his subordinates (Z1), and empowerment leader (Z2). The operational definition of the variables can be seen in the Table 1. The statistical technique used was SMART PLS. Before the analysis, the researchers conducted a validity test and reliability test. The researcher distributed the questionnaires via google forms. Before distributing the questionnaires to the samples, the researchers tested the questionnaires (instrument test) on subjects with the same circumstances but not on the samples studied. An in- strumented test is needed to determine whether the instrument is valid and reliable. The duration of the distribution of the questionnaire was 2 weeks.

The questionnaires were distributed in April and returned entirely in April as well.

RESULTS

Instrument Testing

Table 2. Validity and Reliability

Variable AVE Outer Loading Cronbach's Alpha Composite Reliability

X1 0.626 0.437 - 0.887 0.900 0.921

X2 0.578 0.731 – 0.843 0.931 0.942

X3 0.614 0.765 – 0.910 0.947 0.954

Y 0.524 0.790 – 0.871 0.907 0.923

Z1 0.559 0.753 – 0.893 0.841 0.883

Z2 0.674 0. 711 – 0.865 0.904 0.925

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119 The steps taken for hypothesis testing inclu-

ded instrument testing and hypothesis testing. The first test was an instrument test which included validity and reliability tests. The respondents in this study were staff employees from healthcare companies who filled out the questionnaire via Google Forms. The total of respondents was 137. The enti- re sample was an average age of between 25 to 45 years, with the number of the male respondents at 61,7% and the female respondents at 38,3%. Table 2 showed that all variables had met the AVE criteria, but not all items met the outer loading standard criteria. X1 item has a value of 0.437 smaller than 0.7, so it can be said that this item does not pass the validity test, so it will be deleted in the next st- age because it does not meet the standard criteria.

Based on the table above, it is also known that all variables have met the reliability requirements because they have Cronbach's alpha values and composite reliability smaller than 0.7, so it can be said that all variables in this research model have pass-

ed the reliability test.

Hypothesis Testing

Table 3 showed the result of the direct effect of the PLS test. It could be seen that the direct effects are as follows: there is an effect of servant leadership on work-life balance (p = 0,000), service leadership has no effect on the intention to stay (p = 0,386), servant leadership affects a leader needs to trust his subordinates (p = 0,001), work-life balance influences behavior engagement (p = 0,000), w- ork-life balance affects a leader needs to trust his subordinates (p = 0.000), behavior engagement affects intention to stay (p = 0,000), behavioral engagement has no effect on a leader needs to trust his subordinates (p=0,390), empowerment leader mo- deratestheeffectofengagementbehavioroninten- tion to stay (p = 0,019), a leader need to trust his subordinates has an effect on the intention to stay (p = 0,000), and empowerment leader has no effect on the intention to stay (p = 0.102).

Table 3. Hypothesis Testing Result

Construct Original Sample Sample Mean Standard Deviation T Statistic P Values

X1X2 0.691 0.694 0.052 13.341 0.000

X1Y -0.026 -0.042 0.089 0.389 0.386

X1Z1 0.268 0.262 0.083 3.213 0.001

X2X3 0.770 0.775 0.042 18.391 0.000

X2Z1 0.619 0.615 0.106 5.840 0.000

X3 Y 0.219 0.211 0.053 4.123 0.000

X3 Z1 0.027 0.040 0.098 0.279 0.390

X3*Z2Y 0.075 0.066 0.036 2.070 0.019

Z1 Y 0.705 0.710 0.061 11.532 0.000

Z2 Y 0.116 0.138 0.091 1.274 0.102

DISCUSSION

This research was conducted in the 10 biggest healthcare companies in Indonesia. Most of the respondents were millennials, and they preferred freedom. Millennials, when working, know net- working, being collaborative, being able to bond, have social knowledge, and being proficient tech- nologyusers(Mauldingetal,2012;GuptaandGo- yal, 2018). This generation prefers idealistic values and a vision of loyalty towards individual ma-

nagers and is willing to work hard, but this generation has hopes for immediate rewards and recogni- tion. Servant leadership style is in great demand in the era of globalization. Servant leadership meets the criteria for effective leadership (Gandolfi and Stone, 2018; Miao et al., 2021; Eva et al., 2021).

Millennial employees entering the global workforce require special treatment from the company because of the unique attitude of the millennial generation when working. The servant leadership style

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needs to be applied by managers to deal with this millennial generation employee. This leadership style effectively motivates millennial employees to be more productive and supportive of the company's business (Salsabil et al., 2021; Creighton, 2018).Effectiveservantleadershipencouragespo- sitive and effective communication within team, and that's what millennial employees favor. They value open communication so much that 81% of millennials say they would rather work in a company that prioritizes open communication over a- menities (Creighton, 2018).

Servant Leadership and Work-Life Balance Millennials value leaders who continually seek feedback from their employees and are more likely to provide constructive feedback and recog- nition consistently. This study found that servant leadership has a positive effect on work-life balance. This result supported Chughtai (2018), Lamp- rinouetal.(2021),andUtama(2021),whichfound that there is an effect of servant leadership on work -life balance. Under the effect of a servant leader and a supportive workplace and supervisor, remote workers and non-remote workers will show red- uced symptoms of work burnout and the ability to maintain a better balance between their professional and personal lives (Lamprinou et al., 2021).

Servant Leadership and Intention to Stay Servant leadership focuses on employee retention and development. However, this study found that servant leadership has no effect on the intention to stay. This result was strengthened by several previous researchers who stated that servant leadership has no effect on the intention to stay (Kashyap and Rangnekar, 2016; Brohi et al., 2018;

Albashiti et al, 2021). Servant leadership is not the only factor that affects the intention to stay. Still, there needs to support from leaders who fully beli- eveintheirfollowers'performancesothattheirfol- lowers voluntarily work as well as possible for the company's development without coercion.

Servant Leadership and Leader Needs to Trust His Subordinates

The results of this study indicate that servant leadership positively affects a leader's need to trust his subordinates. This result supported Haq et al. (2021) and Freeborough (2021). Trust is an

expected component in all business activities and is the component that provides dynamic and interpersonal relationships between people and organizations. Building trust in business culture is a crucial foundation for achieving leadership. Employ- ees who trust their leader may feel more committed, satisfied, and committed to their organization.

Trust in leaders also contributes to organizational and personal performance. However, during the COVID-19pandemic, itisnotonlyemployeeswho need to trust their superiors, but in this case, it is also emphasized that superiors need to trust their subordinates. It is because, at work, employees are not only those who the eyes can see but also employees who work from home or whose work activities cannot be seen directly by their leaders. Ma- nagement, however, should still trust in their employees that they can do their job well without being seen directly. Most important in this regard are the results of employees' work (Freeborough, 2021).

Work-Life Balance and Behavior Engagement Behavior engagement is an essential strategy for improving company performance. Engage- ment is the energy employees need to be involved in their work to get better performance (Rich et al., 2010). Employee involvement is a process to create employees' character in their roles to complete their work. Employees use and express themselves physically, cognitively, and emotionally in employee engagement. Work-life balance has an effect on behavior engagement (De Kort, 2017; Parkes and Langford, 2008). This study also found that work-life balance positively affects behavior engagement. This result supports Wood et al. (2020), who found that organizations concerned with organizational outcomes will encourage increased employee work engagement. During this COVID- 19 pandemic, organizations will increasingly strive to create the right environment where employees experience work-life balance. Work and family demands, as well as life balance, will encourage employees to have work engagement.

Work-life Balance and Leader Needs to Trust His Subordinates

Manystudiesshowthatagoodwork-lifeba- lance encourages organizational performance in a good direction and can increase the work satisfaction and the organizational commitment (Katili et

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121 al., 2021). In addition, work-life balance can be in-

terpreted as an idea that includes the compatibility between work, such as goals and career, and life- style, such as health, family, hobbies, and others.

Work-life balance affects leaders' need to trust subordinates (Gordon et al, 2014). The results of this study also indicate that work-life balance positively affects a leader's need to trust his subordinates.

Perceived trust in leaders exists when managers behave ethically, positively affect organizational culture, and treat employees fairly and consistently. It can build managers' trust in employees and encourage employee work-life balance (Gordon et al., 2014).

Behavior Engagement and Intention to Stay One of the most dominant concerns today is employee retention. Organizations need to pay attention by taking proactive steps to positively influence employees so that they remain intent on staying. The results of this study indicate that behavi- or engagement has a positive effect on the intention to stay. Bailey et al. (2017) stated that organiza- tionsexperiencelowervoluntaryturnoverorinten- tion to stay when employees feel involved in their work. Employees with behavior engagement show high-quality performance and positive work, but employees with low levels of engagement result in organizationallosses(Albrechtetal.,2014).Asen- se of work engagement will improve employee performance and reduce the intention to change jobs (Zia et al., 2021). Employees with a sense of work engagement show higher participation levels and an intention to stay (Kim and Gatling, 2018).

Behavior Engagement and Leader Needs to Trust His Subordinates

Employee behavioral engagement is when people fully invest in role-related activities as a positive, satisfying, and work-related state of mind characterized by a passion for work (Melhem and Al Qudah, 2019). Trust refers to the feeling that subordinates are trusted by their supervisor. Trust between parties is an essential element in a coope- rative relationship. In organizational settings, trust can be an important determinant of productivity in individuals, groups, and organizations (Brower et al., 2009). However, in this study, behavior engagement has no effect on a leader's need to trust his

subordinates. This result strengthened Liu et al.

(2018),whofoundbehaviorengagementhasnoef- fectonaleader'sneedtotrusthissubordinates. Em-

ployees will exploit their performance as much as possible if they are fully trusted in their work so that employees work with certainty because they are trusted.

The Effect of Empowerment Leader in Moderating the Effect of Behavior Engagement on Intention to Stay

The results of this study indicate that empowerment leaders strengthen the positive effect of behavior engagement on the intention to stay. Lea- derempowermentbehavioriscloselyrelatedtoen- gagement behavior because when leaders often provide opportunities for employees to empower their skills and ensure that their work is meaningful, employees will show an intention to stay (Mendes and Stander, 2011). Psychological empowerment affects work engagement and causes high innovation and lower the turnover intentions (Bhatnagar, 2012). Otherwise, rude leadership will moderate behavior engagement on intention to stay, which means rude leadership makes relations with employees weaker. It is because the presence of rude leadership further weakens employee engagement behavior, which impacts employees not feeling at home at work (Jha, 2019). Employees do not want to be in a work environment that is psychologically unsafe and less empowered (Bhatnagar, 2012).

Leader Needs to Trust His Subordinates and Intention to Stay

Working in a high-trust work environment improves employee engagement, well-being, and psychological safety, impacting employee turnover (Reddington, 2022). The results of this study indicate that a leader needs to trust his subordinates positively affects the intention to stay. Leaders w- ho can develop trust between employees and the organization will strengthen the organization's effectiveness. Trust in subordinates has unique con- sequences beyond trust in managers. It will discourage subordinates' intention to stop working because of high mutual trust (Brower et al., 2009).

Trust can shape the behavior and views of workers towards the values built by the company and the environment in which people want to work.

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122

Empowerment Leader and Intention to Stay Leadership that empowers employee empowerment, in turn, affects employee engagement so that it affects affective commitment and has an impact on the absence of a desire to move or on the intention to stay (Albrecht and Andreetta, 2011).

However, this study found that an empowered lea- derhasnoeffectontheintentiontostay. Empower- ment leader has no effect on the intention to stay but only as a moderator between engagement behavior and intention to stay.

IMPICATIONS

Our study's findings have important managerial implications for healthcare companies aim- ing to achieve sustainable employee retention thr- oughimprovedleadership, engagement, andwork- life balance. Work-life balance is one of the main factors that can retain employees. The case for work-life balance practices rests on attracting better applicants and reducing work-life conflicts to improve organizational performance. Work-life practices improve performance by reducing work-life conflict.Besidesthat,thecompanyshouldpaymo- re attention to behavioral engagement, empowerment leadership, and trust because these variables positively affect the intention to stay.

RECOMMENDATIONS

This research was conducted in Indonesia's 10 biggest healthcare companies, where most employees are millennials. The method of collecting dataispurposive,withdataacrossworkunitswhe- re the millennial generation is a generation that does not like to be regulated. Then results in millennial employees who see the figure of a leader as unacceptable because this figure is considered to regulate their performance too much. However, a- mong several leadership styles, the servant leadership style is considered not too binding on a millennial. This research also has a static approach. It is because the data collection is done in a cross- section.

The possibility to be investigated further is the transformational leadership style, as this can be more appropriate to use. Future research also should expand the research area and use longitudi- nal data and mixed-generation respondents to vali- date the research model and results.

CONCLUSIONS

This research investigates whether servant leadership, work-life balance, and behavior engagement play roles in employee intention to stay.

The findings of the study showed that servant leadership has a positive effect on work-life balance, servantleadershiphasapositiveeffectonaleader's needs to trust, work-life balance has a positive eff- ectonbehaviorengagement, work-lifebalancehas a positive effect on leader needs to trust his subordinates, behavioral engagement has a positive effect on the intention to stay, empowerment leader moderates the positive effect of behavior engagement on intention to stay, and leader needs to trust his subordinates has a positive effect on the intention to stay. However, service leadership has no effect on the intention to stay, behavioral engagement has no effect on the leader's need to trust his subordinates, and behavioral engagement has no effect on the leader's need to trust his subordinates.

Servant leadership has a negative and insignificant relationshiptotheintentiontostaybecauseitisnot only the servant leadership factor that affects the intention to stay, but there needs to support from leaders who fully believe in the performance of their followers so that their followers voluntarily work as well as possible for the development of the companywithoutanycoercion.Thebehavioral engagement has a positive but not significant relationship with a leader who needs to trust his subordinates. Therefore, the employees will exploit their performance as much as possible if they are fully trusted in their work so that employees work with certainty because they are trusted. Empowerment leader has a significant and insignificant effect on the intention to stay, but only as a moderator between the engagement behavior and the intention to stay.

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