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Ledarskap och psykosocial arbetsmiljö i kommunal äldreomsorg: Skillnader och likheter mellan särskilt boende och hemtjänst
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
2015 (Swedish)Licentiate thesis, comprehensive summary (Other academic)Alternative title
Leadership and psychosocial work environment in municipality old age care : Differences and similarities between nursing homes and home help services (English)
Abstract [en]

Introduction. Municipal eldercare is increasingly multifaceted. First line managers in nursing homes and home help services are responsible for personnel, budget and processes. The resources and work conditions of these managers have changed over time. The first line manager is often responsible not only for economic but also for quality development of their unit. Research focusing on first line management within municipal eldercare is lacking in specific contexts, for example, research on leadership in nursing homes and home help services.

Aims. The aim of this thesis is to study and analyze perceptions of leadership in eldercare. The main objective is to analyze differences in leaders’ and nursing assistants’ perceptions of leadership in nursing homes and home help services, and to study leadership factors and their associations with psychosocial work environment among nursing assistants who are engaged in eldercare.

Design and methods. This thesis is based on two studies, and uses cross-sectional data from two different surveys: the Developmental Leadership Questionnaire, DLQ (Larsson, 2006a) and a Questionnaire for Psychological and Social factors at Work, QPS, (Dallner, et al.,2000). Assessments from 21 leaders and 95 nursing assistants in nursing homes and home help services were analyzed in study I. Assessments from 1132 nursing assistants in nursing homes and in home help services (n=844 nursing homes and n=288, home help service units) were analyzed in article II. The data were analyzed with descriptive and analytic statistics.

Results. Nursing assistants in nursing homes assessed their leaders to be more controlling and observant than nursing assistants in home help services. According the leaders self assessment, leaders in home help services were less successful at being supportive, being a good example, and promoting creativity than leaders in nursing homes. Psychosocial work environment was related to leadership factors, but stronger associations occurred more frequently in nursing homes than in home help services. The leadership factors empowering leadership, support from superiors, focus on human resources and control over decisions were associated with better results on all the variables that were related to the psychosocial work environment in both nursing homes and in home help services.

Conclusions and implications for practice. Organisational differences in conducting leadership in old age care must be considered. Some leadership characteristics are better conditions for creating and maintaining a positive psychosocial work environment for nursing assistants in nursing homes and home help services. Due to the differences in organisational settings, it is important to consider the differences in conditions for conducting leadership. To influence nursing assistants’ performance and to increase quality in eldercare in the long term, appropriate leadership is necessary. Therefore, it is important for the leaders to provide support in work, help to develop skills, encourage employees to participate in important decisions, and show interest in nursing assistants’ well-being. Also, the leaders might benefit if they reduce the specialisation of work, which counteracts the possibility to have variation in work in nursing homes and home help services. In particular, nursing homes should benefit if they reduce the amount of role conflicts, and if nursing assistants receive reasonable quantitative work demands. The municipality eldercare should take into account the organisational differences in conducting leadership in nursing homes in relation to home help services. Recruiting leaders with characteristics that are desirable in the specific context will create better conditions for a good psychosocial work environment in nursing homes and home help services.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare , 2015. , 68 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 63
Keyword [en]
Leadership, psychosocial work environment, old age care, nursing homes, home help services
National Category
Gerontology, specializing in Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-28112ISBN: 978-91-85835-62-1 (print)OAI: oai:DiVA.org:hj-28112DiVA: diva2:859406
Presentation
2015-11-13, Ga 934, Hälsohögskolan i Jönköping, Jönköping, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2015-10-07 Created: 2015-10-07 Last updated: 2015-10-07Bibliographically approved
List of papers
1. Municipal eldercare: Leadership differences in nursing homes and home help services
Open this publication in new window or tab >>Municipal eldercare: Leadership differences in nursing homes and home help services
2015 (English)In: Article in journal (Other academic) Submitted
Abstract [en]

Eldercare organizations have become increasingly multifaceted, and leaders play an important role in such organizations. This study used the developmental leadership questionnaire (DLQ) to compare perceptions of leadership in nursing homes with perceptions of leadership in home help services for older adults. A total of 21 leaders and 95 subordinates responded. Almost all were women; only seven men participated. Both leaders and subordinates perceived more positive leadership styles in nursing homes than in home help services. Leaders self-evaluations showed significant differences in the variables “promoting creativity” (p = 0.021), “management-related competencies” (p = 0.022), “capacity to cope with stress” (p = 0.002), and “results of leadership” (p = 0.034). Evaluations of leaders by subordinates showed significant differences in “not overcontrolling” (p = 0.018). Our findings suggest that the social service should recognize the differences in the way nursing homes and home help services are organized and should recruit leaders with traits and behaviours desirable to each setting.

Keyword
Leadership, subordinates, eldercare, nursing homes, home help services
National Category
Gerontology, specializing in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-28109 (URN)
Available from: 2015-10-07 Created: 2015-10-07 Last updated: 2016-09-07
2. Leadership and the psychosocial work environment in old age care
Open this publication in new window or tab >>Leadership and the psychosocial work environment in old age care
2016 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 11, no 1, 44-54 p.Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To study leadership factors and their associations with psychosocial work environmental among nursing assistants who are engaged in old age care and to analyse (i) differences in the assessment of leadership factors and the assessment of psychosocial work environmental in nursing homes and home help services and (ii) the association between the psychosocial work environment and factors that are related to leadership in nursing homes and home help services.

Background

Leadership factors are an important element of the psychosocial work environment in old age care. The physical distance between leaders and nursing assistants is larger in home help services than in nursing homes. Therefore, it is important to study leadership separately in nursing homes and home help services.

Design

Assessments from 844 nursing assistants in nursing homes and 288 in home help services (45 nursing homes and 21 home help service units) were analysed.

Methods

The data were analysed using linear regression. Age, gender, number of staff at the unit, number of years at the current working unit and educational level were controlled in Model 1. Summarised indexes that were based on all independent variables except the main independent variable were additionally controlled in Model 2.

Results

Psychosocial work environment was related to leadership factors, but stronger associations occurred more frequently in nursing homes than in home help services. Empowering leadership, support from superiors, the primacy of human resources and control over decisions were associated with higher assessments on all the variables that were related to the psychosocial work environment in both the nursing homes and home help services.

Conclusions

Organisational differences in conducting leadership in old age care must be considered. Some leadership characteristics are better prerequisites for creating and maintaining a positive psychosocial work environment for nursing assistants in nursing homes and home help services.

Implications for practice

Due to the differences in organisational settings, it is important to consider the differences in prerequisites in conducting leadership. To influence nursing assistants' performance and to increase quality in old age care in the long term, appropriate leadership is necessary.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keyword
leadership; nursing assistants; old age care; staff; supervision; work environment
National Category
Gerontology, specializing in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-28110 (URN)10.1111/opn.12088 (DOI)000373104200006 ()26073426 (PubMedID)2-s2.0-84958672579 (Scopus ID)
Available from: 2015-10-07 Created: 2015-10-07 Last updated: 2017-04-18Bibliographically approved

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