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Lindberg, M., Skytt, B., Lindberg, M., Wijk, K. & Strömberg, A. (2023). A complex challenge with unclear improvement: the need for involvement, contextualization and facilitation when managers implement a leadership model. Leadership in Health Services, 36(2), 236-246
Öppna denna publikation i ny flik eller fönster >>A complex challenge with unclear improvement: the need for involvement, contextualization and facilitation when managers implement a leadership model
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2023 (Engelska)Ingår i: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 36, nr 2, s. 236-246Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose

Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager’s job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers’ perceptions of, prerequisites for and experiences from the implementation of changes in their manager’s work conditions.

Design/methodology/approach

A grounded theory–based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis.

Findings

Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers’ descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process.

Originality/value

This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.

Ort, förlag, år, upplaga, sidor
Emerald, 2023
Nyckelord
Change management; Health services; Implementation; Leadership; Organisation and administration; Qualitative research
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsofrämjande arbete
Identifikatorer
urn:nbn:se:hig:diva-40080 (URN)10.1108/lhs-05-2022-0055 (DOI)000863665800001 ()36193881 (PubMedID)2-s2.0-85139172682 (Scopus ID)
Tillgänglig från: 2022-10-07 Skapad: 2022-10-07 Senast uppdaterad: 2023-04-25Bibliografiskt granskad
Mathiassen, S. E., Waleh Åström, A., Strömberg, A. & Heiden, M. (2023). Cost and statistical efficiency of posture assessment by inclinometry and observation, exemplified by paper mill work. PLOS ONE, 18(10), Article ID e0292261.
Öppna denna publikation i ny flik eller fönster >>Cost and statistical efficiency of posture assessment by inclinometry and observation, exemplified by paper mill work
2023 (Engelska)Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 18, nr 10, artikel-id e0292261Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Postures at work are paramount in ergonomics. They can be determined using observation and inclinometry in a variety of measurement scenarios that may differ both in costs associated with collecting and processing data, and in efficiency, i.e. the precision of the eventual outcome. The trade-off between cost and efficiency has rarely been addressed in research despite the obvious interest of obtaining precise data at low costs. Median trunk and upper arm inclination were determined for full shifts in 28 paper mill workers using both observation and inclinometry. Costs were estimated using comprehensive cost equations; and efficiency, i.e. the inverted standard deviation of the group mean, was assessed on basis of exposure variance components. Cost and efficiency were estimated in simulations of six sampling scenarios: two for inclinometry (sampling from one or three shifts) and four for observation (one or three observers rating one or three shifts). Each of the six scenarios was evaluated for 1 through 50 workers. Cost-efficiency relationships between the scenarios were intricate. As an example, inclinometry was always more cost-efficient than observation for trunk inclination, except for observation strategies involving only few workers; while for arm inclination, observation by three observers of one shift per worker outperformed inclinometry on three shifts up to a budget of €20000, after which inclinometry prevailed. At a budget of €10000, the best sampling scenario for arm inclination was 2.5 times more efficient than the worst. Arm inclination could be determined with better cost-efficiency than trunk inclination. Our study illustrates that the cost-efficiency of different posture measurement strategies can be assessed and compared using easily accessible diagrams. While the numeric examples in our study are specific to the investigated occupation, exposure variables, and sampling logistics, we believe that inclinometry will, in general, outperform observation. In any specific case, we recommend a thorough analysis, using the comparison procedure proposed in the present study, of feasible strategies for obtaining data, in order to arrive at an informed decision support.

Ort, förlag, år, upplaga, sidor
PLOS, 2023
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Forskningsämne
Hälsofrämjande arbete
Identifikatorer
urn:nbn:se:hig:diva-40999 (URN)10.1371/journal.pone.0292261 (DOI)001082402300022 ()37788296 (PubMedID)2-s2.0-85173062236 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2009-1761
Tillgänglig från: 2023-02-02 Skapad: 2023-02-02 Senast uppdaterad: 2023-11-16Bibliografiskt granskad
Norrgård, A., Tham, P., Strömberg, A. & Kåreholt, I. (2023). How do child welfare social workers assess the leadership of their first-line managers? A 15-year perspective. British Journal of Social Work
Öppna denna publikation i ny flik eller fönster >>How do child welfare social workers assess the leadership of their first-line managers? A 15-year perspective
2023 (Engelska)Ingår i: British Journal of Social Work, ISSN 0045-3102, E-ISSN 1468-263XArtikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

The study aimed to investigate how child welfare social workers assessed the leadership of their first-line managers over a period of fifteen years and to examine whether the assessments have changed over time. More specifically, the analysis focused on the extent to which social workers perceive the leadership of their first-line managers to be empowering, supportive and fair. Data were collected in the years 2003 (n = 293), 2014 (n = 300) and 2018 (n = 309) using the same questionnaire, mainly based on QPS Nordic, which was distributed to social workers working with investigations of children and youth. The results show that the social workers assessed all measured aspects of their first-line managers' leadership as better in 2014 compared to 2003 and significantly better in 2018 compared to 2003. In light of previous studies showing that child welfare managers experience less optimal conditions for their leadership, the results are surprising. How is it possible that the first-line managers, despite their own descriptions of a more difficult leadership situation, are seen as more supportive, empowering and fair in their leadership from the social workers' perspective? Possible explanations for the social workers' better assessments over the years, such as specialisation, are discussed.

This article investigates how child welfare social workers have assessed the leadership of their first-line managers over a period of fifteen years. Questionnaires were collected in the same geographical areas in 2003, 2014 and 2018. The results show that child welfare social workers assessed the leadership of their first-line managers as increasingly empowering, supportive and fair over the years. In light of previous studies showing that child welfare managers experience less optimal conditions for their leadership, the results are surprising. How is it possible that the first-line managers, despite their own descriptions of a more difficult leadership situation, are seen as more supportive, empowering and fair in their leadership from the social workers' perspective? Potential explanations as to why assessments have improved are discussed.

Ort, förlag, år, upplaga, sidor
Oxford Academic, 2023
Nyckelord
child welfare, first-line manager, follow-up study, leadership, questionnaire, social worker
Nationell ämneskategori
Socialt arbete
Identifikatorer
urn:nbn:se:hig:diva-43370 (URN)10.1093/bjsw/bcad255 (DOI)001124880400001 ()
Forskningsfinansiär
AFA Försäkring, 170025
Tillgänglig från: 2023-12-04 Skapad: 2023-12-04 Senast uppdaterad: 2024-03-03Bibliografiskt granskad
Strömberg, A. (2022). Forskning pågår 2022: Akademin för hälsa och arbetsliv. Gävle: Gävle University Press
Öppna denna publikation i ny flik eller fönster >>Forskning pågår 2022: Akademin för hälsa och arbetsliv
2022 (Svenska)Rapport (Övrigt vetenskapligt)
Abstract [sv]

Verksamheten vid akademin för hälsa och arbetsliv utgör en kollegial och tvärvetenskaplig miljö som tar avstamp i människors olika livsvillkor och sammanhang med fokus på människan som individ, i grupper, organisationer och samhällen. Fysisk, psykisk och social hälsa utgör den gemensamma nämn-aren. Utbildningen och forskningen kring dessa livsvillkor handlar om människors välbefinnande i en gynnsam ekologisk, ekonomisk och social miljö.

För att lösa de samhällsutmaningar vi står inför är forskningen och skapandet av ny kunskap viktig. I denna rapport samlas projektbeskrivningar kring den forskning som pågår vid akademin. Forsknings-projekten är sorterade under temporära samlingsrubriker som vi idag ser som starka inriktningar. Forskning och kunskapande formas och omformas vilket ger att projekt och inriktningar ändras över tid. Titeln på rapporten ”Forskning pågår” signalerar just denna föränderlighet.

Rapporten innehåller över 100 projekt som svarar mot samhällsutmaningar inom hälsa och välfärd. Den kunskap som utvecklas genom vår forskning skapar goda förutsättningar för att vi ska kunna bidra till en positiv utveckling inom dessa områden. Ny kunskap kan göra skillnad!

Ort, förlag, år, upplaga, sidor
Gävle: Gävle University Press, 2022. s. 122
Nyckelord
Högskolan i Gävle, forskningsprojekt, pågående forskningsprojekt, akademin för hälsa och arbetsliv
Nationell ämneskategori
Annan medicin och hälsovetenskap Hälsovetenskaper
Forskningsämne
Hälsofrämjande arbete
Identifikatorer
urn:nbn:se:hig:diva-37591 (URN)
Tillgänglig från: 2022-01-11 Skapad: 2022-01-11 Senast uppdaterad: 2023-02-17Bibliografiskt granskad
Wiitavaara, B., Strömberg, A., Mutiganda, J. C., Svensson, M., Hallman, D. & Svensson, S. (2022). Like a fire brigade, but without pay - Experiences of temporary employment among workers in Swedish elderly care. International Journal of Qualitative Studies on Health and Well-being
Öppna denna publikation i ny flik eller fönster >>Like a fire brigade, but without pay - Experiences of temporary employment among workers in Swedish elderly care
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2022 (Engelska)Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631Artikel i tidskrift (Refereegranskat) Submitted
Abstract [en]

This study investigates experiences of temporary work among care personnel in elderly care. Semi-structured interviews were performed with fifteen temporarily employed men and women working as care personnel in municipal nursing homes or home care and analyzed using a phenomenographic approach. The informants’ experiences of having a temporary employment were characterized by either a sense of flexibility or, more common, uncertainty, lack of control over life, time and economy, as well as difficulties associated with always being available. The informants’ experiences of working as a temporary employed were characterized by enjoyment of work and job satisfaction, differing experiences regarding the division of work and communication, but also being in an exposed position. The results presented reflect an experience of temporary employment as being in a vulnerable position. This vulnerability varies with resources and can take different forms.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2022
Nyckelord
Temporary employment, elderly care, vulnerability, financial uncertainty, work environment
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Forskningsämne
Hälsofrämjande arbete
Identifikatorer
urn:nbn:se:hig:diva-40303 (URN)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2019–01257
Tillgänglig från: 2022-10-24 Skapad: 2022-10-24 Senast uppdaterad: 2024-01-29Bibliografiskt granskad
Lundin, K., Silén, M., Strömberg, A., Engström, M. & Skytt, B. (2022). Staff structural empowerment - observations of first-line managers and interviews with managers and staff. Journal of Nursing Management, 30(2), 403-412
Öppna denna publikation i ny flik eller fönster >>Staff structural empowerment - observations of first-line managers and interviews with managers and staff
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2022 (Engelska)Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 30, nr 2, s. 403-412Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

AIM: The aim was to study how first-line managers act to make structural empowerment accessible for nursing staff. Furthermore, to relate these observations to the manager's and their nursing staff's descriptions regarding the staff's access to empowering structures.

BACKGROUND: Staff access to empowering structures has been linked to positive workplace outcomes. Managers play an important role in providing the conditions for structural empowerment.

METHOD: Five first-line managers were observed for two workdays. Managers and staff (n=13) were thereafter interviewed. Field notes and interviews were analyzed using directed content analysis.

RESULTS: The managers displayed intentional actions that could enable their staff access to empowering structures. Managers and staff described the importance of staff's access to empowering structures.

CONCLUSION: Staff who perceive to have access to structural empowerment have managers who are present and available. Unanimity among managers and staff existed in regard to the importance of staff having access to structural empowerment. The managers work continually and intentionally, doing many things at the same time, to provide the staff access to empowering structures.

IMPLICATIONS FOR NURSING MANAGEMENT: The study shows the importance of promoting managers' awareness of staff's access to structural empowerment and maximizing managers' presence and availability to their staff.

Ort, förlag, år, upplaga, sidor
Wiley, 2022
Nyckelord
hospital, nurse managers, nurses, observation, structural conditions, working conditions
Nationell ämneskategori
Hälsovetenskaper
Identifikatorer
urn:nbn:se:hig:diva-37389 (URN)10.1111/jonm.13513 (DOI)000732481200001 ()34783103 (PubMedID)2-s2.0-85121509064 (Scopus ID)
Tillgänglig från: 2021-11-18 Skapad: 2021-11-18 Senast uppdaterad: 2023-02-17Bibliografiskt granskad
Engström, M., Mårtensson, G., Pålsson, Y. & Strömberg, A. (2022). What relationships can be found between nurses' working life and turnover? - A mixed-methods approach. Journal of Nursing Management, 30(1), 288-297
Öppna denna publikation i ny flik eller fönster >>What relationships can be found between nurses' working life and turnover? - A mixed-methods approach
2022 (Engelska)Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 30, nr 1, s. 288-297Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

AIM: to describe why registered nurses decide to leave their work and to investigate relationships between registered nurses' working life and turnover (leaving the unit versus the profession).

BACKGROUND: Much research has explored nurses' intention to leave, while less research has looked at turnover and especially leaving the profession.

METHODS: Data were collected using questionnaires and interviews.

RESULTS: The three most common reasons for both groups (leaving the profession, n=40; leaving unit but not profession, n=256) were high workload, low salary and applied for and got a new job. Multivariate logistic regression analysis revealed statistically significant relationships between turnover and empowering structures, such as access to resources and informal power as well as the factor learning in thriving.

CONCLUSIONS: Structural empowerment, such as good access to resources and informal power, is important to keeping nurses in the profession, while learning seems to increase the risk of leaving the profession when variables such as vitality, resources, informal power and age are held constant.

IMPLICATIONS FOR NURSING MANAGEMENT: To counteract nurses leaving the profession, managers must provide nurses with good access to resources, informal power, such as networks within and outside the organization, and focus on nurses' vitality.

Ort, förlag, år, upplaga, sidor
Wiley, 2022
Nyckelord
registered nurses, resigning, structural conditions, thriving, turnover
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsofrämjande arbete, Inkluderande arbetsliv
Identifikatorer
urn:nbn:se:hig:diva-37155 (URN)10.1111/jonm.13494 (DOI)000715077200001 ()34643314 (PubMedID)2-s2.0-85118593298 (Scopus ID)
Tillgänglig från: 2021-10-15 Skapad: 2021-10-15 Senast uppdaterad: 2023-12-06Bibliografiskt granskad
Strömberg, A. (2021). Forskning pågår 2021: Akademin för hälsa och arbetsliv. Gävle: Gävle University Press
Öppna denna publikation i ny flik eller fönster >>Forskning pågår 2021: Akademin för hälsa och arbetsliv
2021 (Svenska)Rapport (Övrigt vetenskapligt)
Abstract [sv]

För att lösa de samhällsutmaningar vi står inför är forskningen och skapandet av ny kunskap en viktig parameter. Inom akademin för hälsa och arbetsliv har forskningen fokus på hälsa och välfärd. Sedan 2018 har vi inför varje årsskifte samlat in projektbeskrivningar för de forskningsprojekt som pågår. Detta görs för att ge en överblick över forskningen men också som ett underlag för att kunna kommunicera forskningens inriktning och innehåll, såväl internt som externt.

I rapporten är forskningsprojekten sorterade under temporära samlingsrubriker som vi idag ser som starka inriktningar för forskningen vid akademin. Forskning och kunskapande formas och omformas vilket ger att projekt och inriktningar ändras över tid. Titeln på rapporten ”Forskning pågår” signalerar just denna föränderlighet.

Även i år innehåller rapporten över 100 projekt som svarar mot samhällsutmaningar inom hälsa och välfärd. Antalet doktorandprojekt ökar för varje år liksom andelen projekt med extern finansiering och de projekt som sker i samverkan med det omgivande samhället. Den kunskap som utvecklas genom vår forskning skapar goda förutsättningar för att vi ska kunna bidra till en positiv utveckling inom dessa områden. Vi kan göra skillnad!

 

Annika StrömbergAkademichef Akademin för Hälsa och Arbetsliv

Ort, förlag, år, upplaga, sidor
Gävle: Gävle University Press, 2021. s. 130
Nyckelord
Högskolan i Gävle, forskningsprojekt, pågående forskningsprojekt, akademin för hälsa och arbetsliv, AHA, forskning, forskning pågår, 2021
Nationell ämneskategori
Annan medicin och hälsovetenskap Hälsovetenskaper
Forskningsämne
Hälsofrämjande arbete
Identifikatorer
urn:nbn:se:hig:diva-35261 (URN)
Tillgänglig från: 2021-03-03 Skapad: 2021-03-03 Senast uppdaterad: 2023-02-17
Lundin, K., Silén, M., Strömberg, A., Engström, M. & Skytt, B. (2021). Observations and interviews describing first-line manager’s work at hospitals where the staff rates high access to empowering structures. In: : . Paper presented at Nordic Conference in Nursing Research (NCNR 2021), 4-6 October, 2021, Copenhegen, Denmark.
Öppna denna publikation i ny flik eller fönster >>Observations and interviews describing first-line manager’s work at hospitals where the staff rates high access to empowering structures
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2021 (Engelska)Konferensbidrag, Poster (med eller utan abstract) (Övrigt vetenskapligt)
Abstract [en]

Background

In times where hospitals are struggling with recruitment as well as keeping their current workers healthy and willing to stay on, it is important to identify factors that can help work organizations in their work of providing conditions for a good work environment and for a leadership that promotes health and development.

Objective

The aim was to study how first-line managers act at units where the staff has rated their access to empowering structures as high and to describe this together with the first-line managers' and their staff's descriptions regarding the staff's access to empowering structures by using Kanter's theory of structural empowerment as a framework. 

Method

A descriptive design with a qualitative approach collecting data using both observations and interviews. The study sample consisted of five first-line managers (FLM) and 13 staff members, at hospital units in different parts of Sweden, where the staff had rated their access to empowering structures as high using the Conditions of Work Effectiveness Questionnaire – II (CWEQ II) in a previous data collection.

Both the first and last author conducted 80 hours of observations, following each FLM during two workdays, and 15 hours of interviewing both the FLMs and staff members. Fieldnotes of what the FLMs were doing were taken during the observations. On the third day at the unit, interviews were conducted with the FLM and two or three out of their staff. The interviews were semi-structured with questions related to the observations and questions inspired by Kanter’s theory. Data from both MP3 files and notebooks were transferred into a Word document and directed content analysis informed by Kanter’s theory was performed on the material as a whole.

Results

Preliminary results from the ongoing analysis indicate that findings in both the observations and interviews often confirm and support each other.

 

Nyckelord
hospital, nurse managers, nurses, observation, structural conditions, working conditions
Nationell ämneskategori
Omvårdnad
Forskningsämne
Hälsofrämjande arbete
Identifikatorer
urn:nbn:se:hig:diva-40020 (URN)
Konferens
Nordic Conference in Nursing Research (NCNR 2021), 4-6 October, 2021, Copenhegen, Denmark
Tillgänglig från: 2022-09-28 Skapad: 2022-09-28 Senast uppdaterad: 2023-02-17Bibliografiskt granskad
Engström, M., Högberg, H., Strömberg, A., Hagerman, H. & Skytt, B. (2021). Staff working life and older persons' satisfaction with care: a multilevel, correlational design. Journal of Nursing Care Quality, 36(1), 7-13
Öppna denna publikation i ny flik eller fönster >>Staff working life and older persons' satisfaction with care: a multilevel, correlational design
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2021 (Engelska)Ingår i: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065, Vol. 36, nr 1, s. 7-13Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care.

PURPOSE: The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care.

METHODS: A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care.

RESULTS: Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment.

CONCLUSIONS: Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.

Ort, förlag, år, upplaga, sidor
Wolters Kluwer, 2021
Nyckelord
elderly care, empowerment, job satisfaction, nurses, quality of care
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsofrämjande arbete
Identifikatorer
urn:nbn:se:hig:diva-31975 (URN)10.1097/NCQ.0000000000000463 (DOI)000595905000004 ()32079960 (PubMedID)2-s2.0-85097213070 (Scopus ID)
Forskningsfinansiär
AFA Försäkring
Tillgänglig från: 2020-03-02 Skapad: 2020-03-02 Senast uppdaterad: 2023-02-17Bibliografiskt granskad
Projekt
Äldreomsorgens vårdare och ledare; samspelet mellan strukturella förutsättningar, chef- ledarskap, arbetssituation och personalens hälsa [110043]; Högskolan i Gävle
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0001-7261-3496

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