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Empowerment and performance of managers and subordinates in elderly care: a longitudinal and multilevel study
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. (B-LONG)ORCID iD: 0000-0002-3381-5893
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. (B-LONG)
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. (B-LONG)ORCID iD: 0000-0002-1495-4943
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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2017 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, no 8, p. 647-656Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate relationships between first-line managers' ratings of structural and psychological empowerment, and the subordinates' ratings of structural empowerment, as well as their ratings of the managers' leadership-management performance.

BACKGROUND: Work situations in elderly care are complex. To date, few studies have used a longitudinal, correlational and multilevel design to study the working life of subordinates and managers.

METHOD: In five Swedish municipalities, questionnaires were answered twice during 2010-12 by 56 first-line managers and 769 subordinates working in nursing homes or home-help services.

RESULTS: First-line managers' empowerment at Time 1 partially predicted subordinate's structural empowerment and ratings of their managers' leadership-management performance at Time 2. Changes over time partially revealed that the more access managers had to structural empowerment, i.e. increase over time, the higher the ratings were for structural empowerment and managerial leadership-management performance among subordinates.

CONCLUSIONS: Findings strengthen research and theoretical suggestions linking first-line managers' structural empowerment to their subordinates' structural empowerment and ratings of their manager's leadership-management performance.

IMPLICATIONS FOR NURSING MANAGEMENT: Managers with high access to structural empowerment are more likely to provide subordinates access to structural empowerment.

Place, publisher, year, edition, pages
2017. Vol. 25, no 8, p. 647-656
Keywords [en]
first-line manager, leadership-management performance, linear mixed model, structural and psychological empowerment, subordinate
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health-Promoting Work
Identifiers
URN: urn:nbn:se:hig:diva-24874DOI: 10.1111/jonm.12504ISI: 000414511300009PubMedID: 28714218Scopus ID: 2-s2.0-85024843093OAI: oai:DiVA.org:hig-24874DiVA, id: diva2:1134046
Projects
B-LONG
Funder
AFA InsuranceAvailable from: 2017-08-17 Created: 2017-08-17 Last updated: 2021-04-01Bibliographically approved
In thesis
1. Working Life Among First-Line Managers and Their Subordinates in Elderly Care: an Empowerment Perspective
Open this publication in new window or tab >>Working Life Among First-Line Managers and Their Subordinates in Elderly Care: an Empowerment Perspective
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The aim of this thesis was to study the working life of first-line managers and their subordinates in elderly care from an empowerment perspective. Methods: Paper I and II used a qualitative approach, and semi-structured interviews were conducted with 14 male and 14 female first-line managers. Data were analyzed using qualitative content analysis. Paper III and IV used a quantitative approach with a longitudinal, correlational and multilevel design. 78 first-line managers and 1398 subordinates filled in the questionnaire at T1 and 56 first-line managers and 769 subordinates at T2. Data were analyzed using descriptive statistics, multivariate analyses (III & IV) and multilevel modelling (IV). Results: In Paper I and II, the first-line managers reported having a challenging and complex work situation. Although the first-line managers sometimes expressed a need for better access to structural empowerment in terms of information, resources and support, they experienced psychological empowerment in their work. In Paper III, the results indicated that the more access the first-line managers had to structural empowerment over time, the more likely they were to feel psychologically empowered over time, resulting in lower ratings of their stress symptoms and higher ratings of their own self-rated leadership-management performance over time. Another finding in Paper III was the influence the number of subordinates per first-line manager had on the first-line managers’ ratings of structural empowerment and the subordinates’ ratings of structural empowerment and stress symptoms. In Paper IV, the results indicate that the more access the first-line managers had to structural empowerment at T1, the more access the subordinates had to structural empowerment at T2, and the higher the subordinates rated their first-line manager’s leadership-management performance at T2, when controlling for psychological empowerment. Conclusions: The working life of first-line managers in elderly care is complex and challenging, and they seem to need better access to structural empowerment (Paper I-IV). However, although deficiencies in access to structural empowerment were reported, the first-line managers experienced their work as a positive challenge (Paper 1) and felt that, though the work was not easy, it was worth it (Paper II).

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 82
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine ; 1553
Keywords
Elderly Care, First-Line Manager, Structural and Psychological Empowerment, Subordinate, Working Life, Nursing, Omvårdnad
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-29480 (URN)978-91-513-0600-1 (ISBN)
Public defence
2019-05-07, Universitetshuset, Sal IX, Biskopsgatan 3, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-04-23 Created: 2019-04-23 Last updated: 2020-11-23Bibliographically approved

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Hagerman, HeidiHögberg, HansSkytt, BerniceEngström, Maria

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