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How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective?: An interview study
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala University.ORCID iD: 0000-0002-3381-5893
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala University; Lishui University, China .ORCID iD: 0000-0002-9912-5350
Uppsala University.
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala University.ORCID iD: 0000-0002-1495-4943
2019 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1208-1215Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The work situation for first-line managers in elderly care is complex and challenging. Little is known about these managers' work situation from a structural and psychological empowerment perspective.

AIM:

To describe first-line managers' experiences of their work situation in elderly care from a structural and psychological empowerment perspective.

METHOD:

Interviews from 14 female first-line managers were analysed using qualitative content analysis.

RESULTS:

The theme described the managers' work situation as "It's not easy, but it's worth it." In the four subthemes, the managers described their work in terms of "Enjoying a meaningful job," "A complex and demanding responsibility that allows great authority within set boundaries," "Supported by other persons, organisational preconditions and confidence in their own abilities" and "Lacking organisational preconditions, but developing strategies for dealing with the situations."

CONCLUSION:

The managers described having various amounts of access to structural empowerment and experienced a feeling of meaning, competence, self-determination and impact, that is, psychological empowerment in their work.

IMPLICATIONS FOR NURSING MANAGEMENT:

It is vital that first-line managers have access to organisational support. Therefore, upper management and first-line managers need to engage in continuous dialogue to customize the support given to each first-line manager.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 27, no 6, p. 1208-1215
Keywords [en]
elderly care; empowerment; first-line manager; structures of proportions; work situation
National Category
Nursing
Research subject
Health-Promoting Work
Identifiers
URN: urn:nbn:se:hig:diva-29363DOI: 10.1111/jonm.12793ISI: 000486018500019PubMedID: 31102540Scopus ID: 2-s2.0-85072508669OAI: oai:DiVA.org:hig-29363DiVA, id: diva2:1294686
Funder
AFA InsuranceAvailable from: 2019-03-08 Created: 2019-03-08 Last updated: 2021-04-14Bibliographically 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, HeidiEngström, MariaSkytt, Bernice

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