hig.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard-cite-them-right
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • sv-SE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • de-DE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
First-Line Managers’ Perceptions of Their Psychosocial Work Environment in Nursing Homes: A Qualitative Analysis of the Influence of Ownership Type
University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.ORCID iD: 0000-0003-0979-3986
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Lishui University, China.ORCID iD: 0000-0002-9912-5350
University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.ORCID iD: 0000-0001-7028-8247
2023 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, article id 6694499Article in journal (Refereed) Published
Abstract [en]

In the wake of welfare sector reforms and the increasing marketisation of eldercare services, nursing home first-line managers (FLMs) are confronted with escalating work demands within streamlined organisations. Given this background, the aim was to investigate FLMs’ perceptions of their psychosocial work environment and of differences between nursing home ownership types. Nineteen managers from three Swedish municipalities from municipal, outsourced, and private nursing homes participated in semi-structured interviews focused on job demands, job resources, and ownership differences. The FLMs’ perceptions were interpreted as forming two themes. Navigating challenges: striving to cope with demands highlighted various challenges, including recruitment, workload, and lack of organisational support. Key stressors encompassed personnel struggles, time constraints, and complex interactions. Influence of ownership dynamics on the work environment explored variation across ownership types. Private nursing home managers enjoyed more decision-making autonomy but faced more scrutiny than did municipal ones. FLMs in outsourced homes described unique stressors, notably uncertainty and increased workload due to the procurement process. These findings underscore the potential need for tailored systemic changes across different ownership types. The policy implications include enhancing communication and support in municipal homes, reducing the span of control in private homes, and revising the procurement process in outsourced homes. These insights suggest that further research outlining differences between ownership types, particularly private and outsourced nursing homes, is warranted. Such research could aid in formulating specific strategies tailored to each ownership type in order to enhance the psychosocial work environment for FLMs in nursing homes.

Place, publisher, year, edition, pages
Hindawi , 2023. article id 6694499
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-43178DOI: 10.1155/2023/6694499ISI: 001095074600001Scopus ID: 2-s2.0-85176261293OAI: oai:DiVA.org:hig-43178DiVA, id: diva2:1807261
Available from: 2023-10-25 Created: 2023-10-25 Last updated: 2024-06-20Bibliographically approved
In thesis
1. Residential care homes in the age of marketisation: Care workers’ and first-line managers’ psychosocial work environment and well-being across public, outsourced, and private providers
Open this publication in new window or tab >>Residential care homes in the age of marketisation: Care workers’ and first-line managers’ psychosocial work environment and well-being across public, outsourced, and private providers
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Särskilt boende för äldre i marknadiseringens tidevarv : Omsorgspersonal- och första linjens chefers psykosociala arbetsmiljö och välbefinnande hos offentliga, upphandlade och privata utförare
Abstract [en]

The aim was to investigate care workers’ and first-line managers’ (FLMs) psychosocial work environment and well-being across public, outsourced, and private residential care homes. A mixed-methods approach was used, including a systematic review and qualitative and quantitative data. Data included 11 procurement and tender documents, 19 semi-structured interviews with FLMs, and a survey with 253 care workers from three Swedish municipalities. The results did not indicate clear advantages regarding the psychosocial work environment and well-being for any provider type. Internationally, results favoured nonprofit settings for care workers’ well-being concerning commitment, stress, and turnover intentions. The Swedish context had mixed results. FLMs in outsourced and private settings felt they had more influence and better managerial support than in public settings. Care workers in outsourced settings rated emotional demands and burnout higher, while FLMs faced additional stress and demands due to the outsourcing process. Public care workers reported fewer work–life conflicts than private ones. Most care workers reported good job satisfaction, yet about one in four considered leaving their jobs. Marketisation has brought procurement processes that overlook care worker empowerment, with documents emphasising care users while imposing demands on the workforce. There were municipal variations in the documents, FLMs’ work structure, and care workers’ burnout ratings, challenging equality ambitions. The dissertation highlights persistent issues in the psychosocial work environment with high workloads, recruitment challenges, inadequate organisational support, conflicting care logics and a disconnect between political ambitions and the realities of residential care homes. Political decisions do not come with corresponding resources. To address these issues, care workers and FLMs must be prioritised in decisions and policy documents, which could also improve care quality.

Abstract [sv]

Syftet var att undersöka omsorgspersonal och första linjens chefers (FLC) psykosociala arbetsmiljö och välbefinnande inom offentliga, upphandlade och privata driftformer för särskilt boende för äldre (SÄBO). En mixad ansats användes, inklusive en systematisk översikt samt kvalitativa och kvantitativa data. Data omfattade 11 upphandlings- och förfrågningsunderlag, 19 semistrukturerade intervjuer med FLC och en enkätundersökning med 253 omsorgspersonal från tre kommuner. Resultaten visade generellt att personal i icke-vinstdrivande driftformer, internationellt sett, hade bättre välbefinnande vad gäller engagemang, stress och avsikter att sluta. Den svenska kontexten hade blandade resultat, med inga tydliga fördelar för någon driftform gällande arbetsmiljön och välbefinnande. FLC i upphandlade och privata driftformer upplevde att de hade mer inflytande och bättre stöd från ledningen än de i offentlig driftform. Personal i upphandlade driftformer rapporterade högre emotionella krav och utmattning, medan FLC upplevde stress och en hög kravbild på grund av upphandlingsprocessen. Personal inom offentlig sektor upplevde färre konflikter mellan arbete och privatliv än de i privata driftformer. Personalen skattade överlag hög arbetstillfredsställelse, samtidigt som cirka en av fyra övervägde att sluta. Marknadisering har medfört upphandlingsprocesser som förbiser omsorgspersonalens empowerment, med dokument som betonar omsorgstagarna men ställer höga krav på personalen. Resultaten visade på kommunala variationer, vilket utmanar jämlikhetsambitioner. Avhandlingen belyser ihållande problem i den psykosociala arbetsmiljön som hög arbetsbelastning, rekryteringsutmaningar, otillräckligt organisatoriskt stöd, motstridiga logiker och en klyfta mellan politiska ambitioner och verkligheten i SÄBO. Politiska beslut åtföljs inte av motsvarande resurser. Omsorgspersonal och FLC måste prioriteras i beslut och policydokument, vilket också kan bidra till att förbättra omsorgens kvalitet.

Place, publisher, year, edition, pages
Gävle: Gävle University Press, 2024. p. 93
Series
Doctoral thesis ; 50
Keywords
Eldercare, for-profit, job demands–resources theory, marketisation, outsourcing, psychosocial work environment, public sector, social care, structural empowerment, well-being, Jobbkrav–resursteori, marknadisering, offentlig sektor, psykosocial arbetsmiljö, Social omsorg, strukturell empowerment, upphandling, välbefinnande, vinstincitament, äldreomsorg
National Category
Social Work
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-44829 (URN)978-91-89593-40-4 (ISBN)978-91-89593-41-1 (ISBN)
Public defence
2024-09-27, Sal 33:202 och Zoom, Kungsbäcksvägen 47, Gävle, Gävle, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2024-09-03 Created: 2024-06-20 Last updated: 2024-09-03

Open Access in DiVA

fulltext(342 kB)143 downloads
File information
File name FULLTEXT01.pdfFile size 342 kBChecksum SHA-512
60541f11741e1bd64ce096abfc6fe595c094cc9e0289df7519d3921782c3a786277091e28ae72475d046411808a653ec91b22c261a53762025f791d86827ca19
Type fulltextMimetype application/pdf

Other links

Publisher's full textScopus

Authority records

Lindmark, TomasEngström, MariaTrygged, Sven

Search in DiVA

By author/editor
Lindmark, TomasEngström, MariaTrygged, Sven
By organisation
Social WorkCaring Science
In the same journal
Health & Social Care in the Community
Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 143 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 443 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard-cite-them-right
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • sv-SE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • de-DE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf