Background

An increasing age of the workforce necessitates a better understanding of age-related differences in emotions at work to inform age-inclusive workplace policies and practices. This review critically evaluates how age relates to emotion-regulatory strategies at work (emotional labour and emotion regulation), emotional work demands, and associated health and work outcomes.

Methods

Following PRISMA guidelines, we systematically reviewed studies examining relationships between age, emotion-regulatory strategies, emotional work demands, and health/work outcomes. A completed PRISMA 2020 checklist is provided in the Supplementary Materials. Twenty-six studies were included and synthesized narratively.

Results

Across studies, no generalisable pattern of age-related differences emerged. While several studies reported age differences in the associations between emotion-regulatory strategies and health or work outcomes, often indicating comparatively more favourable outcomes among older workers, these findings were not consistently observed across studies, with some studies reporting reversed or null effects. Moreover, studies reporting age differences varied in what aspect these differences reflected, including variation in the frequency or type of strategies used, as well as differences in how these strategies related to outcomes across age. Similarly, associations between emotional work demands and outcomes varied by age in some studies but did not follow a uniform pattern. Overall, the evidence suggests that while age-related differences in these associations are sometimes observed, they are inconsistent, not systematically associated with advantage or disadvantage for any age group, and their underlying mechanisms remain unclear.

Conclusion

Age did not emerge as a robust determinant of how emotion-regulatory strategies or emotional work demands relate to health and work outcomes. The findings underscore the need for more integrative, theoretically grounded, and methodologically rigorous approaches that better account for how age, emotional work demands, regulation, and outcomes are linked, while addressing key conceptual and design challenges.

Trial registration

PROSPERO CRD42022300000, published on 10 May 2022.

Purpose – The purpose of this study is to explore hospital managers’ experiences and reflections concerning the influence of working conditions on nursing staff’s infection prevention behaviours and strategies used by the managers to promote infection prevention work among staff. Design/methodology/approach – The qualitative study uses a reflexive thematic analysis. Six first-line and five second-line managers at surgical and orthopaedic hospital units were interviewed. Findings – Reflecting a balance between resources and responsibility in promoting infection prevention behaviours, four themes were generated: (1) being attentive to staff needs and taking action in a changing healthcare environment, where managers adjust working conditions to minimise interruptions and manage workload; (2) bultivating a positive work climate for both the team and the individual, emphasising team collaboration and role modelling in infection prevention; (3) providing resources for knowledge development and understanding, including appointing hygiene representatives and promoting accessible infection control information; and (4) promoting personal responsibility for compliance and infection-safe workflows, highlighting staff responsibility regardless of working conditions. Originality/value – This study provides new insights into hospital managers’ perspectives on how working conditions influence nursing staff’s infection prevention behaviours and the strategies managers use to support compliance. Unlike prior research focused on frontline staff, this reflexive thematic analysis highlights the managers’ role in balancing organisational support with staff accountability, offering valuable insights into infection control in complex healthcare environments.

Background

First-line healthcare managers navigate complex organizational demands to ensure a good work environment and quality care. Key factors such as expanded span of control, leadership and management performance, and work-related stress significantly influence their job satisfaction. However, how these factors evolve over time in organizational settings remains unclear.

Objective

To examine expanded span of control, leadership and management performance, work-related stress, and job satisfaction among first-line healthcare managers and assess whether the relationships between these variables remained stable over time.

Methods

A repeated cross-sectional design was used to collect annual data from 2020 to 2023 among first-line managers in a Swedish healthcare organization. The Ottawa Hospital Span of Control tool, the Leadership and Management Inventory, the Health & Safety Executive stress tool, and a single-item job satisfaction measure were used to collect data. Kruskal-Wallis tests and Spearman correlation analysis were performed.

Results

An expanded span of control negatively impacted job satisfaction in certain years. Leadership and management performance showed a positive but inconsistent association with job satisfaction. Factors in work-related stress, particularly high demands and strained relationships, consistently had a negative relationship with job satisfaction, whereas control and support positively contributed to greater job satisfaction.

Conclusions

Work-related stress, driven by high demands and poor relationships, significantly decreases job satisfaction. Leadership and management performance influence satisfaction, but inconsistently. Reducing workload and improving support structures can enhance job satisfaction and managerial effectiveness.

Purpose

The purpose of this study is to examine if and how an expanded span of control, management performance and work-related stress indicators (control, support and relationships) influence the time until first-line managers leave their position.

Design/methodology/approach

A prospective longitudinal cohort design involving 87 first-line managers in a Swedish health-care region. Cox proportional hazards regression was used to analyse expanded span of control, work-related stress indicators and management performance as predictors of turnover.

Findings

The findings indicate that first-line managers who were categorized as having moderate concern and a need for improvement in the work-related stress indicators control and manager support had a significantly higher risk of turnover. In contrast, expanded span of control and the number of employees managed per first-line manager did not significantly influence turnover risk. In addition, the work-related stress indicator relationships was not significantly associated with risk of turnover.

Originality/value

This study expands the understanding of actual turnover among first-line managers in health care by exploring how organizational factors influence the decision to leave. Unlike previous research, which primarily examines turnover intentions, this study takes a longitudinal perspective, capturing real turnover events over time. The findings contribute to future research on organizational conditions, providing a basis for developing strategies to improve retention and working conditions for first-line managers in health care.

Purpose

The purpose of this paper is to describe first-line managers’ (FLMs’) experiences and reflections on structural conditions for management practice within hospital settings using Kanter’s theory of structural empowerment.

Design/methodology/approach

A qualitative deductive approach with a descriptive design was used. Interviews were conducted with 11 FLMs in charge of medical or surgical hospital units spread across Sweden. Data were analyzed using a directed content analysis, based on Kanter’s theory of structural empowerment, encompassing such as access to necessary and sufficient resources, information, support and opportunities to learn and develop.

Findings

Findings of this study from the FLMs’ descriptions and reflections shed light on the impact of power dynamics on the structural conditions for management practice. The availability of nursing staff was a fundamental resource in the FLMs’ work performance, ensuring delivery of care to patients and a sound work environment for staff. Additionally, the other structural elements outlined in Kanter’s theory were evident in the findings, as the FLMs wished for structured information flow, identified potential and challenged opportunities for development and emphasized the importance of receiving support from people with a genuine understanding of their work situation.

Originality/valueThe results of this study contribute to the understanding of FLMs’ structural conditions for management practice in hospital settings. The paper’s originality stems from the use of a deductive approach, providing a structured lens with the potential to inform future research and practice in the field of health-care management.

Background

Healthcare-associated infections are a global concern and can be dependent on the infection prevention behaviours of nursing staff, which in turn can be influenced by working conditions. Qualitative studies are scarce, and a greater understanding of the relationship between working conditions and nursing staff behaviour is needed.

Aim

The aim was to describe nursing staff’s experiences and reflections on working conditions and infection prevention behaviours.

Methods

A qualitative study with semi-structured focus group interviews at four surgical units and two orthopaedic hospital units. Twenty-seven nursing staff (12 registered nurses and 15 assistant nurses) participated. Data was analysed using qualitative content analysis.

Results

We generated one theme: Navigating in a complex and shifting context. The result indicates that working conditions are sometimes inadequate, which can hinder the nursing staff’s infection prevention behaviours. Even when working conditions seemed to be sufficient, hygiene routines could fail, since situations constantly arise in a hospital unit that are difficult to predict and regulate.

Discussion

This study highlights the complexities faced by nursing staff in maintaining infection prevention behaviours within the dynamic hospital work environment. While nursing staff are professionally obliged to comply with hygiene routines, organisational support is essential for fostering sustainable working conditions. A multi-tiered approach is needed, from first-line managers to decision-makers, to promote a supportive environment that sustains safe practices.

Aim: The aim of this study was to describe first-line managers’ thoughts on and motives for leaving their position.

Introduction: The turnover rate of first-line managers impacts healthcare organizations’ overall performance. Burnout, dissatisfaction, and desired career advancement contribute to the intention to leave. High turnover negatively impacts patient care and has financial consequences. Involving managers in decision-making, providing support, and addressing workload and resource challenges are known to be crucial factors in retaining managers.

Method: Sixteen semistructured interviews were conducted with first-line managers. Qualitative content analysis was used to analyze the data.

Findings: Our study showed that some first-line managers experience difficulties at work, leading them to reach a breaking point and leave. These difficulties stem from a lack of influence, feeling unheard, and having inadequate support. Some first-line managers reach a point where they feel the need to move on, often due to personal reasons or a lack of motivation. Upon deciding to leave, managers commonly have a plan to ensure a smooth transition for their successor, aiming to help both the new manager and the unit’s staff.

Conclusion: First-line managers can perceive their work situation as challenging and frustrating when they lack authority and support. This can lead to them leaving their role for reasons such as retirement, seeking more time for family, or seeking new work challenges. It is important for healthcare management to empower and support first-line managers. Smooth transitions for successors and staff are crucial, regardless of why a manager leaves.

Background

Nurses work in a knowledge-intensive sector with high demands for lifelong learning. Thriving is a positive psychological state, including a sense of mutual learning and vitality at work. Research on thriving, its antecedents and outcomes is called for. The study aim was to examine thriving as a mediator in the relationships between telephone nurses’ structural empowerment and the outcomes work-personal life benefits, job performance, work-related stress symptoms and turnover intentions, as well as to psychometrically test the Thriving Scale (Swedish version).

Methods

Questionnaire data, a national sample of 409 Swedish telephone nurses, were collected, and relationships were examined using multiple regression analyses with PROCESS macro. Factorial validity of the Thriving Scale was tested using confirmative factor analyses.

Results

There were statistically significant relationships between structural empowerment and the outcomes (work-personal life benefits, job performance, stress symptoms, turnover intentions), and these relationships were mediated by thriving. The Thriving Scale showed good internal consistency, and an acceptable to borderline mediocre fit for factorial validity. Thirty-two percent reported turnover intentions.

Conclusions

Good access to structural empowerment increases nurses’ thriving, which in turn improves work-personal life benefits, job performance, and decreases stress symptoms and turnover intentions. Managers should strive to improve nurses’ thriving at work, emphasizing good access to empowering structures.

Healthcare organizations face increasing challenges in retaining first-line managers, who play a key role in operational stability and patient care. Studies indicate that approximately half of all first-line managers intend to leave their position within 5 years. This highlights the need for updated knowledge about conditions under which they work. A qualitative descriptive design was used to explore first-line managers' perceptions of what is important for them to remain in the managerial role. Data were collected through 20 individual semi-structured interviews with first-line managers from a medium-sized healthcare organization in Sweden between March and June 2022. The data were analyzed using qualitative content analysis. The results are presented through the overarching theme Empowered through support, responsibility, and meaningful contribution. This theme describes how first-line managers sustain their motivation and commitment by developing confidence in their ability to lead, influence others, and create meaningful change. Their confidence is grounded in support, responsibility, and role clarity. The theme also shows how first-line managers handle challenges, make decisions, and act to improve staff well-being and patient care. Through these actions, they contribute to the development of their units. Trust from their manager, autonomy in decision-making, and support from colleagues enhance first-line managers' sense of purpose and motivation, encouraging them to remain in their role. Moreover, balanced workloads and opportunities to make a meaningful impact strengthen their commitment. By recognizing and addressing these aspects, healthcare organizations can better support long-term engagement of first-line managers, fostering sustainable leadership and stability.