A joint training of healthcare line managers and health and safety representatives in facilitating occupational health interventions: a feasibility study protocol for the Co-pilot project.

Healthcare employees are experiencing poor wellbeing at an increasing rate. The healthcare workforce is exposed to challenging tasks and a high work pace, a situation that worsened during and after the COVID-19 pandemic. In turn, exposure to these high demands contributes to poor health, increased turnover, reduced job satisfaction, reduced efficacy, and reduced patient satisfaction and safety. Therefore, it is imperative that we identify measures to mitigate this crisis. One piece of this puzzle is how to implement sustainable tools and processes to improve the work environment of healthcare organizations. In this paper, we present the study protocol for the outlining and piloting of a joint training for pairs of healthcare line managers and their associated health and safety representatives in a Swedish healthcare organization. The objective of the training is to aid and advance the implementation of interventions to improve the work environment at the unit level. Following recommendations in the literature, the training is based on a stepwise approach that considers the specific context and focuses on the involvement of employees in creating interventions based on their needs. A central component of the training is the development of the pairs' collaboration in prioritizing, developing, implementing, and evaluating the interventions. The training is based on an on-the-job train-the-trainer approach in which participants are progressively trained during four workshops in the steps of a participatory intervention process. Between these workshops, the pairs follow the same progressive steps together with their employees to develop and implement interventions at their unit. The pilot will involve four pairs (i.e., eight participants) representing different parts and functions of the organization and will be conducted over a period of three months. We will use a mixed method design to evaluate preconditions, the process, and proximal transfer and implementation outcome factors of the training. The overall aim of the pilot is to appraise its feasibility and be able to adjust the training before a potential scale-up.

Dimensionality, Invariance, and Nomological Network of the Need Satisfaction and Frustration Scale (NSFS): An Extensive Psychometric Investigation in a Swedish Work Cohort.

The present study evaluated the dimensionality, measurement invariance, and nomological network of the Need Satisfaction and Frustration Scale (NSFS) in a sample of Swedish workers. Using confirmatory factor analysis, exploratory structural equation modeling, and bifactor modeling, 30 different measurement models were evaluated cross-sectionally (n = 2123) and longitudinally (n = 1506). Measurement invariance was tested across gender and time. The nomological network of the NSFS was examined through its relations with life satisfaction and cognitive weariness. The findings supported a first-order six-factor ESEM model and measurement invariance of the Swedish version of the NSFS. Need satisfaction was positively related to life satisfaction and unrelated to cognitive weariness. Need frustration was negatively related to life satisfaction and positively related to cognitive weariness. The present study supported a six-factor structure of the Swedish NSFS, which appears suitable for assessing changes over time and gender differences in ratings.

The well-being of young leaders: demands and resources from a lifespan perspective.

Building on the job demand resources (JD-R) model, we examined the experience of work environment and well-being among young leaders in a two-wave survey study of 1,033 leaders within the private sector in Sweden. Our results reveal that young leaders report higher levels of burnout and lower rates of vigor compared to older colleagues. Further, they appraise demand and resources differently, perceiving higher emotional demands and less organizational support, and they seem to struggle with the leader role, seeing it as unclear and conflicting. Our findings underline the necessity of viewing the leader role from a lifespan perspective as well as considering age-specific aspects in the JD-R model. In practice, we urge organizations to improve prerequisites for young leaders by providing support and role clarifications to prevent impaired well-being and improve retention. By bringing leadership and lifespan studies together, we aim for a better understanding of what specific prerequisites young leaders need to thrive in the leader role thus showing how age matters and bring the field of research forward.

Appetite for Destruction: A Psychometric Examination and Prevalence Estimation of Destructive Leadership in Sweden.

There is a growing awareness that destructive leadership has a significant negative impact on employe outcomes. However, little is known about the content and dimensionality of this multidimensional concept, and there are few reliable measures available for organizations and researchers to evaluate these behaviors. Based on a representative sample (N = 1132) of the Swedish workforce, the aim of this study is threefold: first, to examine the factor structure and validity of an easy-to-use multidimensional destructive leadership measure (Destrudo-L)in the general Swedish work context; second, to identify destructive leadership profiles using latent profile analysis (LPA), and determine in what way they are related to employe outcomes; third, to examine the prevalence of destructive leadership using population weights to estimate responses of a population total in the Swedish workforce (N = 3100282). Our analysis supported the structural validity of Destrudo-L, reflecting both a global factor and specific subdimensions. We identified seven unique destructive leadership profiles along a passive and active continuum of destructive leadership behaviors, with the active showing a less favorable relation to employe outcomes. Finally, we found that a substantial proportion of the Swedish workforce report being exposed to destructive leadership (36.4-43.5%, depending on method used). Active destructive leadership was more common in the public sector and passive destructive leadership in the private. Given the potentially severe effects and the commonness of these behaviors, we argue that organizations should work actively with strategies to identify and intervene, to prevent and to handle the manifestation of these harmful behaviors.

Corrigendum: Leadership Training to Increase Need Satisfaction at Work: A Quasi-Experimental Mixed Method Study.

[This corrects the article DOI: 10.3389/fpsyg.2019.02175.].

Communication Strategies: The Fuel for Quality Coach-Athlete Relationships and Athlete Satisfaction.

The present two-study paper examined the role of communication strategies that athletes use to develop their coach-athlete relationship. Study 1 examined the mediating role of motivation, support, and conflict management strategies between the quality of the coach-athlete relationship and athletes' perceptions of sport satisfaction. Study 2 examined the longitudinal and mediational associations of communication strategies and relationship quality across two time points, over a 6-week period. Within both studies, data were collected through multi-section questionnaires assessing the studies' variables. For study 1, structural equation modeling highlighted significant indirect effects for motivation and support strategies between the quality of the coach-athlete relationship and athletes' experiences of sport satisfaction. For study 2, significant indirect effects were found for the athletes' perceptions of the quality of the coach-athlete relationship at time 2 between athletes' use of communication strategies at time point 1 and time point 2. Together these findings provide support for the practical utility of communications strategies in enhancing the quality of the coach-athlete relationship and athlete's experiences of sport satisfaction. In addition, the findings provide evidence to highlight the potential cyclical relationship between communication and relationship quality across time.

Leadership Training to Increase Need Satisfaction at Work: A Quasi-Experimental Mixed Method Study.

With a growing number of studies showing the applicability of the self-determination theory for various work and organizational outcomes, the next logical step is to investigate if and how employee need satisfaction at work can be purposefully increased through an intervention. The purpose of the present study was to test whether we could train managers' display of autonomy, competence, and relatedness support toward employees and whether this resulted in improved employee need satisfaction, well-being, and job performance. Data were obtained from 37 managers (rated by N = 538 subordinates) assigned to either an experimental or control condition at three time points: before, during, and after the training. We also used focus group interviews to evaluate the experience of the training. The quantitative analyses showed no statistically significant improvement in managers' display of needs support or employee need satisfaction. However, the qualitative data pointed toward important factors related to the implementation of need supportive leadership training that should be considered.

Leading for Safety: A Question of Leadership Focus.

BACKGROUND: There is considerable evidence that leadership influences workplace safety, but less is known about the relative importance of different leadership styles for safety. In addition, a leadership style characterized by an emphasis and a focus on promoting safety has rarely been investigated alongside other more general leadership styles. METHODS: Data were collected through a survey to which 269 employees in a paper mill company responded. A regression analysis was conducted to examine the relative roles of transformational, transactional (management-by-exception active; MBEA), and safety-specific leadership for different safety behavioral outcomes (compliance behavior and safety initiative behaviors) and for minor and major injuries. RESULTS: A safety-specific leadership contributed the most to the enhanced safety of the three different kinds of leadership. Transformational leadership did not contribute to any safety outcome over and above that of a safety-specific leadership, whereas a transactional leadership (MBEA) was associated with negative safety outcomes (fewer safety initiatives and increased minor injuries). CONCLUSION: The most important thing for leaders aiming at improving workplace safety is to continuously emphasize safety, both in their communication and by acting as role models. This highlights the importance for leadership training programs aiming to improve safety to actually focus on safety-promoting communication and behaviors rather than general leadership. Furthermore, an overly monitoring and controlling leadership style can be detrimental to attempts at achieving improved workplace safety.

Agreement of Safety Climate: Does it Affect Employees' and Managers' Health and Work Performance?

OBJECTIVE: To investigate whether agreement and disagreement between teams and their managers on safety climate relates to their health and work performance. METHODS: Questionnaire ratings of 47 managers and 211 employees on safety climate and self-rated health, stress, work ability, and work performance were analyzed using polynomial regression with response surface analyses. RESULTS: Teams' stress was lower when there was agreement between the team and the manager on safety climate, and their work performance was lower when the manager rated safety climate higher than the team did. Managers' health, but not their work performance, was higher for managers who were in agreement with their teams. CONCLUSIONS: Agreement between managers and teams on safety climate was related to both employee and manager health outcomes. Disagreement (managers' ratings higher than teams') was negatively related to employee work performance.

Employees' and line managers' active involvement in participatory organizational interventions: Examining direct, reversed, and reciprocal effects on well-being.

This study examined how employee participation and perceptions of line managers' support during a participatory organizational intervention were related to well-being over time. Although previous studies suggest that employees' and managers' active involvement in participatory organizational interventions may be related to well-being, little is known about the temporal aspects, such as at which time during the intervention these factors matter, or possible reciprocal effects. Building on conservation of resources theory, we tested hypotheses concerning direct, reversed, and reciprocal relationships between employee participation and perceptions of line manager support in relation to well-being. We used a four-wave panel design consisting of 159 hospital workers. Cross-lagged analyses showed that perceived line managers' support in the initiation and active phase was related to participation in the active phase. Participation in the initiation and active phase was related to well-being in the active and sustained phase, respectively. Results also revealed that participation in the initiation phase was related to perceived line managers' support in the active phase, which in turn predicted participation in the active phase, which translated into job satisfaction in the sustained phase supporting reversed and reciprocal effects in the form of resource caravans. Theoretical implications for research and practice are discussed.

Making it fit: Associations of line managers' behaviours with the outcomes of an organizational-level intervention.

Line managers' behaviours are important during implementation of occupational health interventions. Still, little is known about how these behaviours are related to intervention outcomes. This study explored the relationship between line managers' intervention-specific transformational leadership (IsTL), intervention fit (the match between the intervention, persons involved, and the surrounding environment), and change in intrinsic motivation and vigour. Both direct and indirect relationships between IsTL and change in intrinsic motivation and vigour were tested. Ninety employees participating in an organizational-level occupational health intervention provided questionnaire ratings at baseline and after 6 months. The results showed IsTL to be related to intervention fit and intervention fit to be related to intrinsic motivation. Using intervention fit as a mediator, the total effects (direct and indirect combined) of IsTL on change in intrinsic motivation and vigour were significant. In addition, IsTL had a specific indirect effect on intrinsic motivation. This study is the first to use IsTL as a measure line managers' behaviours. It is also the first to empirically evaluate the association between intervention fit and intervention outcomes. By including these measures in evaluations of organizational-level occupational health interventions, we can provide more informative answers as to what can make interventions successful.

Transfer of Training After an Organizational Intervention in Swedish Sports Clubs: A Self-Determination Theory Perspective.

Leadership development programs are common in sports, but seldom evaluated; hence, we have limited knowledge about what the participants actually learn and the impact these programs have on sports clubs' daily operations. The purpose of the current study was to integrate a transfer of training model with self-determination theory to understand predictors of learning and training transfer, following a leadership development program among organizational leaders in Swedish sports clubs. Bayesian multilevel path analysis showed that autonomous motivation and an autonomy-supportive implementation of the program positively predicted near transfer (i.e., immediately after the training program) and that perceiving an autonomy-supportive climate in the sports club positively predicted far transfer (i.e., 1 year after the training program). This study extends previous research by integrating a transfer of training model with self-determination theory and identified important motivational factors that predict near and far training transfer.

Are We All in the Same Boat? The Role of Perceptual Distance in Organizational Health Interventions.

The study investigates how agreement between leaders' and their team's perceptions influence intervention outcomes in a leadership-training intervention aimed at improving organizational learning. Agreement, i.e. perceptual distance was calculated for the organizational learning dimensions at baseline. Changes in the dimensions from pre-intervention to post-intervention were evaluated using polynomial regression analysis with response surface analysis. The general pattern of the results indicated that the organizational learning improved when leaders and their teams agreed on the level of organizational learning prior to the intervention. The improvement was greatest when the leader's and the team's perceptions at baseline were aligned and high rather than aligned and low. The least beneficial scenario was when the leader's perceptions were higher than the team's perceptions. These results give insights into the importance of comparing leaders' and their team's perceptions in intervention research. Polynomial regression analyses with response surface methodology allow three-dimensional examination of relationship between two predictor variables and an outcome. This contributes with knowledge on how combination of predictor variables may affect outcome and allows studies of potential non-linearity relating to the outcome. Future studies could use these methods in process evaluation of interventions. Copyright © 2016 John Wiley & Sons, Ltd.

Changes in commitment to change among leaders in home help services.

PURPOSE: The purpose of the this study was to explore the development of commitment to change among leaders in the home help services during organizational change and to study this development in relation to workload and stress. During organizational change initiatives, commitment to change among leaders is important to ensure the implementation of the change. However, little is known of development of commitment of change over time. DESIGN/METHODOLOGY/APPROACH: The study used a qualitative design with semi-structured interviews with ten leaders by the time an organizational change initiative was launched and follow-up one year later. Thematic content analysis was used to analyze the interviews. FINDINGS: Commitment to change is not static, but seems to develop over time and during organizational change. At the first interview, leaders had a varied pattern reflecting different dimensions of commitment to change. One year later, the differences between leaders' commitment to change was less obvious. Differences in commitment to change had no apparent relationship with workload or stress. RESEARCH LIMITATIONS/IMPLICATIONS: The data were collected from one organization, and the number of participants were small which could affect the results on workload and stress in relation to commitment to change. PRACTICAL IMPLICATIONS: It is important to support leaders during organizational change initiatives to maintain their commitment. One way to accomplish this is to use management team meetings to monitor how leaders perceive their situation. ORIGINALITY/VALUE: Qualitative, longitudinal and leader studies on commitment to change are all unusual, and taken together, this study shows new aspects of commitment.

The mediating role of demand and control in the relationship between leadership behaviour and employee distress: a cross-sectional study.

BACKGROUND: The relationship between leadership and employee distress is well established, however, the processes involved in this relationship remain largely unclear. For a stretched nursing workforce, understanding in what ways leadership may influence employee distress is particularly important. OBJECTIVES: To examine possible mediating effects of the work environment factors demand and control in the relationship between leadership behaviour in change, production, and employee orientation and employee distress. DESIGN: Cross-sectional study design. SETTINGS: The study was conducted at a large county council in Sweden providing both institutional and non-institutional care. PARTICIPANTS: A random sample of 1249 employees (primarily nurses, but also a wide range of other healthcare professionals and administrative staff), who had a healthcare manager that was about to enter a leadership development programme (n=171), responded to a web-based questionnaire. The response rate was 62%. METHODS: The employees rated their healthcare managers' behaviour in change, production, and employee orientation, as well as their own perceptions of level of demand, control (subdivided into decision authority and skill discretion), and five distress outcomes. Multilevel analysis was performed. RESULTS: The mediators demand, decision authority, and skill discretion were significant predictors of all five distress outcomes for all three leadership orientations. In eight of 15 regressions, the mediators fully explained the relationships between leadership orientations and outcomes. Four of five relationships with distress outcomes were fully mediated for change-oriented leadership, whereas two of five outcomes were fully mediated for production- and employee-oriented leadership. In all three leadership orientations, the relationship between the mediator skill discretion and the distress measure disengagement were particularly strong, with B-coefficients (-.44, p<.001) twice as high as for any of the other relationships. CONCLUSIONS: It seems that the way that employees perceive healthcare managers' change-oriented behaviour, and how that aspect is related to employee distress, is primarily explained by perception of demand and control. Furthermore, regardless of leadership behaviour orientation, how employees perceive their opportunity to use specific job skills plays an important role in the interplay between perception of healthcare managers' behaviour and disengagement.

Measuring self-rated productivity: factor structure and variance component analysis of the Health and Work Questionnaire.

OBJECTIVE: To test the factor structure and variance components of the productivity subscales of the Health and Work Questionnaire (HWQ). METHODS: A total of 272 individuals from one company answered the HWQ scale, including three dimensions (efficiency, quality, and quantity) that the respondent rated from three perspectives: their own, their supervisor's, and their coworkers'. A confirmatory factor analysis was performed, and common and unique variance components evaluated. RESULTS: A common factor explained 81% of the variance (reliability 0.95). All dimensions and rater perspectives contributed with unique variance. The final model provided a perfect fit to the data. CONCLUSIONS: Efficiency, quality, and quantity and three rater perspectives are valid parts of the self-rated productivity measurement model, but with a large common factor. Thus, the HWQ can be analyzed either as one factor or by extracting the unique variance for each subdimension.

The importance of leadership style and psychosocial work environment to staff-assessed quality of care: implications for home help services.

Work in home help services is typically conducted by an assistant nurse or nursing aide in the home of an elderly person, and working conditions have been described as solitary with a high workload, little influence and lack of peer and leader support. Relations between leadership styles, psychosocial work environment and a number of positive and negative employee outcomes have been established in research, but the outcome in terms of quality of care has been addressed to a lesser extent. In the present study, we aimed to focus on working conditions in terms of leadership and the employee psychosocial work environment, and how these conditions are related to the quality of care. The hypothesis was that the relation between a transformational leadership style and quality of care is mediated through organisational and peer support, job control and workload. A cross-sectional survey design was used and a total of 469 questionnaires were distributed (March-April 2012) to assistant nurses in nine Swedish home help organisations, including six municipalities and one private organisation, representing both rural and urban areas (302 questionnaires were returned, yielding a 65% response rate). The results showed that our hypothesis was supported and, when indirect effects were also taken into consideration, there was no direct effect of leadership style on quality of care. The mediated model explained 51% of the variance in quality of care. These results indicate that leadership style is important not only to employee outcomes in home help services but is also indirectly related to quality of care as assessed by staff members.