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

Abstract

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.

Qualitative Modeling of Burden and Distress among Home Helpers in Japan

“…Although the structure and organization of home help services show large local and regional variations both within and between countries [1], Many countries are facing a growing number of elderly in need of home care assistance from others to perform day-today activities [1][2][3]. A home helper is a person hired to help with housework or the care of elderly people with special needs [1,2,[4][5][6].…”

“…A home helper is a person hired to help with housework or the care of elderly people with special needs [1,2,[4][5][6]. A home helper provides respite and support for informal caregivers, and allows home elderly patients to continue living in their community as independently as possible [2,4,7].…”

Employee effort – reward balance and first‐level manager transformational leadership within elderly care

“…The importance of first‐level managers' TFL style on employees' well‐being and job satisfaction is previously shown in Danish studies among healthcare workers within elderly care , as well as in a Swedish study of home‐help services among assistant nurses . To our knowledge, there are no studies that have examined the relationship between TFL and employees' ER balance and the findings are thus important.…”

The Lock Point of Patient Care Outcomes: Leader of Nursing Service Management: Review

“…Genel olarak hemşirelik hizmetleri yönetiminde kullanılan liderlik stilleri arasında otokratik, demokratik-katı-lımcı ve tam-serbesti tanıyan liderlik stillerinin yanı sıra görev odaklı liderlik yaklaşımlarından biri olan etkileşimci liderlik stili de yer almaktadır. 3,6,7,[20][21][22][23] Ayşe AKBIYIK ve ark.…”

“…3,7,[20][21][22][23] Yaşlı bakım evi, evde bakım hizmetleri ve hastaneler gibi çeşitli sağlık kurumlarında kesitsel, deneysel ve yarı deneysel araştırmalarda dönüşümcü liderlik stilinin hasta bakım kalitesini ve hasta güvenliğini dolaylı yoldan artırarak, hasta sonuçlarına pozitif yönden katkı sağladığı saptanmıştır. 2,21,[26][27][28][29][30][31] İlişki odaklı liderlik yaklaşımları ile yönetilen kliniklerde sağlık hizmeti ile ilişkili enfeksiyonlarda ve hasta mortalite oranlarında belirgin düzeyde azalma, hasta memnuniyetinde artış olduğu belirlenmiştir. [32][33][34] Vogus ve Sutcliffe'nin çalışmasında, ekibe güveni-lir bir tutum sergileyen ve ekibi tarafından güve-nilen hemşire liderlerin varlığında hatalı tıbbi uygulamaların belirgin derecede azaldığı saptanmıştır.…”