Westerberg Kristina, Tafvelin Susanne
Department of Psychology, Umeå University, Umeå, Sweden.
Health Soc Care Community. 2014 Sep;22(5):461-8. doi: 10.1111/hsc.12084. Epub 2013 Dec 6.
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.
居家护理服务工作通常由助理护士或护理助理在老年人的家中进行，其工作条件被描述为独立作业、工作量大、影响力小且缺乏同事和领导的支持。研究已经确立了领导风格、心理社会工作环境与许多积极和消极的员工成果之间的关系，但在护理质量方面的成果较少受到关注。在本研究中，我们旨在关注领导方面的工作条件以及员工的心理社会工作环境，以及这些条件如何与护理质量相关。假设是变革型领导风格与护理质量之间的关系是通过组织和同事支持、工作控制和工作量来调节的。采用横断面调查设计，于2012年3月至4月向瑞典9个居家护理组织的助理护士共发放了469份问卷，其中包括6个市政当局和1个私人组织，涵盖农村和城市地区（共收回302份问卷，回复率为65%）。结果表明我们的假设得到了支持，并且在考虑间接效应时，领导风格对护理质量没有直接影响。中介模型解释了护理质量差异的51%。这些结果表明，领导风格不仅对居家护理服务中的员工成果很重要，而且与员工评估的护理质量也存在间接关系。
