Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden.
School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm, Sweden.
J Nurs Manag. 2019 May;27(4):706-714. doi: 10.1111/jonm.12741. Epub 2019 Feb 8.
The aim of this study was to investigate how restricted decision-making autonomy and conflicting demands impact operational managers' work performance and health.
Managers at operational level (first- and second-line managers') in health care organisations are commonly exposed to strain in their work situation with high demands and a challenging work context. Although they play an important role, the knowledge about the causal associations between stressful job demands and their consequences is limited.
A prospective design with questionnaire data collected at two points in time, 1 year apart, from a sample of operational managers (N = 162) at five Swedish hospitals was used to conduct a structural equation model analysis with cross-lagged paths.
Restricted decision-making autonomy was negatively associated with both the managers' health and their managerial work performance over time.
Health care managers' work performance and health may be sustained by the top management allowing them a higher degree of autonomy in their decision-making.
This study suggests that nursing leaders should create the circumstances for operational managers' to have higher levels of autonomy in their area of responsibility and the freedom to prioritize their managerial workload.
本研究旨在探讨决策自主权受限和需求冲突如何影响运营经理的工作绩效和健康。
医疗机构中运营层面的经理（一线和二线经理）通常面临工作压力，工作要求高，工作环境具有挑战性。尽管他们发挥着重要作用，但关于紧张工作需求与其后果之间因果关系的知识有限。
采用前瞻性设计，在瑞典五家医院的样本中，对运营经理（N=162）进行了为期一年两次的问卷调查，采用交叉滞后路径的结构方程模型分析。
决策自主权受限与经理的健康和管理工作绩效呈负相关。
医疗保健经理的工作绩效和健康状况可能会因高层管理人员允许他们在决策中拥有更高程度的自主权而得到维持。
本研究表明，护理领导者应创造条件，让运营经理在其职责范围内拥有更高程度的自主权，并在管理工作负荷方面拥有更大的自由。
