Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
Medicine College, Lishui University, No. 1 Xueyuan Road, Lishui City, China.
BMC Health Serv Res. 2024 Nov 28;24(1):1491. doi: 10.1186/s12913-024-11945-6.
Leadership and access to structural empowerment are known to influence the work life experiences of staff and quality of care. Knowledge about relationships between specific factors of structural empowerment, leadership and management, staff well-being and quality of care at both an individual and unit level is scarce.
To study the relationship between staff-rated access to empowering structures, leadership and management performance, well-being, and quality of care in hospital settings measured at the individual level and aggregated at the unit level.
A cross-sectional correlative design was applied. Questionnaire data from 331 randomized hospital nursing staff working at 38 units in 25 hospitals in Sweden were analyzed using bivariate correlations and general estimation equation (GEE) models.
Results from the bivariate analysis of relationships confirmed earlier research. In the GEE models, some unexpected results were found and differences between the individual and unit levels. Adding management and leadership as independent factors in the second model showed few relationships of significance to the outcome variables.
Results confirm the importance of staff access to empowering structures in relation to well-being and quality of care. Differences and similarities were shown when studying these relationships at both the individual and unit level. The findings feature implications for hospital management to promote staff access to empowering structures. The findings provide information on how these structures relate to the individual and the unit; information that could be useful when planning or implementing strategies with the aim to promote staff well-being and care quality. The non-significant results for leadership and management in relation to staff outcomes in the GEE-models, raise questions for further research where a shift from individual to organizational focused performances within the field of leadership is implied.
领导力和获得结构授权被认为会影响员工的工作生活体验和护理质量。关于结构授权的具体因素、领导力和管理、员工福祉以及个人和单位层面的护理质量之间的关系的知识很少。
研究医院环境中员工自评获得赋权结构、领导力和管理绩效、福祉和护理质量之间的关系，这些关系在个人层面进行测量，并在单位层面进行汇总。
采用横断面相关性设计。对来自瑞典 25 家医院 38 个单位的 331 名随机抽取的医院护理人员的问卷调查数据进行了分析，使用了双变量相关分析和广义估计方程（GEE）模型。
双变量分析关系的结果证实了早期的研究。在 GEE 模型中，发现了一些意外的结果和个体水平与单位水平之间的差异。在第二个模型中，将管理和领导作为独立因素加入后，发现与结果变量的关系很少具有统计学意义。
结果证实了员工获得赋权结构与福祉和护理质量的重要性。在个体和单位层面研究这些关系时，显示出了差异和相似之处。这些发现对医院管理具有启示意义，以促进员工获得赋权结构。研究结果提供了有关这些结构与个人和单位之间关系的信息；这些信息在规划或实施旨在促进员工福祉和护理质量的策略时可能会很有用。GEE 模型中领导力和管理与员工结果之间的非显著结果，引发了进一步研究的问题，这意味着领导力领域需要从个体转向组织关注的绩效。
