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- Grill, Martin, 1979, et al.
(author)
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Safety leadership at construction sites: the importance of rule-oriented and participative leadership
- 2017
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In: Scandinavian journal of work, environment & health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 43:4, s. 375-384
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Journal article (peer-reviewed)abstract
- Objectives The construction industry accounted for >20% of all fatal occupational accidents in Europe in 2014. Leadership is an essential antecedent to occupational safety. The aim of the present study was to assess the influence of transformational, active transactional, rule-oriented, participative, and laissez-faire leadership on safety climate, safety behavior, and accidents in the Swedish and Danish construction industry. Sweden and Denmark are similar countries but have a large difference in occupational accidents rates. Methods A questionnaire study was conducted among a random sample of construction workers in both countries: 811 construction workers from 85 sites responded, resulting in site and individual response rates of 73% and 64%, respectively. Results The results indicated that transformational, active transactional, rule-oriented and participative leadership predict positive safety outcomes, and laissez-faire leadership predict negative safety outcomes. For example, rule-oriented leadership predicts a superior safety climate (β=0.40, P<0.001), enhanced safety behavior (β=0.15, P<0.001), and fewer accidents [odds ratio (OR) 0.78, 95% confidence interval (95% CI) 0.62-0.98]. The effect of rule-oriented leadership on workers' safety behavior was moderated by the level of participative leadership (β=0.10, P<0.001), suggesting that when rules and plans are established in a collaborative manner, workers' motivation to comply with safety regulations and participate in proactive safety activities is elevated. The influence of leadership behaviors on safety outcomes were largely similar in Sweden and Denmark. Rule-oriented and participative leadership were more common in the Swedish than Danish construction industry, which may partly explain the difference in occupational accident rates. Conclusions Applying less laissez-faire leadership and more transformational, active transactional, participative and rule-oriented leadership appears to be an effective way for construction site managers to improve occupational safety in the industry.
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- Larsman, Pernilla, 1976, et al.
(author)
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Ethical value conflicts in healthcare and their effects on nurses’ health, turnover intent, team effectiveness, and patient safety : a longitudinal questionnaire study
- 2024
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In: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 50:2, s. 113--121
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Journal article (peer-reviewed)abstract
- Objective: Moral distress emanating from value conflicts comprising ethical dimensions pose a threat to nurses’ health and retention, as well as to the quality of care. The aim of the present study was to investigate the relationships between the frequency of ethical value conflicts (EVC), and the perceived distress when they occur, respectively, and nurses’ work-related stress, burnout symptoms, turnover intent, team effectiveness, and patient safety.Method: A two-wave longitudinal cohort questionnaire study was performed among registered nurses at six hospitals in two Swedish regions. Cross-sectional analyses (T1) were based on 1817 nurses in 228 care units (CU), and longitudinal analyses (T1 – T2) on 965 nurses in 190 CU. Hypothesis testing was performed using multilevel controlled regression modeling.Result: The results indicated that nurses who were often exposed to EVC also to a higher extent tended to report these conflicts as stressful. Frequent exposure to EVC induced by insufficient resources, inapt organizational structures or interpersonal staff relations were cross-sectionally associated with work-related stress, burnout symptoms, turnover intent, and team effectiveness. The longitudinal analyses indicated that EVC induced by a lack of resources primarily had negative effects on nurses’ health and well-being. At the CU level, such conflicts also impaired team effectiveness. At the individual level, EVC induced by organizational constraints or interpersonal relations negatively affected care effectiveness.Conclusions: EVC are related to negative consequences in healthcare, and such processes take place both on the individual and organizational levels.
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- Boman, Åse, 1957-, et al.
(author)
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Conceptions of Diabetes and Diabetes Care in Young People With Minority Backgrounds.
- 2015
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In: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 25:1, s. 5-15
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Journal article (peer-reviewed)abstract
- Adolescents with type 1 diabetes (T1DM) need stable self-care routines for good metabolic control to minimize future cardiovascular health complications. These routines are demanding, and might be particularly challenging in underprivileged groups. The aim of this study was to gain in-depth knowledge on the experience of adolescents with T1DM and a non-Swedish background regarding factors that might influence their ability to take care of themselves; in particular, factors that might influence diabetes management routines, their social situation, and the support they receive from caregivers. We interviewed 12 adolescents with T1DM and minority backgrounds. The results indicated resources and constraints in the adolescents' social context and in the health care organization. The adolescents developed conceptions that helped to explain and excuse their self-care failures, and their successes. These findings highlight the importance of integrating T1DM as part of the individual's personal prerequisites. We discuss implications for the organization of diabetes care for adolescents.
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- Boman, Åse, 1957-, et al.
(author)
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Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background
- 2017
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In: Sage Open medicine. - : SAGE Publications. - 2050-3121 .- 2050-3121. ; 5
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Journal article (peer-reviewed)abstract
- Background: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not. Objective: The aim of this study was to identify elements in the patient–pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus. Methods: A total of 12 pediatrician–adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background. Results: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent’s experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration. Conclusion: An extended person-centered approach with focus on the adolescent’s experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician–adolescent consultations may increase integration of the disease.
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- Eklöf, Mats, 1953, et al.
(author)
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Organizational and social-psychological conditions in healthcare and their importance for patient and staff safety. A critical incident study among doctors and nurses
- 2014
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In: Safety Science. - : Elsevier BV. - 0925-7535. ; 70, s. 211-221
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Journal article (peer-reviewed)abstract
- Research on patient safety has indicated that focusing on technologies, routines, control systems, and individual caregiver attributes is not sufficient. The aim of this critical-incident interview study was to identify organizational and social-psychological conditions and processes that Swedish physicians and nurses (n = 36) perceived as important for patient and/or staff safety, and participative safety behavior. Injury due to psychological overload was the most salient type of healthcare worker hazard. Patient and healthcare worker safety went hand in hand. Good patient safety was present when caregivers had good access to their psychological and social capacities. These functions were jeopardized by stress. Our results indicated that quantitative overload, excessive cognitive and emotional complexity, lack of social support and good teamwork, organizational instability, and distrust for and frustration with the way healthcare organizations were managed, caused stress related function impairment in staff, which lead to mistakes and near misses. These aspects also in themselves contributed to risks. Good safety was associated with adequate resources and routines, workplace learning, and supportive unit level managers and colleagues. Features of professional cultures related to ethical norms to offer best possible care for the patient, in spite of insufficient resources, contributed to acceptance of working conditions that could lead to stress and overload.
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- Gadolin, Christian, 1987, et al.
(author)
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Managing health care under heavy stress: Effects of the COVID-19 pandemic on care unit managers’ ability to support the nurses—A mixed-methods approach
- 2022
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In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 30:8, s. 4080-4089
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Journal article (peer-reviewed)abstract
- Aim(s): This study aims to investigate care unit managers’ perceptions of how the COVID-19 pandemic influenced their ability to support the nurses. Background: The COVID-19 pandemic placed extreme pressure on health care organizations. More knowledge regarding how the pandemic influenced care unit managers’ ability to support nurses is central to ensuring high-quality health care in future crises. Method(s): A mixed-methods study in Swedish hospitals with a survey (n = 128) and interviews (n = 20) with care unit managers. Results: Approximately half of the managers reported having spent more time available to and supporting the nurses. Availability was positively predicted by their perceived organizational support while negatively by their job demands. These job demands concerned meeting staff anxiety and managing organizational restructuring. Full focus on direct patient care and strong professional and social support were important job resources. Conclusion(s): For care unit managers to effectively support the nurses during a crisis, they need proficient job resources and moderate job demands. Managers’ perceived organizational support positively affects the quality of their crisis leadership. Creating arenas in which staff collegiality can form and develop is beneficial for the ability to meet future crises. Implications for Nursing Management: This study specifies important job resources that should be acknowledged and reinforced to strengthen the ability of care unit managers to actively support the nurses during a crisis.
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