File
Keisu B-I1, Öhman A2, Enberg B3
1Umeå University, Umeå Centre for Gender Studies, Department of Sociology, Umeå, Sweden, 2Umeå University, Umeå Centre for Gender Studies, Department of Epidemiology and Global Health, Umeå, Sweden, 3Umeå University, Community Medicine and Rehabilitation, Umeå, Sweden
Background: The number of elderly people in Sweden as in other western countries is increasing. The elderly care organisations are facing massive demands to recruit staff including physiotherapists to the sector. Negative aspects, staff dissatisfaction and problems related to internal organisational factors of working in elderly care are well‐known and documented. Less is known about the positive aspects of the working conditions in elderly care. Therefore, this study focuses on such positive factors in Swedish elderly care. Two theoretical models, the Effort-Reward Imbalance model and the Transformational Leadership Style model were combined.
Purpose: The aim was to estimate the potential associations between employee‐perceived transformational leadership style of their managers, and employees´ ratings of effort and reward within elderly care work.
Methods: The article is based on questionnaires distributed at on‐site visits to occupational therapists, physiotherapists, registered nurses (high‐level education) and assistant nurses (low‐level education) in nine elderly care facilities in four Swedish geographical regions. Six workplaces were run by municipalities, two by regional county councils and one by a private healthcare provider. The sample consists of 159 respondents. Effort and reward was measured using the original 17-item Effort-Reward Imbalance questionnaire. The current first-level manager at each workplace was assessed by their staff using the Multi Leadership Questionnaire. In order to grasp the positive factors of work in elderly care, we focused on balance at work, rather than imbalance. Univariate logistic regression analyses with odds ratios and 95% confidence intervals were applied to test associations between effort, reward, effort-reward balance and transformational leadership. Differences between occupations regarding effort-reward balance and transformational leadership were analysed using chi-square tests.
Results: A significant association between employees´ effort-reward balance at work and a transformational leadership style of their first-level managers was found. The transformational leadership subscales idealised influence (attributes), inspirational motivation and intellectual stimulation, all showed significant associations with a balance between effort and reward. An association was also found between employees´ level of education and their assessments of the first‐level managers. The professionals viewed their first-level managers as having a transformational leadership style to a greater extent compared to the assistant nurses. The professionals also assessed their first-level manager as a charismatic role model compared to the assistant nurses.
Conclusion(s): We conclude that the first‐level manager is an important actor for achieving a good workplace within elderly care, since she/he influences employees´ psychosocial working environment. We also conclude that there are differences and inequalities, in terms of well‐being, effort and reward at the work place, between those with academic training and those without, in that the former group to a higher degree evaluated their first‐level manager to perform a transformational leadership style, which in turn is beneficial for their psychosocial work environment. Consequently, this (re)‐produce inequalities in terms of well‐being, effort and reward among the employees at the work place.
Implications: The importance of leadership style for the work environment in terms of experienced balance between effort and reward in elderly care work for different staff groups needs to be highlighted.
Keywords: Effort-reward balande, first-level managers, elderly care
Funding acknowledgements: The project was financed by Forte; Swedish Research Council for Health, Working Lifre and Welfare; dnr. 2011-1140
Purpose: The aim was to estimate the potential associations between employee‐perceived transformational leadership style of their managers, and employees´ ratings of effort and reward within elderly care work.
Methods: The article is based on questionnaires distributed at on‐site visits to occupational therapists, physiotherapists, registered nurses (high‐level education) and assistant nurses (low‐level education) in nine elderly care facilities in four Swedish geographical regions. Six workplaces were run by municipalities, two by regional county councils and one by a private healthcare provider. The sample consists of 159 respondents. Effort and reward was measured using the original 17-item Effort-Reward Imbalance questionnaire. The current first-level manager at each workplace was assessed by their staff using the Multi Leadership Questionnaire. In order to grasp the positive factors of work in elderly care, we focused on balance at work, rather than imbalance. Univariate logistic regression analyses with odds ratios and 95% confidence intervals were applied to test associations between effort, reward, effort-reward balance and transformational leadership. Differences between occupations regarding effort-reward balance and transformational leadership were analysed using chi-square tests.
Results: A significant association between employees´ effort-reward balance at work and a transformational leadership style of their first-level managers was found. The transformational leadership subscales idealised influence (attributes), inspirational motivation and intellectual stimulation, all showed significant associations with a balance between effort and reward. An association was also found between employees´ level of education and their assessments of the first‐level managers. The professionals viewed their first-level managers as having a transformational leadership style to a greater extent compared to the assistant nurses. The professionals also assessed their first-level manager as a charismatic role model compared to the assistant nurses.
Conclusion(s): We conclude that the first‐level manager is an important actor for achieving a good workplace within elderly care, since she/he influences employees´ psychosocial working environment. We also conclude that there are differences and inequalities, in terms of well‐being, effort and reward at the work place, between those with academic training and those without, in that the former group to a higher degree evaluated their first‐level manager to perform a transformational leadership style, which in turn is beneficial for their psychosocial work environment. Consequently, this (re)‐produce inequalities in terms of well‐being, effort and reward among the employees at the work place.
Implications: The importance of leadership style for the work environment in terms of experienced balance between effort and reward in elderly care work for different staff groups needs to be highlighted.
Keywords: Effort-reward balande, first-level managers, elderly care
Funding acknowledgements: The project was financed by Forte; Swedish Research Council for Health, Working Lifre and Welfare; dnr. 2011-1140
Topic: Occupational health & ergonomics; Professional issues
Ethics approval required: Yes
Institution: Community Medicine and Rehabilitation
Ethics committee: The Regional Ethical Review Bord at Umså University
Ethics number: Dnr. 2012-28-31 Ö
All authors, affiliations and abstracts have been published as submitted.
