Reliability and validity of the Italian Version of the Chase Nurse Manager Competencies Scale.

Objectives: This study aimed to translate and test the psychometric properties of the Chase Nurse Manager Competency Instrument (CNMCI) among Italian nurse managers and to provide further support for the scale's validity testing. Methods: An instrument translation and cross-sectional validation study was conducted. The English version was translated into Italian using the translation method, which included pre-translation (establishing equivalence), initial translation, pretesting, review, and administration. From August 2022 to June 2023, 349 nurse managers were recruited through a web survey from 31 public and private healthcare organizations in North, Central, and Southern Italy. Validity assessments included content and structural validity. Reliability was evaluated using Cronbach's α coefficient and test-retest reliability. Results: The content validity confirmed all the items of the CNMCI in the Italian version, including the two measurement sections, "knowledge and understand" and "ability to implement and/or use." The instrument's item-content validity index (I-CVI) ranged from 0.83 to 1.00, while the scale-level content validity index (S-CVI) for both instrument sections was 0.97. The confirmatory factor analysis showed an acceptable fit. In the "knowledge and understand" section, Cronbach's α coefficient was 0.978, and in the "ability to implement and/or use" section, Cronbach's α coefficient was 0.976. The correlation coefficient between each dimension was 0.494-0.908. The test-retest reliability score was 0.82, suggesting good instrument consistency. Conclusions: Overall, the Italian CNMCI demonstrates good reliability and validity for measuring nurse managers' core competencies and supports the construct's multi-dimensionality. Also, our findings support the hierarchical nature of the factors, further supporting the validity of the instrument.

Work life-related loneliness among nurse managers and its effect on life satisfaction: Turkey's example.

AIM: To determine the effects of perceived workplace loneliness on life satisfaction among nurses working as managers. BACKGROUND: Nurses working as managers often encounter negative situations, and their consequences extend beyond their professional responsibilities to encompass nonprofessional domains, including life satisfaction. METHODS: This study enrolled 158 nurse managers (NMs) after gaining their consent. Data from the descriptive cross-sectional study were obtained using the "Descriptive Information Form," "Loneliness in Work Life Scale," and "Life Satisfaction Scale." The relationship between relevant scales was assessed using Pearson's correlation analysis and multiple linear regression. FINDINGS: A moderately strong, negative, and significant relationship was observed between work life-related loneliness and life satisfaction among NMs. Multiple regression analysis revealed that three independent variables-two LAWS subscales and the job satisfaction status-significantly affected NMs' life satisfaction (adjusted R2 = 0.39, p < 0.001). CONCLUSION: Perceived loneliness and professional satisfaction are important predictors of life satisfaction among NMs. Thus, it is crucial to determine the factors that negatively affect the professional satisfaction and perceived loneliness of nurses working as managers and to implement psychosocial interventions in such cases. IMPLICATIONS FOR NURSING AND HEALTH POLICY: This study demonstrates the significance of identifying problems in the professional lives of NMs, who are involved in planning nursing services and implementing interventions to address these problems.

Nursing managers' perceptions of teamwork and collaboration in mining primary healthcare clinics in Gauteng.

BACKGROUND:  Teamwork and collaboration among nursing managers, nurses, doctors and peripheral hospitals treating mining patients is pivotal. A case study of specific mining primary healthcare clinics revealed a lack of teamwork among the doctors and nursing managers, even on decisions that show productivity. OBJECTIVES:  The aim of this study was to explore and describe nursing managers' perceptions of teamwork and collaboration in mining primary healthcare clinics in Gauteng. METHOD:  A qualitative, exploratory, descriptive and contextual research design was adopted to conduct this study. Data were collected by conducting semi-structured individual interviews with 10 participants and thematically analysed. Data saturation was reached by the seventh participant and confirmed with three more interviews. Trustworthiness measures and ethical considerations were preserved as protocols because of the nature of the study. RESULTS:  Three themes emanated from the study: (1) team coordination and support improve teamwork and collaboration in primary healthcare clinics, (2) there is a lack of involvement from the nursing team, negatively influencing teamwork and collaboration and (3) collaboration can improve the quality of healthcare services rendered in mining primary healthcare clinics. CONCLUSION:  All mining primary healthcare clinic team members should be involved in operational activities to foster teamwork and collaboration.Contribution: This study revealed that teamwork and collaboration should be facilitated to improve the quality of healthcare service in mining primary healthcare clinics.

Facility managers' experiences of mentorship in a district of Gauteng province, South Africa.

Background: Mentoring is recommended as a method to assist nurses in developing their leadership roles. Support and mentorship of nursing managers can yield positive results for their organisations because of the leadership quality. The lack of mentorship programmes for newly appointed facility managers has an impact on the management of the facilities. Aim: This study aims to explore and describe how facility managers experience mentorship at primary health care (PHC) facilities. Setting: Participants were drawn from 11 different PHC facilities falling under the three sub-districts: Emfuleni, mid-Vaal and Lesedi. Methods: A qualitative exploratory and descriptive research design was employed to achieve the study objectives. A non-probability purposive sampling method was used to select the facility managers from three sub-districts; a signed informed consent to participate in the study was obtained from each participant. A semi-structured interview guide was used to interview purposively selected facility managers. The interviews were audio recorded and subsequently transcribed verbatim. Data were analysed using the content analysis method. Rigour was ensured, and ethical principles measures were applied. Results: Four themes emerged from the results: the experiences on mentorship, views on mentorship, barriers to mentorship and mentorship improvement strategies. Conclusion: The study found that there was a lack of formal mentoring in the district, and there is a need for benchmarking and the development of a formal mentorship programme. Contribution: The results could be useful in identifying gaps, making recommendations to nursing management and future research. They could further broaden insight into the mentoring needs of facility managers.

Considerations for conducting systematic reviews: A follow-up study to evaluate the performance of various automated methods for reference de-duplication.

Searching multiple resources to locate eligible studies for research syntheses can result in hundreds to thousands of duplicate references that should be removed before the screening process for efficiency. Research investigating the performance of automated methods for deduplicating references via reference managers and systematic review software programs can become quickly outdated as new versions and programs become available. This follow-up study examined the performance of default de-duplication algorithms in EndNote 20, EndNote online classic, ProQuest RefWorks, Deduklick, and Systematic Review Accelerator's new Deduplicator tool. On most accounts, systematic review software programs outperformed reference managers when deduplicating references. While cost and the need for institutional access may restrict researchers from being able to utilize some automated methods for deduplicating references, Systematic Review Accelerator's Deduplicator tool is free to use and demonstrated the highest accuracy and sensitivity, while also offering user-mediation of detected duplicates to improve specificity. Researchers conducting syntheses should take automated de-duplication performance, and methods for improving and optimizing their use, into consideration to help prevent the unintentional removal of eligible studies and potential introduction of bias to syntheses. Researchers should also be transparent about their de-duplication process to help readers critically appraise their synthesis methods, and to comply with the PRISMA-S extension for reporting literature searches in systematic reviews.

Pilot study of an online brief mindfulness-based intervention to improve the well-being of managers and reduce their stress at work.

Objectives. The COVID-19 pandemic, remote work and new technologies have heightened workplace pressures. Effective response and essential organizational changes require business leaders to be more adaptable, with managers' presence playing a pivotal role in successful implementation. The study assesses a brief mindfulness-based emotional regulation for managers (MBERM) intervention, to reduce workplace stress and enhance managerial well-being. Methods. An 8-week non-randomized controlled trial was conducted with a waiting list control group and an intervention group. Pre-post differences were measured by Student's t test or Wilcoxon test, and effect size calculated using the Hedge's g formula. The sample included 23 managers (17 men and six women) with average age 50 years. The study assessed anxiety and depressive symptoms, psychological flexibility, perceived self-efficacy, general work-related well-being, perceived stress and mindfulness. Results. Statistically significant changes were observed in the intervention group in depression, anxiety, work-related acceptance and action, general self-efficacy, exhaustion, alienation, stress and non-reactivity. The control group showed no statistically significant changes in any of the variables. Conclusion. The MBERM intervention could improve the emotional and work-related well-being of managers and reduce stress levels and burnout. Further study of this intervention is needed to promote adherence and ensure a long-term improvement.

The managers' perspectives on service providing in women's harm reduction centers during the COVID-19 pandemic: mixed method study.

BACKGROUND: The COVID-19 pandemic posed significant challenges for managers overseeing women's harm reduction centers. This study seeks to capture managers' perspectives on the service providing in women's harm reduction centers during the COVID-19 pandemic. METHODS: This convergent mixed-method study conducted in three provinces of Iran: Tehran, Khuzestan, and Kermanshah. The study was carried out between January and May 2023. In the quantitative part, the researchers utilized reports from 10 center managers. A researcher-designed questionnaire was employed to collect data on a wide range of services and referrals provided by the centers. The qualitative part of the research involved conventional content analysis and included 12 individual interviews. Two directors from the Ministry of Health and ten managers of women's harm reduction centers participated in the interviews. During the interpretation phase, the researchers compared the quantitative and qualitative findings to obtain a comprehensive understanding of the topic. RESULTS: During the quantitative stage of the study, it was observed that all the managers were women, with an average age of 40.7 ± 7 years. More than half of the managers had obtained a postgraduate education (n = 6, 60%), and a majority of them were married (n = 7, 70%). Additionally, 40% of the managers (n = 4) were working as contractors. During the non-COVID-19 period, there were higher coverage by centers and residents, more referrals of non-injecting drug users and sex workers, and a higher number of group counseling sessions in all three provinces compared to the COVID-19 period. The qualitative analysis revealed two primary themes: "challenges" and "capabilities." CONCLUSIONS: During the COVID-19 pandemic, providing some services and client referrals decreased in the centers, and center managers faced increased challenges. Many of these challenges were in the communication, executive, management, structure, education, financial, civilization, facilities, and socio-cultural sectors. Managers used their skills to manage and control these challenges. It is important to focus on these challenges and managerial capabilities to effectively handle future crises.

Managers in the context of small business growth: a qualitative study of working conditions and wellbeing.

PURPOSE: In view of the importance of managers' wellbeing for their leadership behaviour, employee health, and business effectiveness and survival, a better understanding of managers' wellbeing and working conditions is important for creating healthy and sustainable businesses. Previous research has mostly provided a static picture of managers' wellbeing and work in the context of small businesses, missing the variability and dynamism that is characteristic of this context. Therefore, the purpose of this study is to explore how managers in small companies perceive their working conditions and wellbeing in the context of business growth. METHODS: The study is based on qualitative semi-structured interviews with 20 managers from twelve small companies. Content and thematic analysis were applied. RESULTS: The findings indicate that a manager's working environment evolves from its initial stages and through the company's growth, leading to variations over time in the manager's experiences of wellbeing and work-life balance as well as changes in job demands and resources. Managers' working situation becomes less demanding and more manageable when workloads and working hours are reduced and a better work-life balance is achieved. The perceived improvement is related to changes in organizational factors (e.g. company resources), but also to individual factors (e.g. managers' increased awareness of the importance of a sustainable work situation). However, there were differences in how the working conditions and wellbeing changed over time and how organizational and individual resources affected the studied managers' wellbeing. CONCLUSIONS: This study shows that, in the context of small business, managers' working conditions and wellbeing are dynamic and are linked to growth-related changes that occur from the start of organizational activities and during periods of growth. In addition, the findings suggest that changes in managers' working conditions and wellbeing follow different trajectories over time because of the interaction between organizational and personal factors.

Catalysts for change: A qualitative study of middle managers' perception of nursing professional competence in primary healthcare.

AIM: This study aims to explore middle managers' perception of nursing professional competence within the Norwegian primary healthcare service, a sector vital for managing complex patient needs. DESIGN/METHODS: Semi-structured interviews were conducted with four middle managers across different municipalities in Norway. Qualitative content analyses, following Graneheim and Lundman, were used for analysing the transcription of the interviews and the data collected. FINDINGS: The qualitative content analysis revealed three main themes: the significance of advanced competence, challenges related to competence development and the necessity for defining advanced competence. The findings indicate that middle managers recognise the importance of advanced nursing competence in providing comprehensive patient care, notwithstanding challenges in manpower and competence enhancement. CONCLUSION: This research underlines the significance of investing in increased competence and improved management in primary healthcare and offers valuable insights for healthcare policy and practice to enhance patient care.

The relationship between organizational justice and bullying behaviors among nurses: the role of nurse managers' caring behaviors.

BACKGROUND: Organizational justice is pivotal in fostering a fair and supportive workplace culture, which strengthens the connections between managers and nurses, among nurses themselves, and ultimately, between nurses and their patients. Assessing the perceived levels of organizational justice and managerial behaviors can identify key areas for improving nurses' commitment and loyalty, while simultaneously reducing incidents of workplace bullying. PURPOSE: This study aims to investigate how bedside nurses perceive organizational justice, nurse managers' caring behaviors, and their exposure to workplace bullying. Additionally, it seeks to explore the relationship between organizational justice, nurse managers' caring behaviors, and nurses' perceived exposure to workplace bullying. METHODS: A descriptive-correlational study was conducted in the inpatient care unit of a Saudi hospital. A convenience sample of 256 nurses participated, completing the Organizational Justice Questionnaire (OJQ), the Caring Factor Survey: Caring of the Manager (CFS-CM), and the Negative Acts Questionnaire-Revised (NAQ-R). The collected data were analyzed using descriptive statistics and regression analysis. RESULTS: Descriptive statistics revealed moderate levels of perceived organizational justice and managerial caring behaviors among nurses, alongside low reported exposure to workplace bullying. Significant correlations were found among the studied variables, indicating that higher perceived organizational justice was associated with higher managerial caring and lower workplace bullying (p < 0.05). Mediation analysis demonstrated a significant indirect effect of organizational justice on workplace bullying through the mediating role of nurse managers' caring behaviors (a×b = -0.0652, p < 0.001). Furthermore, the direct effect of organizational justice on workplace bullying remained significant even when accounting for the mediator (c = -0.5509, p < 0.001). CONCLUSION: This study highlights the vital role of organizational justice and managerial caring in cultivating a positive work environment and mitigating workplace bullying. Implementing clear policies and procedures while promoting fairness and equality in resource allocation, decision-making processes, and interactions are essential strategies for fostering positive attitudes and work behaviors among nurses.

Nurse middle managers' proactive work behavior: antecedents and consequences on innovative work behavior and job performance.

PURPOSE: Healthcare organizations require more proactive behaviors from nursing professionals. However, nurse managers' proactivity has rarely been analyzed in the literature and little is known about the antecedents and consequences of their proactive behavior at work. This study examines the relationships between job characteristics (i.e. job autonomy and job variety), psychological empowerment, proactive work behavior and job effectiveness indicators (i.e. innovative work behavior, job performance). We tested a model in which psychological empowerment and proactive work behavior sequentially mediate the relationship between job characteristics and job effectiveness. DESIGN/METHODOLOGY/APPROACH: A cross-sectional study was conducted among nurse middle managers from a French hospital (N = 321). A hypothetical model was developed based on existing theory. Structural equation modeling was used to test the hypotheses. FINDINGS: Results show that psychological empowerment and proactive work behavior fully mediate the relationship between job characteristics and innovative work behavior, and partially mediate the relationship between job characteristics and job performance. ORIGINALITY/VALUE: This study provides insights for understanding how job characteristics can contribute to fostering the proactivity of nurse middle managers and how their proactive work behavior can be positively related to innovative work behavior and job performance. Findings raise several implications for hospital administrators and upper management seeking new ways to enhance nurse middle managers' proactive work behavior and push further their effectiveness at work.

Understanding the conservation-genetics gap in Latin America: challenges and opportunities to integrate genetics into conservation practices.

Introduction: Integrating genetic data into conservation management decisions is a challenging task that requires strong partnerships between researchers and managers. Conservation in Latin America is of crucial relevance worldwide given the high biodiversity levels and the presence of hotspots in this region. Methods: We conducted a survey across Latin America to identify gaps and opportunities between genetic researchers and conservation managers. We aimed to better understand conservation managers' points of view and how genetic research could help conservation practitioners to achieve their goals, by implementing genetic assessments that could effectively inform conservation practices. We distributed an online survey via four regional collaborating organizations and 32 focal points based in 20 Latin American countries. The target respondents were conservation managers of species or areas in Latin America. Results: We collected a total of 468 answered questionnaires from 21 Latin American countries. Most respondents (44%) were from an academic or research institution while non-academics were mainly from non-governmental institutions (30%) and government agencies (25%). Most respondents (65%) have performed or used genetic assessments in their managed area or species, either alone, in partnership, contracting someone else or using published results. For the majority of this group, the genetic results were relevant to their conservation management goals, helping to inform management decisions. Respondents that had not performed genetic assessments (35%) were mainly from the non-academic group, and their main barriers were limited access to funds, genetic lab facilities, and trained personnel to design studies and conduct lab work. Discussion: From the findings, we describe the current situation and provide a general diagnosis of the conservation-genetics gap in Latin America. We describe the gender gap, academic-practitioner co-development of conservation questions and projects, and the nationality and residency of Latin American conservation managers in relation to the countries where they work. We discuss opportunities to co-create research questions and co-develop studies based on conservation practitioners' needs. We offer recommendations for overcoming barriers to integrate genetic information into conservation actions, and advance agendas that fit the needs and realities of the highly heterogeneous, biodiverse and challenging Latin American region.

Impact of decentralized management on sickness absence in hospitals: a two-wave cohort study of frontline managers in Danish hospital wards.

BACKGROUND: This study explores the impact of decentralized management on the sickness absence among healthcare professionals. Sickness absence is a reliable indicator of employees' wellbeing and it is linked to management quality. However, the influence of decentralized management on sickness absence has not been adequately studied. METHODS: The research design combined a two-wave, web-survey of frontline managers in two Danish university hospitals with administrative data on sickness absence at the ward-level. The first and second wave included data from 163165 and 137 frontline managers linked to 121 wards and 108 wards. Data was analysed using an ordinal logistic regression model. RESULTS: Wards where frontline managers had the highest level of decentralised decision authority compared to none showed lower odds of ward-level sickness absence (ORcrude: 0.20, 95% CI: 0.05-0.87). A very high extent of cross-functional decision authority showed lower odds of sickness absence (ORcrude: 0.08, 95% CI: 0.01-0.49). Overall, the results showed a clear data trend, although not all results were statistically significant. CONCLUSION: Higher levels of decentralized management in wards were positively associated with lower risks of sickness absence in hospital wards. The study supports future research on how to empower decision autonomy at the frontline level of management.

Ethical leadership behaviors of senior managers perceived by the junior managers working in public hospitals in Hail, Saudi Arabia.

Objective: To examine junior managers experiences of ethical leadership behaviors exhibited by their senior managers. Methods: In this cross-sectional study, 263 junior health care managers working in public hospitals in Hail, Saudi Arabia were surveyed using a self-administered questionnaire between 20 November, 2022 and 15 February, 2023. Descriptive statistics and regression analysis were employed in the analysis. Statistical Package for Social Sciences (SPSS) version 25 (IBM, Armonk, NY, USA) was used to conduct statistical analyses. Results: The sample consisted of 118 men (44.9%) and the majority (66.6%) of the respondents were below the age of 36 years. In case of working environment, nearly 84% of the participants were satisfied with the relationships that they have had with their supervisors. Regression analysis indicate that women were more likely than men to experience healthy ethical leadership behaviors of their seniors (ß = -0.163, p < 0.05). Ethical leadership behaviors of senior health care managers would not influence by the age or work experience of their juniors. Conclusion: Ethical leadership behavior of senior health care managers was satisfactory. Longitudinal research is needed to investigate how cultural and environmental factors affect the ethical leadership behavior of healthcare managers in Saudi Arabia.

How safety accountability impacts the safety performance of safety managers: A moderated mediating model.

INTRODUCTION: Accountability has been widely used to guide and shape employee behavior to improve employee performance. However, in safety production, whether safety accountability can improve safety performance, to what extent, and what factors are affecting it remain unclear. This study explores the mechanisms through which safety accountability affects the individual safety performance of Chinese enterprise safety managers. METHOD: We construct a new theoretical model based on social identity and conservation of resources theories and test it using survey data on enterprise safety managers. RESULTS: The results of the mediating effect show that safety accountability is a "double-edged sword" for safety performance. On the one hand, safety accountability can improve safety performance by enhancing the professional identification of safety managers. On the other hand, safety accountability can also cause a role overload for safety managers, reducing their safety performance. Finally, the safety climate moderates the mediating effect of professional identification and role overload. PRACTICAL APPLICATIONS: Overall, this study explores the mechanism of safety accountability on safety performance from a micro-perspective, which can enrich the theory and practice of safety production and emergency management.

[Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study]. / Anforderungen, Ressourcen und Arbeitsengagement von Pflegemanager_innen der unteren und mittleren Ebene.

Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study Abstract. Background: Given their responsibilities, lower- and middle-level nurse managers hold a key role in the health care system. Their performance and health are affected by their work engagement, which according to the Job-Demands-Resources-Model depends on job-related demands and resources. To date, there is a lack of studies on the demands, resources, and work engagement of nurse managers in Germany. Objective: First, the study aimed to describe the job demands and resources as well as the work engagement of lower and mid-level nurse managers in hospitals and geriatric care facilities in Germany. Second, the aim was to explore potential differences in these areas between different groups, particularly regarding gender, age, and management level. Methods: The study used a cross-sectional design. Data were collected by an online survey. N = 408 cases could be evaluated. Results: Work overload is the most prominent demand, followed by emotional demands. In terms of resources, nurse managers can primarily draw on positive social relationships. The available professional resources are rated critically. Work engagement is moderate. Conclusions: The study indicates a clear need for action regarding an improvement in work engagement. In particular, work overload and professional resources need to be addressed by appropriate systemwide and organization-related measures.

Scenarios for Assessing Leadership Behaviors of Mid-level Managers in the Greek National Health System Through the Lens of Servant Leadership Theory: A Pilot Study in the Hospital Cluster of North Attica.

This study aimed to develop a scenario-based questionnaire for evaluating medium-level leadership behaviors within the Greek National Healthcare System (NHS), drawing upon the principles of servant leadership theory. Data for this pilot study were collected in the first quarter of 2019, using a sample of 33 (22.9% of all medium-level managerial positions) medium-level managers from the Greek NHS hospital cluster located in North Attica. To assess managerial behaviors, an ordinal scale was employed, revealing non-normal data distributions. Consequently, our analysis involved presenting descriptive statistics, utilizing non-parametric tests to explore distinctions in managerial behaviors, and conducting thematic analysis of responses to open-ended questions, with frequencies and relative frequencies of each theme meticulously recorded. Overall, our findings indicate that, in most cases, managers exhibited positive behaviors toward their employees, regardless of whether the outcomes were positive, negative, or unknown. Positive behaviors towards the administration were comparatively rare. Significant differences were observed, highlighting that managers were more inclined to exhibit positive behaviors when the outcome was known, particularly in scenarios involving employee management. Within each scenario, behavioral patterns varied, with managers demonstrating a propensity to take credit for employee success in positive outcomes but distancing themselves from negative outcomes when reporting to the administration. Furthermore, the survey responses underscored the prevalence of positive attitudes regarding accountability and stewardship, with stewardship showing a positive correlation with scenario-based behaviors. Finally, our study brought to light several challenges in the management of the Greek NHS, including the absence of comprehensive managerial evaluation, the lack of meritocracy, regulatory deficiencies, and a shortage of leadership skills among current managers. These findings emphasize the importance of scenario-based assessments for Greek hospital managers, as they can help connect managerial behaviors to stewardship, accountability, and skills, ultimately contributing to the enhancement of leadership within the Greek NHS.

Health managers' perspectives of community health committees' participation in the annual health sector planning and budgeting process in a devolved unit in Kenya: a cross-sectional study.

Introduction: health sector planning and budgeting are concerned with identifying priorities that guide budgetary allocation to improve health outcomes. Engaging the community in this process empowers them to manage their own health. Despite the benefits and the availability of legislation and structures to mainstream community participation, their involvement is minimal and marred with challenges. This study, therefore, aimed to examine the level and perspectives of health managers on community health committees´ (CHC) participation in health sector planning and budgeting. Methods: the study utilized a cross-sectional research design, incorporating both quantitative and qualitative research methods. Study participants were involved in planning and budgeting. Quantitative data were collected from 100% (n=170) of health managers, while qualitative data were gathered from 100% (n=3) of county department of health executives and 94% (n=83) of community health committee members. Descriptive statistics were utilized to analyze quantitative data, while qualitative data were analyzed thematically. Results: although 87% of the health managers agreed that community health committee participation is beneficial, only 11% of them were satisfied with their participation, and 54% rated CHC participation as low; furthermore, over 50% of health managers disagreed that Community Health Unit (CHUs) have the necessary skills to effectively participate in the process, that adequate budget and time are allocated for CHC participation, and that feedback about the process is provided to them. Conclusion: the county health department of health should allocate more funds and design sustained capacity-building programs to enhance CHC participation in health sector planning and budgeting.

A joint training of healthcare line managers and health and safety representatives in facilitating occupational health interventions: a feasibility study protocol for the Co-pilot project.

Healthcare employees are experiencing poor wellbeing at an increasing rate. The healthcare workforce is exposed to challenging tasks and a high work pace, a situation that worsened during and after the COVID-19 pandemic. In turn, exposure to these high demands contributes to poor health, increased turnover, reduced job satisfaction, reduced efficacy, and reduced patient satisfaction and safety. Therefore, it is imperative that we identify measures to mitigate this crisis. One piece of this puzzle is how to implement sustainable tools and processes to improve the work environment of healthcare organizations. In this paper, we present the study protocol for the outlining and piloting of a joint training for pairs of healthcare line managers and their associated health and safety representatives in a Swedish healthcare organization. The objective of the training is to aid and advance the implementation of interventions to improve the work environment at the unit level. Following recommendations in the literature, the training is based on a stepwise approach that considers the specific context and focuses on the involvement of employees in creating interventions based on their needs. A central component of the training is the development of the pairs' collaboration in prioritizing, developing, implementing, and evaluating the interventions. The training is based on an on-the-job train-the-trainer approach in which participants are progressively trained during four workshops in the steps of a participatory intervention process. Between these workshops, the pairs follow the same progressive steps together with their employees to develop and implement interventions at their unit. The pilot will involve four pairs (i.e., eight participants) representing different parts and functions of the organization and will be conducted over a period of three months. We will use a mixed method design to evaluate preconditions, the process, and proximal transfer and implementation outcome factors of the training. The overall aim of the pilot is to appraise its feasibility and be able to adjust the training before a potential scale-up.

Female managers' organizational leadership during telework: experiences of job demands, control and support.

The frequent use of telework during the COVID -19 pandemic has created a more challenging work situation for managers who need to lead effectively in the virtual space, this especially concerns female managers. Therefor it is of importance to investigate female managers' experiences of job related demands, control and support within this work context. Accordingly, we investigated female managers' experiences of demands, control and support in their organizational leadership during telework. The present study used a deductive, theory-driven, qualitative approach with predetermined themes defined within the demand-control-support model. Data were collected by semi-structured interviews. The female managers had at least 50% of their working hours as telework. The results showed that the female managers experienced demands in terms of hard, fast or even excessive work in order to be available and solve complex problems, and control as varied work content, new learning, planning and decision freedom. Support was experienced in terms of attentive superior manager, good cooperation and helpfulness among colleagues. Theoretical and practical implications of the results are discussed in terms of telework situation for female managers.