Health-promoting leadership: An integrative review and future research agenda.

AIM: To provide a synthesis of the evidence of health-promoting leadership related to nursing by exploring definitions, core attributes and critical conditions. BACKGROUND: Increasing pressure in healthcare settings due to efficiency requirements, population ageing with complex illnesses and projected global shortage of nurses, is a potential threat to nurses' health and job satisfaction, and patient quality of care and safety. New ways of thinking about nursing leadership and evidence-based human resource management are required to improve nursing environments. DESIGN: Integrative literature review. DATA SOURCES: Eight databases were searched: Academic Search Premier, CINAHL, Emerald, ERIC, Web of Science, MEDLINE, Psychinfo and Science Direct. Included papers were published between 2000-2016. REVIEW METHODS: Of 339 papers, 13 were eligible for inclusion: eight qualitative and five quantitative. Studies were assessed for quality using standardized checklists. Framework-based synthesis was used, allowing for themes identified a priori to be specified as coding categories. This method also allows new themes to emerge de novo. RESULTS: Four themes were identified. There are multiple definitions of health-promoting leadership, along with description of the non-health-promoting leader. The health-promoting nurse leader engages in employees' health promotion, and takes responsibility for actions and maintains open communication, accommodating nurses' participation in change processes. Through competence development, the health-promoting organization builds capacity. CONCLUSION: Health-promoting leadership may be a promising path to optimizing nursing outcomes through holistic thinking, which emphasizes the importance of context. Accumulated research is required to build a stronger line of international research, with attention to underlying mechanisms, limiting conditions and behaviours known to health-promoting leadership.

Health-promoting leadership: A qualitative study from experienced nurses' perspective.

AIMS AND OBJECTIVES: To increase knowledge about experienced nurses' understanding of a health-promoting work environment, health-promoting leadership and its role in retention of staff in the nursing workplace. BACKGROUND: The quality of leadership is imperative in creating supportive and health-promoting work environments to ensure workforce productivity and ethically sustainable caring cultures. More knowledge on how leaders can promote health and sustainable careers among nurses is needed. At a time of current and projected nursing shortage, it is important to understand the reasons why nurses intend to remain in their jobs. DESIGN: Qualitative descriptive. METHOD: Twelve experienced registered nurses participated in an individual, digitally recorded, semi-structured interview. Data were transcribed verbatim and subjected to qualitative content analysis of manifest and latent content. RESULTS: A health-promoting work environment should provide autonomy, participation in decision-making, skills development and social support. Health-promoting leaders should be attentive and take action. CONCLUSION: Health-promoting work environments enable nurses to flourish. Having ample autonomy is therefore important to nurses so that when they face new challenges, they see them as a way of using and developing their competencies. Although most nurses claim their own leaders are not health promoting, they have a clear understanding of how a health-promoting leader should act. The health-promoting leader should not only be attentive and promote skills development, but also cater for nurses' meaningfulness. RELEVANCE TO CLINICAL PRACTICE: Nurses in primary health care understand a health-promoting work environment to be a workplace where they can develop, not only clinical skills, but also flourish as human beings. Further, nurses find it health promoting to have a meaningful job, using their competence to make a difference for patients and their families. Nurse Managers have an important role in facilitating meaningfulness in nurses' jobs to retain nurses as a valuable asset for the organisation.

Measuring mental well-being: A validation of the Short Warwick-Edinburgh Mental Well-Being Scale in Norwegian and Swedish.

AIMS: Mental health, currently one of the biggest challenges worldwide, requires attention and research. The aim of this study was to examine the psychometric properties of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and validate the scale for use in Norway and Sweden. SWEMWBS, which includes both hedonic and eudemonic principles of mental well-being, could facilitate useful future studies. METHOD: Data were collected among Norwegian and Swedish hotel managers (N=600) through self-rated online questionnaires. Tests used to examine the psychometric properties of the scale included descriptive statistics, correlations, reliability analyses, and explorative factor analyses in SPSS, as well as confirmatory factor analyses in AMOS. Robustness tests were run for gender and country subsamples. RESULTS: The scale showed adequate internal consistency and reliability. Results of the confirmatory factor analysis showed moderate fit in Norway and Sweden. In addition, the scale showed acceptable construct, criterion-related, and discriminant validity. CONCLUSION: The psychometric properties of the SWEMWBS were acceptable in both the Norwegian and the Swedish translations of the scale.

The effects of performance appraisal in the Norwegian municipal health services: a case study.

INTRODUCTION: Previous research in performance appraisal (PA) indicates that variation exists in learning and job motivation from performance appraisal between occupational groups. This research evaluates the potential effect of job motivation, learning and self-assessment through performance appraisals for health personnel. CASE DESCRIPTION: This article focuses on goal-setting, feedback, participation and training in performance appraisals in municipal health services in Norway; and job motivation, learning and self-assessment of performance are the dependent factors. Questionnaires were distributed to a representative sample of 600 health personnel from the Norwegian municipal health service, with a response rate of 62%. Factor analysis and regression analysis were run in SPSS 12. DISCUSSION AND EVALUATION: The study suggests that respondents learn from performance appraisal. Nurses experienced some higher job motivation from performance appraisal than auxiliary nurses. All subordinates perceived higher job motivation after performance appraisal than managers. CONCLUSION: Useful feedback, active participation and higher education are fundamental elements of discussion in performance appraisal, as well as the role of increasing employees' job motivation. In this study, nurses' job motivation seems to be more effected by PA, than for auxiliary nurses. Both nurses and auxiliary nurses indicate that there is a learning effect from PA. This study may be of interest to health researchers and managers in municipal health services.

Age discrimination in the workplace: validation of the Nordic Age Discrimination Scale (NADS).

Due to population ageing, older workers will make up a larger proportion of the workforce. However, recent reports show an increase in perceived age discrimination among older employees. Previous research found that age discrimination may result in negative feelings, such as uselessness, powerlessness and lower self-esteem. This study develops and validates a scale for monitoring age discrimination in the workplace. The validation study draws on three datasets, from Norway, Sweden and Finland respectively. The study provides a psychometric contribution to the study of the behavioral component of ageism.

Employees' perceptions of justice in performance appraisals.

Of all the tasks undertaken by human resource managers, performance appraisals (PAs) are one of the most unpopular among employees (Meyer 1991, Murphy and Cleveland 1995, Holbrook 2002, Jackman and Strober 2003). As PA guides and plans show (Fletcher 2004, CatalystOne 2010), PAs can be implemented in similar ways in organisations throughout Europe and developed countries elsewhere. But, if employees perceive PA processes as unfair, they may reject the usefulness and validity of the information they receive and so may not be motivated to change behaviour. This article concerns perceptions of organisational justice and explains the results of a study of perceived fairness in PAs among nurses and auxiliary nurses in Norway's municipal health service.

Hearing the Voices of Wingless Angels: A Critical Content Analysis of Nurses' COVID-19 Experiences.

The world has been affected by an outbreak of the novel coronavirus (COVID-19). Health care workers are among those most at risk of contracting the virus. In the fight against the coronavirus, nurses play a critical role. Still, most social media platforms demonstrate that nurses fear that their health is not being prioritized. The purpose of this study is to investigate nurses' experiences through analyzing the main themes shared on Instagram by nurses during the COVID-19 pandemic. In contrast with highly structured research, the current paper highlights nurses' natural language use in describing their experiences during the first months of the outbreak in their workplace. Instagram captions were utilized as a data source. Leximancer was utilized for the content analysis of nurses' narratives towards their coronavirus experience. We sought to accomplish three research objectives: the first was to identify the main themes in the descriptions of nurses' experiences shared via their social media, specifically Instagram; then, to determine the relationships among concepts, and finally, to give useful implications based on the findings. The current study uses a qualitative (i.e., narratives) approach to analyze the main components of the nurses' experiences during the pandemic. The Leximancer software analysis revealed nine major textual themes and the relationships among these themes. In order of the relative importance, the themes were "patients", "coronavirus", "exhaustion", "family", "hospital", "personal protective equipment" (PPE), "shift", "fear", and "uncertainty". The results offer practical implications based on the social media information regarding nurses' overall experiences.

Employable as We Age? A Systematic Review of Relationships Between Age Conceptualizations and Employability.

This systematic review aimed to provide an overview of earlier research on the relationships between age conceptualizations (i.e., calendar age, organizational age, lifespan age, psychosocial age, and functional age) and indicators of employability. We have conducted a systematic literature search using PsycINFO, Academic Search Premier, Business Source Complete, CINAHL, ERIC, MEDLINE, and Science Direct. Two raters evaluated the articles and subsequently distinguished k = 41 studies that met the inclusion criteria for this systematic review. Our review revealed that many researchers adopted different operationalizations to measure employability (15 studies were based on an input- or competence-based measure of employability, 23 studies included an output- or labor market-based measure of employability, and three studies included a combination of both measures). Moreover, most studies included calendar age (40 studies, 97.6%) as indicator of aging at work, and were based on a cross-sectional design (34 studies, 82.9%; 17.1% a longitudinal design). Based on the Standardized Index of Convergence (SIC) method, different types of evidence were found for the relationships between age and the employability measures. For relationships between psychosocial age and lifespan age, on the one hand, and employability measures, on the other hand, too few studies were found to draw conclusions. Yet, for relationships between calendar age and labor market-based measures strong consistent negative relationships were found across the studies, and moderately strong positive relationships were found for functional age and labor market- based measures. For organizational age and both competence-based as well as labor market-based measures moderately strong negative relationships were found. We discuss the implications of these results and propose a research agenda for future studies.

An Open Time Perspective and Social Support to Sustain in Healthcare Work: Results of a Two-Wave Complete Panel Study.

Based on lifespan developmental psychology and psychosocial work characteristics theory, we examined longitudinal relations between calendar age, occupational time perspective, different types of job demands and job resources in relation to sustainable employability (i.e., work ability, vitality and employability) among healthcare workers in Netherlands (N = 1478). Results of our two-wave complete panel study revealed satisfactory fit indices for the metric invariance of the included variables across the two waves (6-month time lag). Our results revealed a negative relation between calendar age and external employability of healthcare workers (limited support for hypothesis 1), and more consistent evidence for positive relations between an open future time perspective and across-time changes in vitality, work ability and external employability (supporting hypothesis 2). Few significant findings were found for relations between specific job demands or job resources and indicators of sustainable employability of healthcare workers (mixed results hypotheses 3 and 4). Our explorative tests of possible moderating effects of age or occupational time perspective in predicting relations between psychosocial work characteristics and indicators of sustainable employability revealed only a significant interaction effect of supervisor support and future time perspective in explaining across-time changes in external employability of healthcare workers (rejecting hypothesis 5 and confirming hypothesis 6). We discuss the practical as well as theoretical implications of these findings, and present recommendations for future research.

A systematic review and meta-analysis: the effect of feedback on satisfaction with the outcome of task performance.

BACKGROUND: Knowledge of how to improve consumer satisfaction with the outcome of co-production in services with high levels of interaction is important for achieving and maintaining a competitive advantage in the service industry. OBJECTIVES: The aim of this paper is to review and meta-analyse research on the relationship between aspects of feedback to customers in interaction-intense encounters and the customer's satisfaction with the outcome. METHODS: We followed recommendations of the Cochrane Handbook for Systematic Review and Interventions to do a review and meta-analysis of relevant empirical research. From January 2018 to July 2018, we systematically searched PsycINFO, Business Source Complete, Science Direct and Web of Science for relevant studies. RESULTS: A total of six articles - consisting of 22 RCTs - were identified and included in the meta-analysis. Results indicate that feedback valence, with an effect size of 0.61 (0.43, 0.78), and feedback style, with an effect size of 0.82 (0.08, 1.57), have an impact on customers' satisfaction with the outcome of co-production. For feedback interventions, effect size -0.29 (-0.69, 0.11), and feedback medium, effect size 0.43 (-0.00, 0.86), the results are inconclusive. CONCLUSIONS: The present study suggest that there is a significant relationship between satisfaction with the outcome of co-production and feedback style and valence. To satisfy customers, service providers should offer positive feedback. In order to extend our knowledge, more studies on the effect of different feedback styles on customers' satisfaction with the outcome of co-production are needed.

Changes in Health and Health Behavior Associated With Retirement.

OBJECTIVES: While poor health contributes to early work exits, it is less clear how early work exits affect health. This study therefore examines changes in health associated with retirement. METHOD: Survey data from gainfully employed individuals aged 57 to 66 in 2002 were used to assess changes in health status and behaviors associated with retirement (49%) 5 years later ( N = 546). RESULTS: Compared with workers, retirees were more likely to report improvements in mental health (odds ratio [OR] = 1.67), and less likely to report mental health deteriorations (OR = 0.56). Retirees were more likely to both increase (OR = 2.03) and reduce (OR = 1.87) their alcohol intake, and to increase physical activity (OR = 2.01) and lose weight (OR = 1.75). DISCUSSION: As welfare states aim to extend working life to counteract repercussions of population aging, findings on possible health benefits for retirees may warrant more focus on the pros and cons of a prolonged working life.

Do spouses coordinate their work exits? A combined survey and register analysis from Norway.

Research on spouses' joint work exits is scarce, although household factors such as spouses' work status, marital quality, and caregiving burdens are likely to affect seniors' work engagement. We therefore examine whether the work exit probability of one spouse affects that of the other. Discrete-time hazard regression analyses of survey data linked to later registry information including all gainfully employed married respondents aged 50-74 with a working spouse (N = 1,764) were used to assess subsequent work exits. A spouse's work exit is a strong predictor of a respondent's work exit (hazard ratio 3.1, 95% confidence interval [2.5, 4.0]). Educational attainment, poor marital quality, and spouses' health and care needs do not predict work exits. Surprisingly, no gender differences are observed. Research on larger survey samples to distinguish different work exit routes and reasons for spouses' joint work exits appears warranted. To account for cultural and welfare state characteristics, cross-national studies ought to be undertaken.