Characteristics of highly rated leadership in nursing homes using item response theory

• Published in: Journal of advanced nursing 2017-12, Vol.73 (12), p.2903-2913
• Main Authors: Backman, Annica, Sjögren, Karin, Lindkvist, Marie, Lövheim, Hugo, Edvardsson, David
• Format: Article
• Language: English
• Subjects: Adult; Aging; Behavior; Feedback; Female; Home health care; Humans; Item response theory; Leadership; long-term care; Male; management; Managers; Medical personnel; Middle Aged; Nursing; nursing home care; Nursing homes; Nursing Homes - organization & administration; Organizational behavior; Professional associations; Questionnaires; Reproducibility of Results; Social work; Subordinates; Supervisor-Subordinate interactions
• ISSN: 0309-2402; 1365-2648; 1365-2648
• DOI: 10.1111/jan.13353

Aim To identify characteristics of highly rated leadership in nursing homes. Background An ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care. Design Cross‐sectional. Method From 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct‐care staff employed in 169 Swedish nursing homes. The staff assessed their managers’ (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 ‐ September 2014, and the study was completed in November 2016. A two‐parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership. Results Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings. Conclusion This study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings.