Working Life Among First-Line Managers and Their Subordinates in Elderly Care : an Empowerment Perspective

Sammanfattning: Aim: The aim of this thesis was to study the working life of first-line managers and their subordinates in elderly care from an empowerment perspective. Methods: Paper I and II used a qualitative approach, and semi-structured interviews were conducted with 14 male and 14 female first-line managers. Data were analyzed using qualitative content analysis. Paper III and IV used a quantitative approach with a longitudinal, correlational and multilevel design. 78 first-line managers and 1398 subordinates filled in the questionnaire at T1 and 56 first-line managers and 769 subordinates at T2. Data were analyzed using descriptive statistics, multivariate analyses (III & IV) and multilevel modelling (IV). Results: In Paper I and II, the first-line managers reported having a challenging and complex work situation. Although the first-line managers sometimes expressed a need for better access to structural empowerment in terms of information, resources and support, they experienced psychological empowerment in their work. In Paper III, the results indicated that the more access the first-line managers had to structural empowerment over time, the more likely they were to feel psychologically empowered over time, resulting in lower ratings of their stress symptoms and higher ratings of their own self-rated leadership-management performance over time. Another finding in Paper III was the influence the number of subordinates per first-line manager had on the first-line managers’ ratings of structural empowerment and the subordinates’ ratings of structural empowerment and stress symptoms. In Paper IV, the results indicate that the more access the first-line managers had to structural empowerment at T1, the more access the subordinates had to structural empowerment at T2, and the higher the subordinates rated their first-line manager’s leadership-management performance at T2, when controlling for psychological empowerment. Conclusions: The working life of first-line managers in elderly care is complex and challenging, and they seem to need better access to structural empowerment (Paper I-IV). However, although deficiencies in access to structural empowerment were reported, the first-line managers experienced their work as a positive challenge (Paper 1) and felt that, though the work was not easy, it was worth it (Paper II).