The manager's role in mobilizing and nurturing development: entrenched and engaged approaches to change

carr s.m. & clarke c.l. (2010) Journal of Nursing Management  18, 332–338
The manager's role in mobilizing and nurturing development: entrenched and engaged approaches to change Aims Drawing on findings from the evaluation of a Health Action Zone (HAZ), this paper explores the manager’s role in promoting and nurturing learning. Background Initiating practice development is a core function of the manager’s role. Learning must be nurtured to reach beyond individual to organizational learning and address knowledge exchange as well as creation. In the United Kingdom, HAZs were established to reduce health inequalities. They embraced a variety of service delivery approaches, all with an emphasis on developing new ways of working and innovation. Methods Qualitative interviews of the HAZ coordinators, performance manager and staff delivering services. Results Two alternative ways of engagement and entrenchment to practice were identified to developing new ways of working and learning from experience. Conclusions Development of sustainable and enduring structures which facilitate learning at both individual and organizational levels are key to utilization of knowledge and accumulation of learning. Implications for nursing management When entrenched and engaged experiential learning in practice are pursued, the role of the manager as a catalyst needs to be highlighted. A tool is proposed to facilitate reflection and promote action plan development. This tool has potential general application, but our experience is that it makes a specific contribution to public health and primary care.     

Being in charge – new mothers' perceptions of reflective leadership and motherhood

Akerjordet k . & Severinsson e . (2010) Journal of Nursing Management 18, 409–417
Being in charge – new mothers' perceptions of reflective leadership and motherhood Aim To explore new mothers’ perceptions of reflective leadership in relation to motherhood. Background Mindfulness, discovery of a deep personal self, sense of life purpose and authenticity appear to be the essence of self-reflective leadership. In this regard, women may be unprepared for the level of distress associated with the transition to motherhood. Method This study comprised interviews with ten new mothers on day 2–3 after giving birth conducted between March and May 2005. The interviews were audio-taped, transcribed verbatim and interpreted by a method grounded in hermeneutics. Results The content of the text was interpreted as one overall theme; the nature of responsibility in motherhood, encompassing the following four sub-themes: ‘Being a good mother by reflecting and developing self-identity’, ‘managing fear, demands and commitments as a mother’, ‘having the necessary resources to act and lead as a mother’ and ‘believing and trusting in others and self as a leader’. Conclusion In the new mother’s transformation and growth of self, true strength has to overcome the vulnerability of life by means of caring and courage mediated by reflective leadership anchored in love.     

Care managers’ view of family influence on needs assessment of older people

Scand J Caring Sci; 2011; 25; 243–252
Care managers’ view of family influence on needs assessment of older people Research has shown that families experience poor involvement in needs assessment of older people while little is known about municipal care managers’ views of family participation. The aim was to explore how municipal care managers view families’ participation in and influence on needs assessment of older people receiving public home help. Individual interviews (n = 26) were conducted with care managers (n = 5) about their previously conducted needs assessments (n = 5–6). As a complement, a focus group interview with care managers (n = 9) from nine different municipalities was conducted. All interviews were analysed using a qualitative content analysis. The results revealed the overarching category, ‘Having to establish boundaries towards family influence and at the same time use them as a resource’, which encompassed five principal categories. How family participation was viewed and handled during the needs assessment process seemed determined by the way care managers set boundaries for their professional responsibility. Their views revealed both distancing and strengthening attitudes. The distancing attitude dominated, in particular towards family members who were not perceived as having any legal rights to be considered, even though their participation was an important resource. To follow legislation and municipal guidelines of allocation of public home help to avoid reprimands caused a need for self‐protection. The care managers seemed pressed by demands from organizations and families, and in this competition, the family lost out. Adherence to organizational developed patterns of handling legislation and guidelines were prioritized. Because family members often are older and assist in providing care, family participation in the needs assessment of older help recipients needs further societal support.     

Developing a questionnaire for conducting cross‐national studies –‘Self‐reported health and needs among elderly Iranians and Swedes’

Scand J Caring Sci; 2010; 24; 372–379
Developing a questionnaire for conducting cross‐national studies –‘Self‐reported health and needs among elderly Iranians and Swedes’ Purpose: This paper describes the process of developing and validating a questionnaire to investigate self‐reported health and care needs of elders in Iran and Sweden. Background: Both developing and developed countries face dilemmas under the current condition of increasing mental and physical health morbidity globally. In order to fully assess and understand the extent of these dilemmas and the global and local factors that alleviate or worsen them, a comparison of the self‐reported health and care needs in a developed and a developing country is required. To these ends, two research teams within a joint international project worked together to construct a questionnaire to measure self‐reported health in elders in Sweden and Iran. Methods: The questionnaire was developed according to a multiphase process, during which the researchers tested the validity and reliability of the questionnaire using various methods and modified it based on the test results. First, the concepts to be used were agreed upon and a literature review was conducted. Thereafter, face and content validity was measured in Iran, looking at the initial items that were developed. The questionnaire was then translated and back‐translated. Finally, both teams conducted a test of content validity using target groups in Iran and Sweden, respectively. Results: Validity was established by testing face and content validity with the use of expert groups. Reliability was also determined according to two different dimensions, stability and internal consistency. Both methods gave satisfactory results, indicating that the instrument was reliable. Conclusion: The questionnaire was thereby developed and titled, ‘Self‐reported health and health‐care needs’. The results confirm validity and reliability of the final version of the questionnaire.