Effects of a Flipped-Learning Empowering Leadership Program on Nurse Leaders, Staff, and Residents in Long-Term Care Facilities
maanantai 17. elokuuta 2026 päivittänyt: I-Hui-Chen
Flipped Learning for Leader Empowering Leadership in Aged Care: A Pilot Cluster Quasi-Experimental Study
This pilot cluster quasi-experimental study tested a 12-week empowering-leadership training program delivered through flipped learning to nurse leaders in residential long-term care facilities, compared with a conventional brochure-based approach.
Six facilities in central Taiwan participated: two (one public, one private) received the flipped-learning program for their leaders, and four (one public, three private) served as controls.
The study examined effects at three levels: nurse leaders' own empowering leadership behaviors and facility-level nursing staff retention/turnover and resident hospitalization rates; nursing staff's perceptions of their leader's empowering behaviors, burnout, psychological empowerment, and job satisfaction; and residents' health status, quality of life, and satisfaction with care.
Tutkimuksen yleiskatsaus
Tila
Valmis
Opintotyyppi
Interventio
Ilmoittautuminen (Todellinen)
287
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.
Opiskelupaikat
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Taichung, Taiwan
- Residential Long-Term Care Facilities
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Osallistumiskriteerit
Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Ei
Kuvaus
Inclusion Criteria:
Nurse Leaders:
- Age ≥ 20 years
- Employed as nursing director, supervisor, or head
- Employed at the facility for more than 6 months
- Willing to participate and able to give informed consent
Nursing Staff:
- Registered nurse, licensed practical nurse, or nursing assistant
- Employed at the facility for ≥ 3 months
- Age ≥ 20 years
- Informed consent given
Residents:
- Resided at the facility for ≥ 3 months
- Mini-Mental State Examination (MMSE) score ≥ 24
- No severe hearing impairment
- Not terminally ill
- Written informed consent given (or via authorized representative as applicable)
Exclusion Criteria:
Nurse Leaders:
- Indicated intent to leave the position within the next 6 months
Opintosuunnitelma
Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Terveyspalvelututkimus
- Jako: Ei satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Kokeellinen: Flipped Learning Intervention
2 residential long-term care facilities (1 public, 1 private): 10 nurse leaders, 40 nursing staff, 100 residents.
Nurse leaders received a 12-week flipped-learning empowering leadership program.
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A 12-week, 24-hour empowering leadership program (one 2-hour module per week).
Each week, a 60-minute instructional video was posted for asynchronous pre-class learning, followed by a 1-hour face-to-face session (small-group discussion, case studies, brief presentations, practical exercises), with instructor summary.
Post-class activities included reflection and assignments.
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Active Comparator: Conventional Learning / Control
4 residential long-term care facilities (1 public, 3 private): 11 nurse leaders, 40 nursing staff, 86 residents.
Nurse leaders received a printed brochure with identical content, without structured flipped-learning sessions.
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Nurse leaders in the control group received a printed brochure covering the same empowerment/empowering-behavior content as the intervention group, without structured flipped-learning sessions.
The research team maintained regular contact to answer questions but provided no additional training.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Leader Empowerment Behavior
Aikaikkuna: Baseline and immediately post-intervention (approximately 12 weeks)
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Leader Empowerment Behavior Scale (Chinese version), a 27-item self-report measure across 5 subscales (extending meaning of work, engaging staff in decision-making, expressing confidence, encouraging goal achievement, providing autonomy).
Each item rated on a 7-point Likert scale (1=strongly disagree, 7=strongly agree); total score range 27-189, with higher scores indicating more empowering leadership behavior (better outcome).
Cronbach's α=0.71; test-retest r=0.83.
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Baseline and immediately post-intervention (approximately 12 weeks)
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Staff-Perceived Leader Empowering Behavior
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Modified version of the Leader Empowerment Behavior Scale, a 27-item measure completed by nursing staff about their leader, across 5 subscales.
Each item rated on a 7-point Likert scale; total score range 27-189, with higher scores indicating more empowering behavior as perceived by staff (better outcome).
Cronbach's α=0.85; test-retest r=0.71.
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Occupational Burnout
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Occupational Burnout Inventory Scale, a 21-item self-report measure across 4 subscales (personal burnout, work-related burnout, client-related burnout, over-commitment to work).
Each item rated on a 5-point Likert scale; total score range 21-105, with higher scores indicating greater burnout (worse outcome).
Cronbach's α=0.80; test-retest reliability=0.78.
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Psychological Empowerment
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Spreitzer's Psychological Empowerment Scale, a 12-item self-report measure across 4 subscales (meaning, competence, self-determination, impact).
Each item rated on a 5-point Likert scale; total score range 12-60, with higher scores indicating greater psychological empowerment (better outcome).
Cronbach's α=0.87; test-retest reliability=0.82.
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Job Satisfaction
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Minnesota Satisfaction Questionnaire Short Form, a 20-item self-report measure.
Each item rated on a 5-point Likert scale; total score range 20-100, with higher scores indicating greater job satisfaction (better outcome).
Cronbach's α=0.88; test-retest reliability=0.84.
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Job Stress
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Single-item self-report measure ("Do you often feel very stressed at work?"), rated on a 5-point Likert scale; score range 1-5, with higher scores indicating greater job stress (worse outcome).
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Health Status (SF-36)
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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36-Item Short Form Health Survey (SF-36), across 8 domains (physical functioning, role limitations due to physical health, role limitations due to emotional problems, pain, emotional well-being, social functioning, energy, general health).
Each domain scored 0-100, with higher scores indicating better health status (better outcome).
Cronbach's α=0.78-0.90;
test-retest reliability=0.86-0.91.
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Quality of Life (WHOQOL-BREF)
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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World Health Organization Quality of Life Questionnaire, Abbreviated Version (WHOQOL-BREF), across 4 domains (physical health, psychological health, social relationships, environmental health).
Domain scores range from 4 to 20, with higher scores indicating better quality of life (better outcome).
Cronbach's α=0.80-0.88;
test-retest reliability=0.90-0.95.
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Care Quality / Customer Satisfaction
Aikaikkuna: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Customer Satisfaction Scale, a 25-item self-report measure across 4 subscales (comfort/cleanliness, nursing care, food services, facility care/services).
Each item rated on a 5-point Likert scale; total score range 25-125, with higher scores indicating greater satisfaction with care quality (better outcome).
Cronbach's α=0.94; test-retest reliability=0.75.
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Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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Nursing Staff Retention Rate
Aikaikkuna: 12-month period prior to the intervention (baseline) and 12-month period beginning approximately 1 month after the 12-week intervention was completed (follow-up)
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12-month period prior to the intervention (baseline) and 12-month period beginning approximately 1 month after the 12-week intervention was completed (follow-up)
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Nursing Staff Turnover Rate
Aikaikkuna: 12-month period prior to the intervention (baseline) and 12-month period beginning approximately 1 month after the 12-week intervention was completed (follow-up)
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12-month period prior to the intervention (baseline) and 12-month period beginning approximately 1 month after the 12-week intervention was completed (follow-up)
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Resident Hospitalization Rate
Aikaikkuna: 12-month period prior to the intervention (baseline) and 12-month period beginning approximately 1 month after the 12-week intervention was completed (follow-up)
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12-month period prior to the intervention (baseline) and 12-month period beginning approximately 1 month after the 12-week intervention was completed (follow-up)
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Yhteistyökumppanit ja tutkijat
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