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Effects of a Flipped-Learning Empowering Leadership Program on Nurse Leaders, Staff, and Residents in Long-Term Care Facilities

17 augustus 2026 bijgewerkt door: 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.

Studie Overzicht

Studietype

Ingrijpend

Inschrijving (Werkelijk)

287

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Taichung, Taiwan
        • Residential Long-Term Care Facilities

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Onderzoek naar gezondheidsdiensten
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: 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.
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.
Actieve vergelijker: 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.
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Leader Empowerment Behavior
Tijdsspanne: Baseline and immediately post-intervention (approximately 12 weeks)
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.
Baseline and immediately post-intervention (approximately 12 weeks)
Staff-Perceived Leader Empowering Behavior
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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.
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Occupational Burnout
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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.
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
Psychological Empowerment
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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.
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
Job Satisfaction
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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.
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
Job Stress
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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).
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
Health Status (SF-36)
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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.
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
Quality of Life (WHOQOL-BREF)
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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.
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
Care Quality / Customer Satisfaction
Tijdsspanne: Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
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.
Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)
Nursing Staff Retention Rate
Tijdsspanne: 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)
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)
Nursing Staff Turnover Rate
Tijdsspanne: 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)
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)
Resident Hospitalization Rate
Tijdsspanne: 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)
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)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 augustus 2018

Primaire voltooiing (Werkelijk)

30 mei 2019

Studie voltooiing (Werkelijk)

30 mei 2020

Studieregistratiedata

Eerst ingediend

13 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

17 augustus 2026

Eerst geplaatst (Werkelijk)

19 augustus 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

19 augustus 2026

Laatste update ingediend die voldeed aan QC-criteria

17 augustus 2026

Laatst geverifieerd

1 augustus 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • CRREC-105-002

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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