Effects of a Flipped-Learning Empowering Leadership Program on Nurse Leaders, Staff, and Residents in Long-Term Care Facilities
17. august 2026 oppdatert av: 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.
Studieoversikt
Status
Fullført
Studietype
Intervensjonell
Registrering (Faktiske)
287
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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-
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Taichung, Taiwan
- Residential Long-Term Care Facilities
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Nei
Beskrivelse
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
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Helsetjenesteforskning
- Tildeling: Ikke-randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: 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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Aktiv komparator: 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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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Leader Empowerment Behavior
Tidsramme: 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
Tidsramme: 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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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Occupational Burnout
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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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Studer hoveddatoer
Studiestart (Faktiske)
1. august 2018
Primær fullføring (Faktiske)
30. mai 2019
Studiet fullført (Faktiske)
30. mai 2020
Datoer for studieregistrering
Først innsendt
13. august 2026
Først innsendt som oppfylte QC-kriteriene
17. august 2026
Først lagt ut (Faktiske)
19. august 2026
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
19. august 2026
Siste oppdatering sendt inn som oppfylte QC-kriteriene
17. august 2026
Sist bekreftet
1. august 2026
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
- CRREC-105-002
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