Effects of a Flipped-Learning Empowering Leadership Program on Nurse Leaders, Staff, and Residents in Long-Term Care Facilities
17 augusti 2026 uppdaterad 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.
Studieöversikt
Status
Avslutad
Betingelser
Studietyp
Interventionell
Inskrivning (Faktisk)
287
Fas
- Inte tillämpbar
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
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Taichung, Taiwan
- Residential Long-Term Care Facilities
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Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Nej
Beskrivning
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
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Hälsovårdsforskning
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
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Experimentell: 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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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Leader Empowerment Behavior
Tidsram: 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
Tidsram: 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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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Occupational Burnout
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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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Studera stora datum
Studiestart (Faktisk)
1 augusti 2018
Primärt slutförande (Faktisk)
30 maj 2019
Avslutad studie (Faktisk)
30 maj 2020
Studieregistreringsdatum
Först inskickad
13 augusti 2026
Först inskickad som uppfyllde QC-kriterierna
17 augusti 2026
Första postat (Faktisk)
19 augusti 2026
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
19 augusti 2026
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
17 augusti 2026
Senast verifierad
1 augusti 2026
Mer information
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Andra studie-ID-nummer
- CRREC-105-002
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