Empowering leadership : bifactor modeling and study of its relationship with psychological and biological indicators of health

Le leadership habilitant (LH), et plus généralement les styles de management favorables au pouvoir d'action des salariés, connaissent un intérêt croissant, aussi bien dans le monde de l'entreprise que dans le secteur public hospitalier. Le mouvement des entreprises libérées est un parfait exemple de cet engouement. Il met en lumière l'engagement de nombreux dirigeants dans la transformation de leurs organisations, vers la liberté d'actions, la responsabilisation et le développement des salariés, au service de la performance collective. Toutefois, un certain nombre d'interrogations demeurent au plan scientifique, notamment quant à l'effet de ces pratiques de management sur la santé. En effet, très peu d'études ont investigué le lien entre les pratiques habilitantes et la santé des salariés. En outre, certains travaux montrent que le LH peut avoir des effets positifs et négatifs, selon que les conduites habilitantes soient mises en œuvre de manière combinée ou isolée. En s'appuyant sur une approche bifactorielle, ce travail étudie l'effet des facteurs globaux et spécifiques du LH sur la santé. Trois études sont présentées : (1) une étude transversale sur l'effet du LH sur la santé psychologique, (2) une étude transversale sur l'effet du LH sur la santé biologique, et (3) une étude expérimentale sur l'effet du LH sur l'évolution de la santé psychologique au cours d'une année. L'ensemble des conduites de LH montre systématiquement un effet positif sur la santé, tant au plan psychologique que biologique. Néanmoins, nos analyses révèlent que la mise en œuvre de certaines conduites de LH peut augmenter le stress perçu et l'épuisement émotionnel, en particulier l'incitation à l'autonomisation. Nos résultats invitent à considérer la promotion du LH dans les organisations comme de véritables campagnes de prévention dans le champ de la santé au travail.Empowering leadership (EL), and more generally leadership styles that promote employee empowerment, are becoming increasingly popular, both in the business world and in the public hospital sector. The movement of the "liberated companies" is a perfect example of this interest. It highlights the effort of many business leaders in transforming their organizations, towards freedom of action, accountability and development of employees, and its positive consequences on collective performance. However, a number of scientific questions remain, particularly concerning the effect of these managerial practices on health. Indeed, very few studies have investigated the link between empowering practices and employee health. Moreover, some studies suggest EL can have negative effects, depending on whether all the empowering behaviors are implemented in combination or in isolation. Using bifactorial approach, this research investigates the effect of global and EL-specific factors on health. Three studies are presented: (1) a cross-sectional study of the effect of EL on psychological health, (2) a cross-sectional study of the effect of EL on biological health, and (3) an experimental study of the effect of EL on changes in psychological health over one year. The combination of all EL behaviors consistently shows a positive effect on health, both psychological and biological. However, our analyses reveal that implementation of certain EL behaviors can increase perceived stress and emotional exhaustion, particularly the empowerment incentives. Our results invite us to consider the promotion of EL in organizations as true prevention campaigns in the field of occupational health

Psychological and Relational Conditions for Job Crafting to Occur

International audienceThis study aimed to provide a wider understanding of the determinants of job crafting by jointly considering employee well- and ill-being (work engagement and exhaustion) and socio-environmental factors (supervisor and colleague support) as possible levers to promote job crafting. A secondary goal of this research was to simultaneously explore the multidimensionality of work engagement and the potentially differentiated associations between the different facets of work engagement and job crafting behaviours. Questionnaire surveys were collected among 533 workers from various organizations located in France. Results from preliminary analyses showed the superiority of a Bifactor Exploratory Structural Equation Modeling (B-ESEM) representation of work engagement when compared to alternative representations of ratings of this multidimensional construct. Specifically, employees' ratings of work engagement simultaneously reflected a global work engagement construct, which co-existed with specific vigor, dedication and absorption components. Results from a predictive model indicated that the different facets of work engagement held differentiated relations with job crafting behaviours, while exhaustion did not significantly relate to any job crafting behaviours. Colleague and supervisor support also held differentiated relations with the demands-related job crafting behaviours, while both forms of support were associated with employees' seeking more job resources. Theoretical and practical implications are discussed

Étude contrôlée randomisée de l’impact à deux ans d’un programme d’intervention sur l’empowerment d’équipes médico-soignantes

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Longitudinal psychological empowerment profiles, their determinants, and some health-related outcomes

International audienceThis research relies on bifactor models to help improve our understanding of the dimensionality of the psychological empowerment construct. We also examined the configurations, or profiles, taken by psychological empowerment dimensions, and documented their stability over time as well as the associations between these profiles and theoretically-relevant predictors (workload, supervisor support, overall organizational justice, and role clarity) and outcomes (alcohol consumption, sleeping difficulties, and depressive symptoms). A sample of 750 healthcare workers completed a questionnaire twice over a one-year period. First, our results showed that employees' psychological empowerment ratings simultaneously reflected a global overarching construct co-existing with four specific dimensions (competence, impact, meaning, and self-determination). Then, five profiles were identified and found to be highly stable over time: Low Empowerment, Moderately High Empowerment and Impact, Normative, High Empowerment, and Moderately High Empowerment and High Meaning. Role clarity was also associated with a higher likelihood of membership into the High Empowerment profile and a lower likelihood of membership into the Low Empowerment one relative to the other profiles. Finally, employees' depressive symptoms were the highest in the Low Empowerment profile

A person-centered perspective on the combined effects of global and specific LMX components for employees

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A longitudinal investigation of structural empowerment profiles among healthcare employees

PurposeResearch on structural empowerment has typically adopted a variable-centered perspective, which is not ideal to study the combined effects of structural empowerment components. This person-centered investigation aims to enhance our knowledge about the configurations, or profiles, of healthcare employees’ perceptions of the structural empowerment dimensions present in their workplace (opportunity, information, support, and resources). Furthermore, this study considers the replicability and stability of these profiles over a period of two years, and their outcomes (perceived quality of care, and positive and negative affect). DesignParticipants completed the same self-reported questionnaires twice, two years apart.MethodsA sample of 633 healthcare employees (including a majority of nurses and nursing assistants) participated. Latent transition analyses were performed.ResultsFive profiles were identified: Low Empowerment, High Information, Normative, Moderately High Empowerment, and High Empowerment. Membership into the Normative and Moderately High Empowerment profiles demonstrated a high level of stability over time (79.1% to 83.2%). Membership in the other profiles was either moderately stable (43.5% for the High Empowerment profile) or relatively unstable (19.7% to 20.4% for the Low Empowerment and High Information profiles) over time. More desirable outcomes (i.e., higher positive affect and quality of care, and lower negative affect) were observed in the High Empowerment profile. ConclusionsThese results highlight the benefits of high structural empowerment, in line with prior studies suggesting that structural empowerment can act as a strong organizational resource capable of enhancing the functioning of healthcare professionals. These findings additionally demonstrate that profiles characterized by the highest or lowest levels of structural empowerment were less stable over time than those characterized by more moderate levels.Clinical RelevanceFrom an intervention perspective, organizations and managers should pay special attention to employees perceiving low levels of structural empowerment, as they experience the worst outcomes. In addition, they should try to maintain high levels of structural empowerment within the High Empowerment profile, as this profile is associated with the most desirable consequences. Such attention should be fruitful, considering the instability of the High Empowerment and Low Empowerment profiles over time.Registration: NCT04010773 on ClinicalTrials.gov (04 July, 2019

Psychosocial and Organizational Processes and Determinants of Health Care Workers’ (HCW) Health at Work in French Public EHPAD (Assisted Living Residences): A Qualitative Approach Using Grounded Theory

International audienceIn a context marked by negative health indicators that make structural aspects more salient, this paper aimed at understanding and explaining the processes and determinants at work that positively and negatively interfere with the professionals’ health in the French public nursing home environment. To this purpose, the qualitative approach by grounded theory was chosen. In total, 90 semi-structured interviews were recorded and 43 were transcribed; in addition, 10 observations of 46 participations in meetings and working groups were carried out in four public service and hospital establishments. Our results indicate that the role of health workers, its definition, and its execution are fundamental to the understanding of their health at work. Two protective and constructive processes are involved in the maintenance and development of the professionals’ health in this work, with considerable confrontations with death and suffering: individual and collective control of emotional and cognitive commitment, and the development of resources for formation, information, and cooperation. Nonetheless, they are jeopardized when a lasting imbalance is generated between the work’s demands and the available resources. This leads to a loss spiral in organizational, inter-individual, and individual resources that makes it difficult to sustain work

Impact of empowering leadership on emotional exhaustion: A controlled interventional study in a large French university hospital complex

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Impact at two years of an intervention on empowerment among medical care teams: study protocol of a randomised controlled trial in a large French university hospital

International audienceBACKGROUND:Empowerment of hospital workers is known as a key factor of organizational performance and occupational health. Nevertheless, empowering workers remains a real challenge. As in many traditional organizations, hospitals follow a bureaucratic model defined by a managerial culture of control and a stratified organization, which at once weaken professionals' mastery of their work and hinder their commitment and performance. Based on the existing literature this protocol describes a new managerial and organizational transformation program as well as the study design of its effect on worker empowerment in a large French public hospital. The project is funded by the French Ministry of Health for a total of 498,180 €.METHODS:This study is a randomized controlled trial conducted in a French university hospital complex (CHU). The CHU comprises 12 sub-centers (SC) with about 20 care units and 1000 employees each. Randomization is performed at SC level. The intervention lasts 12 months and combines accompaniment of healthcare teams, frontline managers and SC directors to empower first-line professionals in the experimental SC. Quantitative outcome measurements are collected over 2 years during mandatory check-ups in the occupational medicine department. The primary outcomes are structural and psychological empowerment, motivational processes, managerial practices, working conditions, health and performance. Mixed linear modeling is the primary data analysis strategy.DISCUSSION:The protocol was approved by the CHU health ethics committee. The results of the analysis of the intervention effects will be reported in a series of scientific articles. The results will contribute to reflection on prevention and management policies, and to the development of Workplace Quality-of-Life. If the intervention is a success, the system will warrant replication in other SCs and in other health facilities.TRIAL REGISTRATION:The study was retrospectively registered at ClinicalTrials.gov on July 4, 2019 (NCT04010773)