Dyadisk lederskap

Hensikten med denne artikkelen er å rette søkelyset mot en del av lederoppgaven som er lite vektlagt i tradisjonell ledelsesteori. En leder må i stor grad forholde seg til sine medarbeidere enkeltvis (i dyader). Et slikt dyadisk lederskap innebærer spesielle utfordringer for en leder. Kvaliteten på relasjonene i dyadene vil variere. Høy kvalitet på en relasjon ser ut til å gi mer tilfredse medarbeidere som yter mer, er mer trofaste mot arbeidsgiver og har mindre fravær. Ulike faktorer i dyadisk lederskap er undersøkt i en intervjuundersøkelse med 17 ledere i drifts- og servicebransjen som hadde innsett betydningen av å bygge enkeltvise relasjoner til sine medarbeider

Dyadic relationships for leaders in facility management

Several studies during the last decades have made evident positive consequences for an organization if a leader obtains relationships of high quality with the single subordinate. The quality of the single relationship is correlated with job performance, job satisfaction, organizational commitment, intention to quit and absence from work. Because the facility management industry is work intensive, these connections are of great importance. By help of a case study with 16 cases, I wanted to get an understanding of how the leaders practiced relation building and whether different qualities in the individual relationship to the subordinates lead to challenges in the work environment. The method was in-depth interviews. The leaders varied in their efforts to build relationships to their single subordinate. Several of them admitted that they had employees they wanted should quit. A few claimed that they did not want to lose any of their employees. The leaders were afraid of showing that they liked some subordinates better than other

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Dyadic relationships for leaders in facility management

Several studies during the last decades have made evident positive consequences for an organization if a leader obtains relationships of high quality with the single subordinate. The quality of the single relationship is correlated with job performance, job satisfaction, organizational commitment, intention to quit and absence from work. Because the facility management industry is work intensive, these connections are of great importance. By help of a case study with 16 cases, I wanted to get an understanding of how the leaders practiced relation building and whether different qualities in the individual relationship to the subordinates lead to challenges in the work environment. The method was in-depth interviews. The leaders varied in their efforts to build relationships to their single subordinate. Several of them admitted that they had employees they wanted should quit. A few claimed that they did not want to lose any of their employees. The leaders were afraid of showing that they liked some subordinates better than other