The effectiveness of health-oriented leadership interventions for the improvement of mental health of employees in the health care sector: a systematic review

"That was one of my most difficult and biggest challenges": experiences, preconditions and preventive measures of health-oriented leadership in virtual teams - A qualitative study with virtual leaders

BACKGROUND

Health-oriented leadership (HoL) has a positive impact on health- and work-related outcomes of employees in face-to-face settings. Increased digitization during the COVID-19 pandemic has led to many changes and increased job demands. According to current state of research, HoL in virtual teamwork is insufficiently researched. The aim of the study is to examine the experiences of virtual leaders during the COVID-19 pandemic and to identify preconditions and preventive measures for promoting HoL.

METHOD

Using a qualitative study design, semi-structured, guide-based telephone interviews were conducted with 16 German virtual leaders between May and July 2021. The collected data were inductively analyzed and interpreted using qualitative content analysis according to Mayring. Explorative analyses of differences between leaders with and without pre-pandemic experiences with virtual leadership were made.

RESULTS

Results indicated that leaders, regardless of pre-pandemic experiences with virtual leadership, faced diverse challenges in implementing HoL in virtual teamwork during the COVID-19 pandemic. Virtual leaders perceived personal preconditions (e.g., leaders' characteristics or behaviors), organizational preconditions (support by management or open-minded corporate culture), social preconditions (e.g., social support by team) and technical preconditions (e.g., sufficient technical equipment) as conducive to implementation of HoL. Almost all leaders with pre-pandemic experience identified a need for structural preventive measures, whereas almost all leaders without pre-pandemic experience reported a need for behavioral preventive measures in order to promote HoL in virtual teams.

CONCLUSIONS

This study suggests that implementing HoL in virtual teamwork is challenging, complex and requires adjustments in leadership behavior. Thereby, the study provides initial empirical findings for a holistic approach to HoL implementation in virtual teams, considering beneficial multilevel preconditions. Due to a limited generalization of present results, longitudinal and interventional studies will be necessary for the analysis of causal relationships in future research. In particular, a holistic research perspective in order to understand the complex, contextual interdependencies of leadership is recommended. In practice, based on a differentiated needs analysis, structural preventive measures for a holistic organizational development as well as behavioral preventive measures for ongoing personnel development are recommended.

Does meaningful work mediate the relationship between empowering leadership and mental health? Evidence from Malaysian SME employees

Introduction

In Malaysia, small and medium enterprises (SMEs) account for more than half of all employment and 98.7% of all businesses. There is little research on empowering behaviors in SMEs, despite leadership empowerment being often practiced. Therefore, the study aims to investigate how empowering leadership affects employees' mental health. The study also reveals meaningful work's role in mediating the relationship between empowering leadership and employees' mental health.

Methods

A stratified random sample approach was used to collect data from 516 employees of Malaysian SMEs. The data was analyzed, and the hypothesis was tested using structural equation modeling (AMOS 21.0) with bootstrap confidence intervals computed to evaluate the mediating effect.

Results

The results demonstrate that empowering leadership significantly improves employees' mental health. Furthermore, the association between empowering leadership and mental health is partially mediated by meaningful work.

Discussion

This study contributes to the present empowering leadership-meaningful work-mental health model for SME employees, which reduces stress and anxiety at the workplace and positively impacts psychological empowerment and their capacity to control their overall emotions in instances of success.

Managers perception of hospital employees' effort-reward imbalance

OBJECTIVE

Hospitals are frequently associated with poor working conditions that can lead to work stress and increase the risk for reduced employee well-being. Managers can shape and improve working conditions and thereby, the health of their teams. Thus, as a prerequisite, managers need to be aware of their employees' stress levels. This study had two objectives: At first, it aimed to test the criterion validity of the Effort-Reward Imbalance (ERI) questionnaire measuring psychosocial workload in hospital employees. Secondly, mean scales of the ERI questionnaire filled in by employees were compared with mean scales of an adapted ERI questionnaire, in which managers assessed working conditions of their employees.

METHODS

Managers (n = 141) from three hospitals located in Germany assessed working conditions of their employees with an adapted external, other-oriented questionnaire. Employees (n = 197) of the mentioned hospitals completed the short version of the ERI questionnaire to assess their working conditions. Confirmatory factor analyses (CFA) were applied to test factorial validity, using the ERI scales for the two study groups. Criterion validity was assessed with multiple linear regression analysis of associations between ERI scales and well-being among employees.

RESULTS

The questionnaires demonstrated acceptable psychometric properties in terms of internal consistency of scales, although some indices of model fit resulting from CFA were of borderline significance. Concerning the first objective, effort, reward, and the ratio of effort-reward imbalance were significantly associated with well-being of employees. With regard to the second objective, first tentative findings showed that managers' ratings of their employees' effort at work was quite accurate, whereas their reward was overestimated.

CONCLUSIONS

With its documented criterion validity the ERI questionnaire can be used as a screening tool of workload among hospital employees. Moreover, in the context of work-related health promotion, managers' perceptions of their employees' workload deserve increased attention as first findings point to some discrepancies between their perceptions and those provided by employees.

Organizational health climate as a precondition for health-oriented leadership: expanding the link between leadership and employee well-being

The link between leadership and employee well-being is long established. In particular, health-oriented leadership is discussed as a leadership style specifically promoting employee well-being. However, the preconditions of health-oriented leadership remain largely unexplored. From the perspective of conservation of resources theory, leaders can only provide resources when receiving some themselves. We propose that organizational health climate (OHC) is an important organization-based resource for a health-oriented leadership style. More specifically, we hypothesize that the relationship between OHC and employee job satisfaction and emotional exhaustion is mediated by health-oriented leadership. We thereby differentiate two levels of analysis: a within-team level and a between-team level. We examined 74 teams with 423 employees of childcare centers at three time points, each 6 months apart. By means of multilevel structural equation modeling, we found OHC to be a significant antecedent of health-oriented leadership at the between-team level. The relationship between OHC and employee job satisfaction was mediated by health-oriented leadership at the between-team level, but not at the within-team level. The relationship between OHC and employee exhaustion showed another pattern of relationships at the different levels of analysis, while it was not significantly mediated by health-oriented leadership. This indicates the value of differentiating between levels of analysis. We discuss the implications for theory and practice that can be drawn from our findings.

What difference does it make? A laboratory experiment on the effectiveness of health-oriented leadership working on-site compared to the digital working context

BACKGROUND

Health-oriented leadership (HoL) represents an important workplace resource for employees. However, as opportunities to work from home increase, the question arises, whether leadership is more or less effective in digital working contexts compared to working on-site.

METHODS

The current research investigates, whether the effectiveness of health-oriented leadership in terms of staff care is influenced by the working context. In a laboratory experiment with a 2 (no staff care vs. staff care) x 2 (working on-site vs. digital) mixed design (N = 60), a moderating effect of the working context on the relationship between staff care and employees' mental exhaustion, heart rate, heart rate variability, engagement and job satisfaction was tested.

RESULTS

Results uncovered positive effects of staff care on employees' mental exhaustion and work-related attitudes in both conditions (d = 1.09-1.91). As expected, the results indicate that the effects on employees' engagement (d = 0.65) and job satisfaction (d = 0.72) are weaker when working digital.

CONCLUSION

Findings show that the effectiveness of staff care might differ between working on-site and working digital. In order to maintain the effectiveness of staff care, leaders and employees should keep regular face-to-face contact also when mainly working from home. The study ties in with research on digital leadership and leadership effectiveness, and contributes to the deeper understanding of situational contingencies of health-specific leadership during the process of digitization.

A study protocol outlining the development and evaluation of a training program for frontline managers on leading well-being and the psychosocial work environment in Danish hospital settings - a cluster randomized waitlist controlled trial

BACKGROUND

Hospital staff are often exposed to stressful psychosocial working conditions and report high levels of stress and burnout, which may negatively impact the safety of employees and patients. Managers hold unique knowledge of workplace conditions and needs of employees, but leadership interventions to improve the well-being of managers and employees in hospital settings are scarce. This study evaluates the effects of a leadership intervention based on a health-oriented leadership approach on the well-being and psychosocial work environment aspects of managers and employees.

METHODS/DESIGN

The study is designed as a randomized, waitlist-controlled trial with two groups (intervention and waitlist control group) and measurements at baseline, 6- and 12-month follow-up. We aim to include 200 frontline managers in Danish hospital settings and their approximately 5,000 employees. The leadership training comprises five full day modules and four smaller group-training sessions over a period of 5 months. The main aim is to improve stress, burnout, self-care, and perceived level of staff-care among managers and employees. Sickness absence will also be assessed at both manager and employee level. In addition, several psychosocial factors will be assessed at the employee level. A quantitative and qualitative process evaluation will also be conducted.

DISCUSSION

Action towards supporting the mental health of hospital employees is important to maintain a strong healthcare system. There is increasing recognition that best practice in workplace mental health requires an integrated approach that prevents harm and promotes positive mental health. There is also increasing understanding of the key role managers' play in maintaining well-being within the workplace, however they often report a lack of knowledge and skills to promote employee mental health. The current leadership training program has been developed for frontline managers working in a hospital setting. The aim is to increase managers' application of strategies to facilitate a healthy psychosocial work environment to benefit well-being and mental health among staff and managers themselves.

TRIAL REGISTRATION

The study was retrospectively registered on November 21, 2022 in Clinical Trial.gov with identifier: NCT05623371.

"Should I Further Engage in Staff Care?": Employees' Disclosure, Leaders' Skills and Goal Conflict as Antecedents of Health-Oriented Leadership

Leaders play a crucial role in employees' health and job satisfaction. When employees show early warning signs that their physical or mental health is at risk, leaders' responsibility gains even more importance. Recent health-specific leadership approaches (health-oriented leadership; HoL) emphasize the importance of leaders ability to perceive employees' warning signals (staff care awareness) to take appropriate action (staff care behavior). However, little is known about the factors facilitating or hindering the transfer from leaders' awareness to concrete behaviors. In an experimental study (N = 91), we examined and manipulated antecedents of staff care behavior: (a) employees' disclosure, (b) leaders' HoL skills, and (c) leaders' goal conflict in a 2 × 2 × 2 mixed factorial design. Employees' disclosure and leaders' skills were positively related to staff care behavior. Leaders' goal conflict was not directly related to staff care behavior but had an indirect effect and diminished the positive relationship between disclosure and staff care behavior. The findings deepen the theoretical understanding of the HoL concept. By studying the influence of employees' disclosure on staff care behavior, our study complements a follower-centered perspective. We provide practical recommendations for workplace health promotion and how leaders' staff care behavior can be fostered.

An innovative Australian doctors' health service: using systems therapy to work with individual medical leaders in an acute public health setting

OBJECTIVE

To describe an innovative doctors' health service (Professional Support Unit) utilising systems therapy to support individual medical leaders across an Australian local public health district.

METHOD

Therapeutic interventions were informed by systems theory, the study of social systems, coherent entities with hierarchical orders united by organising relations of rules, roles, structures and alliances. Systems therapy addresses these relations to effect change. Working with leaders individually was based on the premise of effecting change in the system by changing part of the system, particularly the 'decider subsystem' of the medical lead.

RESULTS

Support was provided to 30 medical leaders (50% of potential cohort). All but five self-referred with zero dropouts. Referrals snowballed gradually and exponentially following psychoeducation sessions normalising struggling and seeking help. Diversity of themes presented or emerging included requests for: (i) psychological support for lead/family, or staff/family; (ii)didactic sessions regarding impairment, ageing doctor, performance management and mental health first aid for doctors; (iv) anger management; (v) difficult staff; and (vi) being undermined or placed in untenable positions. Interventions were accordingly diverse and tailored. A vulnerable-resilience model was developed with practical tips.

CONCLUSIONS

Supporting medical leaders using therapeutic interventions grounded in systems theory may go towards addressing organisational duty of care to maintain safe work systems.

Health-oriented leadership: Antecedents of leaders’ awareness regarding warning signals of emerging depression and burnout

Due to growing demands, there is an increase in depression and burnout causing sickness absence and early retirement. Detecting depression and burnout at an early stage is a crucial task for leaders to allow for early support and prevent more severe illnesses. Within the health-oriented leadership concept, awareness is the ability to recognize followers’ warning signals as a potential health risk. Although it is widely accepted that awareness is a precondition to taking appropriate action, it is yet unclear to what extent leaders recognize the warning signals of followers and which factors facilitate or impede awareness. In an experimental study ( N = 54) and a survey study ( N = 215) we examined antecedents of awareness in followers and leaders: (a) clarity of displayed warning signals in followers, (b) leaders’ stressors, (c) leaders’ autonomy. Even under favorable conditions, only about half of the leaders recognized warning signals as a health risk. Leaders showed lower awareness during times of high stress and low autonomy and when followers displayed less clear warning signals. Autonomy moderated the effect of stress (workload) on awareness, but there was no buffering effect as expected. The findings deepen the theoretical understanding of awareness and suggest that leaders need to know how their awareness may be impeded. We provide practical recommendations for human resource management on how leaders’ awareness can be fostered.

Mental wellbeing among Danish employees during the COVID-19 pandemic: results from a longitudinal study on the role of industry and working environment

Background

The COVID-19 pandemic has had a profound impact on working life. Previous studies have primarily focused on the mental health and wellbeing of healthcare workers and are mostly based on cross-sectional data from non-representative samples. The aim of this study was to investigate mental wellbeing trajectories among employees from different industries, and to longitudinally identify factors that affect mental wellbeing during the COVID-19 pandemic, including job insecurity, fear of COVID-19, working from home or being discharged with wage compensation and management quality.

Methods

Baseline data were obtained from the Danish Health and Wellbeing Survey in 2019 (September–December), with follow-up in September–November 2020. We included 1995 respondents, who completed the questionnaire in both waves and were employed in 2020 and measured mental wellbeing using the Short Warwick–Edinburgh Mental Well-Being Scale.

Results

Mental wellbeing declined among employees in all industries. Employees working from home and employees unsatisfied with management experienced a greater decline in mental wellbeing. We found no differences in mental wellbeing trajectories in relation to fear of infecting others or contracting COVID-19, job insecurity and being discharged with wage compensation.

Conclusions

Mental wellbeing declined among employees in all industries with no difference between industries. Employees working from home may have been particularly vulnerable, and the analyses show that managers play a key role in mitigating the negative consequences of the pandemic by ensuring adequate information and involvement of employees.

Facilitating Health-Oriented Leadership from a Leader’s Perspective

Abstract. Health-oriented leadership (HoL) is vital for the improvement of health and an essential part of psychological risk management. However, the relevance of different antecedent factors is unknown. We used data from a Germany-wide online survey with N = 738 leaders. Referring to the JD-R model, we analyzed leaders’ demands and resources that facilitate or impede health-oriented leadership from a leader’s perspective. Moreover, we examined the relevance of contextual factors like branch, company size, and management span. Whereas results show only small differences for contextual factors, we found positive relationships between leaders’ resources, like autonomy and social support, and negative relationships with workplace demands (availability, multitasking) and HoL from a leader’s perspective. At the organizational level, HoL is positively linked to high-performance work practices and health-oriented HRM strategies. From a leader’s perspective, the findings provide evidence for the relevance of favorable working conditions and human resources practices for improving HoL as part of psychological risk management.

Impact of organizational health-oriented strategies on employees' job performance, perceived medical mistrust as a moderator: A COVID-19 perception-based view

After experiencing the COVID-19 pandemic, employees' health and well-being become a priority for firms. Organizational health-oriented strategies assist them in coping with health-related crises. Based on the social exchange theory, the present study attempts to determine the role of organizational health-oriented strategies in promoting employees' job performance. This study hypothesized that the organizations' health-oriented strategies positively correlate with employees' job performance. This study also assessed the mediating role of employees' psychological wellbeing and trust and moderating role of perceived medical mistrust. For the empirical examination, data of the present study was gathered from the textile sector in China. This study analyzed data through partial least square structural equation modeling (PLS-SEM). For this purpose, Smart-PLS software was used. The outcomes revealed that organizational health-oriented strategies positively enhance the employees' psychological wellbeing, trust, and job performance. Moreover, the results revealed that employees' psychological wellbeing and trust positively mediate the proposed relationships. This study found that perceived medical mistrust moderates the relationship between employees' psychological wellbeing and job performance. However, the findings revealed that perceived medical mistrust does not moderate the relationship between employees' trust and job performance. In addition, the present study's findings provide insights to the firms about the importance of health-oriented strategies. Moreover, this study's findings also serve the literature by providing important theoretical and practical implications.

[Experiencing leadership in the Corona pandemic in Hessian general hospitals: A descriptive qualitative study]

Experiencing leadership in the Corona pandemic in Hessian general hospitals: A descriptive qualitative study Abstract. Background: The second corona pandemic wave is leading to high work demands on the part of nurses and managers of Hessian general hospitals. The associated organizational challenges result in burdens for the managers. Aim: Due to the importance of leaders in securing care structures, this study aims to explore their perception of their leadership role in dealing with the pandemic management. Methods: Telephone qualitative expert interviews with 13 ward and 13 nursing managers of Hessian general hospitals form the basis for the qualitative content analysis that structures the content. Results: To support the nursing staff, the managers choose a personal caring leadership style that also includes the psychosocial needs of the nursing staff. For their part, managers are exposed to high levels of burden, which they counter with professional experience, resilience and an optimistic attitude, among other things. Conclusions: Health-related leadership is essential for maintaining the health of employees. The self care of managers as well as the integration of workplace health promotion into the corporate goal of hospitals should receive more attention for the current and future safeguarding of crisis management.

Sustainable Workplace Mental Well Being for Sustainable SMEs: How?

Sustainable mental health and wellbeing (MHW), as addressed under SDG3, is crucial for achieving sustainable development, notably for sustainable SMEs growth. MWH is specifically interlinked with SDGs 8, 9 and 11: Economic growth and prosperity, sustainable communities, innovation, and jobs. Studies show over 200 million workdays are lost due to poor MHW each year, referring to the global cost of $1 trillion/year in lost productivity and it is increasing every year. Poor workplace MWH is almost an epidemic after COVID-19. It will be a significant challenge for a long time, in particular for SMEs which are hit hardest by the pandemic, as MHW problems have been shown to be a COVID side effect among 1:5 people. Despite the multifactorial aetiology of MHW (individual, social, environmental, and organizational), interventions for workplace MHW mostly refer to ‘one size fits all’ and top-down solutions, primarily asking for the commitment and behaviour change of employees; that has shown to be ineffective. The main assumption underlying the present work is the need for a proactive and tailored MHW frameworks that can be blended to organizational policies. The objective which corresponds to the main purpose of the paper is to provide a 5-staged MWH model, stemming from our evidence-based studies, that may speak for the identified need. We also discuss how the Model can provide a route map on how SMEs can implement and measure SDGs relevant to their business in synergistic interaction with SDG3.

Clinical Leader Series: A Virtual Mental Well-being Initiative for Nurse Leaders During the COVID-19 Pandemic and Beyond

OBJECTIVE

A virtual mental well-being initiative was developed for nurse leaders to provide education about mental health and to teach self-care skills.

BACKGROUND

Because of substantial demand placed on nurse leaders during the COVID-19 pandemic, organizations must address stress and burnout by providing a continuum of care to include education, support, and intervention.

METHODS

All levels of nurse leaders at a multicampus healthcare system were invited to attend. Data were collected on coping, empowerment, burnout, and quality of life. Participant responses to discussion prompts were compiled and reviewed.

RESULTS

Although the independent parallel comparison did not show significant improvements, scores on the coping, empowerment, burnout, and quality-of-life measures were maintained. Discussion prompts yielded valuable insights into nurse leader experiences and session effectiveness.

CONCLUSIONS

This type of education, as well as psychological support, will continue to be needed after the pandemic due to burnout, moral injury, and primary or secondary trauma. Findings are applicable to future crisis situations.

Feasibility, psychological outcomes and practical use of a stress-preventive leadership intervention in the workplace hospital: the results of a mixed-method phase-II study

OBJECTIVES

Hospitals are psychologically demanding workplaces with a need for context-specific stress-preventive leadership interventions. A stress-preventive interprofessional leadership intervention for middle management has been developed. This phase-II study investigates its feasibility and outcomes, including work-related stress, well-being and transformational leadership.

DESIGN

This is a mixed-methods study with three measure points (T0: baseline, T1: after the last training session, T2: 3-month follow-up). Additionally, focus groups were conducted to assess participants' change in everyday work.

SETTING

A tertiary hospital in Germany.

PARTICIPANTS

N=93 leaders of different professions.

INTERVENTION

An interactive group setting intervention divided in five separate sessions ((1) self-care as a leader, (2) leadership attitudes and behaviour, (3) motives, needs and stressors of employees, (4) strengthen the resource 'team', (5) reflection and focus groups). The intervention was conducted between June 2018 and March 2020 in k=5 runs of the intervention.

OUTCOME MEASURES

Feasibility and acceptance were measured with a self-developed intervention specific questionnaire. Psychological outcomes were assessed with the following scales: work-related strain with the Irritation Scale, well-being with the WHO-5 Well-being Index and transformational leadership with the Questionnaire of Integrative Leadership.

RESULTS

After the intervention at T2, over 90% of participants reported that they would recommend the intervention to another coworker (92.1%, n=59) and all participants (n=64) were satisfied with the intervention and rated the intervention as practical relevant for their everyday work. Participants' self-rated cognitive irritation was reduced, whereas their well-being and transformational leadership behaviour were improved over time. Focus group discussions revealed that participants implemented intervention contents successfully in their everyday work.

CONCLUSIONS

This intervention was feasible and showed first promising intraindividual changes in psychological outcomes. Participants confirmed its practical relevance. As a next step, the intervention will be evaluated as part of a multicentre-randomised controlled trial within the project SEEGEN (SEElische GEsundheit am Arbeitsplatz KrankeNhaus).

Staff support in a National Health Service mental health trust in response to the COVID-19 pandemic: qualitative study

BACKGROUND

The COVID-19 pandemic has highlighted the impact work can have on healthcare workers and the importance of staff support services. Rapid guidance was published to encourage preventive and responsive support for healthcare workers.

AIMS

To understand mental healthcare staff's help-seeking behaviours and access to support at work in response to the COVID-19 pandemic, to inform iterative improvements to provision of staff support.

METHOD

We conducted a formative appraisal of access to support and support needs of staff in a National Health Service mental health trust. This involved 11 semi-structured individual interviews using a topic guide. Five virtual staff forums were additional sources of data. Reflexive thematic analysis was used to identify key themes.

RESULTS

Peer-based, within-team support was highly valued and sought after. However, access to support was negatively affected by work pressures, physical distancing and perceived cultural barriers.

CONCLUSIONS

Healthcare organisations need to help colleagues to support each other by facilitating open, diverse workplace cultures and providing easily accessible, safe and reflective spaces. Future research should evaluate support in the evolving work contexts imposed by COVID-19 to inform interventions that account for differences across healthcare workforces.

Reflection on leadership behavior: potentials and limits in the implementation of stress-preventive leadership of middle management in hospitals - a qualitative evaluation of a participatory developed intervention

Background

Mental health and stress prevention aspects related to workplace in hospitals are gaining increasingly more attention in research. The workplace hospital is characterized by high work intensity, high emotional demands, and high levels of stress. These conditions can be a risk for the development of mental disorders. Leadership styles can hinder or foster work-related stress and influence the well-being of employees. Through leadership interventions, leaders may be encouraged to develop a stress-preventive leadership style that addresses both, the well-being of the leaders and of the subordinates. A comprehensive qualitative description of leaders’ experiences with interventions on the topic of stress-preventive leadership is yet missing in the literature. Therefore, we address leaders of middle management regarding the development of stress-preventive leadership styles through supporting interventions. The research questions are: How do leaders of middle management perceive their leadership role in terms of effectiveness in stress prevention? Which potentials and limits in the implementation of stress-preventive leadership are experienced?

Methods

The study follows a qualitative research design and content analysis. We conducted individual interviews with leaders of middle management (n = 30) of a tertiary hospital in Germany for the participatory development of an intervention. This intervention, consisting of five consecutive modules, addressed leaders of middle management in all work areas within one hospital. After participation in the intervention, the leaders were asked to reflect on and evaluate the implementation of the contents learned within focus group discussions. Overall 10 focus group discussions with leaders (n = 60) were conducted.

Results

The results demonstrate that leaders of middle management perceived potentials for a stress-preventive leadership style (e.g., reflection on leadership role and leadership behavior, awareness/mindfulness, and conveying appreciation). However, limits were also mentioned. These can be differentiated into self-referential, subordinate-related, and above all organizational barriers for the implementation of stress-preventive leadership.

Conclusions

Some of the organizational barriers can be addressed by mid-level leadership interventions (e.g., lack of peer-exchange) or possibly by adapted leadership interventions for top management (e.g., lack of stress-preventive leadership styles in top level management). Other organizational limits are working conditions (e.g., staff shortage) that can only be influenced by health policy decisions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12995-021-00339-7.

Effectiveness of health-oriented leadership interventions for improving health and wellbeing of employees: a systematic review

Aim

To identify and summarize the evidence for the effect of health-oriented leadership interventions on health and well-being outcomes at the employee level following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (Moher et al. 2009).

Subject and Methods

A systematic search of relevant studies was conducted in multiple databases. Randomized controlled trials (RCTs), cluster-randomized controlled trials (cRCTs) and controlled before–after studies (CBAs) were included based on the following criteria: interventions that addressed supervisors, to raise awareness for the importance of health issues, teach mindfulness practices for conscious awareness, reduce stress and promote resources at the level of individual behavior, and evaluated the effect on at least one outcome of psychomental stress, absenteeism and well-being on the employee level.

Results

Of 6126 publications retrieved, ten studies were identified for analysis. Significant effects of leadership training were reported on exhaustion tendency, self-reported sickness absence, work-related sickness absence and job satisfaction in studies comparing health-oriented training programs to no intervention. Studies comparing health-oriented leadership training to other training did not report significant effects. Risk of bias was judged to be high in seven studies and unclear in three studies.

Conclusion

Evidence for the effectiveness of health-oriented leadership interventions on employees’ stress, absenteeism or well-being is judged to be low, clearly indicating the need for more and higher-quality research.

The Show Must Go On

Abstract. By disrupting routines at work, the Covid-19 pandemic may have undermined the extent and effectiveness of health-oriented leadership (HoL) in terms of staff-care and self-care. In a survey with two measurement points in the spring of 2020 ( Nt1=264; Nt2=123), we examined whether the stronger the crisis the lower HoL is, while becoming more effective in terms of follower health. Crisis severity turned out to be indirectly related to exhaustion via staff-care and self-care. Staff-care was more effective for follower health the stronger the crisis was. The results were largely supported in a subsample when exhaustion was measured 1 week later. Moreover, the Covid-19 pandemic was indirectly related to crisis severity via hindrance stressors. Findings underline that staff-care was jeopardized but gained in importance during the pandemic. By displaying staff-care, leaders can buffer negative crisis effects on followers. Organizations should strengthen HoL to protect the health of both leaders and followers during crises.

Health-Oriented Leadership and Mental Health From Supervisor and Employee Perspectives: A Multilevel and Multisource Approach

The link between leadership and mental health at the workplace is well established by prior research. However, most of the studies have addressed this relationship from a single-source perspective. The aim of this study was to examine how supervisor and employee ratings of health-oriented leadership correspond to each other and which sources are predictive for employee mental health. We assessed data within 99 teams (headed by 99 supervisors) containing 713 employees in 11 different companies in Southern Germany. Supervisors and their staff completed questionnaires on the supervisors' health-oriented staff-care dimensions awareness, value of health and health behavior (Health-Oriented Leadership Scale, HoL) and current mental distress (Hospital Anxiety and Depression Scale, HADS). Hierarchical linear models revealed that supervisors' self-ratings were significantly related to their employees' ratings (at the team level) only on the health behavior dimension, but not on the health awareness and value of health dimensions. Also, supervisors rated themselves significantly higher on HoL compared to their employees. Employee ratings of HoL significantly predicted their own level of mental distress (direct within-level effect), whereas supervisor ratings of HoL did not predict employees' mental distress at the team level (direct cross-level effect). Supervisors' self-ratings of HoL did not influence the relationship between employee ratings of HoL and their mental distress on an individual level (cross-level interaction). These results highlight the complex relationship between multisource assessments of HoL and employee mental health, emphasizing the importance of subjective perception for mental health. Future studies should investigate under which conditions supervisor and employee ratings correspond to each other and are predictive for mental health at the workplace.