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Nöthel S, Nübold A, Uitdewilligen S, Schepers J, Hülsheger U. Development and validation of the adaptive leadership behavior scale (ALBS). Front Psychol 2023; 14:1149371. [PMID: 37829081 PMCID: PMC10565815 DOI: 10.3389/fpsyg.2023.1149371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023] Open
Abstract
Due to the rapid changes in today's business world, leaders need to, more than ever, adequately and flexibly react to new and changing demands in the workplace. An instrument that captures adaptive leadership behavior is still missing, however. This study describes the development and validation of a concise and timely new leadership instrument, the Adaptive Leadership Behavior Scale (ALBS). Based on a thorough literature review, we developed 27 items as an initial item pool. We tested this set of items with leaders and followers in a pilot study to assess its relevancy and comprehensibility. In Study 1, a field study with 201 employees, we explored the internal structure of the initial item pool with a Principal Component Analysis (PCA). Based on the factor loadings resulting from a second PCA, we reduced the item pool, resulting in a 15-item scale for which we then assessed convergent and divergent validity. In Study 2, a field study with 311 employees, we replicated the findings of Study 1 and assessed additional convergent and divergent validity as well as the model fit with a Confirmatory Factor Analysis (CFA). In Study 3, a multi-source field study with 155 leader-follower dyads we replicated the CFA and additionally assessed criterion-related validity. Results show that the ALBS is a concise and valid instrument for assessing adaptive leadership behavior, thereby building the grounds to extend our understanding of antecedents, mechanisms and consequences of leadership in dynamic environments.
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Affiliation(s)
- Sophie Nöthel
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Annika Nübold
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Sjir Uitdewilligen
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Jan Schepers
- Faculty of Psychology and Neuroscience, Department of Methodology and Statistics, Maastricht University, Maastricht, Netherlands
| | - Ute Hülsheger
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
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Hawley SR. Using adaptive leadership principles to support Public Health 3.0 in multidisciplinary undergraduate education. Leadersh Health Serv (Bradf Engl) 2021. [DOI: 10.1108/lhs-07-2020-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The COVID-19 pandemic has uncovered public health vulnerabilities worldwide, particularly in the hard-hit USA. US public health professionals, regardless of role, may need to exercise leadership in both planned and unexpected situations. This model of practice outside of traditional roles, known as Public Health 3.0, requires adaptive leadership – a systems approach to making progress on complex challenges. Educational programs should improve students’ adaptive leadership competency to prepare them for the public health workforce. This paper aims to provide an educational framework for implementing adaptive leadership instruction for undergraduate students.
Design/methodology/approach
This paper used experiential and traditional instructional strategies and adaptive leadership competencies to develop a semester-length leadership course for undergraduate students in health, nursing, social science, business and education. Adaptive leadership principles were learned and practiced, preparing students for systemic challenges through the lens of Public Health 3.0. Competencies were assessed pre- and post-semester.
Findings
Of 248 students, 72% were health professions majors. Students reported pre-post scores on 29 measures of competency, interest, learning and behavioral change. Quantitative evaluations identified statistically significant improvement in all domains. Additional quantitative feedback indicated improvement on the three Kirkpatrick levels of evaluation assessed (reaction, learning and behavior).
Originality/value
Tiered evaluation methods indicated that this leadership course enhanced participants’ self-reported adaptive leadership learning and competency, as well as intention and ability to translate learning into practice. A broad spectrum of competency development is needed for students entering practice in the Public Health 3.0 era, particularly related to pandemic response.
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Bailey DE, Muir AJ, Adams JA, Thygeson NM, Williams H, Cary MP, Anderson RA. Clinical Encounters and Treatment Initiation for Chronic Hepatitis C Patients: Applications of Adaptive Leadership Framework for Chronic Illness. SAGE OPEN 2019; 9:10.1177/2158244018824461. [PMID: 31903296 PMCID: PMC6941868 DOI: 10.1177/2158244018824461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Chronic Hepatitis C (CHC) is the most common blood-borne infection in the U. S. Patients with CHC undergoing treatment face many challenges including adherence to medications and management of symptoms; health care practitioners are well positioned to facilitate patients' ability to address these challenges. We used the Adaptive Leadership for Chronic Illness Framework to investigate the difficulties inherent in affecting behavior change in patients undergoing treatment. We enrolled 11 patient participants and 10 provider participants. We used data from the first clinical encounter between patients and providers during which treatment was discussed. We found examples of adaptive leadership and categorized these behaviors into three themes: support for medication, coping with family/ home life, and strategizing to manage employment. We also saw examples of what we termed missed opportunities for adaptive leadership. This study illustrates the contributions of adaptive leadership behaviors by healthcare providers and the potential risk to patients in their absence.
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Affiliation(s)
| | - Andrew J Muir
- Department of Medicine, Division of Gastroenterology, School of Medicine, Duke University, Durham NC, USA
| | - Judith A Adams
- University of North Carolina Greensboro, School of Nursing, Greensboro NC, USA
| | | | | | | | - Ruth A Anderson
- University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC USA
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Implementation of a Nurse-Led Family Meeting in a Neuroscience Intensive Care Unit. Dimens Crit Care Nurs 2018; 35:268-76. [PMID: 27487752 DOI: 10.1097/dcc.0000000000000199] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE/OBJECTIVES The aims of this study were to develop, implement, and evaluate the impact of early intensive care unit (ICU) nurse-led family meetings on nurse-family communication, family decision making, and satisfaction of family members. BACKGROUND Intensive care unit nurses are in an ideal position to meet family needs, and family members may cope better with the crisis of an ICU admission if consistent honest information is provided by nurses; however, there are no early ICU family meetings led by bedside nurses. METHODS This quality improvement project was implemented in a 10-bed neuroscience ICU over a 3-month period. A convenience sample of 23 nurses participated in the project. Following development of a communication protocol to facilitate nurse-led meetings, the nurses received education and then implemented the protocol. Thirty-one family members participated in the project. Family members were surveyed before and after the meetings. RESULTS Mean meeting time was 26 (SD, 14) minutes. Following implementation of the meetings, findings demonstrated that families felt that communication improved (P = .02 and P = .008), they had appropriate information for decision making allowing them to feel in control (P = .002), and there was an increase in family satisfaction (P = .001). CONCLUSION Early ICU nurse-led family meetings were feasible, improved communication between ICU nurses and family members, facilitated decision making in ICU families, and increased satisfaction of family members.
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Reuter-Rice K, Doser K, Eads JK, Berndt S. Pediatric Traumatic Brain Injury: Families and Healthcare Team Interaction Trajectories During Acute Hospitalization. J Pediatr Nurs 2017; 34:84-89. [PMID: 28081932 PMCID: PMC5444971 DOI: 10.1016/j.pedn.2016.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 12/22/2016] [Accepted: 12/27/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE To identify common or unique family-healthcare team interactions during acute hospitalization for pediatric patients with a traumatic brain injury (TBI) using a life course trajectory (LCT) theoretical approach. DESIGN AND METHODS A 3-year prospective observational study of 35 children, ages 5 days to 15 years who were admitted to an urban Level-1 trauma hospital for a TBI. We defined brain injury severity using the admission Glasgow Coma Scale score (mild 13-15, moderate 9-12, and severe 3-8). Using a life course trajectory theoretical approach, we extracted from the patient's electronic health record the first eight-days of hospitalization and plotted the number and type of daily family-healthcare team interactions to visualize patterns or phases. RESULTS A general trajectory for each severity group was determined. When individually compared, family trajectories were similar based on injury severity. Visual interpretations of family-healthcare interactions based on the brain injury severity yielded three phases. The interactions phases included: (1) information seeking, (2) watchful waiting and (3) decision making. CONCLUSION Using a LCT approach, phases identified based on injury severity and family interactions support the need for proper timing of tailored communication and support. The findings also support the development of future best care practices that facilitate family's needs, decrease caregiver burden to improve functional outcomes.
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Affiliation(s)
- Karin Reuter-Rice
- Duke University School of Nursing, Durham, NC, USA; Duke University School of Medicine, Department of Pediatrics, Durham, NC, USA; Duke Institute for Brain Sciences, Durham, NC, USA.
| | - Karoline Doser
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
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Notarnicola I, Petrucci C, De Jesus Barbosa MR, Giorgi F, Stievano A, Rocco G, Lancia L. Complex adaptive systems and their relevance for nursing: An evolutionary concept analysis. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12522] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 11/15/2016] [Accepted: 12/03/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Ippolito Notarnicola
- Department of Health, Life and Environmental Sciences; University of L'Aquila; L'Aquila Italy
- Nursing Science Doctorate School; University of L'Aquila; L'Aquila Italy
| | - Cristina Petrucci
- Department of Health, Life and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Maria Rosimar De Jesus Barbosa
- Department of Health, Life and Environmental Sciences; University of L'Aquila; L'Aquila Italy
- Nursing Science Doctorate School; University of L'Aquila; L'Aquila Italy
| | - Fabio Giorgi
- Department of Health, Life and Environmental Sciences; University of L'Aquila; L'Aquila Italy
- Nursing Science Doctorate School; University of L'Aquila; L'Aquila Italy
| | - Alessandro Stievano
- Department of Health, Life and Environmental Sciences; University of L'Aquila; L'Aquila Italy
- Centre of Excellence for Nursing Scholarship; L'Aquila Italy
| | - Gennaro Rocco
- Department of Health, Life and Environmental Sciences; University of L'Aquila; L'Aquila Italy
- Centre of Excellence for Nursing Scholarship; L'Aquila Italy
| | - Loreto Lancia
- Department of Health, Life and Environmental Sciences; University of L'Aquila; L'Aquila Italy
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Adaptive leadership framework for chronic illness: framing a research agenda for transforming care delivery. ANS Adv Nurs Sci 2015; 38:83-95. [PMID: 25647829 PMCID: PMC4417005 DOI: 10.1097/ans.0000000000000063] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We propose the Adaptive Leadership Framework for Chronic Illness as a novel framework for conceptualizing, studying, and providing care. This framework is an application of the Adaptive Leadership Framework developed by Heifetz and colleagues for business. Our framework views health care as a complex adaptive system and addresses the intersection at which people with chronic illness interface with the care system. We shift focus from symptoms to symptoms and the challenges they pose for patients/families. We describe how providers and patients/families might collaborate to create shared meaning of symptoms and challenges to coproduce appropriate approaches to care.
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Neglia E, Anderson RA, Brandon D, Docherty SL. Communication about life-sustaining therapy: insights from the Adaptive Leadership Framework. ACTA ACUST UNITED AC 2013; 1:417-424. [PMID: 25309745 DOI: 10.5750/ejpch.v1i2.682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Effective provider and caregiver communication is central to quality care during treatment for life-threatening illnesses. The study aim was to analyze communication patterns between providers and a parent of an infant with a life-threatening disease using the Adaptive Leadership Framework, which is an activity that involves mobilizing others to adapt to a difficult situation. METHOD A secondary analysis was conducted on one case using 23 interviews with providers and mother of an infant diagnosed with Hurler's syndrome. The interviews focused on decision-making challenges in regard to the infant's treatment and were conducted over a 1-year period (pre-transplant, study entry, monthly, after a life-threatening event or substantial change in treatment and at 1-year post enrollment). Content analysis was used to identify and categorize communication patterns using concepts from the Adaptive Leadership Framework. RESULTS Infant illness events and parent-provider caregiving were chronicled across a 1-year trajectory. Despite the life-threatening nature of Hurler's disease, the parent and providers did not discuss palliative care or end-of-life. The parent sought direction and answers from the providers. The Adaptive Leadership Framework suggested how communication approaches were often mismatched with the needs of the parent. DISCUSSION The results of the study accentuate the need to improve communication between provider and parents about end-of-life for their child. Adaptive Leadership illuminates how providers can influence a parent's behavior when facing a challenging situation. This study suggests that Adaptive Leadership is a useful framework to guide research about healthcare communication in dealing with challenging issues.
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Affiliation(s)
| | - Ruth A Anderson
- Virginia Stone Professor of Nursing, Senior Fellow in the Duke University Center for Ageing and Human Development and Research Development Coordinator, Duke University School of Nursing, Durham, NC, USA
| | - Debra Brandon
- Associate Professor & Director PhD in Nursing Program, Duke University School of Nursing, Durham, NC, USA
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Bailey DE, Docherty SL, Adams JA, Carthron DL, Corazzini K, Day JR, Neglia E, Thygeson M, Anderson RA. Studying the clinical encounter with the Adaptive Leadership framework. J Healthc Leadersh 2012; 2012. [PMID: 24409083 DOI: 10.2147/jhl.s32686] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
In this paper we discuss the concept of leadership as a personal capability, not contingent on one's position in a hierarchy. This type of leadership allows us to reframe both the care-giving and organizational roles of nurses and other front-line clinical staff. Little research has been done to explore what leadership means at the point of care, particularly in reference to the relationship between health care practitioners and patients and their family caregivers. The Adaptive Leadership framework, based on complexity science theory, provides a useful lens to explore practitioners' leadership behaviors at the point of care. This framework proposes that there are two broad categories of challenges that patients face: technical and adaptive. Whereas technical challenges are addressed with technical solutions that are delivered by practitioners, adaptive challenges require the patient (or family member) to adjust to a new situation and to do the work of adapting, learning, and behavior change. Adaptive leadership is the work that practitioners do to mobilize and support patients to do the adaptive work. The purpose of this paper is to describe this framework and demonstrate its application to nursing research. We demonstrate the framework's utility with five exemplars of nursing research problems that range from the individual to the system levels. The framework has the potential to guide researchers to ask new questions and to gain new insights into how practitioners interact with patients at the point of care to increase the patient's ability to tackle challenging problems and improve their own health care outcomes. It is a potentially powerful framework for developing and testing a new generation of interventions to address complex issues by harnessing and learning about the adaptive capabilities of patients within their life contexts.
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Affiliation(s)
- Donald E Bailey
- School of Nursing, Duke University, Durham, NC ; Center for the Study of Aging and Human Development, Duke University, Durham, NC
| | | | | | - Dana L Carthron
- School of Health Science, Division of Nursing, Winston Salem State University, Winston Salem, NC
| | - Kirsten Corazzini
- School of Nursing, Duke University, Durham, NC ; Center for the Study of Aging and Human Development, Duke University, Durham, NC
| | | | | | - Marcus Thygeson
- Medical Services, Blue Shield of California, San Francisco, CA, USA
| | - Ruth A Anderson
- School of Nursing, Duke University, Durham, NC ; Center for the Study of Aging and Human Development, Duke University, Durham, NC
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