Health Care Management Review最新文献

{"title":"Organizational compassion in health care settings: A mixed-methods systematic review of employee experiences and outcomes and contributing organizational traits.","authors":"Jacqueline Galica, Agnès Alsius, Kemal Jemal Mohammed, Danielle Macdonald, Mukemil Awol, Oluwamisimi Oluwole, Jacoba Lilius, Amanda Ross-White, Erna Snelgrove-Clarke","doi":"10.1097/HMR.0000000000000480","DOIUrl":"10.1097/HMR.0000000000000480","url":null,"abstract":"<p><strong>Background: </strong>Organizational compassion (OC), the process in which members of an organization collectively notice, feel, and respond to distress within their organization, can buffer against the stressors experienced by health care professionals. A growing body of research has examined the experiences, outcomes, and contributing traits of organizational compassion in health care.</p><p><strong>Purpose: </strong>The purpose of this review was to synthesize this literature in order to illuminate the processes and practices that foster compassionate organizations and enhance providers' well-being.</p><p><strong>Methods: </strong>We followed the JBI guidelines for mixed-methods reviews, using a convergent segregated approach. Two independent reviewers completed screening, quality assessment, and extraction. Conflicts were resolved by discussion or by a third reviewer. Meta-aggregation was used to synthesize qualitative findings; quantitative results were synthesized narratively.</p><p><strong>Results: </strong>Twenty-four studies (16 qualitative and eight quantitative) were included. Synthesized qualitative findings captured (1) the benefits and enablers of organizational compassion, and (2) the personal and shared journeys of organizational compassion through understanding, becoming, and embodying compassion. A variety of outcomes, predictors, and mediators of OC were identified from the quantitative studies. Notable points of convergence and divergence were found between qualitative findings and quantitative results.</p><p><strong>Practice implications: </strong>A supportive work environment that nurtures sustainable leadership, procedural knowledge, workplace friendships, a culture of service, self-compassion, connections, and space can bring numerous benefits at both individual and organizational levels. Cultivating compassionate organizations is multifaceted and depends on individuals and the overall institutional context. When employees in health care settings experience compassion, it positively impacts their psychological and emotional well-being, enhancing their workplace behavior and performance.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"217-230"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A transdisciplinary assessment of age-friendly cities and communities in Bengaluru Urban, India: Towards a healthy aging framework.","authors":"Naveen Ravindra, N S Shivaraj, Ananth Ram, Angie Abdel Shafei, Nanda Kumar Bidare Sastry","doi":"10.1097/HMR.0000000000000485","DOIUrl":"10.1097/HMR.0000000000000485","url":null,"abstract":"<p><strong>Background: </strong>With the global increase in the elderly demographics, significant challenges are presented for urban environments. The escalation of urbanization and migration trends engenders a heightened demand for cities that are conducive to the needs of older adults. India, with 10.5% of its population aged 60 years and above (National Statistical Office, 2023), faces an urgent imperative to develop age-friendly urban environments. Cities like Bengaluru exemplify both opportunities and challenges in achieving this. As a result, Bengaluru's elderly population is growing, but the city lacks infrastructure to meet their needs. This study assesses the city's age-friendliness in several important areas, matching WHO standards with the Indian setting to offer workable urban solutions.</p><p><strong>Methodology/approach: </strong>A cross-sectional study was conducted across 27 geographic locations comprising 214 discrete public amenities in Bengaluru, using the WHO's \"Checklist of Essential Features of AFCC.\" Data were analyzed across eight domains. Locations were scored across all these domains and categorized based on cumulative scores as not age-friendly, moderately age-friendly, and age-friendly.</p><p><strong>Results: </strong>Among the 27 locations assessed, it was noted that 19 (70.4%) of public areas were clean, 23 (85.2%) of them lacked wheelchair-accessible pavements, and 26 (96.3%) had no safe pedestrian crossings. Well-connected transportation was available in 17 (63%) locations, but only 1 (3.7%) had specialized transport for disabled individuals. Among 25 locations deemed suitable, 20 (80%) were suitable, with only 3 (12%) suitable for the disabled. Overall, 2 (7.4%) locations were completely age-friendly, 2 (7.4%) locations were moderately age-friendly, while the remaining majority, 23 (85.2%) locations, were not age-friendly.</p><p><strong>Conclusion: </strong>This study showcases the varying landscape of urban amenities for the aging population. The results depict deficiencies in accessibility, health care services, and housing. The conceptual framework proposed through this study encompasses key elements promulgated in the UN Healthy Aging Agenda: 2020-2030.</p><p><strong>Practice implications: </strong>This study provides actionable insights for policymakers and urban planners to improve age-friendly urban spaces. By combining inclusive transportation, technology-driven healthcare solutions, and accessible public areas, the proposed framework addresses the social and infrastructural gap. Aligning the city planning with the global frameworks for Age-friendly Cities and Communities (AFCC) standards will ensure that older people live independently, fairly, and with dignity.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S34-S41"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance of digital health technologies in health and aged care: A systematic review and meta-analysis.","authors":"Abhishek Dondapati, Ranjit Kumar Dehury, Gvrk Acharyulu, Subodh Kandamuthan, Sridevi Ayaluri","doi":"10.1097/HMR.0000000000000486","DOIUrl":"10.1097/HMR.0000000000000486","url":null,"abstract":"<p><strong>Background: </strong>As global populations age, health care systems face mounting pressure to provide accessible, efficient, and patient-centered care. Digital health technologies offer promising solutions for supporting older adults' independence and chronic disease management; however, adoption remains inconsistent due to barriers related to perceived usefulness (PU), perceived ease of use (PEOU), and attitudes toward technology (ATT).</p><p><strong>Purpose: </strong>This systematic review and meta-analysis synthesized existing evidence on digital health technology acceptance among older adults, identifying key determinants of behavioral intention (BI) and examining moderating effects of culture, age, and technology type.</p><p><strong>Methods: </strong>A comprehensive search across PubMed, Scopus, and EBSCOhost identified 59 eligible studies. Of these, 19 studies with quantitative data were included in a meta-analysis using random-effects modeling. Correlation coefficients were converted to standardized path coefficients (β) for comparability. Subgroup and meta-regression analyses assessed heterogeneity and moderator effects across cultural regions, age groups, and technology categories.</p><p><strong>Results: </strong>Perceived usefulness emerged as the strongest predictor of adoption (PU → BI: β = 0.72, 95% CI: .70-.73), followed by attitude (ATT → BI: β = 0.53, 95% CI: .50-.56). Perceived ease of use exerted an indirect influence through usefulness (PEOU → PU: β = 0.60), highlighting the interdependence between usability and perceived benefits. Substantial heterogeneity (I2 = 57.5%-99.7%) reflected genuine contextual diversity. Moderation analyses revealed stronger relationships in Western cultures and among younger-old adults (60-70 years). Technology-specific differences showed that digital health platforms benefited most from usefulness-driven adoption, while assistive technologies depended heavily on usability.</p><p><strong>Conclusions: </strong>Acceptance of digital health technologies among older adults is shaped by perceived usefulness, ease of use, and contextual moderators such as culture, age, and technology type. The findings underscore that technology adoption in aging populations is not universal but deeply context-dependent.</p><p><strong>Practical implications: </strong>Health care administrators and designers should prioritize interventions that enhance perceived usefulness and usability through evidence-based, context-specific strategies such as outcome-driven feedback systems, intuitive interfaces, and culturally tailored digital literacy programs. Policy efforts should support iterative evaluation frameworks that adapt to diverse user needs to ensure equitable and sustainable technology adoption in health and aged care.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S42-S55"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value-based health care in mobile integrated health for acute elderly care: A qualitative study of health care professionals in Finland.","authors":"Fan Wang, Sanna Pekanoja, Petri Ahokangas, Miia Jansson","doi":"10.1097/HMR.0000000000000483","DOIUrl":"10.1097/HMR.0000000000000483","url":null,"abstract":"<p><strong>Background: </strong>Health care service providers face increasing challenges in delivering high-quality care due to an aging population, workforce shortages, and limited financial budgets. Mobile Integrated Healthcare (MIH) offers an alternative value-based solution for elderly patients with manageable acute conditions at home. Finland is piloting this model, but its value, task redesign, and cost-efficiency require thorough evaluation before formal integration.</p><p><strong>Purpose: </strong>This study explores the value of MIH for patients and the health care system through the lens of value creation, delivery, and capture.</p><p><strong>Methods: </strong>Qualitative data were collected via semistructured interviews with 21 frontline health care professionals (HCPs) involved in Finland's MIH service.</p><p><strong>Results: </strong>MIH provides human-centered acute care for the elderly, enabling convenient access to emergency services at home and reducing unnecessary hospital visits. Value is cocreated through integrated networks of emergency and social services, leveraging paramedics' and geriatric nurses' expertise while standardizing care pathways. Effective implementation requires coordination and task-shifting across emergency departments, MIH teams, and social care providers.</p><p><strong>Conclusions: </strong>MIH enhances care quality, supports elderly independence, and contributes to the sustainability of the health care system by reducing emergency interventions and hospitalizations.</p><p><strong>Practical implications: </strong>Health managers should prioritize skill development for health care professionals (HCPs), integration across governance, service, HCPs, and patient levels, and the establishment of coordinated information systems. This study offers policymakers a valuable example of how MIH can be organized within a collective, publicly funded health care system to promote equity, accessibility, and sustainability for value-based health care.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S14-S23"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How trust in supervisors relates to health care employee outcomes: A qualitative comparative analysis of the ABI model.","authors":"Graham H Lowman, Jacob M Whitney, James A Meurs, Michael J Maloni","doi":"10.1097/HMR.0000000000000476","DOIUrl":"10.1097/HMR.0000000000000476","url":null,"abstract":"<p><strong>Background: </strong>The trust that health care employees place in their supervisor is critical to creating positive employee outcomes. However, questions remain regarding the development and outcomes of employee-supervisor trust in the health care context.</p><p><strong>Purpose: </strong>Recent studies challenge the often-used ability, benevolence, and integrity (ABI) model of trust, particularly that all three dimensions are needed to build trust. This study contests this assumption of the model, assessing ABI-based trust in a supervisor on health care employee person-job (P-J) fit, job satisfaction, and turnover intentions.</p><p><strong>Methodology/approach: </strong>Using a survey of health care employees, we apply qualitative comparative analysis (QCA), linking ABI configurations to P-J fit, job satisfaction, and turnover intentions.</p><p><strong>Results: </strong>The results indicate that ABI components of trust, indeed, are not all needed for most employees. For instance, if supervisors exhibit high levels of only benevolence or integrity, many employees experience high P-J fit. Similarly, employees experience high job satisfaction when supervisors possess either high levels of ability or benevolence. Finally, employees hold low turnover intentions when supervisors have high levels of just ability or integrity.</p><p><strong>Conclusion: </strong>The results call for refinement of the ABI model in the health care context.</p><p><strong>Practice implication: </strong>Health organizations can train supervisors on specific ABI components based on employee needs, offering strategic use of resources to satisfy and retain employees.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"172-179"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between psychosocial work environment factors and the well-being of frontline hospital managers: A cross-sectional study.","authors":"Ane-Kathrine Lundberg Hansen, Tanja Kirkegaard, Aimee Gayed, Christian Bøtcher Jacobsen, Vita Ligaya Dalgaard","doi":"10.1097/HMR.0000000000000481","DOIUrl":"10.1097/HMR.0000000000000481","url":null,"abstract":"<p><strong>Background: </strong>Promoting manager well-being is important for organizations. Failure to do so can harm employees directly through contagion effects on employee well-being and indirectly by hindering managers' leadership efforts. This comes with the risk of reducing employee motivation and job satisfaction, potentially harming organizational performance. Despite its importance, manager well-being remains underexplored in research.</p><p><strong>Purpose: </strong>This study aims to enhance the understanding of demands and resources in the psychosocial work environment of frontline hospital managers and how these factors are associated with their well-being.</p><p><strong>Methodology/approach: </strong>Using a sample of 514 frontline managers working in Danish hospitals, we analyzed relationships between psychosocial work environment factors and manager well-being through descriptive statistics and OLS regressions. Qualitative insights from an open-ended question were further used to illustrate the investigated dynamics.</p><p><strong>Results: </strong>We observed substantial variation in the managers' well-being levels, with average levels lower than those in the Danish general population. Frontline hospital managers face substantial demands in their daily work, but they also report having access to important resources. For the associations between factors in the psychosocial work environment and manager well-being, we found particularly strong associations between frontline hospital manager well-being and the organizational climate, possibilities for performing work tasks, and emotional as well as quantitative demands.</p><p><strong>Practice implications: </strong>This study contributes to knowledge on well-being among frontline managers and highlights critical factors for public organizations to address in their efforts to support well-being among their managers.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"231-242"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A faulty shield of armor: An exploration of callousness in health care workers.","authors":"Eda Algur, Michaela J Kerrissey, Vivek K Moitra, Jonathan A Paul, Amy C Edmondson, Ingrid M Nembhard","doi":"10.1097/HMR.0000000000000477","DOIUrl":"10.1097/HMR.0000000000000477","url":null,"abstract":"<p><strong>Background: </strong>Callousness-behaving in an impersonal, insensitive, and cynical demeanor toward others-is increasing among health care workers and associated with harm to patient care. Yet, there has been little study of its predictors and effects on workers and workplace functioning.</p><p><strong>Purpose: </strong>This exploratory study aims to develop the theoretical premise for callousness as a distinct construct and examine possible contextual predictors and outcomes of health care workers' callousness to motivate further study and inform organizations' response to this behavior.</p><p><strong>Methodology/approach: </strong>We reviewed the literature to illuminate the distinctiveness of callousness, surveyed 557 workers in 20 hospital intensive care units (ICUs) and then used multilevel generalized structural equation modelling to assess: (1) callousness's link to two hypothesized contextual predictors (work-life balance and psychological safety), (2) whether type of work unit moderates the effect of hypothesized predictors, and (3) callousness's relationship to two workforce-related organizational concerns, that is, intent to stay and proactive behavior.</p><p><strong>Results: </strong>Self-reported callousness is significantly higher when workers report lower work-life balance and psychological safety. This relationship varies with the type of unit in which workers are situated (medical, surgical, or mixed). Callousness is negatively associated with intent to stay in one's job and proactive behavior, and it mediates their relationship with work-life balance and psychological safety.</p><p><strong>Conclusion: </strong>Callousness is associated with elevated threat to workforce stability and quality improvement efforts. Work-life balance and psychological safety may help to mitigate callousness, more so in some work units.</p><p><strong>Practice implications: </strong>Health care managers should act to reduce callousness to thwart staff turnover and retain workers' improvement motivation; both affect care. Fostering psychological safety and work-life balance may aid their efforts.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"180-189"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expatriate health care workers in Saudi Arabia: Exploring workforce integration, advantages, and challenges in a globalized health care system.","authors":"Reem Dheya Alothmany, Ashokkumar Manoharan, Zhou Joe Jiang","doi":"10.1097/HMR.0000000000000487","DOIUrl":"10.1097/HMR.0000000000000487","url":null,"abstract":"<p><strong>Background: </strong>Effective expatriate management has become crucial in the health care sector, driven by the growing number of globally mobile professionals. The Saudi Ministry of Health data shows that 53% of the health care workforce in Saudi Arabia is comprised of expatriates, with expatriate health care workers constituting up to 90% of the workforce in some Gulf Cooperation Council (GCC) countries. In addition, technological advancements such as telemedicine, artificial intelligence, and electronic health records are transforming health care delivery, presenting both opportunities and challenges for expatriate health care workers. Despite these trends, there is a lack of research in examining expatriate outcomes for health systems.</p><p><strong>Purpose: </strong>The purpose of this paper is to examine the advantages and challenges of employing expatriates in Saudi Arabia's health care industry.</p><p><strong>Methodology/approach: </strong>This study employs a mixed-methods approach. Qualitative data were collected from the top management team (TMT) overseeing health care expatriates (N=32), and thematic analysis was used to analyze the data. The findings of this study were triangulated with the secondary data collected from the Ministry of Health and the Saudi Health Council.</p><p><strong>Findings: </strong>The findings reveal five primary advantages-international clinical experience, health care professionalism, ethical patient care, adaptability to local environments, and workforce diversity-and four main challenges: high expatriate labor costs, Saudization policies, operational risks related to knowledge transfer, and language barriers in patient communication.</p><p><strong>Conclusion: </strong>There are more advantages of employing expatriates than challenges, leading to a novel framework. Findings were triangulated with secondary quantitative data, which confirmed the same. This study fills a gap in the expatriate workforce literature by providing empirical insights from the underexplored context of the Middle East, particularly Saudi Arabia. It extends Caligiuri's performance dimension theory by integrating performance outcomes and contextual challenges specific to health care expatriates in Saudi Arabia. The study also offers actionable recommendations to overcome operational challenges, such as expatriates' reluctance to share knowledge and challenges associated with the Saudization policy, with the ongoing need for skilled expatriates. It also contributes to the human resource management and health care/aged care management literature.</p><p><strong>Practical implications: </strong>The study recommends fostering public-private collaborations and partnerships between health care institutions and global universities to address skill gaps and ensure workforce sustainability in Saudi Arabia's health care sector.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S56-S67"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging health and social care: Governance insights from Thailand's S-TOP intermediate care pilot.","authors":"Nalinee Nakittipha Chuakhamfoo, Thi Hue Man Vo, Thaworn Sakunphanit, Phudit Tejativaddhana","doi":"10.1097/HMR.0000000000000494","DOIUrl":"10.1097/HMR.0000000000000494","url":null,"abstract":"<p><strong>Background: </strong>Intermediate Care (IMC) provides intensive rehabilitation to prevent long-term disability among partially dependent individuals. Demand for IMC in Thailand is rising, yet governance frameworks remain underdeveloped. The Seamless Health and Social Services Provision for Elderly Persons (S-TOP) project, a Japan International Cooperation Agency (JICA) pilot, aimed to strengthen IMC governance by improving service delivery for older adults.</p><p><strong>Purpose: </strong>To explore and compare the governance models of IMC in two pilot sites in Thailand from the viewpoints of health and social service providers.</p><p><strong>Methodology/approach: </strong>We explored IMC governance within JICA pilot sites through a qualitative comparative case design. We gathered data from 13 in-depth interviews, site visits, and document reviews. Using thematic analysis, we compared different governance patterns from the provider's perspective to understand how local contexts shape implementation, transdisciplinary teamwork, and overall governance.</p><p><strong>Findings: </strong>Two distinct governance models emerged, both perceived by stakeholders as having achieved integration of health and social care. The lead organization model enabled direct service creation and flexible resource allocation, while the shared governance model leveraged strong health care networks and community altruism to coordinate care within the national framework. Despite differing in seniority structures, with one based on position and the other on age, both models enhanced service accessibility and promoted health equity through tailored, community-based systems.</p><p><strong>Conclusions: </strong>Community-based IMC governance succeeds when aligned with local structural and cultural contexts. The integration of health and social care requires adaptable mechanisms, whether through local government leadership or collaborative health care networks, while respecting culturally embedded decision-making norms.</p><p><strong>Practice implications: </strong>The lead organization model suits decentralized settings with strong local government. The shared governance model suits centralized settings with robust health care networks and cultural assets like age-based seniority and altruism. Health administrators should cultivate transdisciplinary teams that integrate professional expertise with community knowledge and respect local decision-making norms.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S77-S85"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Let me handle this myself\": The value of psychological empowerment and kaleidoscope career orientation for career sustainability.","authors":"Denise Mary Jepsen, Beatrice Van der Heijden, Sait Gürbüz","doi":"10.1097/HMR.0000000000000490","DOIUrl":"10.1097/HMR.0000000000000490","url":null,"abstract":"<p><strong>Background: </strong>High staff turnover in residential aged care threatens both care quality and workforce sustainability, highlighting the urgent need to understand factors that support employee well-being and performance.</p><p><strong>Purpose: </strong>Building on self-determination theory and the kaleidoscope career model, this study examines how psychological empowerment, authenticity, balance, and challenge predict career sustainability among eldercare staff.</p><p><strong>Methodology: </strong>Cross-sectional survey data from 370 staff in 21 facilities in metropolitan and regional Australia were analyzed. Participants completed validated measures of the predictor variables, job satisfaction, psychological distress, and task performance. Hypothesized relationships were tested using structural equation modeling.</p><p><strong>Results: </strong>Psychological empowerment was positively related to job satisfaction and task performance and negatively related to psychological distress. Contrary to expectations, an authentic career orientation was negatively associated with job satisfaction and positively associated with psychological distress. Balanced career orientation was not associated with any sustainable career indicators. Challenge career orientation was positively associated with job satisfaction and negatively associated with psychological distress.</p><p><strong>Practice implications: </strong>Given the predictive value of psychological empowerment and challenge career orientation for workers' career sustainability, HR professionals and line managers need to be aware of the importance of fostering psychological empowerment in the workplace, and enabling opportunities for growth and development across the working life. In doing so, career sustainability can be protected and supported, which will be reflected in improved retention-relevant outcomes, well-being, and performance. Findings suggest that authenticity-oriented career priorities may be more difficult to realize in structurally constrained care settings.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"253-262"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}