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Background and Objectives Organizational context is thought to influence whether care aides feel empowered, but we lack empirical evidence in the nursing home sector. Our objective was to examine the association of features of nursing homes' unit organizational context with care aides' psychological empowerment. Research Design and Methods This cross-sectional study analyzed survey data from 3765 care aides in 91 Western Canadian nursing homes. Random-intercept mixed-effects regressions were used to examine the associations between nursing home unit organizational context and care aides' psychological empowerment, controlling for care aide, care unit, and nursing home covariates. Results Organizational (IVs) culture, social capital, and care aides' perceptions of sufficient time to do their work were positively associated with all four components of psychological empowerment (DVs): competence (0.17 [0.13, 0.21] for culture, 0.18 [0.14, 0.21] for social capital, 0.03 [0.01, 0.05] for time), meaning (0.21 [0.18, 0.25] for culture, 0.19 [0.16, 0.23] for social capital, 0.03 [0.01, 0.05 for time), self-determination (0.38 [0.33, 0.44] for culture, 0.17 [0.12, 0.21] for social capital, 0.08 [0.05, 0.11] for time), and impact (0.26 [0.21, 0.31] for culture, 0.23 [0.19, 0.28] for social capital, 0.04 [0.01, 0.07] for time). Discussion and Implications In this study, modifiable elements of organizational context (i.e. culture, social capital, and time) were positively associated with care aides' psychological empowerment. Future interventions might usefully target these modifiable elements of unit level context in the interest of assessing their effects on staff work attitudes and outcomes, including the quality of resident care. [ABSTRACT FROM AUTHOR]

The association of organizational context with quality of care in nursing homes is not well understood at the clinical microsystem (care unit) level. This cross-sectional study examined the associations of unit-level context with 10 unit-level quality indicators derived from the Minimum Data Set 2.0. Study settings comprised 262 care units within 91 Canadian nursing homes. We assessed context using unit-aggregated care-aide-reported scores on the 10 scales of the Alberta Context Tool. Mixed-effects regression analysis showed that structural resources were negatively associated with antipsychotics use (B = −.06; p =.001) and worsened late-loss activities of daily living (B = −.03, p =.04). Organizational slack in time was negatively associated with worsened pain (B = −.04, p =.01). Social capital was positively associated with delirium symptoms (B =.12, p =.02) and worsened depressive symptoms (B =.10, p =.01). The findings suggested that targeting interventions to modifiable contextual elements and unit-level quality improvement will be promising. [ABSTRACT FROM AUTHOR]

Background: Digital technologies show a high potential for health promotion and prevention, but an analysis throughout the planning, implementation, and evaluation phases of setting-based health promotion has not yet taken place. It also remains unclear to what extent digital technologies promote participation, partnerships, empowerment, and equity in settings., Purpose: This study is aimed at exploring future trends and possible uses of technologies throughout the phases of setting-based health promotion over the next 5 years. Further, it discusses the use of technologies to build participation, partnerships, empowerment, and equity in settings, and highlights the differences in the predictions of experts from science and practice., Method: A two-stage web-based Delphi survey with experts in setting-based health promotion/prevention was conducted. We conducted a content analysis for open questions and a quantitative analysis for closed questions., Results: According to the experts (N = 42, complete participation in the first round of the survey), digital transformation will increasingly find its way into the various process phases over the next 5 years. In particular, technologies for behavioral change in hybrid formats are expected. The use of technology in the future can lead to more participation, partnerships, empowerment, and equity in settings on the one hand, but on the other hand can also reinforce exclusion and injustice if no suitable underlying conditions are provided., Discussion: Research is needed on technologies for changing setting structures. The development of digital competencies and infrastructures in settings is essential to support the development of health-promoting settings digitally., (© 2023. The Author(s).)