Leadership Behaviours and the Perception of Support for Wellness Among Front-Line Healthcare Providers in Long-Term Care: A Post-Pandemic Recovery Effort

Abstract

The COVID-19 pandemic brought to public attention extensive deficiencies in the long-term care (LTC) sector. LTC in Canada has been struggling with several challenges that reduce the quality of care delivered to residents, such as a lack of funding and standardized regulations. Front-line healthcare providers working in LTC settings have had to deal with work overload and drastic staffing shortages while trying to maintain their own overall well-being. While these workers are facing elevated stress levels, increased burnout symptoms, emotional exhaustion, and daily risks to their physical safety, it is the responsibility of direct managers and supervisors to help support them to the best of their abilities. The perceived availability of social support is associated with workers' positive well-being and leadership behaviours can impact workers' overall health. Thus, I used the social support and buffering hypothesis theory to explore what leadership behaviours can have an impact on perceived social support (PSS) among LTC workers. I used an intrinsic and instrumental case study design, which included reviewing documentary evidence and conducting in-depth, semi-structured interviews with nurses and personal support workers. The study setting was the Perley & Rideau Veterans Health Centre in Ottawa, Ontario. Collected data was analyzed using reflexive thematic analysis to answer two research questions: (1) What leadership behaviours do front-line healthcare providers perceive as being supportive of their overall well-being? (2) What types of social support (emotional, informational, social companionship, and instrumental) do front-line healthcare providers perceive as important or wish to receive from their leaders? Reflexive thematic analysis revealed four main overarching themes for supportive leadership behaviours: (1) relationship-building behaviours; (2) trust-producing behaviours; (3) safety-promoting behaviours; and (4) health-promoting behaviours. Health-promoting behaviours were most prominent in the data, likely because they are not isolated actions but are deeply intertwined with how leaders build and maintain relationships, establish trust, and create a safe working environment. Across all overarching themes, emotional support was particularly poignant to employees. This suggests that emotional support may be foundational to employees' overall perceptions of supportive leadership. The thesis results provide insights that can enhance our understanding of leadership behaviours and PSS in LTC and offer valuable recommendations that can be applied in LTC settings.