The design comprises a two-armed cluster, randomized waitlist controlled design. The goal of
the study is to prevent stress and burnout in middle managers and employees in a hospital
setting. The study population is middle managers in a hospital setting. These managers are
randomized by unit and stratified on number of managers enrolled from each unit to obtain
equal numbers in each arm.
The intervention comprises five training modules with practice in small groups in between.
Training will take place over 5 months. The training will be received in groups of 20 middle
managers and the training will be facilitated by 2 facilitators. Themes of training are
inspired by the concept of Health Oriented Leadership which takes into account that the
well-being of middle managers is important for the well-being of employees. Central themes of
the training are: 1) Self-care and well-being of the manager and how to cope with stress as a
manager. 2) Employee well-being and reducing risk-factors in the psychosocial working
environment of employee mental health problems. 3) Enhancing protective factors social social
support and a healthy team climate. 4) Responding to employees at risk and how to handle
difficult conversations and procedures on return to work. 5) Managing well-being in employees
during changes and pressure.
In order to establish commitment for the waitlist control group, the control group will
receive an offer of a webinar and some written information.
Middle managers in both intervention arms will receive a questionnaire at baseline, after the
intervention and at 6 months follow-up. The intervention group will also receive a short
questionnaire after each training.
The following expectations are hypothesized:
The training will improve self-care and perceived staff-care in middle managers and in
employees in the intervention group when compared to the control group
The training will improve psychological outcomes of stress, well-being, exhaustion and
psychological symptoms among middle managers and employees in the intervention group when
compared to the control group
The training will improve the perceived psychosocial working environment (PSWE) among middle
managers and employees in the intervention group when compared to the control group
The training will reduce sickness absence and retention among middle managers and employees
in the intervention group when compared to the control group
Middle managers who adhere more to the training will experience larger improvements in
self-care, staff-care and mental outcomes