Data Sheet 2_Managers’ perspectives on their role in implementing fall prevention interventions: a qualitative interview study in Norwegian homecare services.doc

IntroductionThe implementation of fall prevention interventions in homecare services is crucial for reducing falls among older adults and effective leadership could determine success. Norwegian homecare services provide home nursing, rehabilitation, and practical assistance, to residents living in private homes or assisted living facilities. This study aims to explore how managers in Norwegian homecare services experience implementation of fall prevention interventions and how they perceive their roles.
MethodsWe conducted 14 semi-structured individual interviews with managers from different levels of homecare services in five city districts. The interviews were transcribed verbatim and reflexive thematic analysis was used to analyze the material.
ResultsThe analysis resulted in three main themes: (1) understanding organizational mechanisms to facilitate new practices, (2) practicing positive leadership behavior to facilitate implementation, and (3) demonstrating persistence to sustain implementation. Our results showed the importance of clear leadership across all levels of the organization and the value of devoting time and utilizing existing systems. Managers described using recognition and positive attitudes to motivate employees in the implementation process. They emphasized listening to and involving employees, providing trust, and being flexible. However, the implementation process could be challenging, highlighting the need for managers to be persistent.
ConclusionManagers at all levels play an important role in the implementation of fall prevention, but there is a need to define and align their specific roles in the process. Understanding how to use existing systems and influence through positive leadership behavior seem to be vital for success. Recognizing the demanding nature of implementation, managers emphasized the importance of systems for long term support. The study findings may influence how managers in clinical practice engage in the implementation process and inform future researchers about managers’ roles in implementation in homecare services.

引言
在居家照护服务中推行跌倒预防干预措施，对降低老年群体跌倒发生率至关重要，而高效的领导力则是决定干预成败的关键。挪威居家照护服务面向居住在私人住宅或辅助生活设施中的居民，提供居家护理、康复治疗与实用帮扶。本研究旨在探讨挪威居家照护服务的管理者对跌倒预防干预措施实施的切身体验，以及他们对自身在该过程中角色的认知。

研究方法
我们对来自五个城市行政区、不同层级居家照护服务机构的管理者开展了14次半结构化个人访谈。访谈内容均进行逐字转录，并采用反思性主题分析对访谈材料进行编码分析。

研究结果
本次分析提炼出三大核心主题：(1) 理解组织运行机制以推动新实践落地；(2) 践行积极领导行为以促进干预实施；(3) 展现坚持精神以维持干预推进。研究结果表明，组织各层级清晰的领导力至关重要，同时投入时间并利用现有系统的举措亦颇具价值。管理者们提及，会通过认可激励与积极态度来调动员工参与干预实施的积极性。他们强调需倾听员工心声、吸纳员工参与、给予员工信任并保持管理灵活性。然而，干预实施过程往往存在诸多挑战，这凸显了管理者具备坚持精神的必要性。

研究结论
各级管理者在跌倒预防干预的实施环节中均发挥着重要作用，但仍需明确并协调其在该过程中的具体角色。明晰如何运用现有系统、通过积极领导行为施加正向影响，似乎是取得干预成功的关键要素。管理者们意识到实施工作的艰巨性，强调需建立长效支持体系。本研究结果可为临床实践中的管理者参与干预实施流程提供指导，同时也可为未来研究者探索居家照护服务领域中管理者的实施角色提供参考依据。