Organisational reform readiness and psychosocial outcomes among assistant nurses

Background

Many healthcare systems face shortages of qualified care workers, prompting efforts to formalise frontline care roles. In Sweden, the introduction of a protected occupational title for assistant nurses represents a major reform in eldercare. Organisational conditions shaping psychosocial work environments during occupational transitions may influence employee well-being, yet little is known about whether perceived organisational preparedness for reform is associated with psychosocial work outcomes.

Objectives

To examine whether perceived organisational preparedness for a major occupational reform predicts psychosocial outcomes among assistant nurses over one year.

Methods

A longitudinal survey was conducted among Swedish assistant nurses at two time points a year apart (T1, N = 617; T2, N = 404). Linear mixed-effects models with repeated measures examined associations between baseline perceived organisational preparedness (prepared vs unprepared) and psychosocial outcomes, including job satisfaction, pride, meaningfulness, and self-rated health.

Results

Perceived organisational unpreparedness was consistently associated with poorer psychosocial outcomes. Participants reporting unprepared organisations had significantly lower job satisfaction, pride, meaningfulness, and self-rated health compared with those reporting readiness. Main effects of preparedness were significant across several models, while preparedness × time interactions were generally non-significant, indicating stable group differences over one year. Time effects were minimal.

Conclusions

Perceived organisational preparedness for occupational reform was linked to sustained differences in psychosocial work outcomes during occupational change. Organisational readiness may represent an important workplace factor influencing employee well-being and work-related health during occupational change. These findings may inform organisational strategies in healthcare.

Key messages

• Perceived organisational readiness for occupational reform was associated with better psychosocial work outcomes among assistant nurses over one year.

• Organisational preparedness during occupational change may influence employee well-being and support healthier work environments in healthcare.