Health-oriented leadership in specialized outpatient palliative care teams in Germany : a qualitative study with palliative care professionals

Abstract

Background: Palliative care leadership is characterized by diversity and collaboration, with an emphasis on interdisciplinary teamwork and shared responsibility. In the context of palliative care, the leadership role is subject to a distinctive set of stressors, which in turn necessitates the implementation of strategies that are conducive to the well-being of the team. The implementation of the Health-oriented Leadership approach (HoL) appears to be a crucial step in advancing the field and addressing the emotional aspects of end-of-life care. Given the growing global need for palliative care, the study aims to provide initial insights into how health-oriented leadership is understood in the field of specialized outpatient palliative care (SAPV),its potential benefits and the challenges to its implementation. Furthermore, the perceived advantages of this approach in the given context will be discussed, and the challenges inherent to its implementation will be presented. Methods: In this qualitative study, a total of 30 semi-structured interviews were conducted with palliative care professionals working in Northern Germany. The participants were distributed equally between leaders and employees, and the interviews were conducted in person. The participants included medical practitioners, nursing staff and a health scientist in palliative care. The data were subjected to an inductive analysis and interpretation in accordance with the qualitative content analysis proposed by Mayring. Exploratory analyses were conducted to identify and examine the differences between leaders and employees. Results: The findings of the study indicate that employees and managers in palliative care hold comparable yet distinct perspectives on the advancement of occupational health (HoL). Both groups emphasised the relevance of a supportive working environment, health promotion measures and effective communication. Employees focused on work-life balance and immediate benefits such as job satisfaction, while managers prioritised adaptive structures and long-term goals such as reducing absenteeism. Communication barriers and resource management were identified as challenges. Both groups emphasised the importance of appreciation, mental health and professional boundaries for a healthy working environment. Conclusion: This study emphasizes the important role of health-oriented leadership in addressing unique challenges in SAPV and fostering a supportive work culture. It highlights the diverse approaches of leaders and employees towards health management and underscored the increasing emphasis on self-care and mental well-being in high-stress healthcare environments.