Organisational reform readiness and psychosocial outcomes among assistant nurses
Abstract
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.
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BibTeX
@article{fallman2026organisational,
title = {{Organisational reform readiness and psychosocial outcomes among assistant nurses}},
author = {SL Fällman and G Jutengren},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.2075},
url = {https://doi.org/10.1093/eurpub/ckag169.2075},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Organisational reform readiness and psychosocial outcomes among assistant nurses
AU - SL Fällman
AU - G Jutengren
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.2075
UR - https://doi.org/10.1093/eurpub/ckag169.2075
AB - 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.
SN - 1101-1262
SN - 1464-360X
ER -