Effects of a Flipped-Learning Empowering Leadership Program on Nurse Leaders, Staff, and Residents in Long-Term Care Facilities

NCT07774767 | Completed

• 1 other identifier: CRREC-105-002
• Study Type: interventional
• Target: 287
• Locations: 1 country
• Sites: 1

Brief Summary

This pilot cluster quasi-experimental study tested a 12-week empowering-leadership training program delivered through flipped learning to nurse leaders in residential long-term care facilities, compared with a conventional brochure-based approach. Six facilities in central Taiwan participated: two (one public, one private) received the flipped-learning program for their leaders, and four (one public, three private) served as controls. The study examined effects at three levels: nurse leaders' own empowering leadership behaviors and facility-level nursing staff retention/turnover and resident hospitalization rates; nursing staff's perceptions of their leader's empowering behaviors, burnout, psychological empowerment, and job satisfaction; and residents' health status, quality of life, and satisfaction with care.

Conditions

Empowering Leadership; Long-Term Care; Nurse Leaders

Outcome Measures

Primary Outcomes (2)

• Leader Empowerment Behavior

  Leader Empowerment Behavior Scale (Chinese version), a 27-item self-report measure across 5 subscales (extending meaning of work, engaging staff in decision-making, expressing confidence, encouraging goal achievement, providing autonomy). Each item rated on a 7-point Likert scale (1=strongly disagree, 7=strongly agree); total score range 27-189, with higher scores indicating more empowering leadership behavior (better outcome). Cronbach's α=0.71; test-retest r=0.83.

  Baseline and immediately post-intervention (approximately 12 weeks)

• Staff-Perceived Leader Empowering Behavior

  Modified version of the Leader Empowerment Behavior Scale, a 27-item measure completed by nursing staff about their leader, across 5 subscales. Each item rated on a 7-point Likert scale; total score range 27-189, with higher scores indicating more empowering behavior as perceived by staff (better outcome). Cronbach's α=0.85; test-retest r=0.71.

  Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)

Secondary Outcomes (10)

• Occupational Burnout

  Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)

• Psychological Empowerment

  Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)

• Job Satisfaction

  Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)

• Job Stress

  Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)

• Health Status (SF-36)

  Baseline (at enrollment) and 3 months after intervention completion (approximately August 2019)

Study Arms (2)

Flipped Learning Intervention

EXPERIMENTAL

2 residential long-term care facilities (1 public, 1 private): 10 nurse leaders, 40 nursing staff, 100 residents. Nurse leaders received a 12-week flipped-learning empowering leadership program.

Behavioral: Flipped-Learning Empowering Leadership Program

Conventional Learning / Control

ACTIVE COMPARATOR

4 residential long-term care facilities (1 public, 3 private): 11 nurse leaders, 40 nursing staff, 86 residents. Nurse leaders received a printed brochure with identical content, without structured flipped-learning sessions.

Behavioral: Educational Brochure (Conventional Learning)

Interventions

Flipped-Learning Empowering Leadership Program BEHAVIORAL

A 12-week, 24-hour empowering leadership program (one 2-hour module per week). Each week, a 60-minute instructional video was posted for asynchronous pre-class learning, followed by a 1-hour face-to-face session (small-group discussion, case studies, brief presentations, practical exercises), with instructor summary. Post-class activities included reflection and assignments.

Flipped Learning Intervention

Educational Brochure (Conventional Learning) BEHAVIORAL

Nurse leaders in the control group received a printed brochure covering the same empowerment/empowering-behavior content as the intervention group, without structured flipped-learning sessions. The research team maintained regular contact to answer questions but provided no additional training.

Conventional Learning / Control

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Nurse Leaders:
• Age ≥ 20 years
• Employed as nursing director, supervisor, or head
• Employed at the facility for more than 6 months
• Willing to participate and able to give informed consent
• Nursing Staff:
• Registered nurse, licensed practical nurse, or nursing assistant
• Employed at the facility for ≥ 3 months
• Age ≥ 20 years
• Informed consent given
• Residents:
• Resided at the facility for ≥ 3 months
• Mini-Mental State Examination (MMSE) score ≥ 24
• No severe hearing impairment
• Not terminally ill

You may not qualify if:

• Nurse Leaders:
• \- Indicated intent to leave the position within the next 6 months

Sponsors & Collaborators

• I-Hui-Chen: lead

Study Sites (1)

Residential Long-Term Care Facilities

Taichung, Taiwan

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor / Principal Investigator & Corresponding Author

Study Record Dates

• First Submitted: August 13, 2026
• First Posted: August 19, 2026
• Study Start: August 1, 2018
• Primary Completion: May 30, 2019
• Study Completion: May 30, 2020
• Last Updated: August 19, 2026

Record last verified: 2026-08

Locations

TW (1)