First-Line Managers’ Leadership Behavior Profiles and Use of Gardens in Residential Care Facilities: An Interview Study

Figures & data

Table 1. Participant characteristics.

Variables	Mean	SD	Median	Range
Age (years)	51.9	6.2	54.0	38−59
Working experience at the facility (years)	7.5	6.4	7.0	1−24
Working experience in elderly care (years)	13.3	6.3	12.0	2−28

Note. Twelve women attended (N=12).

Table 2. Description of location, number of residents and level of care provided, apartment’s size, type of garden and surrounding area.

Location	Number of residents and *level of care provided	Apartments size in square meter	Type of garden and near surrounding area
Three one-story buildings with three units for persons with dementia located in an urban area.	10 residents with dementia	28–38	Three similar gardens reachable from a corridor at the inside of the building. The gardens is enclosed by fences and bushes. Furniture for seating and a hammock in each garden. Below lies a stone pavement with greenery around, a couple of raised garden beds for cultivating of vegetables, strawberries and rhubarb. Parasols are used as protection from sun exposure. The surrounding area consists of a park with trees and greenery, pharmacy, shops and restaurants.
One multi-story building with three floors located in an urban area. At the first floor there is a unit intended for persons with somatic- and persons with dementia diseases. On the second floor there is a unit intended for persons with somatic diseases and on the third floor a unit intended for persons with dementia diseases.	48 residents with somatic diseases 48 residents with dementia	35	Two similar courtyard gardens common for all residents. The gardens are enclosed by the surrounding buildings and the grounds consists of stone pavement. One pergola is located in each garden, seating furniture with tables, trees, bushes with black currants, raised garden beds with strawberries and flowers. Parasols and pergolas with plants are used as protection from sun exposure. The surrounding area consists of a park with greenery, a health center, pharmacy, shops and restaurants.
One multi-story building with three floors located in an urban area. The first floor is intended for persons with dementia diseases. On the second and third floor there is units intended for persons with somatic diseases.	40 residents with somatic diseases 28 residents with dementia	31	A courtyard garden common for all residents, enclosed by the surrounding buildings. The garden ground consists of stone pavement. Furniture for seating and tables, bushes with berries, a few raised garden beds with flowers, strawberries and spice plants. Awnings and parasols are used as protection from sun exposure. The surrounding area consists of the sea, a nearby railway station, shops and restaurants.
One multi-story building with five floors and six units intended for persons with somatic diseases located in a suburban area.	64 residents with somatic diseases	35	A garden common for all residents, enclosed with a wooden fence where the ground consists of stone pavement. Furniture for seating with tables, pots with planted flowers, a couple of hanging baskets with flowers and a decoration in the form of a relatively large wooden boat. Parasols are used as protection from sun exposure. The surrounding area consists of a smaller shopping center with forests nearby.
One multi-story building with four floors and four units intended for persons with dementia diseases located in a suburban area.	60 residents with dementia	32	A newly opened garden common for all residents, enclosed with a hedge where the ground consists of concrete. Furniture for seating with tables. There are plans to plant apple trees and flowers in pots. Parasols are used as protection from sun exposure. The surrounding area consists of a little stream where some ducks are swimming under a little bridge leading over to a smaller business center, both traffic and forests nearby.
One multi-story building with five floors and five units intended for persons with somatic diseases located in a suburban area.	64 residents with somatic diseases	29–47	A common garden for all residents, enclosed by a wooden fence and bushes. The garden ground consists of paved walkways, grass and some gravel. Furniture for seating with tables, garden beds with flowers, strawberries and potatoes. Awnings and parasols are used as protection from sun exposure. The surrounding area consists of forests with fir-and pine trees, a paved road for walking and a shopping center.
Two one-story buildings with two units intended for persons with dementia located in a suburban area.	59 residents with dementia	27–47	A common garden for all residents, enclosed by a wooden fence. The garden ground consists of grass and paved walkways. Furniture for seating and tables, a large box in wooden with perennial flowers, garden beds with potatoes, rhubarb and strawberries. There is also a greenhouse with growing tomatoes and cucumber. Awnings and parasols are used as protection from sun exposure. The surrounding area consists of forests with pine trees, a small grocery store and a health center.
One multi-story building with three floors and three units intended for persons with somatic diseases located in a suburban area.	18 residents with somatic diseases	26–42	A common garden for all residents, enclosed with a wooden fence and bushes. The ground consists of paved walkways and grass. One gazebo, furniture for seating with tables, apple trees, bushes with black currants, raised garden beds for cultivating of potatoes, strawberries and spices. In the garden there are also a rooster and a few hens. Parasols are used as protection from sun exposure. The surrounding area consists of woods, paved walkways and a kindergarten nearby.
A one one-story building intended for persons with dementia located in a suburban area.	44 residents with dementia	25–40
A one-story building with two units intended for persons with somatic diseases and two units intended for persons with dementia diseases in a suburban area.	22 residents with somatic diseases 22 residents with dementia	31–37	A common garden for all residents, enclosed by a wooden fence and hedges. The ground consists of paved walkways and grass. There is a small meadow with flowers, flowers in pots, some apple trees and shrubs with black and red currants. Awnings and parasols are used as protection from sun exposure. The surrounding area consists of a health center, pharmacy and a small shopping center.
A one-story building with two units intended for persons with somatic diseases and one unit intended for persons with dementia located in a rural area.	34 residents with somatic diseases 16 residents with dementia	36–39	Five similar small gardens reachable from the corridor at the inside of the building. Two of the gardens are intended for persons with somatic diseases and three of the gardens is intended for persons with dementia. The garden grounds consists of stone slabs and are enclosed by a wooden fence, trees and bushes. There is seating with tables. Awnings and parasols are used as protection from sun exposure. The surrounding area consists of green areas and paved walkways.
A one-story building with two units intended for persons with somatic diseases and one unit intended for persons with dementia located in a rural area.	17 residents with somatic diseases 10 residents with dementia	26–36	Two gardens for persons with somatic diseases and one for persons with dementia reachable from a corridor inside the building. The gardens are quite similar and enclosed by a wooden fence. The ground consists of stone slabs and some greenery and there is a paved walkway around the house. There is seating furniture with tables, a common gazebo, trees, bushes, perennial plants, and raised garden beds with black currants, flowers and strawberries. Awnings, parasols and the gazebo are used as protection from sun exposure. The surrounding area consists of large green areas and pastures with cows.

Note. *Level of care provided: All residents require much formal care due to health problems e.g. multi-morbidity, ADL-difficulties, anxiety, depression and pain.

Table 3. Overview of examples from the data analysis.

Interview text	Condensed meaning	Subcategory	Category of leadership dimension
I expect that the staff will assist residents who want to go outdoors. The prerequisite is that they show a positive attitude about it.	I expect that the staff will assist residents who want to go outdoors.	Clarifying expected results for a specific task.	Expression of structure
The documented goals for residents rely on the Swedish Fundamental National Values and documentation of residents’ desires in our local implementation plan. If we have documented that a resident regularly wants to visit the garden, the staff must assist this person in outdoor stays.	If we have documented that a resident regularly wants to visit the garden, the staff must assist this person in outdoor stays.	Explaining workplace regulations, policies and routines.	Expression of structure
I hope the staff feel my support and encouragement in the challenging work to calm residents with worry and anxiety. The visits and work in the garden may be a health-promoting resource even for staff.	I hope the staff feel my support and encouragement in the challenging work to calm residents with anxiety.	Giving support and encouragement to staff.	Expression of relation
I am sure that the staff do good planning and know the best way to work with residents in the garden.	The staff know the best way to work with residents in the garden.	Allowing staff to decide the best way to solve a task.	Expression of relation
It does not work for everyone, but staff should, instead of medication, try taking residents out into the garden. This may be health promoting and calming in cases of anxiety.	The staff should, instead of medication, try to taking residents with worry and anxiety out into the garden to calm them and promote health.	Encouraging staff to see problems and opportunities in new ways.	Expression of change