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At baseline, leadership quality was measured using the Copenhagen Psychosocial Questionnaire, and resident handlings [handlings per shift, handlings not using assistive devices, handlings done alone, interruptions to handlings, impediments to handlings] were assessed using observations. Frequency and intensity of low-back pain was assessed monthly during the following year. All variables were averaged for each ward. We used ordinary least squares regressions to examine direct effects of leadership on low-back pain and indirect effects through handlings, using PROCESS-macro for SPSS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>After adjustments for low-back pain at baseline, type of ward, staff ratio (i.e., number of workers divided by number of residents) and proportion of devices not in place, leadership quality showed no effect on prospective low-back pain frequency (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.01 [\u2212\u00a00.05:0.07]) and a small beneficial effect on pain intensity (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u2212\u00a00.02 [\u2212\u00a00.04:0.00]). Resident handlings did not mediate the association between leadership quality and frequency or intensity of low-back pain.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Good leadership quality was associated with a small decrease in prospective low-back pain intensity, but resident handlings did not seem to play a mediating role, although better ward-level leadership quality contributed to fewer workplace-observed resident handlings without assistance. Potentially, organizational factors, such as type of ward and staff ratio, may have a greater influence on handlings and low-back pain than leadership quality per se among eldercare workers.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00420-023-01989-2","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T11:01:48Z","timestamp":1687172508000},"page":"1049-1059","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ward-level leadership quality and prospective low-back pain of eldercare workers: do resident handlings mediate the association?"],"prefix":"10.1007","volume":"96","author":[{"given":"Leticia Bergamin","family":"Januario","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svend Erik","family":"Mathiassen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Holtermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar","family":"Bergstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew Leigh","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reiner","family":"Rugulies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2741-1868","authenticated-orcid":false,"given":"David","family":"Hallman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"1989_CR1","doi-asserted-by":"publisher","first-page":"e179","DOI":"10.1016\/j.ecns.2012.12.001","volume":"9","author":"KA Adamson","year":"2013","unstructured":"Adamson KA, Prion S (2013) Reliability: measuring internal consistency using cronbach\u2019s \u03b1. 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The authors have no competing interests to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was conducted according to the Helsinki Declaration. All participants gave their written informed consent and both the Danish Data Protection Agency and the regional Ethics Committee in Copenhagen, Denmark (H-4-2013-028) approved the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}