Table 3.

JBI QARI data extraction form for interpretive and critical research.

Study (Ref. number) | Country	Design and method	Study aim	Sample description and setting	Relevant findings
Backman et al. (39) Sweden	A cross-sectional design using valid and reliable questionnaires. Data were analyzed using multiple linear regression, including interaction terms.	To explore the association between leadership behaviors among managers in aged care, and person-centeredness of care and the psychosocial climate.	3,661 staff members in residential aged care facilities in Sweden.	Leadership behavior significantly impacts person-centeredness practice and influences the psychosocial climate. Leadership is most needed in units that are less person-centered, suggesting managers need to lead the way more strongly toward excellence in environments where care is less person-centered. Managers have an important role in promoting, developing, and supporting a PCC philosophy and practice of care.
Backman et al. (40) Sweden	A descriptive interview study with semi-structured interviews.	To explore how managers describe leading towards person-centered care in nursing homes.	Twelve nursing home managers within eleven highly person-centered nursing homes purposively selected from a nationwide survey of nursing homes in Sweden.	Leading towards person-centered care was described as having a personal understanding of the PCC concept and how to translate it into practice and maximising the potential of and providing support to care staff, within a trustful and innovative workplace. Managers coordinate several aspects of care simultaneously, such as facilitating, evaluating, and refining the translation of person-centered philosophy into synchronized care actions. To lead PCC, managers may need to be present at the unit.
Backman (41) Sweden	A national, cross-sectional survey. Descriptive statistics and regression modeling were used to explore associations.	To explore the relationship between leadership, person-centered care, and stress of conscience.	2,985 staff members and their managers from 190 nursing homes throughout Sweden.	Leadership was associated with a higher degree of PCC, indicating that a leadership most prominently characterized by coaching and giving feedback, relying on staff and handling conflicts constructively, experimenting with new ideas, and controlling work individually can contribute to a higher degree of PCC provision. Managers play a crucial leadership role in motivating and empowering staff to deliver PCC.
Duan et al. (42) USA	A cross-sectional design using an online survey.	To (1) test the domain-specific relationships of culture change practices with resident quality of life and family satisfaction, and (2) examine the moderating effect of small-home or household models on these relationships.	102 nursing home administrators in the USA.	Changing restrictive institutions to person-centered homes, referred to as NH culture change, is complex and multifaceted. The findings revealed that culture change operationalized through physical environment transformation, staff empowerment, staff leadership, and end-of-life care was positively associated with at least one domain of resident quality of life and family satisfaction, while staff empowerment had the most extensive effects.
Hamiduzz-aman et al. (43) Australia	Qualitative semi-structured interviews and focus-group interviews.	To explore the factors that shape the dimensions of personalized dementia care in rural nursing homes.	104 Australian care staff participated in interviews and/or focus groups.	The issues of leadership and workplace culture are of importance in the implementation of personalized care in residential dementia care. An authoritative leadership style discourages staff to implement personalized care and to be innovative in dementia care. A lack of consideration of family members’ views by management and staff, together with a poorly integrated, holistic care plan, limited resources, and absence of ongoing education for staff, resulted in the ineffective implementation of personalized dementia care.
Jacobsen et al. (44) Norway	A mixed-method study.	To investigate which factors hindered or facilitated staff awareness related to confidence-building initiatives based on PCC.	299 Norwegian staff members responded to the staff survey at baseline and 228 at follow-up.	The results indicated a development toward more PCC being performed compared to the situation before the education intervention. The involvement of leaders appeared to be a key issue in facilitating successful implementation. Leadership, in interplay with staff culture, was the most important factor hindering or promoting staff awareness related to confidence-building initiatives, based on PCC.
Lynch et al. (45) Ireland	Qualitative approach using a complex action research design with multiple methods: non-participatory observation, critical and reflective dialogues with participants, narratives from residents, focus groups with staff, and reflective field notes	To implement and evaluate the effect of using the PCSLF to develop PCC within nursing homes.	Observation: 11 sessions, Household activity (n = 4): 1 leader, 3 staff. Meal times (n = 6): 2 leaders, 4 staff. Meal times (n = 2): 1 leader, 1 staff. Meaningful interactions (n = 5): 1 leader, 4 staff. Leadership behavior (n = 7): 7 leaders (across 3 sessions). Connecting with residents (n = 5): 1 leader, 4 staff. Team meetings (n = 22): 6 leaders, 16 staff (across 2 meetings). Leadership meeting (n = 6): 6 leaders. Residents’ Narratives: Convenience sampling at two time points (n = 8). 4 residents at time 1, 4 different residents at time 2. Focus Groups (Leaders): Time 2 (n = 6): All 6 nursing home leaders. Focus Groups (Staff): Purposive sampling (n = 6). 2 staff from each of 3 households (1 nurse, 1 carer per household). All from a private nursing home in Ireland.	Seven core attributes of the leader that facilitate person-centeredness in others were identified relating to the essence of being; harmonising actions with the vision; balancing concern for compliance with concern for person-centeredness; connecting with the other person in the instant; intentionally enthusing the other person to act; listening to the other person with the heart; and unifying through collaboration, appreciation and trust.
Rokstad et al. (46) Norway	Qualitative descriptive design. Focus-group interviews.	To investigate the role of leadership in the implementation of PCC in nursing homes using Dementia Care Mapping.	18 staff members and 7 leaders from 3 different nursing homes in Norway.	The different roles of leadership characterized as “highly professional”, “market orientated” or “traditional”, seemed to influence to what extent the Dementia Care Mapping process led to the successful implementation of PCC.
Røen et al. (47) Norway	Cross-sectional survey.	To explore and understand the association between PCC, and organizational, staff, and unit characteristics in nursing homes.	1,161 Norwegian staff members from 175 nursing homes.	“Empowering leadership” is associated with PCC. Empowering leadership is a managerial style supporting and encouraging the caregivers to take the initiative and to participate in decisions regarding daily care. An innovative climate was associated with PCC.
Røsvik & Mjørud (48) Norway	Qualitative individual interviews.	To explore managers’ and leaders’ experiences to identify factors that facilitate or impede implementation and use of the VIPS practice model in domestic nursing care and long-term care institutions.	17 managers/head nurses representing 10 workplaces in Norway.	Three global categories described the implementation process: factors that impact the decision made at the municipal level to implement PCC, which highlights the decision-making process before the implementation in the unit; requirements for a good start at the unit level, that is leadership commitment, stability among the staff group and staff training; and finally, factors that help to support the new routines in the unit, such as a determined head nurse, leaders who establish structure, mastery, and positive results and supervising the staff.