The effects of a dilemma management training program on mental health: a prospective study with mid-level executives in hospitals

Purpose: Mid-level executives are confronted with many dilemma situations, in which they are forced to decide between conflicting options, none of them leading to the desired result. If they fail to cope with them constructively, their individual risk for mental strains increases (Gerlmaier and Latniak, 2013). Initial findings focusing on executives in industry (Bossmann, 2020) show that fostering effective dilemma management in executives is a preventive factor against stress-related diseases. Yet, there is little empirical research that evaluates the contribution of dilemma management training on leadership's mental health prevention in hospitals. This study aims to examine whether such a training program, adapted to current working conditions in German hospitals, promotes mid-level executives' mental health.

Design/methodology/approach: A 10-month training program was administered to N = 69 senior physicians, senior nurses and senior service and administrative staff in four hospitals. To evaluate training effects on perceived stress reactivity, on cognitive and emotional irritation over time as well as the effects of the training dose on these results, participants' self-reported measures were collected at four points in time: before (t0), during (t1), immediately after (t2) and three months after the intervention (t3).

Findings: Overall, participants showed less cognitive irritation and perceived stress reactivity over time. However, their emotional irritation did not change significantly. The dose of training participation did not moderate these results.

Originality/value: This paper contributes to the prevention of stress-related diseases and the promotion of sensemaking in mid-level executives' dilemma management routine in the face of increasingly aggravating working conditions due to financial restrictions in the German health-care system. Findings of this study are explained in greater depth using previously reported qualitative data from the same research project.