title: Leading change: a challenge for leaders in Nordic health care.
abstract: OBJECTIVE
  The aim of the present study was to describe personnel's attitudes to change processes between a regional hospital and the primary health care centre as well as investigate these results with regards to theories pertaining to change and leading change.
  
  
  BACKGROUND
  Leadership has three crucial dimensions: focusing on personnel, results/key processes and the ethical base of activities.
  
  
  METHODS
  A survey was conducted in 2003 using a comprehensive questionnaire. The total sample consisted of the personnel (n = 899) at the two organizations (answering rate was 68.8%). The data were analysed descriptively.
  
  
  RESULTS
  Approximately two-thirds of the respondents understood why the merger was occurring. Only one-third expressed that they had received sufficient information regarding the merger. In total 67% felt that the merger would create conflict while approximately one-fourth expressed uncertainty. Despite such negative responses, approximately two-thirds felt there were advantages to the merger. Significant differences were seen between the groups.
  
  
  CONCLUSIONS
  In times of change personnel expect leaders to focus on dialogue with their personnel and to anchor the vision of the change process amongst the personnel.
  
  
  CONCLUSIONS
  By identifying the 'prison of thought' and creating an atmosphere where reflection and discussion are valued the nurse leader can help prevent resistance to change.
authors.affiliation: Health Sciences, Buskerud University College, Drammen 3045, Norway. lisbeth.fagerstrom@hibu.no
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Fagerström
authors.forename: Susanne
authors.initials: S
authors.lastname: Salmela
mesh_terms: D019538:Health Care Surveys; D006801:Humans; D007857:Leadership; D016294:Models, Nursing; D017146:Models, Organizational; D009718:Nurse Administrators; D009745:Nursing, Supervisory; D009936:Organizational Innovation; D011320:Primary Health Care; D012537:Scandinavian and Nordic Countries; D011795:Surveys and Questionnaires; D035501:Uncertainty