背景：中层管理人员在促进养老院的关怀文化中起着关键作用。然而,关于中层管理者的内在动机和他们在发展关怀文化中的责任经验的知识有限。
目的：这项研究的目的是更深入地了解中层管理人员的动机和他们在养老院发展关怀文化的责任经验。
方法：选择了由伽达默尔启发的解释学方法的定性设计，以指导数据的解释。进行了定性半结构化访谈。
方法：数据来自疗养院的13名中层管理人员，2021年9月和10月在挪威北部的六个城市。
方法：该研究得到了挪威研究数据中心的批准。获得参与者的口头和书面知情同意书。
结果：研究结果表明，中层管理者具有非利己主义的动机来促进他们的态度和行为所表达的关怀文化。他们认为有责任促进一种关怀文化，在这种文化中，患者和工作人员都经历了护理，并受到尊重和认可为独特的个人。作为良好的榜样，中层管理人员有责任通过系统地反思护理价值观来体现并提高人们对护理在疗养院文化中的重要性的认识。然而,对财务和行政需求的强烈关注限制了中层管理人员促进关怀文化的可能性，并阻止他们始终按照自己的意愿行事，这往往会导致道德困扰。
结论：与内在动机接触，使领导者能够促进家庭和关怀文化，患者和工作人员都感到尊重和公认为独特的个人。这项研究强调了对疗养院中的关怀价值观进行系统反思的重要性，这导致了所有参与者的价值意识。
BACKGROUND: Middle managers play a key role in promoting a caring culture in nursing homes. However, there is limited knowledge about middle managers\' inner motives and their experiences of their responsibility in developing a caring culture.
OBJECTIVE: The aim of the study is to get a deeper understanding of middle managers\' motives and their experiences of their responsibility to develop a caring culture in nursing homes.
METHODS: A qualitative design with a hermeneutic approach inspired by Gadamer was chosen which guided the interpretation of data. Qualitative semi-structured interviews were conducted.
METHODS: Data were collected from thirteen middle managers in nursing homes, in six municipalities in northern Norway in September and October 2021.
METHODS: The study was approved by the Norwegian Centre for Research Data. Oral and written informed consent was obtained from participants.
RESULTS: The findings show that the middle managers had non- egoistic motives to promote a caring culture as expressed in their attitudes and actions. They felt responsible to promote a caring culture where both patients and staff experienced care and were respected and recognized as unique individuals. Middle managers as good role models are responsible for being present and raising awareness of the importance of care in the nursing home culture by systematically reflecting on care values. However, a strong focus on the financial and administrative demands limits the middle managers\' possibilities to promote a caring culture and prevented them from always acting as they wanted to act, which often causes moral distress.
CONCLUSIONS: Being in contact with inner motives, enables the leader to promote a homelike and caring culture where both patients and staff feels respected and recognized as unique individuals. This study highlights the importance of systematic reflection on caring values in nursing homes which leads to value awareness among all actors.
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