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Spoken service language is critical for service experiences and human welfare in many service settings. However, little is known about how spoken service language can enhance customer well-being in transformative service contexts. This paper explores spoken service language and well-being for customers experiencing vulnerability in a transformative service context, informed by an empirical account of the human welfare service of residential aged care.

Situated within transformative service research (TSR), this study was guided by a theoretical framework of service language and adopts a strengths-based approach to customer experiences of vulnerability. A qualitative multiple case study methodology was applied to explore carers’ perspectives on spoken service language and well-being from three residential aged care homes in Australia.

The findings demonstrate five spoken service language practices and four principles of spoken service language for well-being that co-create customer well-being and support the alleviation of customer experiences of vulnerability. Conceptualised as transformative spoken service language, the spoken service language practices and principles collectively recognise, support and leverage residents’ capabilities and uplift customer well-being, by enacting a process of mattering highly salient to transformative service contexts.

This study is the first to conceptualise how employee spoken service language can be used to support customer well-being and enhance transformative value for customers experiencing vulnerability to align with the goals of TSR. Practically, the study advocates for a greater awareness and more considered use of transformative spoken service language in human welfare and other transformative service contexts.

Despite the large number of Indonesian health-care workers working as migrant care workers in Japan, there is a lack of studies that have investigated this phenomenon or assessed the working conditions of Indonesian care workers working in Japanese aged-care facilities. This study aims to explore the work experiences of Indonesian care workers in Japan.

A qualitative descriptive research design was used, and a purposive sample of 18 Indonesian health-care workers (12 nurses and six midwives) who work as care workers in Japan participated in this study. Semistructured interviews were conducted with these participants between December 2022 and January 2023. The data were analyzed using content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report this study.

Four key themes emerged from the data: easy but mentally challenging, being a care worker is a blessing, working in a partially Muslim-friendly environment and enjoy living: prefer to stay longer.

The work experiences of Indonesian care workers in Japan are complex and multifaceted. By understanding their experiences and needs, the authors can work toward creating more inclusive and supportive workplaces for all.

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.

“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.

The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.

This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs.

The convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs.

Service quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies.

Health-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers.

This study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.

This study aims to investigate the healthcare sector of the United Arab Emirates (UAE) to explore the significance of servant leadership and collaborative culture in fostering social sustainability. The primary objective of this paper is to investigate how servant leadership and a collaborative culture contribute to social sustainability in health care in the UAE. With a focus on promoting well-being within healthcare organizations, the paper aims to uncover the synergies between servant leadership, collaborative culture, and social sustainability.

This paper conducted a multilayer literature review of existing literature on servant leadership, collaborative culture and social sustainability in health care, both globally and specifically in the UAE context, and a conceptual model was proposed.

Servant leadership proves to be a culturally pertinent and effective leadership model within the UAE due to its alignment with cultural values, emphasis on community support, and the robust health-care system that contributes to individual well-being. This combination establishes a solid foundation for fostering a healthy and sustainable society.

Limitations and implications are discussed. The current research has not identified the boundary conditions under which servant leadership and collaborative culture may be more or less effective. This could involve exploring industry-specific influences or contextual factors. Theoretical and practical implications are discussed.

The research seeks to unravel the interconnections between servant leadership, collaborative culture and social sustainability. To the best of the author’s knowledge, none of the studies have explored the interrelationships of these constructs, particularly in the UAE context.

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.

In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.

Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.

There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.

Regarding how the public regulation of human services is perceived within welfare organizations and how the latter cope with it, the role of emotions (as mediators between structure and agency) proves highly relevant while often being hidden beneath the surface. This article shows how a specific approach to such regulation – here: managerialism – may impact on “emotional regimes” at the organizational and individual level, affecting the attainment of organizational goals and workers' health.

The article primarily draws on multiple qualitative case studies across two welfare sectors (four organizations) in Germany (continuing education/active inclusion; long-term care). The study research was conducted between 2020 and 2022 and based on 36 interviews with caseworkers and managers, focus group interviews and expert dialogues at industry level.

The results suggest that the managerialist regulation of welfare services breeds complex and ambiguous emotional regimes. Business-like management techniques elicit various emotions, affecting the motivational basis of human service work. While the experience of hard challenges may raise positive feelings, coping patterns often put strain on organizations and staff alike. In the short run, related emotional regimes tend to make service delivery proceed smoothly, yet in the long run they may have corrosive effects and problematic repercussions on macro-level developments.

The study highlights the role of emotions in publicly regulated human service settings by intermingling macro- and micro-level processes and thereby broadens the perspective of welfare state research as it reveals the impact of (managerialist) regulation on the dynamic organizational chemistry of such settings.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

Healthcare property has become an important alternate property sector in recent years for many international institutional investors. The purpose of this paper is to assess the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French healthcare property in a French property portfolio and mixed-asset portfolio over 1999–2020. French healthcare property is seen to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. Drivers and risk factors for the ongoing development of the direct healthcare property sector in France are also identified, as well as the strategic property investment implications for institutional investors.

Using annual total returns, the risk-adjusted performance, portfolio diversification benefits and performance dynamics of French direct healthcare property over 1999–2020 are assessed. Asset allocation diagrams are used to assess the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. The role of specific drivers for French healthcare property performance is also assessed. Robustness checks are also done to assess the potential impact of COVID-19 on the performance of French healthcare property.

French healthcare property is shown to have different performance dynamics to the traditional French property sectors of office, retail and industrial property. French direct healthcare property delivered strong risk-adjusted returns compared to French stocks, listed healthcare and listed property over 1999–2020, only exceeded by direct property. Portfolio diversification benefits in the fuller mixed-asset portfolio context were also evident, but to a much lesser extent in a narrower property portfolio context. Importantly, this sees French direct healthcare property as strongly contributing to the French property and mixed-asset portfolios across the entire portfolio risk spectrum and validating the property industry perspective of healthcare property being low risk and providing diversification benefits in a mixed-asset portfolio. However, this was to some degree to the loss or substitution of traditional direct property exposure via this replacement effect. French direct healthcare property and listed healthcare are clearly shown to be different channels in delivering different aspects of French healthcare performance to investors. Drivers of French healthcare property performance are also shown to be both economic and healthcare-specific factors. The performance of French healthcare property is also shown to be different to that seen for healthcare property in the UK and Australia. During COVID-19, French healthcare property was able to show more resilience than French office and retail property.

Healthcare property is an alternate property sector that has become increasingly important in recent years. The results highlight the important role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio, with French healthcare property having different investment dynamics to the other traditional French property sectors. The strong risk-adjusted performance of French direct healthcare property compared to French stocks, listed healthcare and listed property sees French direct healthcare property contributing to the mixed-asset portfolio across the entire portfolio risk spectrum. French healthcare property’s resilience during COVID-19 was also an attractive investment feature. This is particularly important, as many institutional investors now see healthcare property as an important property sector in their overall portfolio; particularly with the ageing population dynamics in most countries and the need for effective social infrastructure. The importance of French direct healthcare property sees direct healthcare property exposure accessible to investors as an important alternate real estate sector for their portfolios going forward via both non-listed healthcare property funds and the further future establishment of more healthcare REITs to accommodate both large and small institutional investors respectively. The resilience of French healthcare property during COVID-19 is also an attractive feature for future-proofing an investor’s portfolio.

This paper is the first published empirical research analysis of the risk-adjusted performance, diversification benefits and performance dynamics of French direct healthcare property, and the role of direct healthcare property in a French property portfolio and in a French mixed-asset portfolio. This research enables empirically validated, more informed and practical property investment decision-making regarding the strategic role of French direct healthcare property in a portfolio; particularly where the strategic role of direct healthcare property in France is seen to be different to that in the UK and Australia via portfolio replacement effects. Clear evidence is also seen of the drivers of French healthcare property performance being strongly influenced by healthcare-specific factors, as well as economic factors.