| Sumario: | Background: First-line healthcare managers navigate complex organizational demands to ensure a good work environment and quality care. Key factors such as expanded span of control, leadership and management performance, and work-related stress significantly influence their job satisfaction. However, how these factors evolve over time in organizational settings remains unclear. Objective: To examine expanded span of control, leadership and management performance, work-related stress, and job satisfaction among first-line healthcare managers and assess whether the relationships between these variables remained stable over time. Methods: A repeated cross-sectional design was used to collect annual data from 2020 to 2023 among first-line managers in a Swedish healthcare organization. The Ottawa Hospital Span of Control tool, the Leadership and Management Inventory, the Health & Safety Executive stress tool, and a single-item job satisfaction measure were used to collect data. Kruskal-Wallis tests and Spearman correlation analysis were performed. Results: An expanded span of control negatively impacted job satisfaction in certain years. Leadership and management performance showed a positive but inconsistent association with job satisfaction. Factors in work-related stress, particularly high demands and strained relationships, consistently had a negative relationship with job satisfaction, whereas control and support positively contributed to greater job satisfaction. Conclusions: Work-related stress, driven by high demands and poor relationships, significantly decreases job satisfaction. Leadership and management performance influence satisfaction, but inconsistently. Reducing workload and improving support structures can enhance job satisfaction and managerial effectiveness.
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