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Eriksson E, Jordal M, Hjelm K, Engström M. Job satisfaction and wellbeing among migrant care workers in nursing homes: An integrative review. Nurs Open 2023; 10:3486-3505. [PMID: 36658244 PMCID: PMC10170958 DOI: 10.1002/nop2.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/05/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023] Open
Abstract
AIM To systematically analyse and synthesize studies investigating job satisfaction (including turnover and turnover intention) and wellbeing (physical, social and psychological including work stress, acculturation stress and sick leave) among migrant care workers in nursing homes. DESIGN An integrated review was conducted. METHODS Joanna Briggs Institute's manual guided the analysis of qualitative data (n = 31). Quantitative data (n = 17) were summarized and integrated with the qualitative findings. RESULTS Migrants described high job demands, limited control and social support, and stress possibly related to acculturation. Although, compared to natives (born in the country), inconsistent results were reported about wellbeing and job satisfaction, migrant care workers reported enjoying the relational aspects of work and feeling pride when providing care. A satisfying work environment for migrant care workers enables them enjoying working in elderly care with pride. PUBLIC CONTRIBUTION Help managers to promote an inclusive working life in line with the United Nations Sustainable Development Goal number 8.
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Affiliation(s)
- Elisabet Eriksson
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Malin Jordal
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Katarina Hjelm
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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State Tested Nursing Assistants' Workplace Experiences That Threaten or Support Intent to Stay. Rehabil Nurs 2021; 45:323-331. [PMID: 33332793 DOI: 10.1097/rnj.0000000000000232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Over 1 million Americans utilize skilled nursing facilities (SNFs) annually. Within SNFs, State Tested Nursing Assistants (STNAs) are primary caregivers; however, low retention rates are notable and threaten patient care. DESIGN A phenomenological, qualitative study was conducted to explore intrinsic factors that influence STNAs' intent to stay in their positions. METHODS Ten STNAs employed at for-profit SNFs participated in semistructured face-to-face interviews. Data were analyzed to identify broad concepts and recurrent themes. FINDINGS Findings suggest that intrinsic factors supporting and threatening intent to stay included the fulfillment of basic psychological needs. Supporting themes included self-confidence, appreciation, positive relationships, and a willingness to go beyond required duties. Threatening themes included frustration, lack of support, and career advancement opportunities. CONCLUSIONS Findings provide an understanding of factors that influence STNAs' intent to stay. CLINICAL RELEVANCE The results may help guide the development of responsive strategies that improve quality and continuity of care in SNFs.
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Paolillo A, Silva SA, Carvalho H, Pasini M. Exploring patterns of multiple climates and their effects on safety performance at the department level. JOURNAL OF SAFETY RESEARCH 2020; 72:47-60. [PMID: 32199577 DOI: 10.1016/j.jsr.2019.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/12/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION This paper represents a first attempt to fill a gap in research about different specific climates and safety outcomes, by empirically identifying patterns of climates and exploring the possible effect of different climates at the department level on some specific safety outcomes. The first objective was to explore how different specific climates (safety, communication, diversity and inclusion) can be associated to each other, considering the department level of analysis. The second objective was to examine the relationships between those patterns of climates with safety performance (compliance and participation behaviors). METHOD A total of 429 blue-collar workers in 35 departments answered a questionnaire covering safety, diversity, inclusion, and communication climate measures. Cluster analysis was performed to identify clusters of departments with different climate patterns and their impact on safety compliance and safety participation behaviors. Subsequently, a hierarchical multiple linear regression was conducted at the individual-level to test the effect of climate patterns, by controlling for some sociodemographic variables. RESULTS Results showed the existence of four differentiated clusters of departments. Three of those clusters showed homogenous patterns (coherent association among perceptions of low, medium and high climates) and one heterogeneous (low and medium perceptions). The findings also revealed that the higher the climates perceptions, the higher the levels of safety participation and safety compliance, with safety participation being more affected than compliance. CONCLUSIONS The present research showed the associated effects of some organizational climate factors, such as fair treatment, inclusion, safety and communication within the organization, which had not been previously studied in their combined relationships, on safety behaviors. Practical applications: Several other organizational climate factors, such as fair treatment, inclusiveness and communication, may play an important role in safety, showing the importance of broadening the focus on safety climate as one of the main predictors of safety behaviors.
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Affiliation(s)
- Anna Paolillo
- Department of Management, Kingston Business School, Kingston University London, Kingston Hill, Kingston upon Thames KT2 7LB, United Kingdom.
| | - Silvia A Silva
- Instituto Universitário de Lisboa (ISCTE-IUL), BRU-IUL, Portugal
| | - Helena Carvalho
- Instituto Universitário de Lisboa (ISCTE-IUL), CIES-IUL, Portugal
| | - Margherita Pasini
- Department of Philosophy, Education and Psychology, University of Verona, Italy
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Haas AD, Hunter DA, Howard NL. Bringing a structural perspective to work: Framing occupational safety and health disparities for nursing assistants with work-related musculoskeletal disorders. Work 2018; 59:211-229. [DOI: 10.3233/wor-172676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Alysa D. Haas
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, WA, USA
| | - Daniel A. Hunter
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, WA, USA
| | - Ninica L. Howard
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, WA, USA
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Abstract
INTRODUCTION Globally, life expectancy together with multimorbidity and chronic diseases are increasing. This leads to a growing demand for care and hence for healthcare personnel and nurses. To meet this demand, healthcare workers from abroad are increasingly hired. The nurses' workplace in general is characterized by physically and psychologically demanding tasks, while that of migrant and minority nurses is additionally characterized by discriminatory practices. The present knowledge about the health of migrant and minority nurses and the terminology in this context are diverse. Thus, the purpose of this review is to systematically identify and synthesize international publications that explicitly focus on migrant nurses' health. MATERIALS AND METHODS A systematic review of relevant studies was undertaken using the databases Medline, PsycINFO, CINAHL and Web of Science. The screening process was conducted in several phases. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines while the methodological quality assessment of the included papers was performed with the Mixed Method Appraisal Tool (MMAT). RESULTS Out of 11,599 citations initially obtained, 14 empirical studies were included in the final synthesis. The methodological quality of the empirical studies and reviews was diverse. The majority of the studies were conducted in the US and the nurses under study migrated from countries like the Philippines, India, Europe, and Africa. Among migrant nurses of different origins, there are differences in their physiological responses to stress. Migrant nurses and native nurses differ in reporting work-related injuries. DISCUSSION Migrant and minority nurses are at high risk of work-related injuries and discrimination than native or majority nurses. However, mixed results were obtained, namely that the reported health of migrant nurses either improves over time or it decreases. This review revealed that discrimination is the leading cause of impaired health amongst migrant and minority nurses.
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Affiliation(s)
- Benjamin Schilgen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Service Research in Nursing, Institute for Health Service Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Occupational Health Research, German Social Accident Insurance Institution for the Health and Welfare Services, Hamburg, Germany
| | - Oriana Handtke
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mike Mösko
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Seabury SA, Terp S, Boden LI. Racial And Ethnic Differences In The Frequency Of Workplace Injuries And Prevalence Of Work-Related Disability. Health Aff (Millwood) 2017; 36:266-273. [PMID: 28167715 PMCID: PMC6198680 DOI: 10.1377/hlthaff.2016.1185] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Occupational injuries and illnesses lead to significant health care costs and productivity losses for millions of workers each year. This study used national survey data to test for differences between members of minority groups and non-Hispanic white workers in the risk of workplace injuries and the prevalence of work-related disabilities. Non-Hispanic black workers and foreign-born Hispanic workers worked in jobs with the highest injury risk, on average, even after adjustment for education and sex. These elevated levels of workplace injury risk led to a significant increase in the prevalence of work-related disabilities for non-Hispanic black and foreign-born Hispanic workers. These findings suggest that disparities in economic opportunities expose members of minority groups to increased risk of workplace injury and disability.
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Affiliation(s)
- Seth A Seabury
- Seth A. Seabury is a visiting associate professor of ophthalmology and director of the Keck-Schaeffer Initiative for Population Health Policy at the Keck School of Medicine and the Leonard D. Schaeffer Center for Health Policy and Economics, both at the University of Southern California, in Los Angeles. He is also a faculty research fellow at the National Bureau of Economic Research
| | - Sophie Terp
- Sophie Terp is an assistant professor of clinical emergency medicine at the Keck School of Medicine, University of Southern California
| | - Leslie I Boden
- Leslie I. Boden is a professor of environmental health at the School of Public Health, Boston University, in Massachusetts
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Antecedents to workplace injury in the health care industry: A synthesis of the literature. Health Care Manage Rev 2016; 41:42-55. [PMID: 25533751 DOI: 10.1097/hmr.0000000000000043] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The U.S. Department of Labor has identified the health care industry as a major source of all U.S. workplace injuries. Studies have shown that injury within the health care workforce is related to high turnover rates, burnout, poor job satisfaction, and leaving the health care workforce permanently, thus contributing to the existing health care workforce shortages. PURPOSE The purpose of this synthesis of the literature was twofold. The first was to conduct a comprehensive evaluation of the occupational health and safety literature to determine the key antecedents to health care provider injury. The second was to utilize the National Institute for Occupational Safety and Health (NIOSH) framework to organize the findings. METHODOLOGY Empirical studies published between 1985 and 2013 examining work-related injuries sustained by nurses and nurses' aides were systematically reviewed and evaluated for inclusion in the synthesis of the literature. Thirty-six studies met the criteria for inclusion. Using the NIOSH framework, antecedent variables to workplace injury were identified and then grouped into three broad categories that were highlighted during the synthesis: organization of work, job characteristics, and safety programs and training. A fourth category, individual characteristics, was added based on its use by many studies. FINDINGS Over half of the studies (n = 20) included factors within the organization of work category. Over two thirds of the studies (n = 26) included job characteristics such as task and demand. Nine studies contained information related to safety programs and training, whereas 17 studies included information on individual factors. The findings suggest that the NIOSH framework, with the addition of individual characteristics, provide a foundation for conceptually organizing occupational health and safety studies. PRACTICE IMPLICATIONS Health care administrators and leaders should be aware and understand the antecedents to workplace injury that will assist their organizations in developing training programs to reduce the current excessive rates of health care provider injury.
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Muntaner C, Ng E, Prins SJ, Bones-Rocha K, Espelt A, Chung H. Social class and mental health: testing exploitation as a relational determinant of depression. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2015; 45:265-84. [PMID: 25813501 DOI: 10.1177/0020731414568508] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study tests whether social class exploitation operates as a relational mechanism that generates mental health inequalities in the nursing home industry. We ask, does social class exploitation (i.e., the acquisition of economic benefits from the labor of those who are dominated) have a systematic and predictable impact on depression among nursing assistants? Using cross-sectional data from 868 nursing assistants employed in 50 nursing homes in three U.S. states, we measure social class exploitation as "ownership type" (private for-profit, private not-for-profit, and public) and "managerial domination" (labor relations violations, perceptions of labor-management conflict). Depression is assessed using the original and revised versions of the Center for Epidemiologic Studies Depression Scale (CES-D and CESD-R). Using two-level logistic regressions, we find that private for-profit ownership and higher managerial domination are predictive of depression among nursing assistants even after adjustment for potential confounders and mediators. Our findings confirm the theoretical and empirical value of applying a social class approach to understanding how mental health inequalities are generated through exploitative mechanisms. Ownership type and managerial domination appear to affect depression through social relations that generate mental health inequalities through the process of acquiring profits, controlling production, supervising and monitoring labor, and enforcing disciplinary sanctions.
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Affiliation(s)
- Carles Muntaner
- Department of Public Health Sciences, Graduate School, and School of Health Policy & Management, College of Health Science, Korea University, Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713, Republic of Korea
| | - Edwin Ng
- Department of Public Health Sciences, Graduate School, and School of Health Policy & Management, College of Health Science, Korea University, Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713, Republic of Korea
| | - Seth J Prins
- Department of Public Health Sciences, Graduate School, and School of Health Policy & Management, College of Health Science, Korea University, Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713, Republic of Korea
| | - Katia Bones-Rocha
- Department of Public Health Sciences, Graduate School, and School of Health Policy & Management, College of Health Science, Korea University, Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713, Republic of Korea
| | - Albert Espelt
- Department of Public Health Sciences, Graduate School, and School of Health Policy & Management, College of Health Science, Korea University, Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713, Republic of Korea
| | - Haejoo Chung
- Department of Public Health Sciences, Graduate School, and School of Health Policy & Management, College of Health Science, Korea University, Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713, Republic of Korea
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Lee SJ, Nam B, Harrison R, Hong O. Acute symptoms associated with chemical exposures and safe work practices among hospital and campus cleaning workers: a pilot study. Am J Ind Med 2014; 57:1216-26. [PMID: 25223949 DOI: 10.1002/ajim.22376] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cleaning workers are regularly exposed to cleaning products containing hazardous chemicals. This study investigated acute symptoms associated with chemical exposures among cleaning workers and their safe work practices. METHODS This cross-sectional study included 183 cleaning workers employed in an academic medical center and affiliated health sciences campuses in Northern California. Data on respiratory, eye, skin, neurological, and gastrointestinal symptoms and occupational factors were collected by in-person interviews or self-administered questionnaires. RESULTS Chemical-related symptoms (several times monthly or more often) were more common among workers who performed patient area cleaning (44%) than hospital custodians (36%) or campus custodians (28%). After controlling for age, sex, and job title, symptoms were associated with exposure to carpet cleaners (OR = 2.98, 95% CI 1.28-6.92), spray products (OR = 2.82, 95% CI 1.16-6.82), solvents (OR = 2.71, 95% CI 1.20-6.15), and multi-purpose cleaners (OR = 2.58, 935% CI 1.13-6.92). Except for gloves, regular use of personal protective equipment was infrequent. CONCLUSIONS Study findings suggest a need for additional interventions such as use of less toxic products to reduce health risks among cleaning workers.
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Affiliation(s)
- Soo-Jeong Lee
- School of Nursing; University of California, San Francisco; San Francisco California
| | - Bora Nam
- School of Nursing; University of California, San Francisco; San Francisco California
| | - Robert Harrison
- School of Medicine; University of California, San Francisco; San Francisco California
| | - OiSaeng Hong
- School of Nursing; University of California, San Francisco; San Francisco California
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Adám B, Rasmussen HB, Pedersen RNF, Jepsen JR. Occupational accidents in the Danish merchant fleet and the nationality of seafarers. J Occup Med Toxicol 2014; 9:35. [PMID: 25349623 PMCID: PMC4209059 DOI: 10.1186/s12995-014-0035-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 10/07/2014] [Indexed: 11/21/2022] Open
Abstract
Background The aim of the study was to examine occupational accidents reported from non-passenger merchant ships registered in the Danish International Ship Register in 2010-2012, with a focus on analysing nationality differences in the risk of getting injured in an accident. Methods Data about notified occupational accidents were collected from notifications sent to the Danish Maritime Authority and from records of contact with Danish Radio Medical. Events were matched by personal identification and accident data to create a unified database. Stratified cumulative time spent on board by seafarers was used to calculate accident rates. Incidence rates of different nationalities were compared by Poisson regression. Results Western European seafarers had an overall accident rate of 17.5 per 100000 person-days, which proved to be significantly higher than that of Eastern European, South East Asian and Indian seaman (adjusted incidence rate ratio 0.53, 0.51 and 0.74, respectively), although differences decreased over the investigated period. Smaller but in most cases still significant discrepancies were observed for serious injuries. The back injury rate of Western European employees was found especially high, while eye injuries seem to be more frequent among South East Asian workers. Conclusions The study identified substantial differences between nationalities in the rate of various accidents reported from merchant ships sailing under the Danish flag. The differences may be attributed to various factors such as safety behaviour. Investigation of special injury types and characterisation of effective elements of safety culture can contribute to the improvement of workplace safety in the maritime sector.
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Affiliation(s)
- Balázs Adám
- Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark ; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates
| | - Hanna Barbara Rasmussen
- Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark
| | - Randi Nørgaard Fløe Pedersen
- Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark
| | - Jørgen Riis Jepsen
- Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark
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Kaur H, Luckhaupt SE, Li J, Alterman T, Calvert GM. Workplace psychosocial factors associated with hypertension in the U.S. workforce: a cross-sectional study based on the 2010 national health interview survey. Am J Ind Med 2014; 57:1011-21. [PMID: 25137617 DOI: 10.1002/ajim.22345] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To explore associations between self-reported hypertension and workplace psychosocial factors that are common among U.S. workers and to identify industries and occupations (I&Os) that are associated with a high prevalence of hypertension, even after adjustment for common known risk factors. METHODS Data from the 2010 National Health Interview Survey were used to examine relationships between the prevalence of self-reported hypertension and job insecurity, hostile work environment, work- family imbalance, work hours and I&O. RESULTS Job insecurity (adjusted prevalence ratio (aPR): 1.11; 95% confidence interval (CI): 1.04-1.19)) and hostile work environment (aPR: 1.15; 95% CI: 1.03-1.29) were significantly associated with hypertension. Hypertension prevalence was significantly elevated among those employed in Healthcare Support occupations and Public Administration industries. CONCLUSION Addressing hostile work environments and the stress associated with job insecurity may improve workers' health. Other occupational factors that contribute to the variation in prevalence of hypertension by I&O should be sought.
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Affiliation(s)
- Harpriya Kaur
- University of Nebraska Medical Center; Omaha Nebraska
| | - Sara E. Luckhaupt
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Jia Li
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Toni Alterman
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Geoffrey M. Calvert
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
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Hurtado DA, Sabbath EL, Ertel KA, Buxton OM, Berkman LF. Racial disparities in job strain among American and immigrant long-term care workers. Int Nurs Rev 2012; 59:237-44. [PMID: 22591096 PMCID: PMC3622248 DOI: 10.1111/j.1466-7657.2011.00948.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nursing homes are occupational settings, with an increasing minority and immigrant workforce where several psychosocial stressors intersect. AIM This study aimed to examine racial/ethnic differences in job strain between Black (n = 127) and White (n = 110) immigrant and American direct-care workers at nursing homes (total n = 237). METHODS Cross-sectional study with data collected at four nursing homes in Massachusetts during 2006-2007. We contrasted Black and White workers within higher-skilled occupations such as registered nurses or licensed practical nurses (n = 82) and lower-skilled staff such as certified nursing assistants (CNAs, n = 155). RESULTS Almost all Black workers (96%) were immigrants. After adjusting for demographic and occupational characteristics, Black employees were more likely to report job strain, compared with Whites [relative risk (RR): 2.9, 95% confidence interval (CI) 1.3 to 6.6]. Analyses stratified by occupation showed that Black CNAs were more likely to report job strain, compared with White CNAs (RR: 3.1, 95% CI: 1.0 to 9.4). Black workers were also more likely to report low control (RR: 2.1, 95% CI: 1.1 to 4.0). Additionally, Black workers earned $2.58 less per hour and worked 7.1 more hours per week on average, controlling for potential confounders. CONCLUSION Black immigrant workers were 2.9 times more likely to report job strain than White workers, with greater differences among CNAs. These findings may reflect differential organizational or individual characteristics but also interpersonal or institutional racial/ethnic discrimination. Further research should consider the role of race/ethnicity in shaping patterns of occupational stress.
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Affiliation(s)
- D A Hurtado
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA.
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