Challenge-related stress and felt challenge: Predictors of turnover and psychological health in aged care nurses

Registered nurses' perceptions and experience of working in aged care: A qualitative approach

AIM

To understand and report on the perceptions and experiences of registered nurses in the aged care sector.

DESIGN

An exploratory qualitative study.

METHODS

Semi-structured telephone interviews were utilised as the primary data collection method. Fifteen registered nurses were interviewed. All interviews were recorded, transcribed verbatim and analysed using conventional content analysis. Participants were quoted verbatim to ensure authenticity.

RESULTS

The results indicated a demand for increased administrative and staffing support in the aged care workplace. Poor morale and unethical practices contributed to negative perceptions and attitudes among nurses towards aged care. Managing and communicating with older people was reported as challenging, which impacts nursing staff recruitment and retention. Future work is needed to ensure that outstanding clinical role models and leadership support nursing staff recruitment and retention. Incorporating aged care content into the nursing curriculum and providing professional development opportunities to aged care professionals would be the foundation towards solutions, as the study primarily explored nurses' perspectives.

The precarious resilience of aged care employees enrolled in an Australian online dementia course: A cross-sectional study of occupational health and well-being

OBJECTIVE

Australian aged care workforce surveys offer limited information about those who engage in online dementia education regarding their occupational health and well-being. A salutogenic approach was applied to an aged care context to quantitatively assess both positive and negative aspects of health at work to inform the development of workplace interventions tailored to those interested in self-development.

METHODS

Physical, psychological and occupational health were measured in an online cross-sectional survey of general health, chronic conditions, psychological distress, positive and negative affect, job satisfaction, access to workplace amenities and turnover intentions of aged care workers undertaking an online dementia course in October 2014.

RESULTS

Participants (N = 662) rated their general physical health as good and a minority experienced chronic conditions such as obesity. Overall, workers had average levels of positive and negative affect and low distress. However, 25% were likely to have a mental health condition. While most were employed on a permanent basis (80%) and reported moderate job satisfaction, 18% were likely to leave their job. There were some gaps in workplace amenities to support health and well-being: for example, 13% reported no access to lunch break areas.

CONCLUSIONS

Results suggest precarious resilience in aged care workers enrolled in an Australian online dementia course. Workplace interventions that focus on preventative health strategies are required to address the health risks associated with higher than national averages of obesity and mental health, and reduce exposure of workers to physical and psychological harms.

Eldercare's Turnover Intention and Human Resource Approach: A Systematic Review

Eldercare workers' turnover intentions have caused serious concern given their high demand and pivotal role in ensuring elderly individuals' well-being. This systematic review examined the main factors of eldercare employees' turnover intentions with the purpose of identifying gaps and structure a novel human resource (HR) approach framework for eldercare social enterprises through a global literature review and realistic conclusions. A total of 29 publications appeared between 2015 and 2021 were digitally extracted from six databases and are extensively discussed in this review. Resultantly, eldercare workers' turnover intentions were positively impacted by job burnout, low job motivation, and restricted job autonomy. The findings of this study correspond to those of past literature, which highlighted the necessity of thoroughly examining eldercare worker retention practices from an organisational (HR) perspective. Furthermore, the current study outlines the factors influencing eldercare workers' turnover intentions as well as determine proper HR approaches to mitigate employee turnover issues among eldercare workers for organisational sustainability.

Evaluation on service quality in institutional pensions based on a novel hierarchical DEMATEL method for PLTSs

In recent years, to address the continued aging of China’s population, the Chinese government has focused on the issue of pensions through a series of pension policies. The traditional system of institutional pensions is facing serious challenges, with a variety of novel pension modes placing them under enormous pressure. Furthermore, the development of institutional pensions has been restricted by many factors, such as long construction cycles and high fees, meaning that this traditional system no longer meets the pension needs of the elderly. Improving the service quality of institutional pensions is inevitable for future progress. Thus, identifying the key factors that influence the service quality of institutional pensions, and understanding the relationships between these factors, is hugely significant. Furthermore, traditional decision-making trial and evaluation laboratory (DEMATEL) method can not solve this problem because the number of factors is too large. To address these issues, we establish an evaluation system for Chinese pension institutions, and propose a hierarchical DEMATEL model based on probabilistic linguistic term sets (PLTSs), which can help decision makers to find the key factors influencing service quality in institutional pensions and deal with the evaluation problem with a large number of criteria. The proposed hierarchical DEMATEL model based on PLTSs fully reflects experts’ preferences and evaluation information, and is able to identify the directions in which China’s pension institutions should improve their quality of service. In addition, we use the best-worst method (BWM) to calculate the importance values of each subsystem, which makes the cause-effect relationship between subsystems more reasonable than the traditional DEMATEL method. Finally, we apply our method to evaluate nursing homes in Zhenjiang, Jiangsu province and propose some managerial implications.

Indicators of job quality in the Australian aged care workforce: A scoping review

OBJECTIVE

As governments grapple with ageing populations, there is a need to understand more about the aged care workforce and how it is managed.

METHODS

We undertook a scoping review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Scopus and PubMed were used to identify papers published between 2010 and 2020. We mapped the breadth and scale of the evidence base according to the QuInnE indicators of job quality.

RESULTS

Out of 642 titles and abstracts that were screened, 122 were selected. Outcomes were measured across a range of domains, including wages, employment quality, education and training, working conditions, work/life balance and consultative participation and collective representation. These were distributed unevenly, revealing evidence gaps.

CONCLUSIONS

We identified significant knowledge gaps regarding Australia's aged care workforce at a time when the sector is coming under fresh scrutiny and projections indicate that it will face critical labour shortfalls going forward.

Linking Diversity and Mental Health: Task Conflict Mediates Between Perceived Subgroups and Emotional Exhaustion

Diversity and psychological health issues at the workplace are pressing issues in today’s organizations. However, research linking two fields is scant. To bridge this gap, drawing from team faultline research, social categorization theory, and the job-demands resources model, we propose that perceiving one’s team as fragmented into subgroups increases strain. We further argue that this relationship is mediated by task conflict and relationship conflict and that it is moderated by psychological empowerment and task interdependence. Multilevel structural equation models on a two-wave sample consisting of 536 participants from 107 work teams across various industries and work contexts partially supported the hypotheses: task conflict did indeed mediate the positive relationships between perceived subgroups and emotional exhaustion while relationship conflict did not; effects on stress symptoms were absent. Moreover, contrary to our expectations, neither empowerment, nor task interdependence moderated the mediation. Results indicate that team diversity can constitute a job demand that can affect psychological health. Focusing on the mediating role of task conflict, we offer a preliminary process model to guide future research at the crossroads of diversity and psychological health at work.

A thematic literature review of innovative strategies to prepare nursing students for aged-care

BACKGROUND

The exponential rise in people living longer but requiring residential care is adding pressure to already overstretched aged care nurses. Consequently, a person-centred care culture in residential care remains aspirational, rather than a reality. For nursing students in Australia and elsewhere, clinical placements in aged care facilities are under-utilised due to negative perceptions about the likelihood for learning. Creative strategies to engage students to safely challenge ageist thinking and to inspire enthusiasm for learning in this context are needed.

OBJECTIVES

The purpose of this thematic review of the literature is to better understand challenges related to learning in aged care settings and identify innovative strategies to enhance nursing student learning experiences in residential aged care placements.

REVIEW METHODS

A literature review was undertaken in 2019 using CINAHL, PUBMED, Elsevier, Medline, ProQuest and Google Scholar. The search was limited to papers that were peer reviewed, in English, and published between 2001 and the date of review (mid-2019) in order to situate the review in the new millennium.

RESULTS

47 articles and books were included in the review that introduce solutions and innovative strategies that could be used to improve students' attitudes to learning in aged care and from older people. The literature review was categorized into three main themes, including: barriers to working with older people; the need for pedagogical change to foster empathy; and innovative strategies to address barriers.

CONCLUSION

These themes are useful to consider in designing engaging learning and teaching for nursing students to be effective in working in aged care.

Occupational stress and associated risk factors among nurses: a cross-sectional study

Background: Nursing can be demanding and stressful with occupational stress posing a serious threat to nurses and patient outcomes. Aims/Objectives: To determine the prevalence of nurses' occupational stress and its associated risk factors. Design: Cross-sectional survey design. Methods: Nurses in 115 tertiary-level hospitals in 13 provinces in Iran were surveyed from August 2016-December 2017. Demographic information and occupational stress were assessed. 5422 distributed questionnaires were distributed with 2895 of returned surveys analyzed. One-way ANOVA and multiple linear regression analyses identified risk factors for occupational stress. Results: Mean score for overall occupational stress was 3.48 indicating a stress level between moderate and high, with 78.4% of respondents reporting that their job was stressful. Nurses reported issues with shiftwork, staffing, pay, workplace discrimination, management, policy and excessive workloads as sources of occupational stress. Risk factors in the multivariate analysis for higher occupational stress were female gender (p = .002), being married (p = .008), having lower educational levels (p < .001), increased work hours (p <.001), and working in emergency (p = .025), general wards (p = .012) and teaching hospitals (p < .001). Conclusions: The high prevalence of occupational stress amongst nurses in Iran demonstrates the extent of the issue, with recent reforms not effectively addressing occupational stress. The risk factors identified allow for more targeted interventions.

Live to Work or Work to Live? An Age-Moderated Mediation Model on the Simultaneous Mechanisms Prompted by Workaholism Among Healthcare Professionals

The "aging population" implies an increased proportion of older professionals and a growing demand for healthcare services. Healthcare professionals are often highly committed to their work which can be reflected in high levels of workaholism, being a double-edged sword that can prompt both positive and negative mechanisms, differently affecting younger and older healthcare workers. The present study aims to gain insights into the relationships between healthcare professionals' age, workaholism and job satisfaction, by estimating the sequential mediating roles of workload perceptions and emotional exhaustion. We used original survey data, including information on 750 healthcare professionals. Overall, the negative relationship between workaholism and job satisfaction was shown to be sequentially (and partially) mediated by workload perceptions and emotional exhaustion. Multi-Group SEM analyses revealed differences across three age groups (under 35; between 35 and 50; over 50). Only in the two younger age groups, we found a direct and positive relationship between workaholism and job satisfaction. In all age groups, we found the negative relationship between workaholism and job satisfaction to be sequentially (and partially) mediated by workload perceptions and emotional exhaustion. The indirect effects were relatively stronger in the younger age group. Workaholism can prompt both a "gain spiral" and "a loss spiral" among healthcare professionals. The first reflects workaholism to function as a job resource fostering job satisfaction (only for the two younger age groups). The second reflects workaholism to function as a job demand reducing job satisfaction. This mechanism was shown to be stronger with an increasing age.

Nursing students’ ethical challenges in the clinical settings: A mixed-methods study

Background:

Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process.

Objectives:

This study aimed to explore and to evaluate the nursing students’ ethical challenges in the clinical settings in Iran.

Research design:

This was a mixed-methods study with an exploratory sequential design.

Participants and research context:

A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively.

Ethical considerations:

The ethical committee of Kerman University of Medical Sciences, Iran, approved the protocol of the study.

Findings:

Three main categories were extracted from qualitative data including Low attention of nurses to the patients’ preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the “Low attention of nurses to the patients’ preferences” subscale.

Discussion:

The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students’ ethical challenges.

Conclusion:

Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students’ ethical challenges and their impact on nursing students’ clinical experiences.