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Tan AK, Capezuti E, Samuels WE, Backhaus R, Wagner LM. Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study. J Nurs Scholarsh 2024; 56:430-441. [PMID: 38169102 DOI: 10.1111/jnu.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment. OBJECTIVE The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress. DESIGN This study was a descriptive, cross-sectional survey using targeted sampling. PARTICIPANTS A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting. METHODS This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses. RESULTS The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = -0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = -0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = -0.19, p = 0.001). CONCLUSION Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession. CLINICAL RELEVANCE Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay. Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.
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Affiliation(s)
- Amil Kusain Tan
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - Elizabeth Capezuti
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - William Ellery Samuels
- The Graduate Center, City University of New York, New York, New York, USA
- Hunter-Bellevue School of Nursing, Hunter College of CUNY, New York, New York, USA
| | - Ramona Backhaus
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, Netherlands
| | - Laura M Wagner
- University of California San Francisco, San Francisco, California, USA
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Herz M, Bösl S, Gebhard D. Individual and organizational interventions to promote staff health and well-being in residential long-term care: a systematic review of randomized controlled trials over the past 20 years. BMC Nurs 2024; 23:195. [PMID: 38519896 PMCID: PMC10958844 DOI: 10.1186/s12912-024-01855-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Staff in residential long-term care (RLTC) experience significant physical and mental work demands. However, research on specific interventions to promote staff health and well-being in RLTC facilities is limited. This systematic review aimed to synthesize the current evidence on health promotion interventions among RLTC staff. METHODS A comprehensive systematic literature review was conducted on studies published between January 2000 and April 2023. Four electronic databases were searched, including PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and PsychArticles via EBSCO. The review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The methodological quality of the included studies was assessed using the Risk of Bias Assessment tool (RoB 2). RESULTS A total of 26 publications, referring to 23 different interventions with a randomized controlled design were included. Among these interventions, ten used training/educational approaches, six used behavioral approaches, and seven employed a multimodal approach. Significant improvements in health and well-being outcomes were found in four interventions using a training/educational approach, three interventions using a behavioral approach, and four interventions using a multimodal approach. Within the interventions studied, twelve specifically targeted the reduction of job demands, while only one intervention exclusively addressed job resources among RLTC staff. Furthermore, ten interventions addressed primary outcomes that encompassed both job demands and job resources. CONCLUSION Current evidence for health promotion interventions among RLTC staff is still limited, but research suggests that there is potential to improve certain outcomes related to RLTC staff health and well-being. Future research is recommended to contemplate a tailored intervention design that encompasses both individual-level and organizational-level approaches, and gender-specific physiological and sociological characteristics of RLTC staff. Moreover, detailed reporting of the development process, and research on the interaction between job demands and resources of RLTC staff are also recommended.
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Affiliation(s)
- Michael Herz
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany.
| | - Sabina Bösl
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
- European Foundation for the Care of Newborn Infants, Hofmannstrasse 7A, 81379, Munich, Germany
| | - Doris Gebhard
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
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Mallon A, Mitchell G, Carter G, Francis McLaughlin D, Linden M, Brown Wilson C. Exploring Resilience in Care Home Nurses: An Online Survey. Healthcare (Basel) 2023; 11:3120. [PMID: 38132010 PMCID: PMC10742816 DOI: 10.3390/healthcare11243120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Resilience is considered a core capability for nurses in managing workplace challenges and adversity. The COVID-19 pandemic has brought care homes into the public consciousness; yet, little is known about the resilience of care home nurses and the attributes required to positively adapt in a job where pressure lies with individuals to affect whole systems. To address this gap, an online survey was undertaken to explore the levels of resilience and potential influencing factors in a sample of care home nurses in Northern Ireland between January and April 2022. The survey included the Connor-Davidson Resilience Scale, demographic questions and items relating to nursing practice and care home characteristics. Mean differences and key predictors of higher resilience were explored through statistical analysis. A moderate level of resilience was reported among the participants (n = 56). The key predictors of increased resilience were older age and higher levels of education. The pandemic has exposed systemic weakness but also the strengths and untapped potential of the care home sector. By linking the individual, family, community and organisation, care home nurses may have developed unique attributes, which could be explored and nurtured. With tailored support, which capitalises on assets, they can influence a much needed culture change, which ensures the contribution of this sector to society is recognised and valued.
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Affiliation(s)
- Anita Mallon
- School of Nursing & Midwifery, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (G.M.); (G.C.); (D.F.M.); (M.L.)
| | | | | | | | | | - Christine Brown Wilson
- School of Nursing & Midwifery, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (G.M.); (G.C.); (D.F.M.); (M.L.)
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Wu SA, Morrison-Koechl JM, McAiney C, Middleton L, Lengyel C, Slaughter S, Carrier N, Yoon MN, Keller HH. Multi-Level Factors Associated with Relationship-Centred and Task-Focused Mealtime Practices in Long-Term Care: A Secondary Data Analysis of the Making the Most of Mealtimes Study. Can J Aging 2023; 42:696-709. [PMID: 37278323 DOI: 10.1017/s0714980823000156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Mealtimes in long-term care (LTC) can reinforce relationships between staff and residents through relationship-centred care (RCC) practices; however, meals are often task-focused (TF). This cross-sectional study explores multi-level contextual factors that contribute to RCC and TF mealtime practices. Secondary data from residents in 32 Canadian LTC homes were analyzed (n = 634; mean age 86.7 ± 7.8; 31.1% male). Data included resident health record review, standardized mealtime observation tools, and valid questionnaires. A higher average number of RCC (9.6 ± 1.4) than TF (5.6 ± 2.1) practices per meal were observed. Multi-level regression revealed that a significant proportion of variation in the RCC and TF scores was explained at the resident- (intraclass correlation coefficient [ICC]RCC = 0.736; ICCTF = 0.482), dining room- (ICCRCC = 0.210; ICCTF = 0.162), and home- (ICCRCC = 0.054; ICCTF = 0.356) levels. For-profit status and home size modified the associations between functional dependency and practices. Addressing multi-level factors can reinforce RCC practices and reduce TF practices.
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Affiliation(s)
- Sarah A Wu
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Laura Middleton
- Kinesiology and Health Sciences, University of Waterloo, Waterlo, ON, Canada
| | - Christina Lengyel
- Department of Food and Human Nutrition Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Susan Slaughter
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Natalie Carrier
- École des sciences des aliments, de nutrition et d'études familiales, Université de Moncton, Moncton, NB, Canada
| | - Minn-Nyoung Yoon
- Department of Dentistry & Dental Hygiene, University of Alberta, Calgary, AB, Canada
| | - Heather H Keller
- Kinesiology and Health Sciences, University of Waterloo, Waterlo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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Skytt B, Högberg H, Engström M. An explorative and confirmative factor analysis of the Leadership and Management Inventory-II among staff working in elderly care. Leadersh Health Serv (Bradf Engl) 2023; ahead-of-print:66-83. [PMID: 37962108 PMCID: PMC10871065 DOI: 10.1108/lhs-01-2023-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/18/2023] [Accepted: 10/02/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden. DESIGN/METHODOLOGY/APPROACH Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061). FINDINGS The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results. ORIGINALITY/VALUE The instrument measures both leadership and management performance and can be used to continually measure managers' performances as perceived by staff to identify areas for development.
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Affiliation(s)
- Bernice Skytt
- Faculty of Health and Occupational Studies, University
of Gävle, Gävle, Sweden and Department of Public Health and Caring Sciences,
Uppsala University, Uppsala, Sweden
| | - Hans Högberg
- Faculty of Health and Occupational Studies, University
of Gävle, Gävle, Sweden
| | - Maria Engström
- Faculty of Health and Occupational Studies, University
of Gävle, Gävle, Sweden; Department of Caring Sciences, Uppsala
University, Uppsala, Sweden
and Nursing Department, Medicine and Health College, Lishui
University, Lishui, China
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Backman A, Lindkvist M, Lövheim H, Sjögren K, Edvardsson D. Exploring the impact of nursing home managers' leadership on staff job satisfaction, health and intention to leave in nursing homes. J Clin Nurs 2023; 32:7227-7237. [PMID: 37283193 DOI: 10.1111/jocn.16781] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/03/2023] [Accepted: 05/23/2023] [Indexed: 06/08/2023]
Abstract
AIMS AND OBJECTIVES To explore the impact of nursing home leadership and staffing characteristics on staff job satisfaction, health and intention to leave. BACKGROUND The number of older people has outpaced growth in the nursing home workforce worldwide. Identifying predictors with the potential to positively impact staff job satisfaction, health and intentions to leave are important. Leadership of the nursing home manager can be one such predictor. DESIGN Cross-sectional design. METHODS A sample of 2985 direct care staff in 190 nursing homes in 43 randomly selected municipalities in Sweden completed surveys on leadership, job satisfaction, self-rated health and intention to leave (response rate 52%). Descriptive statistics and Generalised Estimating Equations were conducted. The STROBE reporting checklist was applied. RESULTS Nursing home managers' leadership was positively related to job satisfaction, self-rated health and low intention to leave. Lower staff educational levels were related to poorer health and lower job satisfaction. CONCLUSIONS Nursing home leadership plays a significant role in the job satisfaction, self-reported health and intention to leave of direct care staff. Low education levels among staff seem to negatively influence staff health and job satisfaction, suggesting that educational initiatives for less-educated staff could be beneficial for improving staff health and job satisfaction. RELEVANCE TO CLINICAL PRACTICE Managers seeking to improve staff job satisfaction can consider how they support, coach and provide feedback. Recognising staff achievement at work can contribute to high job satisfaction. One important implication for managers is to offer continuing education to staff with lower or no education, given the large amount of uneducated direct care workers in aged care and the impact this may have on staff job satisfaction and health. NO PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was required to outcome measures in this study. Direct care staff and managers contributed with data.
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Affiliation(s)
| | - Marie Lindkvist
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine in Umeå, Umeå, Sweden
| | - Karin Sjögren
- Department of Nursing, Umeå University, Umeå, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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Cardiff S, Gershuni O, Giesbergen-Brekelmans A. How local, first-line nurse leaders can positively influence nurse intent to stay and retention: A realist review. J Clin Nurs 2023; 32:6934-6950. [PMID: 37421611 DOI: 10.1111/jocn.16813] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 07/10/2023]
Abstract
AIMS AND OBJECTIVES To explore evidence on how local nurse leaders can positively influence nurse retention. BACKGROUND Nurse turnover and retention is a wicked problem with multiple interrelated factors and no one solution. Local nurse leadership has the potential to positively influence nurse intent to stay directly or via various factors. DESIGN A realist review. METHODS Having designed a search strategy based on a tentive programme theory, 1386 initial hits in three databases were screened and reduced to 48 research articles published between 2010-2021. The articles' content were coded for findings that supported, refined or contradicted four ContextMechanismOutcome configurations. RESULTS Sufficient evidence was found to support four guiding lights encouraging local nurse leaders to: (1) foster relational connectedness; (2) enable professional practice autonomy; (3) cultivate healthful workplace cultures; (4) support professional growth and development. Mutuality and reciprocity is also key if leaders themselves are to experience wellbeing and growth. CONCLUSIONS Person-centred, transformational and resonant local nurse leaders can positively influence nurse intent to stay within the workplace or organisation. REPORTING METHOD Conform JCN guideline 'What to cover in the main tekst by article type' for reviews. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Shaun Cardiff
- School of People & Healthcare Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Olga Gershuni
- School of People & Healthcare Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Anne Giesbergen-Brekelmans
- School of People & Healthcare Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands
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8
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Takeda S, Fukuzaki T. Development of the Workplace Interpersonal Problems Scale for Care Workers (WIPS) and examination of its reliability and validity. Heliyon 2023; 9:e20156. [PMID: 37809750 PMCID: PMC10559914 DOI: 10.1016/j.heliyon.2023.e20156] [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: 05/14/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction The turnover rate of care workers has remained high by global standards, with previous studies showing an association between workplace interpersonal relations and care worker turnover and turnover intentions. This study details the development of the Workplace Interpersonal Problems Scale for Care Workers (WIPS) and examines its reliability and validity according to the COSMIN guidelines. Methods A total of 476 care workers employed by elder care facilities participated in the study. This study examined the reliability and validity of the WIPS after its development. Reliability was evaluated using Cronbach's α, test reliability with the standard error of measurement, and test-retest reliability with the intraclass correlation coefficient. Content validity, construct validity, and structural validity were examined to evaluate validity. Results Both total and subscale scores of the WIPS had a Cronbach's α coefficient >0.75 and high test-retest reliability (intraclass correlation coefficient, 0.75). Content validity analysis showed the item-content validity index of ≥0.90 for all WIPS items, confirming 100% of the hypotheses for testing construct validity. Confirmatory factor analysis showed an acceptable fit for the hypothesized six-factor construct (CFI = 0.92, TLI = 0.91, RMSEA = 0.07, SRMR = 0.05). Conclusions The WIPS was found to be a valid and reliable instrument. With the growth of the elderly population worldwide, we believe that the WIPS will be a useful quantitative measure to assess workplace interpersonal problems affecting care workers in various aspects.
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Affiliation(s)
- Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Japan
| | - Toshiki Fukuzaki
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Japan
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9
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Ausserhofer D, Tappeiner W, Wieser H, Serdaly C, Simon M, Zúñiga F, Favez L. Administrative burden in Swiss nursing homes and its association with care workers' outcomes-a multicenter cross-sectional study. BMC Geriatr 2023; 23:347. [PMID: 37268879 DOI: 10.1186/s12877-023-04022-w] [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: 11/30/2022] [Accepted: 05/06/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Care workers in nursing homes often perform tasks that are rather related to organizational or management activities than 'direct patient care'. 'Indirect care activities', such as documentation or other administrative tasks are often considered by care workers as a burden, as they increase overall workload and keep them away from caring for residents. So far, there is little investigation into what kind of administrative tasks are being performed in nursing homes, by which type of care workers, and to which extent, nor how administrative burden is associated with care workers' outcomes. PURPOSE The objective of this study was to describe care workers' administrative burden in Swiss nursing homes and to explore the association with four care worker outcomes (i.e., job dissatisfaction, emotional exhaustion, intention to leave the current job and the profession). METHODS This multicenter cross-sectional study used survey data from the Swiss Nursing Homes Human Resources Project 2018. It included a convenience sample of 118 nursing homes and 2'207 care workers (i.e., registered nurses, licensed practical nurses) from Switzerland's German- and French-speaking regions. Care workers completed questionnaires assessing the administrative tasks and burden, staffing and resource adequacy, leadership ability, implicit rationing of nursing care and care worker characteristics and outcomes. For the analysis, we applied generalized linear mixed models, including individual-level nurse survey data and data on unit and facility characteristics. RESULTS Overall, 73.9% (n = 1'561) of care workers felt strongly or rather strongly burdened, with one third (36.6%, n = 787) reporting to spend 2 h or more during a "normal" day performing administrative tasks. Ratings for administrative burden ranged from 42.6% (n = 884; ordering supplies and managing stocks) to 75.3% (n = 1'621; filling out the resident's health record). One out of four care workers (25.5%, n = 561) intended to leave the profession, whereby care workers reporting higher administrative task burden (OR = 1.24; 95%CI: 1.02-1.50) were more likely to intend to leave the profession. CONCLUSION This study provides first insights on care workers' administrative burden in nursing homes. By limiting care workers' burdensome administrative tasks and/or shifting such tasks from higher to lower educated care workers or administrative personnel when appropriate, nursing home managers could reduce care workers' workload and improve their job satisfaction and retention in the profession.
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Affiliation(s)
- Dietmar Ausserhofer
- Claudiana Research, College of Health Care-Professions, Bolzano-Bozen, Italy
- Institute of Nursing Science, Department of Public Health, University of Basel, Bernoullistr. 28, 4056, Basel, Switzerland
| | - Waltraud Tappeiner
- Claudiana Research, College of Health Care-Professions, Bolzano-Bozen, Italy
| | - Heike Wieser
- Claudiana Research, College of Health Care-Professions, Bolzano-Bozen, Italy
| | - Christine Serdaly
- Serdaly&Ankers Snc, 210 Route de Florissant, 1231, Conches, Switzerland
| | - Michael Simon
- Institute of Nursing Science, Department of Public Health, University of Basel, Bernoullistr. 28, 4056, Basel, Switzerland
| | - Franziska Zúñiga
- Institute of Nursing Science, Department of Public Health, University of Basel, Bernoullistr. 28, 4056, Basel, Switzerland
| | - Lauriane Favez
- Institute of Nursing Science, Department of Public Health, University of Basel, Bernoullistr. 28, 4056, Basel, Switzerland.
- School of Engineering and Management Vaud, HES-SO University of Applied Sciences and Arts Western Switzerland, Yverdon-les-Bains, Switzerland.
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10
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Takeda S. Factors Related to Turnover and Intention to Leave the Care Working Profession in Japan: A Review. Yonago Acta Med 2023; 66:196-201. [PMID: 37229365 PMCID: PMC10203648 DOI: 10.33160/yam.2023.05.001] [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: 03/08/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023]
Abstract
Globally, the elderly population is growing rapidly. The number of elderly people requiring nursing care is expected to increase along with the elderly population. However, the high turnover rate of care workers has caused a labor shortage, which in turn has encouraged further turnover, creating a vicious cycle. Preventing turnover is an important issue not only for the physical and mental health of care workers but also for the quality of nursing care. In particular, Japan has emerged as the world's first super-aged society, experiencing an increase in the number of elderly people requiring nursing care and a shortage of care workers. This review summarizes the research on factors influencing care worker turnover and intent to leave the profession in Japan. Additionally, workplace interpersonal problems have been shown to be consistently associated with care worker turnover or intention to leave in previous studies that were reviewed.
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Affiliation(s)
- Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503, Japan
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11
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Jurij R, Ismail IR, Alavi K, Alavi R. Eldercare's Turnover Intention and Human Resource Approach: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3932. [PMID: 36900943 PMCID: PMC10002382 DOI: 10.3390/ijerph20053932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Rahimah Jurij
- Graduate School of Business, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Ida Rosnita Ismail
- Graduate School of Business, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Khadijah Alavi
- Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Rokiah Alavi
- Kuliyyah of Economics and Management Science, International Islamic University Malaysia, Kuala Lumpur 50728, Malaysia
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12
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Sun C, Xing Y, Wen Y, Wan X, Ding Y, Cui Y, Xu W, Wang X, Xia H, Zhang Q, Yuan M. Association between career adaptability and turnover intention among nursing assistants: the mediating role of psychological capital. BMC Nurs 2023; 22:29. [PMID: 36732804 PMCID: PMC9894670 DOI: 10.1186/s12912-023-01187-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND High turnover intention of nursing assistants was detrimental to the sustainability of long-term care. Career adaptability is an important determinant in reducing turnover intention, but little research has explored the mechanism from the perspective of psychological capital. The aim of this study was to analyze the association between career adaptability and turnover intention and to examine the mediating role of psychological capital between career adaptability and turnover intention among nursing assistants in mainland China. METHODS A cross-sectional online study was conducted among 276 nursing assistants from eight nursing homes in Nanjing, China. The participants' career adaptability, psychological capital, and turnover intention were obtained. SPSS 26.0 and Amos 24.0 software were employed for statistical analysis. RESULTS Career adaptability was positively related to psychological capital and negatively linked to turnover intention (P < 0.01). Psychological capital played a fully mediating role (β = -0.085, P < 0.05) in the relationship between career adaptability and turnover intention, and the largest indirect effect was generated through the curiosity dimension. CONCLUSIONS The management of long-term care facilities should focus on assessing the level of career adaptability of nursing assistants. The overall improvement of career adaptability and psychological capital is conducive in reducing turnover intention. Targeted interventions are recommended to improve career adaptability and reduce turnover intentions by increasing career curiosity. Online career adaptability programs can be developed for nursing assistant students to improve their psychological capital and facilitate career transitions.
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Affiliation(s)
- Changxian Sun
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China ,grid.495415.8Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Yurong Xing
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Yuting Wen
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Xia Wan
- grid.89957.3a0000 0000 9255 8984The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Yaping Ding
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Yan Cui
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Wenhui Xu
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Xiaoxiao Wang
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Hongling Xia
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Qian Zhang
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Min Yuan
- grid.495415.8Jiangsu Vocational Institute of Commerce, Nanjing, China ,grid.443514.30000 0004 1791 5258Jinshen College of Nanjing Audit University, Nanjing, China
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Lindmark T, Engström M, Trygged S. Psychosocial Work Environment and Well-Being of Direct-Care Staff Under Different Nursing Home Ownership Types: A Systematic Review. J Appl Gerontol 2023; 42:347-359. [PMID: 36214292 PMCID: PMC9841825 DOI: 10.1177/07334648221131468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
This systematic review investigated the psychosocial work environment and well-being of direct-care staff under different nursing home ownership types. Databases searched: Scopus, Web of Science, Cinahl, and PubMed, 1990-2020. Inclusion criteria: quantitative or mixed-method studies; population: direct-care staff in nursing homes; exposure: for-profit and non-profit ownership; and outcomes: psychosocial work environment and well-being. In total, 3896 articles were screened and 17(n = 12,843 participants) were assessed using the Joanna Briggs Institute Critical Appraisal tools and included in the narrative synthesis. The results were inconsistent, but findings favored non-profit over for-profit settings, for example, regarding leaving intentions, organizational commitment, and stress-related outcomes. There were no clear differences concerning job satisfaction. Job demands were higher in non-profit nursing homes but alleviated by better job resources in one study. The result highlights work environment issues, with regulations concerning for-profit incentives being discussed in terms of staff benefits.
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Affiliation(s)
- Tomas Lindmark
- Faculty of Health and Occupational Studies, Department of Social Work, University of Gävle, Gävle, Sweden,Tomas Lindmark, Faculty of Health and Occupational Studies, Department of Social work, University of Gävle, Kungsbäcksvägen 47, Gävle 801 76, Sweden.
| | - Maria Engström
- Faculty of Health and Occupational Studies, Department of Caring Science, University of Gävle, Gävle, Sweden
| | - Sven Trygged
- Faculty of Health and Occupational Studies, Department of Social Work, University of Gävle, Gävle, Sweden
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Takeda S, Fukuzaki T. Relationship between turnover intention and workplace personal relations among care workers employed by elder care facilities. Psychogeriatrics 2023; 23:86-93. [PMID: 36332615 DOI: 10.1111/psyg.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study focuses on care workers at elder care facilities to examine what factors (including workplace personal relations) influence turnover intention and to what extent. Based on this analysis, the study discusses the content of workplace personal relations problems in qualitative terms. METHODS The study targeted care workers at elder care facilities. There were 406 participants with no missing data who were analyzed. The survey period ranged from September to November 2021. Questions consisted of basic attributes, turnover intention, problems with workplace personal relations, content of personal relation problems, and psychological distress. RESULTS Female care workers were 2.25 times more likely than male care workers to have turnover intention. Care workers with workplace personal relation problems were 1.97 times more likely than those without these problems to have high turnover intention. Moreover, with regard to psychological distress, the ratio increased to 4.99 times. The following six categories were extracted from the text data on workplace personal relation problems: insufficient communication, bullying, sense of unfair workload, different attitudes to care work, difficulty in guidance for subordinates/new staff, and labelling. CONCLUSIONS Gender, workplace personal relation problems, and psychological distress have shown to affect care workers' turnover intentions. To prevent care worker turnover, future studies should focus on the development and impact of strategies to improve workplace personal relations specific to care workers, targeting the six factors identified in this study.
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Affiliation(s)
- Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago, Tottori, Japan
| | - Toshiki Fukuzaki
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago, Tottori, Japan
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15
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Boateng AB, Opoku DA, Ayisi-Boateng NK, Sulemana A, Mohammed A, Osarfo J, Hogarh JN. Factors Influencing Turnover Intention among Nurses and Midwives in Ghana. Nurs Res Pract 2022; 2022:4299702. [PMID: 36439941 PMCID: PMC9683982 DOI: 10.1155/2022/4299702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/29/2022] [Accepted: 11/08/2022] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Nurse turnover intention, defined as a measure of nurses' desire to leave their positions, is a global public health issue with a grave impact on the healthcare workforce. However, literature on it is limited in sub-Saharan Africa, an at-risk region. This study aimed to determine the predictors of turnover intention among nursing staff at a tertiary hospital in Kumasi, Ghana. METHODS This was an institution-basedcross-sectional study conducted among 226 randomly selected nurses and midwives working at a tertiary healthcare center in Kumasi, Ghana. Data were collected by using a structured questionnaire. Significant predictors of turnover intention were analyzed by using multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p value <0.05 was used. RESULTS The prevalence of turnover intention among study participants was 87.2% (197/226). About two-thirds (61.5%, 139/226) of the participants were exposed to a high level of workplace hazards. Management support (AOR = 3.09, 95% CI = 1.09-8.75), salary (AOR = 0.07, 95% CI = 0.01-0.46), inadequate number of staff on duty per shift (AOR = 3.36, 95% CI = 1.08-10.47) and participants' rank (AOR = 6.81, 95% CI = 1.18-39.16) were significantly associated with turnover intention. CONCLUSION Overall, the turnover intention was high. Hence, there is a need for policymakers, health administrators, and nurse managers to implement strategies such as increasing staff strength, providing adequate support, incentives, and other forms of motivation for nurses and midwives to help reduce the rate of turnover intention.
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Affiliation(s)
- Angelina Boatemaa Boateng
- Department of Occupational and Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Douglas Aninng Opoku
- Department of Occupational and Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Allen Clinic, Family Healthcare Services, Kumasi, Ghana
| | - Nana Kwame Ayisi-Boateng
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alhassan Sulemana
- Department of Environmental Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aliyu Mohammed
- Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Osarfo
- Department of Community Medicine, School of Medicine, University of Health and Allied Health Science, Ho, Ghana
| | - Jonathan N. Hogarh
- Department of Environmental Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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16
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Fuchs K, Vögeli S, Schori D, Händler-Schuster D. Nurses' experiences of an outreach interprofessional mental health service for nursing homes: a qualitative descriptive study. J Psychiatr Ment Health Nurs 2022; 29:755-765. [PMID: 35620909 PMCID: PMC9546410 DOI: 10.1111/jpm.12847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/17/2022] [Accepted: 05/18/2022] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Treatment and mental health care in familiar environments are beneficial for older people experiencing mental health issues. But there are not enough qualified and specialized nurses who can meet the complex needs of nursing home residents experiencing mental health issues. The University Hospital of Psychiatry Zurich, Switzerland, established an outreach interprofessional mental health service to foster the care for residents experiencing mental health issues in nursing homes. Based on existing studies, little can be said about whether nurses in nursing homes find these types of services helpful. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Nurses in nursing homes caring for residents experiencing mental health issues felt relieved by having inclusive support from the interprofessional mental health service. Nurses appreciated the mental health team and felt accompanied and more confident in their daily work. Results showed that nurses wanted to be included in the care and treatment processes and to work as partners on an equal footing with the mental health team. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Outreach interprofessional mental health services for nursing homes should take into account nurses' views and professional experience, and value and respect their role as nurses. Outreach interprofessional mental health services for nursing homes should offer further training in psychiatric nursing, include an accessible contact person in the team, and develop clear processes and responsibilities. ABSTRACT INTRODUCTION: Outreach interprofessional mental health services for nursing homes can increase the quality of care for residents experiencing mental health issues but research on how nurses in nursing homes experience such a service is lacking worldwide. AIM To describe how nurses experience the involvement of an outreach interprofessional mental health team in the care for older people experiencing mental health issues in nursing homes and to identify barriers to and facilitators of interprofessional collaboration. METHOD Qualitative descriptive analysis based on 13 semi-structured interviews. Framework analysis and complex adaptive systems theory were applied. RESULTS One core theme with two main categories: Nurses experienced relief from burden through inclusive support provided by the mental health team. Main categories were feeling accompanied and confident as a nurse and partnership-based collaboration. DISCUSSION Results showed for the first time that nurses felt supported by the mental health team and were encouraged to find new ways of coping with challenging situations. IMPLICATIONS FOR PRACTICE To empower nurses, mental health teams should take into account nurses' perceptions in the treatment process, value and respect their role as nurses, transfer knowledge in both formal and informal settings, establish a steady and reliable contact person, and define processes and responsibilities.
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Affiliation(s)
- Karin Fuchs
- Institute of Nursing, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Samuel Vögeli
- Directorate of Nursing, Therapies and Social Work, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Dominik Schori
- Directorate of Nursing, Therapies and Social Work, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Daniela Händler-Schuster
- Institute of Nursing, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland.,Department Nursing Science and Gerontology, Private University of Health Sciences, Medical Informatics and Technology (UMIT TIROL), Hall in Tyrol, Austria.,School of Nursing, Midwifery and Health Practice, Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
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17
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Crocker M, Milte R, Duff G, Lawless M, Corlis M, Ratcliffe J. Are Australians willing to pay more tax to support wage increases for aged care workers? Findings from a national survey. Australas J Ageing 2022; 41:513-521. [PMID: 35581941 DOI: 10.1111/ajag.13094] [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: 08/22/2021] [Revised: 03/21/2022] [Accepted: 04/20/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To explore the perceptions of the Australian public regarding Australia's aged care workforce, including their willingness to pay more tax to fund better pay and conditions for aged care workers. METHODS An online survey was developed and administered to a representative sample of Australian adults (aged ≥18 years) by age group, gender and Australian state. Survey respondents completed a series of attitudinal statements to elicit their perceptions of the value of Australia's aged care workforce and were asked to indicate their willingness to pay additional tax to fund better pay and conditions for aged care workers. Those who gave a positive response were then asked to indicate what percentage of additional tax per year they would be willing to pay to ensure better pay and conditions for aged care workers. RESULTS A total of 2033 adult respondents completed the survey. A majority (78%) of respondents either 'agreed' or 'strongly agreed' that aged care workers should be paid more. Approximately half of the respondents (50.57%) expressed a willingness to pay more tax to ensure better pay and conditions for aged care workers. The mean willingness to pay was 1.31% additional tax overall, and mean percentage additional tax values were relatively consistent across key socio-demographic indicators. CONCLUSIONS A majority of the Australian public are in favour of improving the wages and employment conditions of aged care workers. However, only one in two Australians is willing to pay more tax to ensure better pay and conditions for aged care workers.
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Affiliation(s)
- Matthew Crocker
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Rachel Milte
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Gordon Duff
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Michael Lawless
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Megan Corlis
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
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18
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Zarska A, Avgar AC, Sterling MR. Relationship Between Working Conditions, Worker Outcomes, and Patient Care: A Theoretical Model for Frontline Health Care Workers. Am J Med Qual 2021; 36:429-440. [PMID: 34310376 PMCID: PMC10570923 DOI: 10.1097/01.jmq.0000735508.08292.73] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite the integral role that frontline health care workers play in providing care to older adults and those with chronic conditions and disabilities, few studies have examined the relationships between the working conditions endured by this workforce, the quality of the care they deliver, and the outcomes of patients for whom they care. Thus, the authors: (1) developed a novel conceptual framework that highlights these relationships and (2) performed a comprehensive search and analysis of the literature (PubMed, AgeLine, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, Scopus, Web of Science) to assess the relationships proposed in the framework. A total of 31 studies were included. The results suggest that working conditions affect workers themselves, the care they deliver, and their patients' outcomes. Additional studies, as well as policy solutions, are needed to address the issues faced by this workforce in order to improve health care delivery.
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Affiliation(s)
- Aleksandra Zarska
- Cornell University, School of Industrial and Labor Relations, Ithaca, NY Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
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19
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Elstad JI, Vabø M. Lack of recognition at the societal level heightens turnover considerations among Nordic eldercare workers: a quantitative analysis of survey data. BMC Health Serv Res 2021; 21:747. [PMID: 34315457 PMCID: PMC8315089 DOI: 10.1186/s12913-021-06734-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Recruiting and retaining staff are standing challenges in eldercare. Low pay, difficult working conditions, and social relations at the workplace impact on turnover intentions. Few studies have used quantitative data for estimating the role of recognition by the wider society for staff instability. This study examines how perceived lack of recognition at the societal level affects Nordic eldercare workers’ considerations of leaving their jobs. Methods The 2015 Nordcare survey among frontline eldercare workers in Denmark, Finland, Norway, and Sweden (N = 3,677) is analysed. Issues such as working conditions, financial strain, work-life balance, and appreciation by care recipients and colleagues, were covered. Recognition at the societal level was measured by perceptions of being valued by top municipal leaders, mass media, and the general public. Analyses are made with cross-tabulations and multivariate linear probability regression models. Results In the total sample, 41.1 % had “seriously considered to quit during the last 12 months”. About one third felt “not at all valued” by top municipal leaders, while one fourth felt “not at all valued” by mass media. In bivariate analyses, perceptions of recognition were strongly associated with considerations to quit. These associations were reduced, but remained sizeable and highly significant in multivariate analyses adjusted for age, gender, health, working conditions, financial stress, workplace relations, and other known turnover predictors. Conclusions Lack of recognition by societal agents such as top municipal leaders, mass media, and the general public, is widely felt by Nordic eldercare workers. Feeling poorly valued by such sources is associated with frequent considerations to leave one’s employment. Perceived lack of recognition by the wider society has a significant and independent impact on staff instability in the eldercare sector. Societies’ recognition order is embedded in social structures which are resistant to change, but policies which succeed in raising the societal recognition of eldercare work may contribute to reduced retention difficulties in eldercare. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06734-4.
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Affiliation(s)
- Jon Ivar Elstad
- NOVA, Centre of Welfare and Labour Research, Oslo Metropolitan University, P.O.Box 4, St. Olavs Plass, 0130, Oslo, Norway.
| | - Mia Vabø
- NOVA, Centre of Welfare and Labour Research, Oslo Metropolitan University, P.O.Box 4, St. Olavs Plass, 0130, Oslo, Norway
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20
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Thompson GN, McClement SE, Peters S, Hack TF, Chochinov H, Funk L. More than just a task: intimate care delivery in the nursing home. Int J Qual Stud Health Well-being 2021; 16:1943123. [PMID: 34180776 PMCID: PMC8245091 DOI: 10.1080/17482631.2021.1943123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose: Intimate care procedures, such as bathing and toileting, are often regarded as simple, humble tasks. However, the provision of such care transforms a very private, personal activity into a social process. Understanding this complex process and the psychological impact it has on those providing and receiving care is critical in order to mitigate potential distress. The purpose of this study to examine the experience of delivering and receiving intimate personal care in the NH. Methods: A focused ethnographic approach with participant observation, semi-structured interviews, focus groups and drop-in sessions, document review, and field notes. Data were analysed using constant comparative analysis. Results: Quality care in this context is predicated on the care provider recognition of the emotional impact of care delivery on the care recipient. Our analysis identified that the overarching theme, of providing quality person-centred intimate care, requires creating and maintaining a relational space that promotes integrity. Conclusions: The provision of intimate personal care consists of a complex interplay at the level of resident/care provider interaction (micro level); health care organization (meso level); and policy (macro level). Each of these levels interacts with and influences the other two. The components identified in our model may provide the basis from which to further examine resident experiences of quality intimate personal care.
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Affiliation(s)
- Genevieve N Thompson
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Susan E McClement
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sheryl Peters
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harvey Chochinov
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura Funk
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, Manitoba, Canada
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21
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Helgesen AK, Adan YH, Dybvik Bjørglund C, Weberg‐Haugen C, Johannessen M, Åsmul Kristiansen K, Vasskog Risan E, Relusco ML, Skaarer‐Heen HM, Sørensen TS, Vedå L, Abrahamsen Grøndahl V. Nurses' experiences of delirium and how to identify delirium-A qualitative study. Nurs Open 2021; 8:844-849. [PMID: 33570283 PMCID: PMC7877158 DOI: 10.1002/nop2.691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/25/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
AIM Delirium is a serious, acute medical condition which places a heavy burden on the patient, his or her family and healthcare professionals. There have been only a limited number of studies to explore nurses' experiences of delirium and how delirium is identified in community care. The research questions of the study are as follows: "How do community care nurses' experience delirium?" and "How is delirium identified?". DESIGN This study has been designed as an explorative and descriptive study. METHODS A topic-based interview guide was developed containing questions associated with the Registered Nurses' experiences of their meetings with people with delirium and their identification of delirium. RESULTS Nurses working in the community care need to know more about delirium as they play a key role in treatment. Our results also show that the participants have difficulty in establishing whether a patient is suffering from acute confusion/delirium, depression or dementia.
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Affiliation(s)
- Ann Karin Helgesen
- Faculty of Health and Welfare SciencesØstfold University CollegeHaldenNorway
| | - Yassin Husein Adan
- Faculty of Health and Welfare SciencesØstfold University CollegeHaldenNorway
| | | | - Chris Weberg‐Haugen
- Faculty of Health and Welfare SciencesØstfold University CollegeHaldenNorway
| | - Mona Johannessen
- Faculty of Health and Welfare SciencesØstfold University CollegeHaldenNorway
| | | | | | - Ma Lorinda Relusco
- Faculty of Health and Welfare SciencesØstfold University CollegeHaldenNorway
| | | | - Tina Sofie Sørensen
- Faculty of Health and Welfare SciencesØstfold University CollegeHaldenNorway
| | - Linea Vedå
- Faculty of Health and Welfare SciencesØstfold University CollegeHaldenNorway
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22
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Kilaberia TR. Organizational commitment among residential care workers. J Aging Stud 2020; 55:100894. [PMID: 33272454 DOI: 10.1016/j.jaging.2020.100894] [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: 01/04/2020] [Revised: 09/06/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
The growth of the older adult population and documented demand of health, allied health, and social care professionals contrast starkly with the reality that the eldercare field, including care organizations, struggle to attract and retain committed workers. Extant studies evaluate organizational capacity to engender commitment by examining various job and workplace factors. Drawing on 44 interviews, observations of 62 meetings, and a 5-year immersion, this organizational ethnography looks at commitment factors at a large, urban, faith-based residential senior care organization. Commitment factors are delineated on three levels such as daily tensions and rewards, value-based tensions and rewards, deal breakers and clinchers. Identity-based factors such as affective bonds with older persons and sharing in faith values sustain commitment on the person level whereas interprofessional tensions may detract from commitment. This study extends the knowledge base by incorporating perspectives of care workers such as social workers, chaplains, rehabilitation, recreational, diet and environmental services workers in addition to the more commonly examined groups such as nurses and certified nursing assistants, and in a setting that includes Assisted Living in addition to long-term care.
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Affiliation(s)
- Tina R Kilaberia
- Betty Irene Moore School of Nursing, University of California - Davis Health, 2450 48th St, Sacramento, CA 95817, United States of America.
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23
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Xiao LD, Harrington A, Mavromaras K, Ratcliffe J, Mahuteau S, Isherwood L, Gregoric C. Care workers' perspectives of factors affecting a sustainable aged care workforce. Int Nurs Rev 2020; 68:49-58. [PMID: 33058198 DOI: 10.1111/inr.12635] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/28/2020] [Accepted: 09/15/2020] [Indexed: 11/26/2022]
Abstract
AIMS To identify the reasons why workers decide to enter, stay or leave the aged care workforce; and the factors influencing them to transition between community and residential sectors in Australia. BACKGROUND Factors affecting the recruitment and retention of suitable care workers in aged care are complex and influenced by personal, institutional and societal factors. METHODS A qualitative description study design. RESULTS In total, 32 staff participated in the study. Five main themes were identified: entering aged care with a passion for the job; entering aged care as it is the only employment option; factors attracting care workers to stay in aged care; factors influencing care workers to leave the job; and preferring to work in residential aged care rather than community aged care. CONCLUSION Issues relating to the attraction and retention of aged care workers are influenced by personal, institutional and societal factors. Critical shortages in the aged care workforce make the industry more susceptible to crises such as COVID-19 outbreaks. IMPLICATION FOR NURSING PRACTICE Aged care organizations need to create a positive psychosocial work environment for staff to improve the attraction and retention of skilled care workers. They also need to develop staff recruitment guidelines to ensure care workers with the appropriate skills and training and a passion for working with older adults are selected. Staff development programmes need to focus on learning activities that enable staff to build peers support in the work environment. IMPLICATIONS FOR HEALTH POLICY There is a need to mandate curriculum to enable nursing students to receive more gerontological education and exposure to aged care throughout their education. Aged care quality standards need to mandate transition support for new graduate nurses.
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Affiliation(s)
- Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Ann Harrington
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Kostas Mavromaras
- Future of Employment and Skills Research Centre (FES), The University of Adelaide, Adelaide, SA, Australia
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Stephane Mahuteau
- Future of Employment and Skills Research Centre (FES), The University of Adelaide, Adelaide, SA, Australia
| | - Linda Isherwood
- Future of Employment and Skills Research Centre (FES), The University of Adelaide, Adelaide, SA, Australia
| | - Carolyn Gregoric
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
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24
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Helgesen AK, Fagerli LB, Grøndahl VA. Healthcare staff's experiences of implementing one to one contact in nursing homes. Nurs Ethics 2019; 27:505-513. [PMID: 31288598 DOI: 10.1177/0969733019857775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Person-centred care is often described as an ideal way of preserving vulnerable persons' wellbeing and dignity and an essential component of quality-care delivery. However, the staff find that making the care dignified is the most challenging issue, often because of effectivity, everyday stress and overload. In the interests of making the care more person-centred, systematic intervention involving 'one-to-one contact' (resident - carer) was trialled for 30 min twice a week over 12 months in two units in a nursing home in Eastern Norway. OBJECTIVES The aim of the study was to elicit healthcare staff's experiences of implementing 'one-to-one contact' between residents and carers in nursing homes. METHODS The study has a grounded-theory inspired design. Two groups of health care staff were each interviewed three times. Data were collected over an 18-month period. ETHICAL CONSIDERATIONS The study was approved by the Data Protection Official for Research under the auspices of the Norwegian Social Science Data Services. FINDINGS The core category is 'One-to-one contact' at a nursing home is possible, but requires open-mindedness. The core category indicates that open-mindedness is required, since it does not take much for scepticism to take over and cause reversion to habitual practices. The category Expectant but Sceptical describes staff thoughts and experiences before the implementation phase got underway. The category Positive but Undecided describes staff experiences 6 months into the intervention and after 12 months. CONCLUSIONS This study has revealed that systematic 'one-to-one contact' between resident and carer in nursing home is achievable, and that such a simple action might be an important step towards achieving more person-centred care as the resident is seen more as a person. However, in order to make a more person-centred and dignified approach to care constant attentiveness and awareness is required, as there were ongoing factors counteracting it.
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Zúñiga F, Chu CH, Boscart V, Fagertun A, Gea-Sánchez M, Meyer J, Spilsbury K, Devi R, Haunch K, Zheng N, McGilton KS. Recommended Common Data Elements for International Research in Long-Term Care Homes: Exploring the Workforce and Staffing Concepts of Staff Retention and Turnover. Gerontol Geriatr Med 2019; 5:2333721419844344. [PMID: 31192274 PMCID: PMC6540698 DOI: 10.1177/2333721419844344] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/26/2019] [Indexed: 11/21/2022] Open
Abstract
The aim of this review is to develop a common data element for the concept of staff retention and turnover within the domain of workforce and staffing. This domain is one of four core domains identified by the WE-THRIVE (Worldwide Elements to Harmonize Research in Long-Term Care Living Environments) group in an effort to establish an international, person-centered long-term care research infrastructure. A rapid review identified different measurement methods to assess either turnover or retention at facility level or intention to leave or stay at the individual staff level. The selection of a recommended measurement was guided by the WE-THRIVE group’s focus on capacity rather than deficits, the expected availability of internationally comparable data, and the goal to provide a short, ecologically viable measurement. We therefore recommend to measure staff’s intention to stay with a single item, at the individual staff level. This element, we argue, is an indicator of staff stability, which is important for reduced organizational cost and improved productivity, positive work environment, and better resident–staff relationships and quality of care.
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Affiliation(s)
| | | | - Veronique Boscart
- Conestoga College, Kitchener, Ontario, Canada.,Toronto Rehabilitation Institute, Ontario, Canada
| | - Anette Fagertun
- Centre for Care Research west, Western Norway University of Applied Sciences, Bergen, Norway
| | | | | | | | | | | | - Nancy Zheng
- University of Toronto, Ontario, Canada.,Toronto Rehabilitation Institute, Ontario, Canada
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Norman RM, Iversen HH, Sjetne IS. Development, adaptation and psychometric assessment of the extended brisbane practice environment measure for nursing homes (B-PEM-NH) for use in the Norwegian setting. Geriatr Nurs 2018; 40:302-313. [PMID: 30553554 DOI: 10.1016/j.gerinurse.2018.11.007] [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: 10/17/2018] [Revised: 11/20/2018] [Accepted: 11/26/2018] [Indexed: 11/26/2022]
Abstract
Care workers' work environment is known to be associated with patient and nurse outcomes. To our knowledge no questionnaire is available for assessing this environment for all care workers in the Norwegian nursing-home setting. This paper describes the development, adaptation and assessment of such a questionnaire: the extended Norwegian version of the Brisbane Practice Environment Measure for Nursing Homes (B-PEM-NH). This version was developed and assessed using semistructured interviews, a reference group meeting, translation, adaptation, and pretesting, and psychometric assessment including exploratory and confirmatory factor analyses, and retest. We tested hypotheses to assess relations to other variables. The final factor solution comprised 41 items and 9 factors: interpersonal leadership, professional development, resources, professional leadership, input and acknowledgement, patient and next-of-kin focus, multidisciplinary collaboration, language misunderstandings, and feeling unsafe. The assessment showed that the B-PEM-NH had good psychometric properties, suggesting that the questionnaire is suitable for application in similar settings.
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Affiliation(s)
- Rebecka Maria Norman
- Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway; University of Oslo, Faculty of Medicine, Institute of Health and Society, Department of Health Management and Health Economics, PO Box 1130 Blindern, 0318 Oslo, Norway.
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Perreira TA, Berta W, Laporte A, Ginsburg L, Deber R, Elliott G, Lum J. Shining a Light: Examining Similarities and Differences in the Work Psychology of Health Support Workers Employed in Long-Term Care and Home and Community Care Settings. J Appl Gerontol 2017; 38:1595-1614. [PMID: 29164989 DOI: 10.1177/0733464817737622] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Health Support Workers (HSWs) provide up to 80% of care to residents and clients in the long-term care (LTC) and home and community care (HCC) sectors but have received little research attention compared with the regulated professions. The authors explore similarities and differences in the work psychology of HSWs employed in LTC and HCC settings. Data were collected via survey from 276 LTC and 184 HCC HSWs. Descriptive statistics and path analyses were conducted. HSWs in LTC and HCC settings have significant, positive associations between organizational citizenship behaviors directed toward the organization (OCB-Os) and psychological empowerment, as well as intention to stay (ITS) and job satisfaction. For LTC sector HSWs, there are significant relationships between OCB-Os and quality of work life (QWL), ITS and work engagement, and individual performance and both job satisfaction and QWL. For the HCC sector, OCB-Os and ITS are significantly and directly related to organizational commitment. This study has implications for organizations interested in developing targeted interventions to improve the retention of HSWs.
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Affiliation(s)
| | | | | | | | | | | | - Janet Lum
- Ryerson University, Toronto, ON, Canada
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