Home care nurses' perception of the challenges they faced during the COVID-19 pandemic: a qualitative study

BACKGROUND

Despite the significant role they play in the whole health care system, home care nurses are not paid the attention they deserve. Besides highlighting their significant role in the health care system, the COVID-19 pandemic also posed several challenges for home care nurses.

OBJECTIVE

The purpose of this study is to explain the nurses' perception of the challenges of home care during the Covid-19 pandemic.

METHODS

The present study was a qualitative study with a conventional content analysis approach conducted from November 2020 to September 2021. Participants included 16 home care nurses who were purposefully selected based on the eligibility criteria. After obtaining ethical authorization, the data were collected through semi-structured interviews. MAXQDA Version 10 software was used for data mangement. Data analysis was performed using the Granheim and Lundman five-step method. Guba and Lincoln criteria were utilized for trustworthiness.

FINDINGS

The seven main categories obtained in this study included "the onset of a new chapter: from avoidance to relapse", "burnout", "vortex of moral distress", "social stigma", "difficulty in breaking the transmission chain", "care inhibitors related to the patient and family" and "support deficiency: the crisis of home care nursing agencies during the crisis".

CONCLUSION

The results showed that nurses working in home care during the Covid-19 pandemic experienced several challenges in various fields. This study captured the nurses' perception of the challenges of home care during the Covid-19 pandemic, a period of unprecedented change and difficulty. These challenges included lack of support, psychological problems, and dealing with new experiences. Identifying these challenges can help improve the quality of home care nursing and planning in this area.

Examining Factors Associated With Minority Turnover Intention in State and Local Public Health Organizations: The Moderating Role of Race in the Relationship Among Supervisory Support, Job Satisfaction, and Turnover Intention

CONTEXT

There is a need to understand minority governmental public health workforce turnover to ensure the retention of public health minority workers, capitalize on diversity benefits, and enhance public health's capacity to serve diverse populations.

OBJECTIVE

This study assesses the moderating effect of minority health workers' race on (1) the relationship between the workforce environment, particularly employees' perceptions of their pay and supervisory support on job satisfaction, and (2) the relationship between job satisfaction and turnover intentions.

DESIGN

Using the 2017 Public Health Workforce Interests and Needs Survey (PH WINS), a cross-sectional survey of the public health workforce, a hierarchical logistic regression modeling technique was used to assess the moderating role of race on the relationship between supervisory support, pay and job satisfaction, and turnover intentions.

SETTING AND PARTICIPANTS

The PH WINS survey data from state and local health department employees.

MAIN OUTCOME MEASURE

Job satisfaction, pay, supervisory support, and turnover intention.

RESULTS

Job satisfaction was found to mediate the relationship between the work environment factors of pay satisfaction and supervisory support and turnover. Our findings also suggest that while race moderates the influence of compensation and supervisory support on job satisfaction, race has no moderating effect on the job satisfaction-turnover intentions relationship.

CONCLUSIONS

A focus on boosting job satisfaction, particularly through pay equity and perceived support, may reduce turnover among minority public health personnel.

Forgotten Front Line: Understanding the Needs of Unionized Home Health Aides in Downstate New York During the COVID-19 Pandemic

During the coronavirus disease 2019 (COVID-19) pandemic, home health aides (HHAs) provided daily medical and personal care to community-dwelling older adults and those with chronic conditions. Prior qualitative studies have found that providing care during COVID-19 left HHAs susceptible to physical, financial, and emotional risks. However, limited quantitative data exist The objective of this study was to assess the impact of COVID-19 on HHAs and to understand the challenges and opportunities for current and future pandemic planning. A cross-sectional survey of 256 HHAs in the downstate New York region was conducted by telephone in English, French Creole, Chine, Spanish, and Russian between August and November 2020. The survey found that HHAs experienced a variety of physical, financial, and emotional challenges during COVID-19. To better support this work force, action by public health officials and policymakers is warranted, particularly with respect to workplace protections and safety, mental health, compensation, and access to basic resources.

Disease-specific nutrition for the elderly and their Caretakers- What was and what could be

INTRODUCTION

Older adults who suffer from chronic illnesses often employ the help of Home Care Aides (HCAs). These HCAs assist their client's nutrition and other activities of daily living. However, many HCAs who care for the elderly are themselves unaware of proper nutrition habits that can improve health outcomes. This project proposal centers on a nutrition-training program that focuses on HCAs and their knowledge of proper nutrition. It will challenge participants to eat better using foods are best suited to the chronic illness that their client suffers from.

APPROACH

The Nutrition Training Package contains materials that can be used in training sessions conducted over two days. Each day consists of interactive activities, discussions and presentations. These materials were adapted from interventions used by the Healthy Aging Program- an intervention previously hosted by EverThrive IL.

OUTCOMES

Although pilot testing is yet to be conducted, the training package is complete and ready for implementation.

CONCLUSION

Based on literature review, the contents of the Nutrition Training Package for Home Care Aides will guide participants through stages of the Model of Change, simultaneously creating the self-efficacy to contribute to elongated, healthier living for the elderly.

Maximizing Home Health Aide Retention: The Impact of Control and Support on the Job

BACKGROUND AND OBJECTIVES

This study examined relationships between the level of control and support and home health aides (HHAs) job satisfaction and intent to leave the job.

RESEARCH DESIGN AND METHODS

Data derive from a survey of 512 HHAs in Massachusetts. Logistic regression using generalized estimating equations was employed for the analysis. Dependent variables included satisfaction and intent to leave the job as a home care aide generally and satisfaction and intent to leave the job at the aide's current agency.

RESULTS

The findings showed that greater control and support on the job were important predictors of positive work outcomes, controlling for job demands and other covariates. The odds of HHAs being satisfied with their job as a home care aide increased with the degree of control, whereas the odds of HHAs being satisfied with their job at their current agency increased with the extent of support. Control was negatively associated with HHAs' intent to leave the job as an aide; no relationship was found between control or support and HHAs' intent to leave their current agency.

DISCUSSION AND IMPLICATIONS

The results from this study illustrate the importance for HHAs of having control and autonomy in their work, as well as the benefit of support from supervisors and the home care agency, on satisfaction and intent to leave. Expanding HHA's ability to maintain control over their day-to-day work, as well as enhancing the supports available to them, is likely to benefit home care workers, clients, and agencies through increased retention.

Home Care Aide Safety Concerns and Job Challenges During the COVID-19 Pandemic

Home care aides are on the frontlines providing care to vulnerable individuals in their homes during the COVID-19 pandemic yet are often excluded from policies to protect health care workers. The goal of this study was to examine experiences of agency-employed home care aides during the COVID-19 pandemic and to identify ways to mitigate concerns. We used an innovative journaling approach with thirty-seven aides as well as in-depth interviews with fifteen aides and leadership representatives from nine home health agencies in New York and Michigan. Workers described a range of concerns around workplace safety including uncertainty around whether a client had COVID-19, inadequate access to personal protective equipment and safe transportation, as well as fundamental changes to interactions with clients. Agencies also faced challenges acquiring personal protective equipment for their aides. This research points to needed resources to support home care aides and home health agencies both during a public health crisis and in the future.

Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic: A Qualitative Analysis

Importance

Home health care workers care for community-dwelling adults and play an important role in supporting patients with confirmed and suspected coronavirus disease 2019 (COVID-19) who remain at home. These workers are mostly middle-aged women and racial/ethnic minorities who typically earn low wages. Despite being integral to patient care, these workers are often neglected by the medical community and society at large; thus, developing a health care system capable of addressing the COVID-19 crisis and future pandemics requires a better understanding of the experiences of home health care workers.

Objective

To understand the experiences of home health care workers caring for patients in New York City during the COVID-19 pandemic.

Design, Setting, and Participants

From March to April 2020, a qualitative study with 1-to-1 semistructured interviews of 33 home health care workers in New York City was conducted in partnership with the 1199SEIU Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest health care union in the US. Purposeful sampling was used to identify and recruit home health care workers.

Main Outcomes and Measures

Audio-recorded interviews were professionally transcribed and analyzed using grounded theory. Major themes and subthemes were identified.

Results

In total, 33 home health care workers employed by 24 unique home care agencies across the 5 boroughs of New York City participated. Participants had a mean (SD) age of 47.6 (14.0) years, 32 (97%) were women, 21 (64%) were Black participants, and 6 (18%) were Hispanic participants. Five major themes emerged: home health care workers (1) were on the front lines of the COVID-19 pandemic but felt invisible; (2) reported a heightened risk for virus transmission; (3) received varying amounts of information, supplies, and training from their home care agencies; (4) relied on nonagency alternatives for support, including information and supplies; and (5) were forced to make difficult trade-offs in their work and personal lives.

Conclusions and Relevance

In this qualitative analysis, home health care workers reported providing frontline essential care, often at personal risk, during the COVID-19 pandemic. They experienced challenges that exacerbated the inequities they face as a marginalized workforce. Interventions and policies to better support these frontline health care professionals are urgently needed.

The Role of Training and Work-Related Injury on Home Health Workers’ Job Satisfaction: Analysis of the National Home and Hospice Care Survey

The purpose of this study was to describe personal, job, agency, environmental, and ergonomic factors that affect job satisfaction among home health workers (HHWs). A cross-sectional design was conducted, and data from the National Home and Hospice Care Survey ( N = 3,274) were analyzed using a multilevel structural equation model (generalized structural equation model). HHWs with excellent training knowledge were about 1.5 times more likely to report a higher degree of job satisfaction compared with those with poor training knowledge, and those who reported a work-related injury were 66% more likely to report lower job satisfaction score. Job satisfaction is associated with work environment, leadership support, and work-related training. Future research and a follow-up survey are needed to understand HHWs’ workforce and be better positioned to meet their need so that they may meet the need of the aging population.