The Hybrid Multiple-Criteria Decision-Making Model for Home Healthcare Nurses’ Job Satisfaction Evaluation and Improvement

Objectives: To investigate and evaluate the key factors related to job satisfaction performance of home healthcare nurses (HHNs).

Methods: A total of 31 HHNs from three community hospitals in Zhejiang province were invited to participate in the study. They completed a questionnaire survey based on the home healthcare nurse job satisfaction scale (HHNJS) from February to March 2022. Consistent fuzzy preference relation (CFPR) methods and important-performance analysis (IPA) were used to obtain the attribute weights and performance for HHNs job satisfaction.

Results: The results showed that the attributes of C₁₃, C₁₄, C₁₅, C₂₃, C₂₄, C₄₂, C₅₁, and C₅₂ were key factors influencing HHNs job satisfaction.

Conclusion: The hybrid multiple-criteria decision-making (MCDM) model can help home-healthcare-agency administrators better understand the key factors related to HHNs job satisfaction and establish reasonable improvement strategies.

The development and validation of the Japanese version of job satisfaction scale: a cross-sectional study on home healthcare nurses

Objective

A reliable and valid tool is required to assess home healthcare nurses’ job satisfaction for evaluating and improving the work environment and clinical practice of home healthcare. This study aimed to develop and examine the Japanese version of the Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS-J). The Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS) was translated into Japanese; a backward translation was performed until equivalence between the original and the backward-translated HHNJS was confirmed. Subsequently, a mail survey was conducted among 409 home healthcare nurses from 154 home healthcare agencies in Japan. We evaluated construct validity through Confirmatory Factor Analysis (CFA), and criterion-related validity and internal consistency were also tested.

Results

The CFA revealed a second-order seven-factor structure and adequate internal consistency, although, the fit of the data to the factor structure was moderate. As per the goodness-of-fit indices of the final model of the CFA, the comparative fit index was 0.89 and root mean square error of approximation was 0.06. This newly translated scale can be used to assess the job satisfaction of home healthcare nurses within Japan. The HHNJS-J evaluated acceptable reliability and validity among Japanese home healthcare nurses and had application in clinical practice in Japan.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06092-2.

Impact of Organizational Attributes on Nurse Satisfaction in Home Health

With the nursing shortage continuing to worsen, the retainment of current nursing staff becomes increasingly important for health care organizations. Specific organizational attributes have been found to have a significant relationship with nurse satisfaction in the acute care setting. Results from this study demonstrate a significant relationship between certain organizational attributes and nurse satisfaction in the home health care setting.

Indicators of Job Satisfaction of Home Healthcare Nurses in the San Francisco Bay Area of California

The purpose of this study was to identify the factors that provide job satisfaction for home healthcare nurses and to determine if the nurses' educational level makes a difference in job satisfaction. Data were collected using Ellenbecker's (2004) 21-item Home Healthcare Nurses Job Satisfaction Scale. The study results indicated the majority of this population of home healthcare nurses was satisfied on all items, except in having the power to change agency policy. Educational level made no significant difference in job satisfaction. Recommendations include encouraging agencies to include clinicians in policy decision-making and management of patient care. Nursing education programs should ensure nurses graduate with the skills necessary for policy development and to make decisions that positively impact patient care.

Home health agency work environments and hospitalizations

BACKGROUND

An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs.

OBJECTIVES

To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living.

METHODS AND DESIGN

Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge.

RESULTS

Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments.

CONCLUSION

Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care.

Work environment characteristics of high-quality home health agencies

This concurrent mixed-method study examines the nurse work environment of high-quality Medicare-certified home health agencies. High-quality (n=6) and low-quality (n=6) home health agencies were recruited using agency-level publicly reported patient outcomes. Direct care registered nurses (RNs) from each agency participated in a focus group and completed the Practice Environment Scale of the Nurse Work Index (PES-NWI). No significant differences were found in the PES-NWI results between nurses working in high- and low-quality agencies, though nurses in high-quality agencies scored higher on all subscales. Nurses working in all the high-quality agencies identified themes of adequate staffing, supportive managers, and team work. These themes were not consistently identified in low-quality agencies. Themes of supportive managers and team work are reflective of effective leadership at the manager level. Agencies struggling to improve quality of care might consider developing their managers' leadership skills.

Occupational health-related experiences in rural Tasmania

This descriptive, explorative study sought to identify the occupational-related health experiences of community nurses in their workday within rural North West Tasmania. Tasmania is one of eight states and territories that form Australia. The findings indicate the majority of community nurses consider their health average or better, although 30% reported being overweight; 5% reported smoking; 60% reported feeling tense, anxious or depressed sometimes during the week. In the 12 months prior to survey 48% of participants had experienced a work-related injury or illness. At least two thirds of participants spent an average of 1.5 hours teaching nursing students and 2 hours teaching medical students, per week. Hazards (needlestick injury, items obstructing passageways, debris within homes), dogs and use of mobile telephones were regularly associated with weekly work incidents. Interestingly, more time was spent in a day on documentation than with clients or professional development.

Home healthcare practice environment: predictors of RN satisfaction

Since 2000, Medicare-certified home healthcare agencies have undergone significant regulatory changes that directly affect registered nurses. The satisfaction of 201 nurses from 19 home healthcare agencies was examined. Home healthcare nurses reported slightly lower satisfaction than hospital nurses and were approximately 50% less satisfied than they were in 2000. Satisfaction had a negative relationship with years worked as a home healthcare nurse (r= -.25, p< .01). Controlling for years of home healthcare experience, control over practice decisions and practice setting decisions were significant predictors of satisfaction. With the demand for home healthcare nurses expected to increase 109% by 2020, development of a National Database of Nursing Quality Indicators for home healthcare that includes satisfaction as a nurse-sensitive outcome might be helpful.

The Essentials of Magnetism for Home Health

OBJECTIVE

The purpose of this study was to determine what home health nurses perceived to be the Essentials of Magnetism in the home healthcare setting.

BACKGROUND

Research in the acute care setting has established relationships between organizational attributes, nurse satisfaction, and quality outcomes. However, little is known in the home health setting on the importance and the impact of these relationships. More research is needed to further understand the implications to home healthcare.

METHODS

Registered nurses (N = 260) were asked to identify the top 10 attributes from the 37-item Dimensions of Magnetism instrument developed by Kramer and Schmalenberg. The top 10 Essentials of Magnetism attributes were obtained by tabulation of the number of respondents to each question.

RESULTS

The results showed that 7 of the top 8 Essentials of Magnetism items chosen by the home health nurses (n = 106) were the same Essentials of Magnetism items chosen by acute care nurses in previous studies. A test-retest of the top 10 items revealed a high level of reliability (.77).

CONCLUSION

Although the results demonstrate similar attributes as those identified in the acute care setting, noted differences need further review to understand their role in registered nurse satisfaction and quality.

Agencies MAKE A DIFFERENCE in Home Healthcare Nurse??? job Satisfaction

The purpose of this study was to explore the factors that contribute to variability in home healthcare nurses' job satisfaction. Nurses completed the 30-item Home Healthcare Nurses Job Satisfaction Scale specifically designed to measure job satisfaction of home healthcare nurses. Results suggest that the greatest amount of variability in satisfaction for home healthcare nurses are salary and benefits, stress and workload, and organizational factors, that is, factors over which organizations and management have the most control.

Home Healthcare Nurses' Job Satisfaction Scale: refinement and psychometric testing

AIMS

This paper describes a study to further develop and test the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale, including reliability and construct and criterion validity.

BACKGROUND

Numerous scales have been developed to measure nurses' job satisfaction. Only one, the Home Healthcare Nurses' Job Satisfaction Scale, has been designed specifically to measure job satisfaction of home healthcare nurses. The Home Healthcare Nurses' Job Satisfaction Scale is based on a theoretical model that integrates the findings of empirical research related to job satisfaction.

METHODS

A convenience sample of 340 home healthcare nurses completed the Home Healthcare Nurses' Job Satisfaction Scale and the Mueller and McCloskey Satisfaction Scale, which was used to test criterion validity. Factor analysis was used for testing and refinement of the theory-based assignment of items to constructs. Reliability was assessed by Cronbach's alpha internal consistency reliability coefficients. The data were collected in 2003.

RESULTS

Nine factors contributing to home healthcare nurses' job satisfaction emerged from the factor analysis and were strongly supported by the underlying theory. Factor loadings were all above 0.4. Cronbach's alpha coefficients for each of the nine subscales ranged from 0.64 to 0.83; the alpha for the global scale was 0.89. The correlations between the Home Healthcare Nurses' Job Satisfaction Scale and Mueller and McCloskey Satisfaction Scale was 0.79, indicating good criterion-related validity.

CONCLUSIONS

The Home Healthcare Nurses' Job Satisfaction Scale has potential as a reliable and valid scale for measurement of job satisfaction of home healthcare nurses.

Exercise of Autonomous Home Care Practice

This study examined how the value of autonomy is reflected in home healthcare agencies' practice models and how staff registered nurse (RN) characteristics (education, experience, certification) relate to the RNs' perception of their ability to exercise autonomous practice: control over practice decisions (clinical autonomy) and control over practice setting decisions (organizational autonomy). RNs (N = 82) from 11 agencies were found to have more control over practice decisions than practice setting decisions. No significant relationship was found between RN characteristics of education, RN experience, home healthcare experience, and specialty certification.

A theoretical model of job retention for home health care nurses

BACKGROUND

Predicted severe nursing shortages and an increasing demand for home health care services have made the retention of experienced, qualified nursing staff a priority for health care organizations.

AIMS

The purpose of this paper is to describe a theoretical model of job retention for home health care nurses.

METHODS

The theoretical model is an integration of the findings of empirical research related to intent to stay and retention, components of Neal's theory of home health care nursing practice and findings from earlier work to develop an instrument to measure home health care nurses' job satisfaction.

DISCUSSION

The theoretical model identifies antecedents to job satisfaction of home health care nurses. The antecedents are intrinsic and extrinsic job characteristics. The model also proposes that job satisfaction is directly related to retention and indirectly related to retention though intent to stay. Individual nurse characteristics are indirectly related to retention through intent to stay. The individual characteristic of tenure is indirectly related to retention through autonomy, as an intrinsic characteristic of job satisfaction, and intent to stay.

CONCLUSIONS

The proposed model can be used to guide research that explores gaps in knowledge about intent to stay and retention among home health care nurses.

Increasing job satisfaction, quality care, and coordination in home health

Data from 188 home health employees revealed that working for a reputable agency, having adequate business/office support, and interactions with patients were positively associated with job satisfaction. New employees viewed positive relationships with supervisors as an important indicator of job satisfaction, whereas senior employees reported recognition/acknowledgment to relate more with job satisfaction. Reduced workload, improved work environment, and frequent meetings were viewed as critical elements of quality care provision and coordination. Practice improvements are highlighted.

Collaboration with Master’s Students in Home Health Care Research

Changes in health care have created an increasingly complex home health care environment, one in which knowledge derived from research is essential to provide patient care. The development of knowledge is enhanced when nurse researchers, nurse providers, and graduate nursing students collaborate to conduct research. Collaboration in research has many benefits. It benefits graduate students by providing opportunities to gain the skills needed for the advance practice role. It benefits academic researchers by advancing their programs of research, providing additional student resources and a fresh perspective. It benefits providers and the nursing profession by expanding knowledge that defines the profession, drives practice, and holds nurses accountable. Most important, collaborative research efforts benefit patients by assuring that nurses in the future are experienced in research and have the abilities to design, implement, and evaluate nursing care based on scientific evidence, ensuring access to safe and effective care.