Factors associated with the self-perceived ability of nursing staff to remain working until retirement: a questionnaire survey

The role of workday characteristics on perceived stress and time pressure among nurses in Finnish long-term care - a cross-sectional study

BACKGROUND

Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance).

METHODS

A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients' care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression.

RESULTS

Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy.

CONCLUSIONS

Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses.

PATIENT OR PUBLIC CONTRIBUTION

Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.

Factors associated with work ability among employees of an Italian university hospital

BACKGROUND

A growing body of evidence clearly documents the benefits of integrated systems approaches to protecting and promoting the safety, health and well-being of workers. The purpose of this study is to provide a holistic view of the work ability of employees of an Italian University Hospital measuring their resources in relation to job demands. In particular, it examines socio-demographics, family and organizational antecedents of health professionals' work ability.

METHODS

A survey was conducted to assess the work ability of healthcare professionals, including physicians, nurses and administrative staff, working at the University Hospital of Modena (Italy). The data collection allows us to get a sample of 443 workers, who correspond to 11% of the target population. The data were analyzed using preliminary statistics on the main characteristics of the sample in terms of work ability, socio-demographic variables, family and organizational characteristics. In addition, logit models of the likelihood of having high work ability were estimated using SPSS version 25.

RESULTS

Work ability decreases with increasing age, comorbidity, high body mass index, having at least one child under 5 and/or a dependent adult, having a poor work-life balance, and doing more than 20 h of housework. Specific job resources can significantly promote work ability, including relationship-oriented leadership, autonomy in decision making and individuals' skill match. The nursing profession is associated with a low work ability. Finally, a significant gender gap has been documented. Women find it more difficult to reconcile life and work, especially when they have children of preschool age and work in professions with greater responsibilities, as in the case of women doctors, who experience lower work capacity.

CONCLUSIONS

Our results suggest that it is necessary to consider other factors, in addition to age, that are equally relevant in influencing work ability. Consequently, organisational interventions could be implemented to improve the work ability of all workers. In addition, we propose targeted interventions for groups at risk of reduced work capacity, in particular older workers (45 years and over), nurses, women with children of preschool age and in the position of physician.

Relationship between turnover intention and workplace personal relations among care workers employed by elder care facilities

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.

The introduction of care robots as a leadership challenge in home care facilities in Finland

Aims

This paper analyses the factors that influence home care employees’ intention to introduce robots.

Background

The introduction of different kinds of care robots is a topical issue in elderly care now and in the near future.

Methods

Cross‐sectional research conducted through a questionnaire. The survey data (N = 162) were collected in five locations around Finland in 2019. The analysis was carried out by regression analysis, Sobel test and by Hayes’ bootstrapping method.

Results

The results show that self‐efficacy is pivotal in the willingness to introduce care robots. Employees’ age increases the enthusiasm to introduce robots but reduces self‐efficacy. Work engagement does not correlate with self‐efficacy or behavioural intention related to the introduction of care robots.

Conclusions

The present paper reveals the significance of attitudes, cognitive factors and age in the adoption of care robots in home care facilities.

Practical implications

It is important to pay attention to supporting the employees’ sense of technology management and the construction of a robot‐positive atmosphere when introducing care robots, and the development of skills of older employees and employees with a lower educational level should be supported.

Nurses Working in Nursing Homes: A Mediation Model for Work Engagement Based on Job Demands-Resources Theory

This study examined the impact that the attractiveness of working in nursing homes and autonomous clinical judgment have on affective occupational commitment, and whether work engagement mediates these relationships. This analysis was based on the job demands-resources theory. The study setting was 1200 nursing homes (including long-term care welfare facilities and long-term care health facilities) in eastern Japan. An anonymous, self-report questionnaire survey was administered to two nurses from each facility, resulting in a prospective sample of 2400 participants. Overall, 552 questionnaires were analyzed, in which structural equation modeling and mediation analysis using the bootstrap method were performed. The results showed that the attractiveness of working in nursing homes does not directly affect affective occupational commitment; work engagement fully mediates the impact of attractiveness of working in nursing homes on affective occupational commitment. Additionally, autonomous clinical judgment showed a direct impact on both work engagement and affective occupational commitment, indicating that work engagement partially mediates the impact on affective occupational commitment. To increase the affective occupational commitment of nurses working in nursing homes, managers should help nurses recognize the attractiveness of working in nursing homes, and then provide appropriate support to help such nurses work in a motivated manner.

Association between burnout and wellness culture among emergency medicine providers

OBJECTIVE

Burnout is a common occurrence among healthcare providers and has been associated with provider wellness culture. However, this association has not been extensively studied among emergency medicine (EM) providers. We aim to determine the association between EM provider burnout and their culture of wellness, and to elicit the independent wellness culture domains most predictive of burnout prevention.

METHODS

This was a multi-center observational study. We enrolled EM physicians and advanced practice providers from sixteen different emergency departments (EDs). Provider wellness culture and burnout surveys were performed. The wellness culture domains included in this study are personal/organizational value alignment, provider appreciation, leadership quality, self-controlled scheduling, peer support, and family support. Correlations between each wellness culture domain and burnout were analyzed by Pearson correlation co-efficiency, and their associations were measured by multivariate logistic regression with adjustments of other confounders.

RESULTS

A total of 242 ED provider surveys were entered for final analysis. The overall burnout rate was 54% (130/242). Moderate correlations were found between burnout and two wellness culture domains (value alignment: r=-0.43, P<0.001 and provider appreciation: r=-0.49, P<0.001). The adjusted odds ratio of provider appreciation associated with burnout was 0.44 (95% confidence interval, 0.25-0.77; P=0.004), adjusted odds ratio of family support was 0.67 (95% confidence interval, 0.48-0.95; P=0.025).

CONCLUSION

ED providers have a relatively high burnout rate. Provider burnout might have certain associations with wellness culture domains. Provider appreciation and family support seem to play important roles in burnout protection.

Factors influencing the recruitment and retention of registered nurses in adult community nursing services: an integrative literature review

BACKGROUND

Adult community nursing services are evolving around the world in response to government policies and changing patient demographics. Amidst these changes, recruitment and retention of community nursing staff are proving a challenge. An integrative literature review has identified multiple factors that influence nurse retention in adult community nursing with sparse information on recruitment factors. Although factors impacting retention of community nurses have been identified, their generalisability around the world is a challenge as they are context and co-dependent. Indicating the need for this area of study to be explored at a local level, as the same factors present with different findings globally.

AIM

To establish factors influencing recruitment and retention of registered nurses in adult community nursing services.

DESIGN

Integrative literature review.

DATA SOURCES

Four electronic databases were searched in August 2019 from January 2008 to December 2018: CINAHL Complete, Web of Science, MEDLINE and PROQUEST. Both qualitative and quantitative studies focusing on factors influencing community nursing recruitment and retention were included.

REVIEW METHODS

An integrative literature review methodology by Whittemore and Knafl (The integrative review: updated methodology. Journal of Advanced Nursing 52, 546-553) was followed, supported by Cochrane guidelines on data synthesis and analysis using a narrative synthesis method. The Center for Evidence-Based Management (CEBMa) critical appraisal tools were used for study quality assessment.

RESULTS

Ten papers met the study inclusion criteria. Data synthesis and analysis revealed individual and organisational factors influencing the retention of community nurses with the following three dominant themes: (1) work pressure, (2) working conditions and (3) lack of appreciation by managers.

CONCLUSION

The review identified context-dependent factors that influence adult community nurses' retention with limited generalisability. There is a lack of data on factors influencing recruitment into adult community nursing; further research is needed to explore factors affiliated to community nursing recruitment.

Identifying contemporary early retirement factors and strategies to encourage and enable longer working lives: A scoping review

AIM

Accelerating population ageing is raising concern in many countries now in relation to the availability of workers for essential work roles and responsibilities. A scoping research literature review was done to identify factors currently associated with early retirement and contemporary strategies to encourage and support longer working lives.

METHODS

Using the PRISMA-ScR Checklist, we searched the Directory of Open Access Journals and EBSCO Discovery Service for published 2013-2018 research articles using the keyword/MeSH term "early retirement"; 54 English-language articles in peer-review journals were reviewed.

RESULTS

Seven early retirement factors were revealed: Ill health, good health, workplace issues, the work itself, ageism, social norms and having achieved personal financial or pension requirement criteria. Six suggested solutions, none proven effective, were identified: Occupational health programmes, workplace enhancements, work adjustments, addressing ageism, changing social norms and pension changes.

CONCLUSIONS

The evidence base on early retirement prevention is not strong, with qualitative investigations needed for in-depth understandings of early retirement influences and mixed-methods studies needed to test early retirement prevention solutions for their effects.

IMPLICATIONS FOR PRACTICE

Until more evidence is available, every organisation should perform an early retirement risk assessment and identify current versus needed policies and programmes to encourage and enable more middle-aged and older people to work longer.

Intention to Extend Working Life among Thai Registered Nurses in Ministry of Public Health: A National Survey

The serious shortage of registered nurses (RNs) in Thailand has made the Thai government tentatively propose a policy to extend the working life of Ministry of Public Health nurses. This study aimed to estimate the proportion of those RNs who intend to extend their working life and analyzed the associations between general characteristics, quality of work life, and job characteristics of the RNs and their intention to work past retirement age. This cross-sectional study was conducted from October 2016 to April 2017. Self-administered questionnaires were distributed nationally to 3,629 RNs in the age group 55-59 years and working for the Ministry of Public Health (MoPH), Thailand. The response rate was 85.0% (3,092 RNs). Due to the small number of male participants (n=74), males were excluded from the study. The analysis was limited to the 3,018 participants who returned the questionnaire and met the inclusion criteria. Descriptive statistics and multiple logistic regression were used for data analysis. Of the 3,018 participants, the proportion of RNs intending to extend their working life from 60 to 65 years was 30.5%. In the Service Department, the factors significantly associated with intention to extend working life were perceived good or very good health status, no shift work, monthly income more than 50,000 THB (1,595 USD), and having moderate or good working resources (p<0.01). In the four Academic Departments, perceived good or very good health status, monthly income more than 50,000 THB, family members not against the working life extension, and moderate or good working resources were the factors affecting intention to extend working life (p<0.01). This study indicated that understanding the various factors related to the intention to extend working life among RNs could lead to the design of appropriate programs to encourage them to continue working after the current retirement age.

The Role of the Registered Nurse Working in Substance Use Disorder Treatment: A Hermeneutic Study

Substance Use Disorders (SUDs) are a national public health crisis. However, there is minimal existing research literature on the role of the nurse working in SUD treatment. The purpose of this study was to describe the meaning of the professional role of the registered nurse working in the SUD setting. The study utilized a Heideggerian Phenomenological approach with a modified Colaizzi method for analysis and interpretation. The nine study participants, two males and seven females, aged 27-60 had worked in SUD treatment for 1-37 years. Three major themes, with sub-themes, emerged: Defining the Role for Self; Learning the Role; and Navigating with Ease in an Unchangeable Culture. Findings demonstrated that nurses in SUD treatment value their role and the care of patients with SUDs. Patient recovery or relapse influenced job satisfaction. Significantly, the findings highlighted an outdated role with rigid boundaries and no real contemporary identity. Findings can be used to address the need for a contemporary SUD nursing identity and to support ongoing involvement of nurses in health policy related to SUDs.

The health of working nurses: Hypertension prevalence, awareness, treatment and control by medication

AIMS

To investigate hypertension awareness, prevalence and treatment in nurses.

BACKGROUND

Nurses are the largest health workforce group, currently facing an ageing demographic and the risk of chronic disease such as hypertension. Little is known about hypertension in nurses despite the potential impact on work productivity.

METHODS

A cross-sectional online survey was distributed to nurses and midwives via the professional association and nursing directors. Questions were taken from published longitudinal health studies for blood pressure, hypertension and key sociodemographic and health factors.

RESULTS

The participants' (n = 5,041) mean age was 47.99 (SD 11.46) years. The majority knew their blood pressure, more so if they were female, of higher body mass index and aged 45-64 years, but less so if they were smokers. Hypertension prevalence increased with age, peaking at the oldest ages and the majority were treated (anti-hypertensive medication), less so if aged <55 years. Many nurses treated for hypertension had poor blood pressure control, were most often aged 45-54 years and were smokers.

CONCLUSIONS

Hypertension prevalence is less in nurses than in the general population, however, once diagnosed treatment is not optimized.

IMPLICATIONS FOR NURSING MANAGEMENT

The potential impact of hypertension on older nurses' work productivity justifies work-based support for risk reduction behaviours.

Factors Associated With Stability of Health Nursing Services for Children With Medical Complexity

The objectives of our study are to: (1) identify the factors associated with lack of stable home healthcare nursing services for children with medical complexity, and (2) describe the implications of unstable home healthcare nursing for children, caregivers, nurses, and home healthcare agencies. We collected qualitative data in 20 semistructured in-depth interviews (15 English, 5 Spanish) with 26 primary caregivers of children with medical complexity, and 4 focus groups of 18 home healthcare nurses inquiring about their experiences about home healthcare nursing services for children with medical complexity. During an iterative analysis process, we identified recurrent themes related to stability of home healthcare nursing. Lack of stability in home healthcare nursing was common. These include: (1) not finding nurses to cover shifts, (2) nurse turnover, (3) nurses calling out frequently, and (4) nurses being fired by caregivers. Reasons for lack of stability of home healthcare nursing services were multifactorial and included: nurse-level, child-level, caregiver-level, residence-level, agency-level, and system-level factors. Lack of stable home healthcare nursing affected the well-being of children with medical complexity, and contributed to substantial caregiver burden. There were negative implications of unstable home healthcare services for nurses and home healthcare agencies as well. Lack of stable home healthcare nursing services is a major problem in the home care of children with medical complexity. Although some of the factors for unstable home healthcare nursing services are not modifiable, there are others that are potentially modifiable. Ensuring stable home healthcare nursing services will likely improve care of children and reduce caregiver burden.

Does More Respect from Leaders Postpone the Desire to Retire? Understanding the Mechanisms of Retirement Decision-Making

The demographic trends (i.e., low birth rates and increasing longevity) pose challenges with regard to the increase of the average employee age along with a lack of skilled personnel on the labor market. Society, organizations, and individuals are confronted with the question on how to prolong working lives in the future. Based on socioemotional selectivity theory, the purpose of this study was to investigate the relationship between respectful leadership and older workers’ desired retirement age. In particular, we took a closer look at job satisfaction, subjective health, and work-to-private life conflict as underlying mechanisms. Further, we tested for the moderating role of occupational self-efficacy as an auxiliary condition for the assumed relationships of respectful leadership. We tested our hypothesized model using data from 1,130 blue- and white-collar workers aged 45–65 years. The results of structural equation modeling indicated that respectful leadership was positively related to older workers’ desired retirement age and that this relationship was mediated by subjective health and work-to-private life conflict but not by job satisfaction. The findings add to the literature on resources in retirement decision-making; notably, they highlight the importance of leadership behavior for older workers’ motivation and socioemotional needs.

Is socially integrated community day care for people with dementia associated with higher user satisfaction and a higher job satisfaction of staff compared to nursing home-based day care?

OBJECTIVES

To investigate whether community-based (CO) day care with carer support according to the proven effective Meeting Centres Support Programme model is associated with higher satisfaction of people with dementia (PwD) and their informal caregivers (CG) and with a higher job satisfaction among care staff compared to traditional nursing home-based (NH) day care.

METHOD

Data were collected in 11 NH day care centres and 11 CO day care centres. User satisfaction of PwD and CG was evaluated in the 11 NH day care centres (n_PwD = 41, n_CG = 39) and 11 CO day care centres (n_PwD = 28, n_CG = 36) with a survey after six months of participation. Job satisfaction was measured only in the six NH day care centres that recently transformed to CO day care, with two standard questionnaires before (n_STAFF = 35), and six months after the transition (n_STAFF = 35).

RESULTS

PwD were more positive about the communication and listening skills of staff and the atmosphere and activities at the CO day care centre. Also, CG valued the communication with, and expertise of, staff in CO day care higher, and were more satisfied with the received emotional, social and practical support. After the transition, satisfaction of staff with the work pace increased, but satisfaction with learning opportunities decreased.

CONCLUSION

PwD and CG were more satisfied about the communication with the staff and the received support in CO day care than in NH day care. Overall job satisfaction was not higher, except satisfaction about work pace.

Work motivation, task delegation and job satisfaction of general practice staff: a cross-sectional study

BACKGROUND

Recent research has shown that a high degree of task delegation is associated with the practise staff's overall job satisfaction, and this association is important to explore since job satisfaction is related to medical as well as patient-perceived quality of care.

OBJECTIVES

This study aimed: (1) to investigate associations between degrees of task delegation in the management of chronic disease in general practice, with chronic obstructive pulmonary disease (COPD) as a case and the staff's work motivation, (2) to investigate associations between the work motivation of the staff and their job satisfaction.

METHODS

The study was based on a questionnaire to which 621 members of the practice staff responded. The questionnaire consisted of a part concerning degree of task delegation in the management of COPD in their respective practice and another part being about their job satisfaction and motivation to work.

RESULTS

In the first analysis, we found that 'maximal degree' of task delegation was significantly associated with the staff perceiving themselves to have a large degree of variation in tasks, odds ratio (OR) = 4.26, confidence interval (CI) = 1.09, 16.62. In the second analysis, we found that this perceived large degree of variation in tasks was significantly associated with their overall job satisfaction, OR = 2.81, confidence interval = 1.71, 4.61.

CONCLUSION

The results suggest that general practitioners could delegate highly complex tasks in the management of COPD to their staff without influencing the staff's work motivation, and thereby their job satisfaction, negatively, as long as they ensure sufficient variation in the tasks.