Brannon D, Barry T, Kemper P, Angelelli J; AcademyHealth. Meeting (2005 : Boston, Mass.).
Abstr AcademyHealth Meet. 2005; 22: abstract no. 4474.
The Pennsylvania State University, Dept. of Health Policy and Administration, 116 Henderson Bldg, University Park, PA 16802 Tel. (814) 863-8514 Fax (814) 863-2905
RESEARCH OBJECTIVE: To identify the job rewards and concerns of providing personal care in diverse long term care settings and to assess how those rewards and concerns relate to organizational commitment, operationalized as turnover intention . STUDY DESIGN: A paper and pencil survey was administered to direct care workers (DCWs) currently employed at long term care provider organizations. The Job Role Quality (JRQ) questionnaire (Marshall et. al. 1991) and two items measuring turnover intention were administered to two different samples in a cross sectional survey. The factor structure of the JRQ scales was assessed and minor modifications made to the a piori scales. Variations by provider organizational type were identified. Regression models controlling for provider type were tested to assess relationships among rewards and concerns, respectively, and intent to turnover. POPULATION STUDIED: Surveyed were direct care workers at nursing homes, assisted living facilities, home care agencies, and adult day health centers participating in the Better Jobs, Better Care Demonstration (n= 200~) and those from the same array of providers in a 2004 survey of long term care workers in Pennsylvania DCWs (n=600~). These are individuals who provide hands-on personal care (e.g. assistance with bathing, toileting, dressing, transferring, and feeding) and are not LPNs or RNs. PRINCIPAL FINDINGS: In analysis of the PA sample, a significant provider type effect was observed (p=.006). Nursing and personal care facilities workers were more likely to express an intent to leave than were comparable workers in home care or adult day centers. Two reward factors, one measuring how challenging and rewarding the work itself is (p.=.12) and the other measuring supervisor support (p.=000) were inversely related to intent to leave. The factors helping others, decision authority, and pay satisfaction were not significant in the multivariate model. In terms of the relationship between concern factors and intent to leave, provider type was also significant (p=.000), with the same pattern as above. Controlling for provider type, work overload (p=.000), the perception of a dead end job (p=.000) and poor supervision (p=.011) were positively related to intent to leave. Hazards related to illness and injury and racial or gender discrimination were not significant factors. Additional analyses are in progress, including incorporation the BJBC sample as it is completed. CONCLUSIONS: Turnover intentions, which are predictive of turnover, are influenced by factors derived from the job itself. These include the extent to which rewarding aspects of the work are perceived, including supervisor support and to a lesser extent challenge and recognition. Controlling for provider effects, the more overload, perceptions of a dead end job and poor supervision a direct care worker reports, the more likely she is to report turnover intentions. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Long term managers need resources to improve supervision of direct care workers. Policy-makers need to address the impact of caregiver overload in order to stabilize this important workforce.
Publication Types:
Keywords:
- Adult
- Career Mobility
- Caregivers
- Cross-Sectional Studies
- Data Collection
- Employment
- Humans
- Intention
- Long-Term Care
- Nursing Homes
- Nursing Staff, Hospital
- Occupations
- Pennsylvania
- Personnel Turnover
- Questionnaires
- Social Environment
- Work
- manpower
- hsrmtgs
UI: 103623937
From Meeting Abstracts