Breaking the cycle: how Spain's dependency care system creates occupational inequalities in geriatric nursing assistants and the need for reform.

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal for Equity in Health Pub Date : 2025-03-18 DOI:10.1186/s12939-025-02426-1
Mireia Campoy-Vila, Albert Espelt, Júlia Jubany, Olga Borao, Anna Canet-Torres, Carles Muntaner
{"title":"Breaking the cycle: how Spain's dependency care system creates occupational inequalities in geriatric nursing assistants and the need for reform.","authors":"Mireia Campoy-Vila, Albert Espelt, Júlia Jubany, Olga Borao, Anna Canet-Torres, Carles Muntaner","doi":"10.1186/s12939-025-02426-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The implementation of Spain's Dependency Law aimed to enhance care for those with dependency needs. However, its focus on privatized service provision has raised concerns about potential inequalities in working conditions for geriatric nursing assistants working in long-term care, particularly regarding resources, workload, and labour protections between public and private ownership. This study aims to explore the employment conditions, working conditions and health status of geriatric nursing assistants in Spanish nursing homes, specifically examining the potential impact of facility ownership type.</p><p><strong>Methods: </strong>We conducted a descriptive cross-sectional study including geriatric nursing assistants working in nursing homes in Spain in the year 2022. The final sample consisted of 344 nursing assistants recruited using the snowball and self-selection sampling methods. Data were collected using a computerized, self-administered questionnaire. The variables studied encompassed employment and working conditions and health-related factors, including physical and mental health status assessed using 12-Item Short Form Health Survey (SF-12v1), physical activity levels, and characteristics of back pain. To examine the association between the descriptive variables and facility ownership, Poisson regression models with robust variance were fitted.</p><p><strong>Results: </strong>Nursing assistants in private nursing homes were significantly more likely to report worse working and health-related conditions (aPR = 1.19, 95% CI: 1.07-1.32) compared to those in public facilities. For example, only 22.6% of public workers felt they lacked time for tasks, compared to 48.2% in private nursing homes. Similarly, emotional exhaustion was more prevalent among private staff (86.6% vs. 71.7%).</p><p><strong>Conclusions: </strong>The results highlight the negative impact of neoliberal policies, particularly the privatization of nursing homes, on the working conditions of geriatric nursing assistants, exacerbating health inequalities. A shift towards a community-based care model with increased public investment is essential to improve working conditions, promote healthy aging, and enhance the quality of care provided by nursing assistants.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"24 1","pages":"77"},"PeriodicalIF":4.5000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal for Equity in Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12939-025-02426-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The implementation of Spain's Dependency Law aimed to enhance care for those with dependency needs. However, its focus on privatized service provision has raised concerns about potential inequalities in working conditions for geriatric nursing assistants working in long-term care, particularly regarding resources, workload, and labour protections between public and private ownership. This study aims to explore the employment conditions, working conditions and health status of geriatric nursing assistants in Spanish nursing homes, specifically examining the potential impact of facility ownership type.

Methods: We conducted a descriptive cross-sectional study including geriatric nursing assistants working in nursing homes in Spain in the year 2022. The final sample consisted of 344 nursing assistants recruited using the snowball and self-selection sampling methods. Data were collected using a computerized, self-administered questionnaire. The variables studied encompassed employment and working conditions and health-related factors, including physical and mental health status assessed using 12-Item Short Form Health Survey (SF-12v1), physical activity levels, and characteristics of back pain. To examine the association between the descriptive variables and facility ownership, Poisson regression models with robust variance were fitted.

Results: Nursing assistants in private nursing homes were significantly more likely to report worse working and health-related conditions (aPR = 1.19, 95% CI: 1.07-1.32) compared to those in public facilities. For example, only 22.6% of public workers felt they lacked time for tasks, compared to 48.2% in private nursing homes. Similarly, emotional exhaustion was more prevalent among private staff (86.6% vs. 71.7%).

Conclusions: The results highlight the negative impact of neoliberal policies, particularly the privatization of nursing homes, on the working conditions of geriatric nursing assistants, exacerbating health inequalities. A shift towards a community-based care model with increased public investment is essential to improve working conditions, promote healthy aging, and enhance the quality of care provided by nursing assistants.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
期刊最新文献
Applications of equity frameworks in theory-based health behavior interventions: a scoping review. Impact of an innovative case-based payment reform on hospital cost variation: insights from cerebral infarction inpatients in China. Breaking the cycle: how Spain's dependency care system creates occupational inequalities in geriatric nursing assistants and the need for reform. Equity of access in rural and metropolitan dementia diagnosis, management, and care experiences: an exploratory qualitative study. Examining the magnitude of inequality and inequity in use of healthcare resources among older Australians with cognitive decline.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1