Yinfei Duan, Trina Thorne, Alba Iaconi, Yuting Song, Seyedehtanaz Saeidzadeh, Malcolm Doupe, Peter G Norton, Carole A Estabrooks
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We standardized the outcomes using z-scores.</p><p><strong>Results: </strong>Between T<sub>1</sub> and T<sub>2</sub>, care aides in care units with less favorable work environments-characterized by less supportive leadership, weaker work culture, less effective team communication and feedback mechanisms, and insufficient structural resources and staffing-experienced a statistically significant decline in job satisfaction (B = -0.17, P < .01) and professional efficacy (B = -0.20, P < .01), along with an increase in exhaustion (B = 0.15, P < .05) and in cynicism (B = 0.27, P < .001). Those in more favorable work environments exhibited no statistically significant changes in these variables during the same period. 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引用次数: 0
摘要
目的：本研究考察了2014年至2020年初长期护理（LTC）之家护理单位工作环境与护理助理工作满意度和职业倦怠（疲惫、愤世嫉俗、职业效能降低）趋势之间的关系。设计：本研究是一项回顾性纵向研究，使用老年护理研究项目翻译研究收集的护理助理调查数据，共分三个时期：2014年9月- 2015年5月（T1）、2017年5月- 2017年12月（T2）和2019年9月- 2020年3月（T3）。环境和参与者：该研究包括631名护理助理，他们来自加拿大3个省84个LTC家庭的分层随机样本，在所有3个时间点参与数据收集。方法：采用“时间与工作环境”交互作用的混合效应线性回归来评估工作环境是否与工作满意度（密歇根组织评估问卷工作满意度子量表）和职业倦怠（Maslach职业倦怠量表）的趋势相关。我们使用z分数对结果进行标准化。结果:T1和T2之间,在护理单元护理助手少有利工作environments-characterized支持性的领导,较弱的工作文化,团队的有效沟通和反馈机制和结构性资源不足和staffing-experienced工作满意度显著下降(P < . 01)和B = -0.17,专业的功效(B = -0.20, P < . 01),以及增加疲惫(B = 0.15, P < . 05)和犬儒主义(B = 0.27, P <措施)。在同一时期，那些在更有利的工作环境中工作的人在这些变量上没有统计学上的显著变化。此外，在较不利的工作环境中的护理人员从T2到T3的疲劳程度继续增加（B = 0.16, P < 0.05）。结论和启示：在研究期间，护理单位层面的积极工作环境减轻了护理助理工作满意度和倦怠的恶化。改善工作环境的有针对性的干预措施有望维持护理人员队伍的复原力。
Changing Trends in Job Satisfaction and Burnout for Care Aides in Long-Term Care Homes: The Role of Work Environment.
Objectives: This study examined the association between care unit work environments in long-term care (LTC) homes and trends in care aides' job satisfaction and burnout (exhaustion, cynicism, reduced professional efficacy) from 2014 to early 2020.
Design: This was a retrospective longitudinal study using data from care aide surveys collected by the Translating Research in Elder Care research program over 3 periods: September 2014-May 2015 (T1), May 2017-December 2017 (T2), and September 2019-March 2020 (T3).
Settings and participants: The study included 631 care aides from a stratified random sample of 84 LTC homes in 3 Canadian provinces, who participated in data collection at all 3 time points.
Methods: We used mixed-effects linear regression with a "time by work environment" interaction to assess whether work environment is associated with trends in job satisfaction (Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale) and burnout (Maslach Burnout Inventory-General Survey). We standardized the outcomes using z-scores.
Results: Between T1 and T2, care aides in care units with less favorable work environments-characterized by less supportive leadership, weaker work culture, less effective team communication and feedback mechanisms, and insufficient structural resources and staffing-experienced a statistically significant decline in job satisfaction (B = -0.17, P < .01) and professional efficacy (B = -0.20, P < .01), along with an increase in exhaustion (B = 0.15, P < .05) and in cynicism (B = 0.27, P < .001). Those in more favorable work environments exhibited no statistically significant changes in these variables during the same period. Moreover, care aides in less favorable work environments continued to experience an increase in exhaustion from T2 to T3 (B = 0.16, P < .05).
Conclusions and implications: A positive work environment at the care unit level mitigated the deterioration in care aides' job satisfaction and burnout over the period studied. Targeted interventions to improve work environments show promise in sustaining the resilience of the care aide workforce.
期刊介绍：
JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates.
The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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