the relation between group living home care and demands, control and social support of care staff
TRANSCRIPT
Improving Mental Health by Sharing Knowledge
Bernadette Willemse, Dieneke Smit,
Jacomine de Lange & Anne Margriet Pot
The relation between group living home care and demands, control and
social support of care staff
Research on care staff increasingly important:
• Growing number of people with dementia
• Decreasing labor force
Variety in living arrangements
Group living home care:
• Number of characteristics integrated
• Different job characteristics
– Working alone more often
– Domestic tasks
2
Background
IPA 2010: Santiago de Compostela 28-09-2010
Job Demand-Control Support model1,2
Organization of care Job characteristics Staff wellbeing
Group living home care characteristics
Demands
Control
Social support
Job satisfaction
1 Karasek,1979
2 Johnson and Hall, 1988
IPA 2010: Santiago de Compostela 28-09-2010
Intention to leave
Sickness leave
Burnout
Are group living home care characteristics
related to care staff perceived…
• Demands
• Control
• Supervisor social support
• Coworker social support
… taking functioning of residents and staff
ratio into account
4
Research question
IPA 2010: Santiago de Compostela 28-09-2010
Methods: design and sample
LAD-study:
• Cross-sectional design
• 136 living arrangements representing different types of nursing home care
• 1147 care staff (59%)
• 1327 residents (84%)
IPA 2010: Santiago de Compostela 28-09-2010
Methods: measures (1)
IPA 2010: Santiago de Compostela 28-09-2010
Care organization
• Group living home care characteristics:
14 items (0-56)
– Staff does not wear a uniform
– Residents can get out of bed when they want
– Living rooms have a homely atmosphere
– The meals are prepared in the kitchen of the unit/home
• Staff ratio care staff: time tables
Methods: measures (2)
Care staff:
• Job characteristics (LQWQ)
– Demands: Work and time pressure– Control: Decision authority– Social support co-workers– Social support supervisor
• Domestic tasks
Residents:
• Assistance needed in ADL (KATZ)• Behavioral problems (NPIQ)
IPA 2010: Santiago de Compostela 28-09-2010
8
Who is the care staff?
IPA 2010: Santiago de Compostela 28-09-2010
Demographic characteristics N %
Sex
Male
Female
63
1083
5,5
94,5
Age (mean, SD) 43,0
(10,1)
Educational level
< Level 2
Level 2
Level 3
Level 4
Level 5
41
125
853
52
78
3,6
10,9
74,2
4,5
6,8
Contract hours per week
< 8 hours
8-16 hours
16-24 hours
24-32 hours
>32 hours
15
137
373
347
276
1,3
11,9
32,5
30,2
24,1
9
What are the tasks of care staff?
IPA 2010: Santiago de Compostella 28-09-2010
Tasks N %
Cleaning part of tasks 725 63,3
Cooking part of tasks 591 51,6
Laundry part of tasks 504 44,0
Integral tasks (cooking, laundry, cleaning)
No integral tasks
1 other task
2 other tasks
3 other tasks
319
219
223
385
27,8
19,1
19,5
33,6
10
Preliminary analysis
IPA 2010: Santiago de Compostela 28-09-2010
BPSD ADL Staff Ratio Tasks GLHC Demands Control SSL
1. BPSD
2. ADL .243**
3. Staff ratio -.017 -.097**
4. Domestic tasks -.098** -.232** .268**
5. Group living home care -.048 -.342** .379** .747**
6. Demands .080** .142** -.270** -.167** -.244**
7. Control -.043 -.066* .116** .155** .210** -.476**
8. Support leader -.011 -.075* .084** .021 .081** -.330** .425**
9. Support colleagues -.010 -.033 .036 -.015 .045 -.173** .336** .312**
Results: GLHC characteristics
More group living home care characteristicsin a living arrangement is related to:
• Less perceived demands (β=-.151; p<.01)
• More perceived control (β=.205; p<.01)
… of care staff
IPA 2010: Santiago de Compostela 28-09-2010
Results: domestic tasks
More domestic tasks is related to:
• Less perceived demands (β=-.075; p<.05)
• More perceived control (β=.121; p<.05)
… of care staff
IPA 2010: Santiago de Compostela 28-09-2010
Limitations of the study
• Cross-sectional design
• Different types of demands:
– Only one type of demands (mental) studied
– Effect GLHC on emotional demands?
IPA 2010: Santiago de Compostela 28-09-2010
Conclusions
IPA 2010: Santiago de Compostella 28-09-2010
• Care staff in arrangements
- with more GLHC characteristics
- where they have more domestic tasks
… perceive less demands and more control
Further research
Organization of care Job characteristics Wellbeing
Group living home care characteristics
Demands
Control
Social support
Job satisfaction
IPA 2010: Santiago de Compostela 28-09-2010
Intention to leave
Sickness leave
Burnout
Further information
Bernadette Willemse
www.trimbos.nl
Program on Aging,
Netherlands institute for Mental Health and Addiction
28-09-2010IPA 2010: Santiago de Compostella