WHAT CAN WE LEARN FROM COMPARING JOB AUTONOMY OF ASSISTIVE PERSONNEL IN SIX COUNTRIES? 

 RE-IMAGING LONG-TERM RESIDENTIAL CARE; AN INTERNATIONAL STUDY OF PROMISING PRACTICES (FUNDED BY THE SOCIAL SCIENCES AND RESEARCH COUNCIL OF CANADA – MAJOR COLLABORATIVE RESEARCH INITIATIVE -MCRI) 

BY PREETI ZANWAR (USA), KATE LAXER (CANADA), SUZANNE DAY (CANADA), FRODE JACOBSEN (NORWAY), LIZ LLOYD (UK), MONIKA GOLDMANN (GERMANY), MARTA SZEBEHELY (SWEDEN), JACQUELINE CHOINIERE (CANADA), PAULINE VAILLANCOURT ROSENAU (USA)

PRESENTED BY PAULINE ROSENAUPANEL ON PROFESSIONAL/NON-PROFESSIONAL WORK MCRI CONFERENCE, BERGEN, NORWAYMAY 14, 2014

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WHY STUDY AUTONOMY OF ASSISTIVE PERSONNEL

Job Autonomy

Important Social Determinant of Health

Health of workers

Happiness of workers

Overall Wellbeing

Quality higher

Productivity greater

Lack of Job Control / Job Flexibility

Stress, Mental disorders, Depression, Anxiety

Risk for Coronary heart disease, musculoskeletal injuries

Low job satisfaction

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Source: Karasek & Theorell,1990, p. 66

MULTIPLE METHODS

On site visits

Nursing home records

Training manuals, organizational charts

Staff data (training level, demographics, absentee rates, turnover information)

Interviews - nursing home executive officers, medical directors, nursing staff, assistive personnel, all support staff.

Observation of assistive personnel (on all shifts - day and night)

Data to supplemental case study material:

- Organisation for Economic Co-Operation and Development (OECD) databases

- National databases of all six countries

- Comparative Perspectives on Precarious Employment Database (CPD)

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PRELIMINARY FINDINGS

Based on U.S. and Canada: complete Britain and Norway: in process, site visit complete Germany, and Sweden: to be completed in late May 2014

Workers value autonomy : signifies trust and respect

Formal Institutional level policies – wide variation

Implementation of policies – theoretical

Policies trickle down to workers Same institution, different reports…. Why? Imperfect or incomplete implementation? differential application? Role of perception

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CONCLUSION

Autonomy is desirable and can be beneficial for individual workers and institutions

However, it goes against dominant management philosophy in place for decades

Autonomy is viewed as power Power is assumed to be zero-sum Dispersing power is viewed as a “loss”

Benefits of worker autonomy to institution are underestimated

Cost to institution of autonomy is low Important for attracting employees

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LIMITATIONS

Generalizability

Autonomy not measured

Health outcomes for individual workers not measured

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ACKNOWLEDGEMENTS

Co-Authors

Preeti Zanwar (USA)

Kate Laxer (Canada)

Suzanne Day (Canada)

Frode Jacobsen (Norway)

Liz Lloyd (UK)

Monika Goldmann (Germany)

Marta Szebehely (Sweden)

Jacqueline Choiniere (Canada)

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