No abstract

Symptom burden increases as the end of life approaches but differs between high- and low-context facilities and between residents with and without dementia. Trajectories of treatable, burdensome symptoms at the end of life in nursing homes should be a priority focus for quality improvement. Modifiable features of organizational context that are linked to symptom burden offer new potential strategies and interventions for quality improvement.

RÉSUMÉLes aides-soignants non réglementés fournissent la majorité des soins directs dans les résidences pour personnes âgées. Nos travaux précédents ont rapporté un premier profil démographique des aides-soignants de l’ouest du Canada par le programme de recherche Translating Research in Elder Care (TREC; 2007-2022) visant les services de santé appliqués. Dans cette étude, nous présentons les caractéristiques démographiques, liées à la santé et à la vie professionnelle d’aides-soignants provenant de 91 résidences pour personnes âgées de l’ouest du Canada. Les données démographiques et liées au travail ont significativement varié selon les régions et les modèles de propriété ou d’opération. Notre cohorte longitudinale de l’Alberta et de Winnipeg présentait davantage d’épuisement émotionnel (attribut négatif), d’efficacité professionnelle (attribut positif) et d’expérience avec les comportements réactifs liés à la démence chez les résidents. En général, les résultats indiquent peu d’amélioration ou de détérioration de la santé des aides-soignants et de la qualité de la vie professionnelle. Étant donné que les initiatives provinciales et nationales pour la planification et la formation de la main-d’œuvre dans ce domaine sont limitées, ceci indique que le système des soins de longue durée n’est pas préparé pour soigner efficacement la population canadienne vieillissante.

BackgroundUnregulated health care aides provide the majority of direct health care to residents in long term care homes. Lower job satisfaction as reported by care aides is associated with increased turnover of staff. Turnover leads to inferior job performance and negatively impacts quality of care for residents. This study aimed to determine the individual and organizational variables associated with job satisfaction in care aides.MethodsWe surveyed a sample of 1224 care aides from 30 long term care homes in three Western Canadian provinces. The care aides reported their job satisfaction and their perception of the work environment. We used a hierarchical, mixed-effects ordered logistic regression to model the relative odds of care aide job satisfaction for individual, care unit, and facility factors.ResultsCare aide exhaustion, professional efficacy, and cynicism were associated with job satisfaction. Factors in the organizational context that are associated with increased care aide job satisfaction include: leadership, culture, social capital, organizational slack—staff, organizational slack—space, and organizational slack—time.ConclusionsOur findings suggest that organizational factors account for a greater increase in care aide job satisfaction than do individual factors. These features of the work environment are modifiable and predict care aide job satisfaction. Efforts to improve care aide work environment and quality of care should focus on organizational context.

Despite an increasing literature on professional nurses' job satisfaction, job satisfaction by nonprofessional nursing care providers and, in particular, in residential long-term care facilities, is sparsely described. The purpose of this study was to systematically review the evidence on which factors (individual and organizational) are associated with job satisfaction among care aides, nurse aides, and nursing assistants, who provide the majority of direct resident care, in residential long-term care facilities. Nine online databases were searched. Two authors independently screened, and extracted data and assessed the included publications for methodological quality. Decision rules were developed a priori to draw conclusions on which factors are important to care aide job satisfaction. Forty-two publications were included. Individual factors found to be important were empowerment and autonomy. Six additional individual factors were found to be not important: age, ethnicity, gender, education level, attending specialized training, and years of experience. Organizational factors found to be important were facility resources and workload. Two additional factors were found to be not important: satisfaction with salary/benefits and job performance. Factors important to care aide job satisfaction differ from those reported among hospital nurses, supporting the need for different strategies to improve care aide job satisfaction in residential long-term care.