Challenging Aggressive Behaviors Experienced by Personal Support Workers in Comparison to Home Care Workers: Relationships between Caregiver Experiences and Psychological Health

Abstract

Personal support workers (PSW) are caregivers for children and adults with intellectual and developmental disabilities (IDDs) or adults experiencing mental illness or other behavioral health conditions. The work can be very meaningful, but many PSWs must prepare for, monitor, and manage challenging behaviors, including aggression. This study was designed to estimate the prevalence of aggression experienced by PSWs in Oregon, and compare it to a previous sample of Oregon home care workers (HCWs). This comparison included an analysis of relationships between exposures to aggression and psychological health factors. PSWs in Oregon (N = 240) were surveyed electronically at a single time point. PSWs generally reported higher rates of exposure to aggression compared to HCWs. Experiences with aggression were positively associated with fatigue and weakly associated with depression, but not stress. PSWs’ self-reported lost work time injury rate was elevated compared to the US average, but it was comparable to previous self-reported injury rates from HCWs. Physical demands of work were the most prevalent reported primary safety concern, followed by challenging behaviors (including aggression). Developing tailored training to help PSWs understand, plan for, minimize, and manage challenging behaviors is a social priority.

Research on Abuse in Home Care: A Scoping Review

“…At any moment, clients may engage in violent outbursts toward home care workers, who must remain professional and not take these outbursts personally ( Markkanen et al, 2014 ; Nakaishi et al, 2013 ). The psychological well-being of home care workers is compromised by clients who display abusive behavior toward them during routine care ( Abey-Nesbit et al, 2021 ; Womack et al, 2020 ). Home care workers who fear experiencing abuse and have poor relationships with clients cite negative health impacts such as insomnia, burnout, and anxiety ( Grasmo et al, 2021 ; Hanson et al, 2015 ; Ifediora, 2018 ; Möckli et al, 2020 ).…”