Managers’ Perspectives of Quality of Care in Service Housing and Home Care Services: A Qualitative Study

Corneliusson, Laura; Pesonen, Tiina; Ruotsalainen, Salla; Sulander, Juhani; Noro, Anja; Sinervo, Timo

doi:10.1177/23337214221142938

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…The results are in line with the findings of an earlier study on the association between lower job satisfaction and insufficient staffing [ 15 ]. Moreover, managers in the older people care in Finland described similar problems as factors that contributed to poorer care quality in a study from Corneliusson et al [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Job demand and job resource factors explaining stress and job satisfaction among home care nurses – a mixed-methods sequential explanatory study

Kaihlanen,

Ruotsalainen,

Väisänen

et al. 2023

BMC Nurs

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Background Increasing home care has been seen as a way to respond to the growing care needs of the aging population. To secure a sufficient number of nurses to provide home care, it is essential to identify and take into account the factors related to their well-being and job satisfaction. This study examined associations of both objective and subjective job demands and resources with stress and job satisfaction among nurses working in home care. Methods This study used a mixed-methods sequential explanatory design. First, quantitative data was collected with a survey, followed by a qualitative survey with open-ended questions. Linear regression analyses and qualitative content analysis with an inductive approach were used to analyze the quantitative and qualitative data, respectively. Joint display in a form of a table was used to integrate the results. Results Of the objectively measured job demands and resources, higher proportion of direct care time and higher number of interruptions were associated with higher stress in the fully adjusted models. Of the subjective measures, higher time pressure, role conflicts and disruptions were associated with higher stress. Higher time pressure, role conflicts, and disruptions in the workday were associated with lower job satisfaction, whereas higher care continuity and having more autonomy were associated with higher job satisfaction. The results of the qualitative study, in which the nurses described their experiences of their working week, partly explained and confirmed the results of the quantitative study but were also contradictory in some respects. Conclusions Many demands, both subjectively experienced and objectively measured in terms of work organization, may undermine home care nurses’ well-being and enjoyment at work. A severe nursing shortage combined with a growing number of clients is the reality of home care, significantly increasing the risk of burnout and turnover among employees. Strategies must be developed urgently to ensure sufficient personnel in home care. For example, investments should be made in opportunities for autonomous planning of work, and promotion of good cooperation and functionality of work teams.

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Section: Discussionmentioning

confidence: 99%

Job demand and job resource factors explaining stress and job satisfaction among home care nurses – a mixed-methods sequential explanatory study

Kaihlanen,

Ruotsalainen,

Väisänen

et al. 2023

BMC Nurs

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Determinants of received care time among Finnish home care clients and assisted living facility residents: a time-motion study

Pesonen,

Väisänen,

Aaltonen

et al. 2024

BMC Geriatr

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Background Ageing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients’ care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients’ received care time in different care settings. Methods Cross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time. Results Physical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings. Conclusions Physical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs.

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The role of workday characteristics on perceived stress and time pressure among nurses in Finnish long-term care – a cross-sectional study

Väisänen,

Ruotsalainen,

Hietapakka

et al. 2024

BMC Health Serv Res

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Background Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance). Methods A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients’ care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression. Results Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy. Conclusions Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses. Patient or public contribution Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.

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Managers’ Perspectives of Quality of Care in Service Housing and Home Care Services: A Qualitative Study

Cited by 3 publications

References 31 publications

Job demand and job resource factors explaining stress and job satisfaction among home care nurses – a mixed-methods sequential explanatory study

Job demand and job resource factors explaining stress and job satisfaction among home care nurses – a mixed-methods sequential explanatory study

Determinants of received care time among Finnish home care clients and assisted living facility residents: a time-motion study

The role of workday characteristics on perceived stress and time pressure among nurses in Finnish long-term care – a cross-sectional study

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