Table 1 Description of independent variables assessing the work environment, work stressors and care workers’ health complaints
Variable Name | Description | Measurement |
|---|---|---|
Work environment | ||
Leadership | 5-item subscale “Nurse manager ability, leadership, and support of care workers” of the Practice Environment Scale-Nursing Work Index (PES-NWI) [60], assessing support by direct supervisors, their competency, back-up in decision making, praise and recognition given, and the use of mistakes as learning opportunities and not criticism | 4-point Likert-type scale from 1 = strongly disagree to 4 = strongly agree Cronbach’s α = .84 |
Staffing and resource adequacy | 3-item subscale “Staffing and resources adequacy” of the PES-NWI [60], assessing whether there was enough time and opportunity to discuss resident care problems, enough qualified personnel to provide quality resident care, and enough staff to perform all necessary tasks | 4-point Likert-type scale from 1 = strongly disagree to 4 = strongly agree Cronbach’s α = .74 |
Job autonomy | Single item (Investigator developed), assessing whether care workers decide autonomously how to perform their work | 4-point Likert-type scale from 1 = strongly disagree to 4 = strongly agree |
Shared decision making | Single item of the PES-NWI [60], assessing opportunities for care workers to participate in nursing home policy decisions (e.g., about resident care or work organization) | Idem |
Advancement opportunities | Single item of the PES-NWI [60], assessing opportunities for professional advancement (e.g., continuing education opportunities, special tasks within the team/in the nursing home) | Idem |
Teamwork and safety climate | Combination of two subscales of the Safety Attitude Questionnaire (SAQ) [61]. Based on confirmatory factor analysis, the original two subscales for Teamwork and Safety Climate could not be confirmed. Three items with low item discrimination (corrected item-scale correlation < 0.4) were removed. This resulted in one 10-item single factor for Teamwork and Safety Climate, assessing, e.g., the opportunity to speak up or to ask questions when something is not understood, the extent to which other team members provide assistance when needed, the opportunity to discuss errors and to learn from each other, and the reception of feedback about one’s performance. | 5-point Likert-type scale from 1 = strongly disagree to 5 = strongly agree with the option “don’t know” Cronbach’s α = .89 |
Available director of nursing | Single item of the PES-NWI [60], assessing whether the director of nursing is available for the care staff | 4-point Likert-type scale from 1 = strongly disagree to 4 = strongly agree |
Resonant nursing home administrator | Single item of the PES-NWI [60], assessing whether the nursing home administrator has an “open ear” and responds to issues raised by the care staff | Idem |
Work stressors | ||
Of the original 30-item Health Professions Stress Inventory (HPSI) [62], 2 items were selected based on expert ratings concerning their relevance in the nursing home context. Exploratory factor analysis identified 3 factors. | 5-point Likert-type scale ranging from 0 = never to 4 = very often | |
Conflict and lack of recognition | 6-item subscale, assessing, e.g., disagreement with other health professionals concerning residents’ treatment, conflicts with supervisors, not being asked about one’s opinion concerning decisions about one’s job, and not being paid enough | Idem Cronbach’s α = .76 |
Workload | 3-item subscale, assessing, e.g., having so much work to do that not everything can be done well and not having enough people working to perform the work well | Idem Cronbach’s α = .74 |
Lack of preparation | 3-item subscale, assessing, e.g., lacking the training to meet residents’ needs, being afraid of making a mistake in the residents’ treatment and being overwhelmed by caring for terminally ill residents | Idem Cronbach’s α = .63 |
Health complaints | ||
Physical health | From the original Swiss Health Survey [63], 5 items on health complaints, including back pain, joint pain, tiredness, problems with sleeping, and headache were extracted to assess care workers’ self-reported physical health. We combined the 5 items to form a sum index ranging from 0 to 10 to express care workers general health condition. | 3-point Likert-type scale from “1 = not at all to 3 = strongly” Cronbach’s α = .70 |
Depleted from work | Single item according to the Maslach Burnout Inventory [64], assessing care workers’ feelings of being depleted at the end of a working day | 7-point Likert-type scale from "0 = never to 6 = daily" |