“…The survey process for both work and home distribution included 4 mailings spaced 2 weeks apart in the following sequence: an initial mailing of the survey packet, a reminder postcard, a re-mail of the survey packet to nonrespondents to the initial survey, and a final reminder postcard. The survey packets consisted of a cover letter explaining the survey and including the elements of informed The questionnaire included the following sections: sociodemographic items (gender, ethnicity, educational achievement, years worked in the nursing home, and years worked in present position), job satisfaction (6 items with the 5-point scale ranging from "never" to "most or all of the time"), a modified version of the Health Profession Stress Inventory (HPSI, containing 28 items with a 5-point scale ranging from "never" to "often or frequently"), 19 a modified version of a communication effectiveness instrument, 20 and questions regarding staff perceptions of resident safety (34 items with the 5-point scale ranging from "never" to "all of the time"). 21 Facility-specific response rates were calculated by nursing staff type (nurses and nursing assistants), distribution method (direct to employee home versus distributed at work), and wave of mailing (first and second wave).…”