Key Factors for Enhancing Home Care Workers’ Intention to Stay by Multiple-Criteria Decision Analysis

Abstract

The ageing population is increasing rapidly in Taiwan, where the ageing rate exceeds even that of Japan, the United States and France. The increase in the disabled population and the impact of the COVID-19 pandemic have resulted in an increase in the demand for long-term professional care, and the shortage of home care workers is one of the most important issues in the development of such care. This study explores the key factors that promote the retention of home care workers through multiple-criteria decision making (MCDM) to help managers of long-term care institutions retain home care talent. A hybrid model of multiple-criteria decision analysis (MCDA) combining Decision-Making Trial and Evaluation Laboratory (DEMATEL) and the analytic network process (ANP) was employed for relative analysis. Through literature discussion and interviews with experts, all factors that promote the retention and desire of home care workers were collected, and a hierarchical MCDM structure was constructed. Then, the hybrid MCDM model of DEMATEL and the ANP was used to analyze the questionnaire data of seven experts to evaluate the factor weights. According to the study results, the key direct factors are improving job satisfaction, supervisor leadership ability and respect, while salary and benefits are the indirect factor. This study uses the MCDA research method and establishes a framework by analyzing the facets and criteria of different factors to promote the retention of home care workers. The results will enable institutions to formulate relevant approaches to the key factors that promote the retention of domestic service personnel and to strengthen the intention of Taiwan’s home care workers to stay in the long-term care industry.

Exploring a career pathway for home support workers in Ireland: a systematic scoping review of the international evidence

“…The meaning of the work, and recognising the joyful moments of the work, supported HSW's resilience during the COVID-19 pandemic ( 226 ). Other research from Germany, UK, Finland and Taiwan, underscores the significance of understanding the factors involved in job satisfaction for retaining employees by developing more tailored and effective job satisfaction strategies ( 227 – 230 ), particularly fair workload and intensity ( 231 ).…”

Nurses’ Workplace Perceptions in Southern Germany—Job Satisfaction and Self-Intended Retention towards Nursing

“…Nurses, the largest group in healthcare, require enhanced job satisfaction and retention [26]. Studies analyze job satisfaction and retention factors globally [1,20,[27][28][29][30][38][39][40][41][42][43]. As shown in Table 1, retention factors include (i) personal attributes (health, education, marital status, age), (ii) job characteristics (supportive leadership, autonomy, stress, and professional growth), and (iii) organizational context (wages, relationships, working environment, and employer location).…”

“…Niskala et al [26] and Penconek et al [27] emphasize leadership's role, noting that nurses with leaders who foster shared decision-making, e.g., individual working patterns, are more satisfied [45]. Specchia et al [39], Boateng et al [20] and Hsu et al [42] recognize leadership style as a key influencer on nurse satisfaction, which is further enhanced by development and promotion opportunities. Additionally, high job stress can lead to dissatisfaction and intentions to leave primarily when the workload is too demanding [20,27,29,40].…”

“…Additionally, high job stress can lead to dissatisfaction and intentions to leave primarily when the workload is too demanding [20,27,29,40]. In (iii), the organizational context, Hsu et al [42] found out that wages contribute to the intention to remain. Nonmonetary rewards, including good relationships with colleagues and patients, are essential [1].…”

“…The rural or urban location of the employer also impacts satisfaction, with external factors affecting satisfaction more in urban areas due to the ease of changing employers [28]. [29] Higher Educational Status + 1 [38] Marital Status and Having Children + 1 [1,38] Older (>30 Years) and Having Job Experience + 1,2 [29,38,41,43] Job * Leadership Support, Supervision, and Authenticity + 1 [26,27,29,38,39,42] Leadership Style: Passive-Avoidant, Laissez-Faire − 1 [27,39] Leaders Themselves Unsatisfied − 1 [27] High Job Stress and Workload − 1,2 [1,20,27,29,40] Professional Growth and Development + 1 [1,20,38,39] Job Autonomy and Freedom + 1 [1,[27][28][29]45] Organizational * Financial Factors (Salary and Benefits) + 1,2 [42] Staff Relationship (e.g., Social Support) + 1 [1,27,29,38] Patient Relationship + 1 [29] Involvement and Codetermination + 1 [20,27,29,45] Urban Employer Location − 1 [28] Physical Working Environment and Equipment +…”