Which factors are related to Finnish home care workers’ job satisfaction, stress, psychological distress and perceived quality of care? - a mixed method study

Abstract

Background The desire to increase the role of home care in Finland has created problems in home care work. Working conditions have deteriorated, the quality of care experienced is low, and staff members suffer from time pressure and stress, amongst other things. The aim of this article is to explore the challenges, stressors, teamwork and management factors that are associated with home care staff members’ well-being, job satisfaction and experienced care quality, and further, how staff members experience their work. Methods A survey was sent to home care workers in two case organizations that participated in the study. In addition, semi-structured theme interviews with home care workers were conducted. The data from the survey was analysed using analysis of covariance, and interview data was analysed using the Grounded Theory-based method from Gioia et al. Results Respondents of the survey and the interview participants were mainly female practical nurses. The results from the survey showed, for example, that time pressure was associated with higher stress and psychological distress, and interruptions were associated with lower job satisfaction and higher stress. In addition, variables related to teamwork, such as participative safety, were shown to explain the variation in quality of care. The analysis of the interview data further brought up dissatisfaction with management practices, which seems to have led to a decrease in job satisfaction. Exhaustion and strain were present among staff members, which originated from an insufficient number of carers. Conclusions Current working conditions and work practices in Finnish home care are experienced stressful. The results from this study indicate that having more autonomy at work was associated with job satisfaction, according to both analyses. Team climate and idea implementation were related to quality of care. Therefore, increasing self-organizing team practices might be a possible development method for improving working conditions and staff members’ well-being. Implementing self-organizing team practices could possibly also attract employees to work in home care and prevent turnover.

A Scoping Review of Psychosocial Risks to Health Workers during the Covid-19 Pandemic

“…Nurses as an occupational category, are found to be particularly exposed to PSR [ 18 , 19 , 20 ]. Exposure to physical hazards and psychosocial risks in healthcare arises from working overtime, work overload, and time pressure [ 21 , 22 , 23 ], an insufficient number of rest breaks and days away from work, leading to poor work-life balance [ 14 , 24 ], shiftwork [ 25 , 26 ], low wages and job insecurity [ 27 , 28 , 29 ], and exposure to adverse social behaviour, such as violence and harassment [ 30 , 31 ]. Precarious employment is increasing, particularly in the elderly- and long-term care sector with many migrant workers [ 32 , 33 ]; this type of employment is a source of financial stress due to income insecurity which can affect the health of workers [ 34 ].…”

Work community factors, occupational well‐being and work ability in home care: A structural equation modelling

“…Unlike in the results of several previous studies (Bartels et al., 2019 ; Galatsch et al., 2013 ; Van der Heijden et al., 2017 ; Hirschl & Gondim, 2020 ; Leijon et al., 2017 ), the factors of Social support or Influence on work shifts did not have a significant direct relationship to Occupational well‐being or Work ability in our study. However, this result is partly supported by Ruotsalainen and others ( 2020 ) who examined various factors, such as work stressors and job control, including social support, relations to job satisfaction, stress and psychological distress in the context of Finnish home care. According to their findings, social support was not a significant predictor in any of the multivariate models.…”

“…Unlike in the results of several previous studies (Bartels et al, 2019;Galatsch et al, 2013;Van der Heijden et al, 2017;Hirschl & Gondim, 2020;Leijon et al, 2017) in any of the multivariate models. (Ruotsalainen et al, 2020. ) The nature of work in home care may be relevant to these results.…”

“…According to Ruotsalainen et al. ( 2020 ), work interruptions and time pressures were associated with higher perceived stress in the work of Finnish home care workers.…”

“…Instead, occupational well‐being has been described with the terms job satisfaction, intent to stay working and work engagement, resources and work‐related stress (e.g. Hirschl & Gondim, 2020 ; Kvist et al., 2012 ; Ruotsalainen et al., 2020 ). These concepts have often been viewed from the perspective of individual workers and their work, the work community, and the work organization (Arian et al., 2018 ; Cotton & Hart, 2003 ; Hirschl & Gondim, 2020 ; Schulte & Vainio, 2010 ).…”