Workplace support, role overload, and job satisfaction of direct care workers in assisted living

This study aims to enhance our understanding of job satisfaction of direct care workers in assisted living facilities. Low job satisfaction is related to high turnover rates and lower quality of care in assisted living. We integrate two theories of job satisfaction to investigate relationships among workplace support, role overload, and job satisfaction. Data are from a survey of 984 direct care workers in 108 assisted living facilities. Results from multilevel hierarchical linear models (HLM) indicate that job satisfaction varies both within and among facilities. Job satisfaction is negatively associated with role overload, and it is positively associated with institutional support, supervisor instrumental and emotional support, and coworker emotional support. These workplace support measures and role overload are separately and independently associated with job satisfaction. Enhancing job satisfaction of assisted living direct care workers will likely require a multipronged approach that includes improving institutional, supervisor, and coworker support while simultaneously directly addressing role overload.     

“They are the reason I come to work”: The meaning of resident–staff relationships in assisted living

This article aims to provide understanding of how direct care workers (DCWs) in assisted living facilities (ALFs) interpret their relationships with residents and to identify factors that influence the development, maintenance, quality, and meaning of these relationships. Qualitative methods were used to study two ALFs (35 and 75 beds) sequentially over seven months. Researchers conducted in-depth interviews with 5 administrative staff and 38 DCWs and conducted 243 h of participant observation during a total of 99 visits. Data were analyzed using a grounded theory approach. Results showed that the emotional aspect of caregiving provides meaning to DCWs through both the satisfaction inherent in relationships and through the effect of relationships on care outcomes. Within the context of the wider community and society, multiple individual- and facility-level factors influence DCW strategies to create and manage relationships and carry out care tasks and ultimately find meaning in their work. These meanings affect their job satisfaction and retention.     

Doing competent residential child and youth care work: The normative and experiential dimensions

This article presents two complementary dimensions in competent residential child and youth care. Within the normative dimension, competence in residential work is discussed on the societal, organizational, interpersonal and personal levels. The goal of residential care, according to this dimension, is to enable the child or the youth to return to society as a well-functioning adult. Within the experiential dimension, competent residential care is discussed as it is experienced by both child care workers and their clients. The goal of residential care, according to this dimension, is to focus on the quality of the children's present lives. A possible avenue to integrate these dimensions is presented and implications for policy, program planning, and training are suggested.     

The Business of Caring: Women's Self‐Employment and the Marketization of Care

Our goal in this article is to contribute to a differentiated analysis of paid caring work by considering whether and how women's experiences of such work is shaped by their employment status (for example, self‐employed versus employee) and the nature of care provided (direct or indirect). Self‐employed care workers have not been widely studied compared with other types of care workers, such as employees providing domestic or childcare in private firms or private homes. Yet their experiences may be quite distinct. Existing research suggests that self‐employed workers earn less than employees and are often excluded from employment protection. Nonetheless, they often report greater autonomy and job satisfaction in their day‐to‐day work. Understanding more about the experiences of self‐employed caregivers is thus important for enriching existing theory, research and policy on the marketization of care. Addressing this gap, our article explores the working conditions, pay and levels of satisfaction of care workers who are self‐employed. We draw on interviews from a small‐scale study of Canadian women engaged in providing direct care (for example, childcare) and indirect care (for example, cleaning).     

Complexities of cultural difference in social care work in England

The ageing of the ethnic minority population in Britain has led to a more ethnically diverse older client group for social care services than has ever been the case. This article focuses on the issue of how social care staff in England experience working across differences of culture, ethnicity, religion, and language. First, the article critically discusses the concept of cultural competence. Then, it reports on the perspectives of social care staff on their attempts to work in a culturally competent way. Individual in-depth qualitative interviews were carried out with 39 social care practitioners, and thematically analysed. Themes related to professional competence, appropriate behaviour, and training needs. Some practitioners felt unable to perform to their accustomed skill level when working across diversity, which has implications for the quality of care provided and job satisfaction. Other practitioners were confident in working across diversity. The key difference between these practitioners was a degree of cultural reflexivity. Recommendations for training are provided.     

Facility Ownership and Resident Satisfaction with Assisted Living

Abstract

Although the majority of assisted living facilities operate as for-profit organizations and serve increasingly frail elderly populations, little is known about the impact of ownership on the quality of care in assisted living. This study examines the relationship between facility ownership and the quality of care in assisted living, using resident satisfaction as a quality indicator. The assessed aspects of satisfaction include health care, housekeeping, physical environment, relationships with staff, and social life/activities. The relationship of facility ownership to resident satisfaction is examined controlling for resident psychological well-being, functional ability, facility size, and staff resources. Data were collected in personal interviews with 156 residents, including 96 residents in eight for-profit facilities and 60 residents in five nonprofit facilities in Maryland. Residents in the sampled nonprofit facilities were more satisfied with assisted living than were residents in the for-profit facilities. In particular, residents in nonprofit facilities were more satisfied with health care, physical environment, and social life/activities in the facility. Better understanding of the relationship between facility ownership and resident satisfaction can help administrators create environments that maximize resident satisfaction in both nonprofit and for-profit facilities.     

Client satisfaction with live-in and live-out home care workers in Israel

In an era of globalization where the migration of longterm care workers is common, foreign live-in home care workers can compensate for the unavailability of family members and, perhaps, even substitute for institutional care in the provision of long-term care services to disabled older persons. This study examines differences in home care satisfaction between disabled older persons in Israel with "live-in" home care workers and those with "live-out" workers, and explores some differences in sociodemographic and personal characteristics between these two groups. Face-to-face interviews were held with a random sample of 93 older persons in Beer-Sheva. Older persons with live-in home care workers were more satisfied with their home care service than those with live-out workers. Those with live-in workers were more severely disabled, tended not to have any children living in close proximity, although an adult child was available as an informal caregiver. Communication difficulties between the elderly persons and their home care workers were found not to affect negatively the satisfaction with the service.     

Addiction Social Work Fellowship Program in Canada

Substance use disorders (SUD) disproportionally contribute to the global social and economic cost of disease; however, their treatment has been inadequate in large part due to an enduring research to practice gap in which competencies for treating and preventing SUDs are often lacking from social work education curricula. Training social workers in managing SUDs has been separated from nurse and physician training, partly due to the long-standing divide between the behavioral health and medical care system. Recently, a new interdisciplinary fellowship in addiction social work, nursing and medicine has been established in Vancouver, Canada. We describe the novel fellowship program and outline initial impact of the training on knowledge and skills in addiction social work from our qualitative evaluation of the fellowship. We conclude that training social workers, and other allied health professionals alongside physicians and nurses may extend the reach of this type of training program even further.     

Client Satisfaction with Live-In and Live-Out Home Care Workers in Israel

Abstract

In an era of globalization where the migration of long-term care workers is common, foreign live-in home care workers can compensate for the unavailability of family members and, perhaps, even substitute for institutional care in the provision of long-term care services to disabled older persons.

This study examines differences in home care satisfaction between disabled older persons in Israel with “live-in” home care workers and those with “live-out” workers, and explores some differences in socio-demographic and personal characteristics between these two groups. Face-to-face interviews were held with a random sample of 93 older persons in Beer-Sheva.

Older persons with live-in home care workers were more satisfied with their home care service than those with live-out workers. Those with live-in workers were more severely disabled, tended not to have any children living in close proximity, although an adult child was available as an informal caregiver. Communication difficulties between the elderly persons and their home care workers were found not to affect negatively the satisfaction with the service.     

The Influence of Managed Care on Job-Related Attitudes of Social Workers

This study explores the relationships between the levels of conflict that social workers experience when interfacing with managed care organizations and outcome variables including job satisfaction, organizational commitment, emotional exhaustion, and turnover intentions. A total of 591 social workers practicing in mental health agencies in New York State completed self-administered and anonymous questionnaire packets that included several measures: Level of conflict that workers experience when interfacing with managed care organizations (CMC), job satisfaction, organizational commitment, emotional exhaustion, and turnover intentions. Results showed that CMC had statistically significant correlations with organizational commitment and with emotional exhaustion. The author discusses the role of social work schools and agencies in offering new educational opportunities and training in order to improve workers' skills, which are necessary for communicating and negotiating with managed care organizations.     

The impact of health care reform on the workforce caring for older adults

This article summarizes the Patient Protection and Affordable Care Act (ACA) provisions that have a direct or indirect impact on the workforce caring for the elder population, explores the challenges to developing the workforce, and critiques the adequacy of the ACA provisions in meeting those challenges. The ACA is the first comprehensive federal legislation to acknowledge gaps in the workforce caring for the elder population. However, its provisions are inadequate given insufficient supply in the number and types of workers necessary both to meet the caregiving demand of the growing elder population and to implement the delivery system reforms instituted by the ACA. One of the challenges is that the workforce is not prepared for the new service delivery models specified in the legislation. They are not trained, supported, or held accountable for effective care coordination and service integration, and they lack the requisite skills, knowledge, and competencies. Moreover, it is likely to remain difficult to recruit and retain competent direct care workers, who represent the largest component of the long-term care workforce, because of the negative industry image, noncompetitive wages and benefits, a challenging work environment, and inadequate education and training. Several of the ACA provisions for developing the workforce have not received appropriations. Most are also demonstration projects of limited scope and duration.     

Factors impacting intention to leave in social workers and child care workers employed at voluntary agencies

Introduction

To ameliorate high turnover in child welfare, researchers have attempted to identify factors that lead to undesirable turnover. While this has been studied extensively, little attention has been paid to turnover based upon job roles. Like social workers in child welfare, the field of child care also experiences high turnover. Child care workers employed in child welfare settings are no exception. The current study seeks to understand differential factors that impact intent to leave for preventive and child care workers employed in child welfare agencies.

Materials and methods

Data for prevention workers (n = 538) were obtained from all preventive service programs under contract with the City. Data for child care workers (n = 222) were obtained from three voluntary agencies located elsewhere in the State. The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included job satisfaction, intention to leave, career commitment, and agency investment. Data were analyzed using bivariate analysis and Structural Equation Modeling (SEM).

Results

Child care workers had more positive perceptions of child welfare and planned to stay in child welfare longer. Despite this, prevention workers felt more invested in their work. Child care and prevention workers had different levels of satisfaction with their jobs although overall job satisfaction did not differ nor did their intention to leave. Tenure at the agency was predictive of career investment. Investment, perceptions of child welfare, satisfaction with nature of work, and contingent rewards were associated with career commitment. Commitment and satisfaction with supervision were the greatest predictors of intention to leave.

Discussion

There is a gap in literature addressing child care workers in child welfare, and future study of this group is needed. Child care workers are just as likely to intend to leave their jobs as prevention workers. For both groups, it appears that investment in their jobs increases commitment to the field which reduces intention to leave.     

Intention to leave in social workers and educators employed in voluntary child welfare agencies

Introduction

Individuals employed in child welfare settings can have a profound impact on children in care. Research shows that direct care staff can have an effect on emotional and physical outcomes for children with whom they work. This paper seeks to expand knowledge of the child welfare workforce by studying educators employed in child welfare settings and comparing their job satisfaction and intent to leave with that of prevention workers employed in similar settings.

Materials and methods

Data for prevention workers (n = 538) were obtained from workers employed at all preventive service programs under contract with a large municipality. Data for educators were obtained from voluntary agencies located elsewhere in the state (n = 139). The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included various aspects of job satisfaction, intention to leave, and whether workers regretted taking their jobs. Data were analyzed using bivariate analysis and structural equation modeling (SEM).

Results

While both educators and prevention workers varied on different domains of job satisfaction, their overall satisfaction did not differ nor did their intention to leave their jobs. Satisfaction with contingent rewards, the nature of the work and opportunities for promotion along with not regretting taking one's job were predictive of thinking about leaving one's job. Thinking about leaving was predictive of taking concrete steps towards actual leaving.

Discussion

While people both prevention workers and educators report different levels of job satisfaction and work conditions in their agencies, job title itself has less to do with a worker's intention to leave, as measured by both thinking about leaving and taking steps towards actively looking for a new job, than other factors. Larger contextual factors may be at play in workers' decisions to stay employed. Suggestions are made for reducing turnover intentions along with suggestions for further study to clarify the role of organizational factors in workers' intention to leave.     

Comparisons of marriage and family therapists, psychologists, psychiatrists, and social workers on job-related measures and reactions to managed care in Iowa

This study compares marriage and family therapists (MFTs) to psychologists, psychiatrists, and social workers on job-related measures, such as job autonomy, job satisfaction, burnout, and intention to stay in their present position, as well as on reactions to a managed care initiative in the state of Iowa. Findings indicate that MFTs scored significantly lower than other practitioners on job autonomy and intention to stay in their present position, but there were no differences in job satisfaction or burnout. Marital and family therapists also reported less dissatisfaction with the managed care initiative than psychiatrists, although virtually all practitioners were dissatisfied with the managed-care program. These findings indicate some dissatisfaction within the MFT profession and may be relevant to practitioners seeking to change or expand their practice, as well as to the needs of MFTs in their training programs.     

Self–care practices among social workers: do they predict job satisfaction and turnover intention?

ABSTRACT

The current health and mental health care delivery system in the United States strives to provide efficient quality care at a lower cost. This cost-effective approach and recent budget cuts have created new challenges for social workers. This study explores the relationships between self-care strategies, role stress, job autonomy, and job satisfaction and turnover intention. Four-hundred sixty-nine social workers were surveyed to assess multiple measures of self-care including professional support, professional development, coping strategies, and professional resilience, and their effects on job satisfaction and turnover intention. Role stress and job autonomy were also examined in relation to job satisfaction and turnover intention. The results supported the main hypotheses that claimed that self-care strategies are associated with both job satisfaction and turnover intention. The author discusses the important implications of these findings in education and training of both students and practitioners.     

The Mediating Effect of Resilience Between Social Support for Exercise and Resident Satisfaction in Assisted Living

This study examined whether residents' level of resilience mediated the relationship between social support for exercise from staff and resident satisfaction in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from four assisted living facilities. Using structural equation modeling, we found that mood and social support for exercise from staff were the only variables associated with resilience. Mood, gender, cognition, and social support for exercise from staff directly influenced resident satisfaction and explained 31% of the variance in the model. Implications for future research and practice are discussed.     

Establishing Positive Youth Development Approaches in Group Home Settings: Training Implementation and Evaluation

This article reports on a training program for group home supervisors that was designed to utilize positive youth development principles in work with youth transitioning from care to independent living. Over a period of 5 months, eight one-day training sessions took place across one state in the U.S. (Massachusetts) with a total of 186 group care staff in attendance. The evaluation consisted of three components: observation of participant feedback during training, training day post-test, and follow-up with participants 2–3 months after training. Implications of the data, particularly barriers to implementation of training programs, are discussed.     

Dignity Strategies in a Neoliberal Workfare Kitchen Training Program

Welfare-to-work training (workfare) programs are designed to technically and affectively prepare marginalized people for jobs that are often routinized and dirty. They are expected to accept personal responsibility for their situation and demonstrate submission to bosses as means of “working off” their “debt” to society. Ethnographic observation at workfare training sites has tended to emphasize the indignities that trainees suffer, with less attention to how workers maintain dignity in the face of these experiences. Using ethnographic observation and interviews in a Chicago workfare kitchen training program, we show that neoliberal kitchen training work encompasses paradoxical expectations for trainee-workers; they must demonstrate high levels of discretion and creativity required in professional kitchen work and demonstrate submission to charismatic authority as a means of getting kitchen work done and of affective compliance with the goals of the program. To combat the direct efforts of others to produce indignities, trainees developed two dignity strategies that are highly dependent on the structure of kitchen work: operating in a slipstream, and banking confidence that allows them to take liberties normally allowed for chef-trainers. These findings contribute to sociological understandings of workplace dignity, a privilege that has been especially elusive for the poor under welfare-to-work programs.     

New directions: introducing the ‘Best Article’ Award

This research, conducted in 1998, examines the career expectations of student social workers as they approach the end of their DipSW training. The study looked at students' attitudes towards seeking a job following the end of their course, including their aspirations and their self-assessed readiness to practise. It also looked at the perspective of local social work agencies, seeking their views on how well prepared newly qualified social workers are for the realities of practice. The majority of students were planning to seek full-time employment in the statutory sector with local social work agencies in the field of community care. Most students did not expect to be promoted within the first five years after qualifying; job satisfaction was regarded as more important than career development. In the longer term, however, the majority envisaged that they would progress beyond the level of basic grade social worker. Issues were identified in relation to students' perceived readiness to practise, the availability of suitable employment in the area of students' preference, and the numbers of social work students able to work through the medium of Welsh.     

Foster parent perceptions of competency: Implications for foster parent training

Studies have examined factors that impact successful placements in foster care. Absent from this body of research, however, are factors that promote foster parent competence. The purpose of this study was to assess perceived competency of foster parents, subsequent to pre-service training, in tasks of foster parenting across 12 domains of foster parenting as recommended by previous research. The sample consisted of 20 foster parents who had completed foster parent training within the past five years. Although foster parents in this study rated themselves as competent in primary domains of foster parenting, there were mixed results as to their satisfaction and acceptance of demands of foster parenting in relation to foster family adjustment and working with a complex care system. Implications for therapeutic interventions are discussed.