Risk Profiles for Chronic Stress in Employees of Nursing Homes and the Role of Physical Activity A Regression Tree Analysis

Background: Employees of nursing homes are facing numerous stressors. As chronic stress and nursing turnover are a major concern in societies dealing with staff shortages and overloaded health care systems, a better understanding of the combined effects of stressors and the identification of risk patterns are crucial as well as the potential of physical activity as a resource or stressor. Aims: To address this issue, this study aims to (1) identify individual stress risk profiles and (2) analyze the effect of physical activity on stress in employees of nursing homes. Method: 275 employees (79.2% female and 70.5% aged older than 35 years) completed a survey. Using a machine learning method, a regression tree analysis was performed. Results: The combination of high work-privacy conflict and high role conflict was identified as a very high-risk profile for chronic stress in elderly care. Within the regression tree, work-privacy conflict was identified as the strongest determinant of individual chronic stress values. Vigorous occupational physical activity was the only relevant physical activity parameter positively correlated with stress values and thus acted as a stressor. Physical activity did not act as a resource. Limitations: The exploratory analyses of this study are limited due to the cross-sectional nature of the data. Conclusion: The study provides valuable insights to healthcare managers and policymakers on ways to reduce stress in employees of nursing homes and underlines the physical activity paradox.