Nursing assistants' job commitment: effect of nursing home organizational factors and impact on resident well-being

被引：104

作者：

Bishop, Christine E. ^{[1
]}

Weinberg, Dana Beth ^{[2
]}

Leutz, Walter ^{[1
]}

Dossa, Almas ^{[3
]}

Pfefferle, Susan G. ^{[4
]}

Zincavage, Rebekah M. ^{[1
]}

机构：

[1] Brandeis Univ, Heller Sch Social Policy & Management, Schneider Inst Hlth Policy, Waltham, MA 02454 USA

[2] CUNY Queens Coll, Dept Sociol, Flushing, NY 11367 USA

[3] Edith Nourse Rogers Mem Vet Adm Hosp, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA 01730 USA

[4] Washington Univ, George Warren Brown Sch Social Work, Ctr Mental Hlth Serv Res, St Louis, MO 63130 USA

来源：

GERONTOLOGIST | 2008年 / 48卷

关键词：

workforce; turnover; frontline caregivers; high-performance management; culture change;

D O I：

10.1093/geront/48.Supplement_1.36

中图分类号：

R4 [临床医学]; R592 [老年病学];

学科分类号：

1002 ; 100203 ; 100602 ;

摘要：

Purpose: The purpose of this study was to investigate (a) whether certified nursing assistants (CNAs) are more committed to nursing home jobs when they perceive their jobs as enhanced (greater autonomy, use of knowledge, teamwork), and (b) whether CNA job commitment affects resident satisfaction. Design and Methods: A qualitative exploration of management philosophy and practice and of CNAs' views of their jobs in 18 Massachusetts nursing homes formed the basis for a survey administered to 255 CNAs in 15 homes. A quality-of-life questionnaire was administered to 105 residents. Logistic regression accounting for clustering estimated the effect of personal characteristics, satisfaction with tangible job rewards, and aspects of job design on CNAs' intent to stay in current jobs. A general linear model estimated the effect of job commitment on residents' satisfaction with their relationship to nursing staff. Results: After we accounted for satisfaction with wages, benefits, and advancement opportunities, good basic supervision was most important in affecting CNAs' intent to stay in their jobs. Job enhancements were not significantly related to intent to stay. Residents were more satisfied with their relationships to nursing staff and their quality of life on units where a higher proportion of CNAs were committed to their jobs. Implications: The finding that greater job commitment of CNAs is associated with better quality of relationships and life for residents implies that better jobs lead to better care. Culture change transformation that increases CNA autonomy, knowledge input, and teamwork may not increase workers' commitment to jobs without improvements in basic supervision.

引用

页码：36 / 45

页数：10

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