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The relationship between small-scale nursing home care for people with dementia and staff's perceived job characteristics

Published online by Cambridge University Press:  10 February 2014

B.M. Willemse ,
M.F.I.A. Depla ,
D. Smit  and
A.M. Pot
B.M. Willemse*
Affiliation:
Netherlands Institute of Mental Health and Addiction, Program on Aging, P.O. Box 725, 3500 AS Utrecht, the Netherlands Department of Clinical Psychology, Faculty of Psychology and Education, Vrije Universiteit (VU), Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands
M.F.I.A. Depla
Affiliation:
Department of General Practice and Elderly Care Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
D. Smit
Affiliation:
Netherlands Institute of Mental Health and Addiction, Program on Aging, P.O. Box 725, 3500 AS Utrecht, the Netherlands Department of Clinical Psychology, Faculty of Psychology and Education, Vrije Universiteit (VU), Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands
A.M. Pot
Affiliation:
Netherlands Institute of Mental Health and Addiction, Program on Aging, P.O. Box 725, 3500 AS Utrecht, the Netherlands Department of Clinical Psychology, Faculty of Psychology and Education, Vrije Universiteit (VU), Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands School of Psychology, University of Queensland, St Lucia, QLD 4072, Brisbane, Australia
*
Correspondence should be addressed to: B.M. Willemse, Netherlands Institute of Mental Health and Addiction, Program on Aging, P.O. Box 725, 3500 AS Utrecht, the Netherlands. Phone: +31-30-2959210; Fax: +31-30-2971111. Email: bwillemse@trimbos.nl.
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Abstract

Background:

Over the past few decades, new care models that are more resident-oriented and directed toward small-scale and homelike environments have been developed worldwide. The impact of these care models on the quality of life of residents has been studied. However, little research has been conducted to gain insight into how these new care models influence healthcare staff's work environment. This study focuses on the consequences of small-scale care on staff's perceived job characteristics.

Methods:

Data were derived from a sample of 136 Dutch living arrangements providing nursing home care for people with dementia (2008/2009), in which 1,327 residents and 1,147 staff participated. The relationship between two indicators of small-scale care (small-scale care characteristics and total number of residents with dementia in facility) and staff's job characteristics (job demands, decision authority, coworker and supervisor support) were studied with multilevel regression analyses. All analyses were adjusted for staff, resident, and living arrangement characteristics when needed.

Results:

Both indicators of small-scale care were associated with job demands; staff perceived less time and work pressure as more characteristics of small-scale care were integrated and the facility had less residents with dementia in total. Only one indicator was associated with decision authority. As more characteristics of small-scale care were integrated, staff's perceived decision authority was higher. No relationship was found with coworker and supervisor social support.

Conclusions:

Knowing that job demands and decision authority are important predictors of job appraisal and well-being, our findings show that small-scale care could have a beneficial impact on healthcare staff's work environment.

Keywords

nursing home carelong-term carecare modelpsychosocial work environmentjob designworkloadautonomy
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 5 , May 2014 , pp. 805 - 816
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Aiken, L. H. et al. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ (Clinical Research Ed.), 344, e1717.CrossRefGoogle ScholarPubMed
Berkhout, A. J. M. B., Boumans, N. P. G., Nijhuis, F. J. N., Van Breukelen, G. P. J. and Abu-Saad, H. H. (2003). Effects of resident-oriented care on job characteristics of nursing caregivers. Work & Stress, 17, 337–353.CrossRefGoogle Scholar
Bishop, C. E., Squillace, M. R., Meagher, J., Anderson, W. L. and Wiener, J. M. (2009). Nursing home work practices and nursing assistants’ job satisfaction. The Gerontologist, 49, 611–622.CrossRefGoogle ScholarPubMed
Bowers, B. J., Lauring, C. and Jacobson, N. (2001). How nurses manage time and work in long-term care. Journal Of Advanced Nursing, 33, 484–491.CrossRefGoogle ScholarPubMed
Brazil, K., Maitland, J., Ploeg, J. and Denton, M. (2012). Identifying research priorities in long term care homes. Journal of the American Medical Directors Association, 13, 84.CrossRefGoogle ScholarPubMed
de Jonghe, J. F. M., Kat, M. G., Kalisvaart, C. J. and Boelaarts, L. (2003). Neuropsychiatric inventory questionnaire (NPI-Q): a validity study of the Dutch form. Tijdschrift Voor Gerontologie En Geriatrie, 34, 74–77.Google ScholarPubMed
de Rooij, A. H. P. M., Luijkx, K. G., Declercq, A. G., Emmerink, P. M. J. and Schols, J. M. G. A. (2012). Professional caregivers’ mental health problems and burnout in small-scale and traditional long term care settings for elderly people with dementia in the Netherlands and Belgium. Journal of the American Medical Directors Association, 13, 486.CrossRefGoogle ScholarPubMed
Edberg, A. K., Bird, M., Richards, D. A., Woods, R., Keeley, P. and Davis-Quarrell, V. (2008). Strain in nursing care of people with dementia: Nurses’ experience in Australia, Sweden and United Kingdom. Aging & Mental Health, 12, 236–243.CrossRefGoogle ScholarPubMed
Edvardsson, D., Sandman, P. O., Nay, R. and Karlsson, S. (2008). Associations between the working characteristics of nursing staff and the prevalence of behavioral symptoms in people with dementia in residential care. International Psychogeriatrics, 20, 764–776.CrossRefGoogle ScholarPubMed
Flynn, M. and McKeown, M. (2009). Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix research. Journal of Nursing Management, 17, 759–766.CrossRefGoogle ScholarPubMed
Funaki, Y., Kaneko, F. and Okamura, H. (2005). Study on factors associated with changes in quality of life of demented elderly persons in group homes. Scandinavian Journal of Occupational Therapy, 12, 4–9.CrossRefGoogle Scholar
Johnson, J. V. and Hall, E. M. (1988). Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. American Journal of Public Health, 78, 1336–1342.CrossRefGoogle ScholarPubMed
Johnson, J. V., Hall, E. M. and Theorell, T. (1989). Combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population. Scandinavian Journal of Work, Environment & Health, 15, 271–279.CrossRefGoogle Scholar
Kane, R. A., Lum, T. Y., Cutler, L. J., Degenholtz, H. B. and Yu, T. C. (2007). Resident outcomes in small-house nursing homes: a longitudinal evaluation of the initial green house program. Journal of the American Geriatrics Society, 55, 832–839.CrossRefGoogle ScholarPubMed
Karasek, R. A. (1979). Job demands, job decision latitude, and mental strain: implications for job redesign. Administrative Science Quarterly, 24, 285–307.CrossRefGoogle Scholar
Karasek, R. A. (1998). Demand-Control model: a social, emotional and physiological approach to stress risk and active behaviour development. In Stellman, J. M. (ed.), Encyclopedia of Occupational Health and Safety (pp. 34). Geneva: International Labour Office.Google Scholar
Karasek, R. A. and Theorell, T. (1990). Healthy Work: Stress, Productivity and the Reconstruction of Working Life. New York, NY: Basic Books.Google Scholar
Katz, S. (1983). Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. Journal of the American Geriatrics Society, 31, 721–727.CrossRefGoogle ScholarPubMed
Kirwan, M., Matthews, A. and Scott, P. A. (2013). The impact of the work environment of nurses on patient safety outcomes: a multi-level modelling approach. International Journal of Nursing Studies, 50, 253–263.CrossRefGoogle ScholarPubMed
Kramer, M., Maguire, P. and Brewer, B. B. (2011). Clinical nurses in Magnet hospitals confirm productive, healthy unit work environments. Journal of Nursing Management, 19, 5–17.CrossRefGoogle ScholarPubMed
Malmberg, B. and Zarit, S. H. (1993). Group homes for people with dementia: a Swedish example. The Gerontologist, 33, 682–686.Google ScholarPubMed
Morgeson, F. P., Dierdorff, E. C. and Hmurovic, J. L. (2010). Work design in situ: understanding the role of occupational and organizational context. Journal of Organizational Behavior, 31, 351–360.CrossRefGoogle Scholar
Orme, L. and Maggs, C. (1993). Decision-making in clinical practice: how do expert nurses, midwives and health visitors make decisions? Nurse Education Today, 13, 270–276.CrossRefGoogle ScholarPubMed
Pekkarinen, L., Sinervo, T., Perala, M. L. and Elovainio, M. (2004). Work stressors and the quality of life in long-term care units. The Gerontologist, 44, 633–643.CrossRefGoogle ScholarPubMed
Pot, A. M. (2013). Improving nursing home care for dementia: is the environment the answer? Aging & Mental Health.CrossRefGoogle Scholar
Pot, A. M. and de Lange, J. (2010). Living Arrangements for People with Dementia Study. A Study of Nursing Home Care for People with Dementia. Utrecht: Trimbos-Instituut.Google Scholar
Rabig, J., Thomas, W., Kane, R. A., Cutler, L. J. and McAlilly, S. (2006). Radical redesign of nursing homes: applying the green house concept in Tupelo, Mississippi. The Gerontologist, 46, 533–539.CrossRefGoogle ScholarPubMed
Schoenmakers, F. (2012). Employers Survey 2 Care and Welfare, Youth and Child Care 2011. Zoetermeer: Panteia.Google Scholar
Skovdahl, K., Fahlstrom, G., Horttana, B. M., Winblad, B. and Kihlgren, M. (2008). Demanding behaviours and workload in elderly care in Sweden: occurrence at two time points within a decade. Scandinavian Journal of Caring Sciences, 22, 323–330.CrossRefGoogle ScholarPubMed
Smit, D., de Lange, J., Willemse, B. and Pot, A. M. (2012). The relationship between small-scale care and activity involvement of residents with dementia. International Psychogeriatrics, 24, 722–732.CrossRefGoogle ScholarPubMed
Spilsbury, K., Hewitt, C., Stirk, L. and Bowman, C. (2011). The relationship between nurse staffing and quality of care in nursing homes: a systematic review. International Journal of Nursing Studies, 48, 732–750.CrossRefGoogle ScholarPubMed
te Boekhorst, S., Depla, M. F. I. A., de Lange, J., Pot, A. M. and Eefsting, J. A. (2007). Small-scale group living for elderly with dementia: a clarification. Tijdschrift Voor Gerontologie En Geriatrie, 38, 17–26.Google ScholarPubMed
te Boekhorst, S., Depla, M. F. I. A., de Lange, J., Pot, A. M. and Eefsting, J. A. (2009). The effects of group living homes on older people with dementia: a comparison with traditional nursing home care. International Journal of Geriatric Psychiatry, 24, 970–978.CrossRefGoogle ScholarPubMed
te Boekhorst, S., Depla, M. F. I. A., Pot, M. A., de Lange, J. and Eefsting, J. A. (2011). The ideals of group living homes for people with dementia: do they practice what they preach? International Psychogeriatrics, 23, 1526–1527.CrossRefGoogle ScholarPubMed
te Boekhorst, S., Willemse, B., Depla, M. F. I. A., Eefsting, J. A. and Pot, A. M. (2008). Working in group living homes for older people with dementia: the effects on job satisfaction and burnout and the role of job characteristics. International Psychogeriatrics, 20, 927–940.CrossRefGoogle ScholarPubMed
van der Doef, M. and Maes, S. (1999a). The Leiden Quality of Work questionnaire: its construction, factor structure, and psychometric qualities. Psychological Reports, 85, 954–962.CrossRefGoogle ScholarPubMed
van der Doef, M. and Maes, S. (1999b). The Job Demand-Control (-Support) model and psychological well-being: a review of 20 years of empirical research. Work & Stress, 13, 87–114.CrossRefGoogle Scholar
Verbeek, H. (2011). Redesigning dementia care: an evaluation of small-scale homelike care environments, Ph.D. thesis. Maastricht, the Netherlands: Maastricht University.Google Scholar
Verbeek, H., van Rossum, E., Zwakhalen, S. M. G., Kempen, G. I. J. M. and Hamers, J. P. H. (2009). Small, homelike care environments for older people with dementia: a literature review. International Psychogeriatrics, 21, 252–264.CrossRefGoogle ScholarPubMed
Verbeek, H., Zwakhalen, S. M. G., van Rossum, E., Ambergen, T., Kempen, G. I. J. M. and Hamers, J. P. H. (2010a). Dementia care redesigned: effects of small-scale living facilities on residents, their family caregivers, and staff. Journal of the American Medical Directors Association, 11, 662–670.CrossRefGoogle ScholarPubMed
Verbeek, H., Zwakhalen, S. M. G., van Rossum, E., Ambergen, T., Kempen, G. I. J. M. and Hamers, J. P. H. (2010b). Small-scale, homelike facilities versus regular psychogeriatric nursing home wards: a cross-sectional study into residents’ characteristics. BMC Health Services Research, 10, 30.CrossRefGoogle Scholar
Willemse, B. M., de Jonge, J., Smit, D., Depla, M. F. I. A. and Pot, A. M. (2012). The moderating role of decision authority and coworker- and supervisor support on the impact of job demands in nursing homes: a cross-sectional study. International Journal of Nursing Studies, 49, 822–833.CrossRefGoogle ScholarPubMed
Willemse, B. M., Smit, D., de Lange, J. and Pot, A. M. (2011). Nursing home care for people with dementia and residents’ quality of life, quality of care and staff well-being: design of the living arrangements for people with dementia (LAD)-study. BMC Geriatrics, 11.CrossRefGoogle ScholarPubMed
Zimmerman, S. et al. (2005). Attitudes, stress, and satisfaction of staff who care for residents with dementia. The Gerontologist, 45, 96–105.CrossRefGoogle ScholarPubMed