Factors Affecting Frontline Workers’ Satisfaction with Supervision Objective: This research was guided by a stress and support model to examine the effects of frontline workers’ background characteristics, personal stressors, job-related stressors, and workplace support on satisfaction with supervision. Methods: Survey data were collected from 644 workers in 49 long-term–care settings that employed them. Regression analysis were used to determine the effects of worker level and then Hierarchical Linear Modeling (HLM) and organizational factors on the outcome. Results: Although all four variable categories made significant contributions to explaining satisfaction with supervision, the most powerful were personal stressors and job-related stressors. Results from HLM analysis showed frontline workers in nursing homes and those employed in for-profit organizations had lower levels of satisfaction with supervision. Discussion: Findings suggest organizational interventions to address workers’ financial and health issues and management practices such as better training programs and peer mentoring could enhance workers’ satisfaction with supervision. Read more
What is the Relationship Between Background Characteristics and the Dyadic Strain Experienced by Individuals with Dementia This article examines how the background characteristics of an individual with dementia (IWD) are related to the dyadic relationship of the caregiver and IWD. Results indicate that selected background characteristics of IWDs (n = 119), such as marital status, living arrangement, and education level, influence the relationship that the IWD has with his or her caregiver. Findings provide family caregivers, researchers, and practitioners with a broader understanding of how an IWD’s background affects the relationship between the caregiver and the IWD. Use of this knowledge has potential to expand the breadth and depth of new and innovative interventions for IWDs. Read more
The Impact of Stress and Support on Direct Care Workers’ Job Satisfaction Purpose: This research applies a stress and support conceptual model to investigate the effects of background characteristics, personal and job-related stressors, and workplace support on direct care workers’ (DCW) job satisfaction. Design and Methods: Researchers collected survey data from 644 DCWs in 49 long-term care (LTC) organizations. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. We examined the influence of components of the LTC stress and support model on DCW job satisfaction. Initially, we ran a multiple regression analysis by entering individual-level DCW predictors with job satisfaction as the outcome. Subsequently, we used hierarchical linear modeling to examine the influence of organizational factors on DCW job satisfaction after controlling for significant individual-level DCW variables. Results: Components of the model explained 51% of the variance in DCW job satisfaction. Background characteristics of DCWs were less important than personal stressors (e.g., depression), job-related stressors (e.g., continuing education), and social support (e.g., interactions with others) in predicting job satisfaction. Results from hierarchical linear modeling analysis showed that nursing homes compared to the two other types of LTC organizations had lower average DCW job satisfaction rates, as did organizations offering lower minimum hourly rates and those reporting turnover problems. Implications: Study findings underscore the importance of targeting both DCW-level and organizational-level factors to increase DCW job satisfaction. Read more
The Impact of Stress and Support on Nursing Assistant Satisfaction With Supervision This research applies a stress-and-social-support conceptual model to investigate the effects of personal and facility characteristics, job-related and personal stressors, and social support in the workplace on nursing assistant (NA) satisfaction with supervision. Survey data are from in-person interviews with 338 NAs employed at 22 skilled nursing facilities. Structural equation modeling was used to determine the model’s goodness of fit. Results show that personal stressors (family, financial, and health concerns) have the greatest impact on satisfaction with supervision. Positive support in the workplace attenuated the effects of job-related stressors on the outcome. Findings suggest NAs’ personal stressors require careful attention from supervisory and human resources staff because they directly affect worker satisfaction with supervision. Employee Assistance Programs and training for supervisors in team building, communication, and motivational skills are needed to promote more positive relationships with and among NAs. Read more
Planning for the Future Together in Culturally Diverse Families Making Everyday Care Decisions The stress of providing long-term care to a relative with a cognitive impairment (eg. dementia) is often compounded by the difficulties encountered when making care decisions on behalf of the individual (ie. care receiver). This article describes research within culturally diverse families that explores decision making in everyday care from the perspective of both the caregiver and the care receiver. Our findings suggest that persons with cognitive impairments are able to express preferences for care, and that there are more similarities than differences across culturally diverse families. Read more
The Influence of Religious and Personal Values on Nursing Home Residents’ Attitudes Toward Life-Sustaining Treatments A cross-sectional survey design was used to interview 133 Jewish, Catholic and Protestant residents from 13 nursing homes to examine the influence of religious and personal values on attitudes toward life-sustaining treatments. Subjects on average were 83 years old, Caucasian and female, with more than half having Advance Directives (ADs). Jewish subjects, as well as those who relied on God, were better educated and more anxious about death, had significantly more positive attitudes toward life-sustaining treatments at the end-of-life. On the other hand, those who had implemented ADs desired fewer life-sustaining treatments. Finding demonstrate that understanding individual desires for life-sustaining treatments is complex. Practitioners who provide education on end-of-life decisions need to discuss a myriad of issues including individual religious and personal values and other characteristics in an effort to understand and respect treatment choices. Read more
Involvement of Elders in Care-Related Decision A Black/White Comparison This research uses data from 244 family caregivers to examine racial differences in the composition of care-related decision-making networks. Analyses reveal blacks are significantly less likely to identify the older care recipient as involved or as the key decision maker when compared to whites. The older individual's physical and mental impairments are also important predictors of the involvement in decision making. Discussion addresses sensitivity to racial differences and elder cognitive capacity in assessing older individual decision-making involvement. Read more
Enhancing Mutual Respect Among Nursing Assistants, Residents, and Residents’ Families Interviews with nursing assistants and residents revealed ways in which they experience respect, disrespect, attachment, and distancing in their relationships with each other. As a result of these findings, an in-service session on interpersonal respect was developed for nursing assistants. Manifestations of disrespect and strategies for promoting mutually respectful relationships among residents, their families, and staff in the facility are presented. Read more
