New TREC Publication

Influence of organizational context on nursing home staff burnout: A cross-sectional survey of care aides in Western Canada

Stephanie A. Chamberlain, Andrea Gruneir, Matthias Hoben, Janet E. Squires, Greta G. Cummings, Carole A. Estabrooks

International Journal of Nursing Studies

Read, download...

Abstract

Our study examined care aide characteristics, organizational context, and frequency of dementia-related resident responsive behaviours associated with burnout. Burnout is the experience of emotional exhaustion, cynicism, and professional inefficacy. Care aide burnout has implications for turnover, staff health, and quality of care.

Design and methods

We used surveys collected from 1194 care aides from 30 urban nursing homes in three Western Canadian provinces. We used a mixed-effects regression analysis to assess care aide characteristics, dementia-related responsive behaviours, unit and facility characteristics, and organizational context predictors of care aide burnout. We measured burnout using the Maslach Burnout Inventory, Short Form.

Results

We found that care aides were at high risk for emotional exhaustion and cynicism, but report high professional efficacy. Statistically significant predictors of emotional exhaustion included English as a second language, medium facility size, organizational slack-staff, organizational slack-space, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of cynicism were care aide age, English as a second language, unit culture, evaluation (feedback of data), formal interactions, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of professional efficacy were unit culture and structural resources. Greater care aide job satisfaction was significantly associated with increased professional efficacy.

Implications

This study suggests that individual care aide and organization features are both predictive of care aide burnout. Unlike care aide or structural characteristics of the facility elements of the organizational context are potentially modifiable, and therefore amenable to intervention.

What is already known about the topic?

  • Burnout in healthcare settings leads to increased turnover and absenteeism.
  • Research examining burnout in care aides who work in nursing home settings indicates that individual characteristics such as age, education, and job satisfaction, predict burnout.

What this paper adds

  • Our results demonstrate that care aides who work in nursing homes have moderate-high levels of emotional exhaustion and cynicism, but concurrently high levels of professional efficacy.
  • We found that modifiable features of the organizational context including culture, evaluation (feedback of data), formal interactions, structural resources, organizational slack-staff, and organizational slack-space predict nursing home care aide burnout.