Perceived Work Environment, Educational Status, Staffing Levels, and Work Outcomes in Long-Term Care Settings During COVID-19

Eunhee Cho; Kyung Hee Lee; Bada Kang; Jiyoon Jang; Jinhee Shin; Sameh Eltaybani; Noriko Yamamoto-Mitani; Min Jung Kim

doi:10.1016/j.jamda.2023.08.009

Perceived Work Environment, Educational Status, Staffing Levels, and Work Outcomes in Long-Term Care Settings During COVID-19

J Am Med Dir Assoc. 2023 Oct;24(10):1600-1605. doi: 10.1016/j.jamda.2023.08.009. Epub 2023 Sep 9.

Authors

Eunhee Cho¹, Kyung Hee Lee¹, Bada Kang¹, Jiyoon Jang¹, Jinhee Shin², Sameh Eltaybani³, Noriko Yamamoto-Mitani³, Min Jung Kim⁴

Affiliations

¹ Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea.
² Woosuk University College of Nursing, Wanju-Gun, Jeollabuk-do, South Korea.
³ Department of Gerontological Home Care and Long-term Care Nursing, University of Tokyo, Tokyo, Japan.
⁴ Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea. Electronic address: mjkim8916@gmail.com.

PMID: 37696496
DOI: 10.1016/j.jamda.2023.08.009

Abstract

Objectives: Coronavirus disease (COVID-19) has severely affected older residents in long-term care (LTC) settings. However, care workers' perceptions of their work environment and potential impact on their work outcomes during the pandemic is not well known. This study examined associations between care staff's perceived work environment, educational status, and facility staffing levels and work outcomes of care staff in LTC settings during the COVID-19 pandemic.

Design: This study employed a cross-sectional, observational, correlational design.

Setting and participants: A total of 207 care staff were conveniently recruited from 30 LTC settings in South Korea.

Methods: The perceived work environment, educational status of care staff, and facility staffing levels (ie, beds-to-registered nurse [RN] and beds-to-nursing assistant [NA] or care worker ratios), as well as their work outcomes (ie, general and COVID-19 specific outcomes) were collected using questionnaires. Multivariable binary logistic regressions were conducted, controlling for the characteristics of care staff (ie, age, sex, occupation, and career length) and facilities (ie, location, bed size, ownership, and residents' disease and care profiles).

Results: Approximately 45% of the participants were either NAs or care workers, and 38% were RNs. More than half (53.14%) perceived their work environment to be good. LTC staff who perceived their work environment to be poor were more likely to be dissatisfied with their work [odds ratio (OR) 20.88), experience high burnout (OR 8.63), intend to leave the facility within a year (OR 5.00), and experience increased overtime work (OR 3.58) and work-life imbalance (OR 1.93) due to COVID-19.

Conclusions and implications: LTC work environments should be improved and government-led initiatives for ensuring such improvements should be implemented to enable a better response to future public health crises and maintain the quality of care for and safety of residents in LTC settings.

Keywords: COVID-19; care staff; long-term care; work outcome.