Abstract 9465: Does Connectedness Matter: The Association Between Mutuality and Job Satisfaction Among Home Health Aides Caring for Adults with Heart Failure

Abstract

Introduction: Adults with heart failure (HF) are increasingly aging in place and requiring help at home. However, due to poor compensation and the challenging nature of the work, home health aide (HHA) turnover rates are high. Identifying modifiable factors that can promote HHAs’ job satisfaction may help retain this workforce. We examined whether mutuality, or the connectedness between HHAs and their HF patients, is associated with HHAs’ job satisfaction. Methods: We conducted a cross-sectional survey of English-speaking agency-employed HHAs caring for an adult with HF in New York City. Mutuality was assessed with the Mutuality Scale, a validated 15-item scale measuring overall mutuality and its’ four domains (love, shared values, reciprocity, shared pleasurable activities). The overall scale and each domain score range from 0-4; higher scores indicate greater mutuality. Job satisfaction was assessed with one question; responses were categorized using a 4-point Likert scale. We used multivariable robust Poisson regression to examine the association between mutuality and job satisfaction, adjusting for HHAs’ demographics, employment, and HF caregiving history. Results: We studied 200 HHAs employed by 22 home care agencies; 94% (187 of 200) were female, 73% (145 of 200) were foreign-born, 43% (82 of 191) were non-Hispanic Black. They had a mean age of 48 years (SD 14), worked as a HHA for a median of 9 years (IQR 5-15), and spent a median of 24 hours/week (IQR 8-36) with a HF patient. The overall mean mutuality score was 2.92 (SD 0.79) and 80% (160 of 200) were satisfied with their job. Mean scores were lowest for reciprocity (2.62 [0.99]) and highest for shared pleasurable activities (3.16 [0.80]). In fully adjusted models, the overall mutuality score and each of the 4 domain scores were associated with increased job satisfaction. Only the shared activities domain was statistically significant (aPR: 1.17 [95% CI 1.04-1.32]). Conclusions: Greater mutuality, specifically the shared activities domain, between HHAs and HF patients was associated with higher job satisfaction. Our findings suggest that this modifiable domain of mutuality may be a possible target for interventions to promote mutuality between HHAs and patients as well as HHA job satisfaction.