Risk factors for work-related stress and subjective hardship in health-care staff in nursing homes for the elderly: A cross-sectional study.

Abstract

This study aimed to explore potential risk factors for work-related stress by, detailing working conditions and subjective hardship according to occupational category in health-care staff working with elderly patients. A cross-sectional descriptive survey was conducted in 105 nursing homes for the elderly in France. Data on nursing home working conditions were collected by occupational physicians. The study population was limited to those in direct contact with the elderly, who were divided into 3 occupational groups defined by qualifications and tasks: housekeepers (HKs), nursing assistants (NAs) and nurses (Ns). Employees answered a questionnaire on their perceived working conditions and vocational training courses. Psychosocial stress was assessed with the Siegrist questionnaire. The subjects included 706 HKs, 1,565 NAs and 378 Ns, and the findings showed confusion of tasks and responsibilities in the study population. Verbal abuse by residents was reported by 60.9% of HKs (versus 76.2% of NAs and 76.7% of Ns, p<0.001). Physical attack by residents was more frequently reported by NAs (59.1%) than Ns (52.8%) or HKs (38.0%) (p<0.001). Nearly 10% of employees reported clear effort/reward imbalance (10.4% of NAs, 9.2% of Ns and 7.0% of HKs, p=0.059). Great hardship related to proximity to death was reported by 40.5% of HKs (versus 37.3% of NAs and 22.6% of Ns; p<0.001). To prevent stress related to insufficient ability, nursing home workers should be encouraged to attend job training courses, which should cover knowledge of the specific care needs of elderly patients and of the authority/responsibility required to do their job.