Abstract
ObjectivePrevious studies have shown that high workload affects health negatively. However, studies are lacking among home care workers. The aim of this study is to examine the burden of perceived workload on health-related quality of life (HRQoL) among home care workers and to determine whether psychosocial factors modify such a relationship.MethodsA cross-sectional study was conducted in which 1162 (58% response rate) home care workers participated. The psychosocial factors were measured by QPSnordic. HRQoL was measured by EuroQol 5 dimensions, from which responses were translated into quality-adjusted life year scores (QALY). Propensity scores were used with absolute risk differences (RD). Stratified analysis was used to test the buffer hypothesis of the demand–control–support model.ResultsPersonnel with a high workload had a statistically significant 0.035 lower QALY than personnel with a normal workload. This difference was also statistically significant for the Visual Analogue Scale (RD 5.0) and the mobility (RD 0.033) and anxiety/depression scales (RD 0.20) dimensions of EQ-5D. For QALY, the effect of a high workload compared to a normal workload was higher, with low (RD 0.045, significant) compared with high (RD 0.015, non-significant) social support; while it was similar, and non-significant results, for low and high control.ConclusionsOur study shows that lowered work burden would be beneficial for home care personnel. Furthermore, our results suggest that interventions aimed at increasing social support could reduce work-related illness.
Highlights
Sweden is currently facing a demographic transition with an increasing elderly population and, an increase in life expectancy
Individuals experiencing low social support seems to be more affected by high workload for quality-adjusted life year scores (QALY) than those experiencing high social support, as there was only a statistical significance for low and not high social support, with an effect estimate of 0.045 compared to 0.015 (Table 5)
The same pattern existed for anxiety/depression, where a high workload increased the absolute numbers of individuals with problems who had low social support with 26% compared to 13% for those with high social support, both increases being statistically significant (Table 6)
Summary
Sweden is currently facing a demographic transition with an increasing elderly population and, an increase in life expectancy. The total number of elderly people receiving assistance from home care has been growing (The Swedish National Board of Health and Welfare 2018). This has put many municipalities’ home care systems under a lot of stress. The number of elderly people receiving home care has increased, and they live in their home for a longer time and receive more advanced health care in their homes (The Swedish National Board of Health and Welfare 2018) For this reason, both the workload and work complexity have increased for home care workers. Health and medical interventions are done by licensed nurses or by the home care workers with delegation by a nurse
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