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Kee K, van Wieringen M, Nies H, Beersma B. The relationships between certified nursing assistants' voice behaviour and job satisfaction, work engagement and turnover intentions: A two-wave survey study. J Adv Nurs 2025; 81:798-808. [PMID: 38733076 PMCID: PMC11730803 DOI: 10.1111/jan.16238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/18/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024]
Abstract
AIM Whereas voice behaviour has been identified as a key precursor to safe and high-quality patient care, little is known about how voice relates to key workforce outcomes. This study aimed to investigate the relationships between certified nursing assistants' perceived promotive voice behaviour (speaking up with suggestions for future improvement) and prohibitive voice behaviour (speaking up about problems or potentially harmful situations) and their self-reported levels of job satisfaction, work engagement and turnover intentions. DESIGN AND METHODS Dutch certified nursing assistants were recruited for a two-wave survey study through non-random convenience sampling. The final sample contained 152 respondents. The data were analysed using multiple linear regression analyses. In all analyses, the dependent variable at time one was controlled for. RESULTS Certified nursing assistants' promotive and prohibitive voice behaviour at time one were found to be positively related to their level of job satisfaction at time two while controlling for job satisfaction at time one. No relationships with work engagement or occupational turnover intentions were found. CONCLUSION While previous research has found positive effects of voice on patient safety outcomes and team and organizational improvements in care organizations, we demonstrate that voice is also related to a key workforce outcome, that is, certified nursing assistants' job satisfaction. IMPLICATIONS AND IMPACT Recognizing the interplay between voice behaviour and job satisfaction underscores the importance of creating work environments where certified nursing assistants feel able and willing to make their voices heard-with ideas and suggestions, as well as information regarding problems and concerns. PATIENT OR PUBLIC INVOLVEMENT Three certified nursing assistants have contributed to the development of the survey.
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Affiliation(s)
- Karin Kee
- Department of Organization SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Marieke van Wieringen
- Department of Organization SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Henk Nies
- Department of Organization SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Bianca Beersma
- Department of Organization SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
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Thwaites C, McKercher JP, Fetherstonhaugh D, Blackberry I, Gilmartin-Thomas JFM, Taylor NF, Bourke SL, Fowler-Davis S, Hammond S, Morris ME. Factors Impacting Retention of Aged Care Workers: A Systematic Review. Healthcare (Basel) 2023; 11:3008. [PMID: 38063576 PMCID: PMC10706301 DOI: 10.3390/healthcare11233008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 10/16/2024] Open
Abstract
Retention of care support workers in residential aged care facilities and home-based, domiciliary aged care is a global challenge, with rapid turnover, low job satisfaction, and poorly defined career pathways. A mixed-methods systematic review of the workforce literature was conducted to understand the factors that attract and retain care staff across the aged care workforce. The search yielded 49 studies. Three studies tested education and training interventions with the aim of boosting workforce retention and the remaining 46 studies explored opinions and experiences of care workers in 20 quantitative, four mixed-methods and 22 qualitative studies. A range of factors impacted retention of aged care staff. Two broad themes emerged from the analysis: individual and organisational factors facilitating retention. Individual factors related to personal satisfaction with the role, positive relationships with other staff, families, and residents, and a cooperative workplace culture. Organisational factors included opportunities for on-the-job training and career development, appropriate wages, policies to prevent workplace injuries, and job stability. Understaffing was often cited as a factor associated with turnover, together with heavy workloads, stress, and low job satisfaction. With global concerns about the safety and quality of aged care services, this study presents the data associated with best practice for retaining aged care workers.
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Affiliation(s)
- Claire Thwaites
- Academic and Research Collaborative in Health, La Trobe University, Melbourne, VIC 3086, Australia; (J.P.M.); (N.F.T.); (S.L.B.); (M.E.M.)
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC 3150, Australia;
| | - Jonathan P. McKercher
- Academic and Research Collaborative in Health, La Trobe University, Melbourne, VIC 3086, Australia; (J.P.M.); (N.F.T.); (S.L.B.); (M.E.M.)
| | - Deirdre Fetherstonhaugh
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Irene Blackberry
- Care Economy and Research Institute and John Richards Centre for Rural Ageing Research, La Trobe University, Albury-Wodonga, VIC 3086, Australia;
| | - Julia F-M. Gilmartin-Thomas
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia;
- Allied Health Department, Alfred Health, Melbourne, VIC 3181, Australia
| | - Nicholas F. Taylor
- Academic and Research Collaborative in Health, La Trobe University, Melbourne, VIC 3086, Australia; (J.P.M.); (N.F.T.); (S.L.B.); (M.E.M.)
- Eastern Health, Box Hill, VIC 3128, Australia
| | - Sharon L. Bourke
- Academic and Research Collaborative in Health, La Trobe University, Melbourne, VIC 3086, Australia; (J.P.M.); (N.F.T.); (S.L.B.); (M.E.M.)
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | | | - Susan Hammond
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC 3150, Australia;
| | - Meg E. Morris
- Academic and Research Collaborative in Health, La Trobe University, Melbourne, VIC 3086, Australia; (J.P.M.); (N.F.T.); (S.L.B.); (M.E.M.)
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, Melbourne, VIC 3150, Australia;
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Miller VJ, Maziarz L, Wagner J, Bell J, Burek M. Nursing assistant turnover in nursing homes: A scoping review of the literature. Geriatr Nurs 2023; 51:360-368. [PMID: 37104907 DOI: 10.1016/j.gerinurse.2023.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Nurse aide turnover in long-term care is projected to increase in the coming years. Guided by a social ecological framework, this scoping review systematically searched for peer-reviewed journal articles on nursing assistant or nurse aide turnover in nursing homes. METHODS Using the PICO and PRISMA guidelines, 8 university-based library databases via EBSCOhost were searched to source peer-reviewed journal articles published between 2002 and 2022 on nurse aide turnover in nursing homes. RESULTS The initial article search revealed 997 articles. After a three-stage article screening and removal process, a final sample of 43 articles (N = 43) remained. Guided by levels of influence, nurse aide turnover is found to be influenced by intrapersonal, interpersonal, institutional, community, and public policy level factors. CONCLUSION Findings highlight the need for further research with nursing facility administrators and nurse aides to evaluate the complex interactions within long-term care nursing homes.
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Affiliation(s)
- Vivian J Miller
- College of Health and Human Services, Bowling Green State University, 223 Health and Human Services Bldg, Bowling Green, OH 43403, USA.
| | - Lauren Maziarz
- College of Health and Human Services, Bowling Green State University, 223 Health and Human Services Bldg, Bowling Green, OH 43403, USA
| | - Jennifer Wagner
- College of Health and Human Services, Bowling Green State University, 223 Health and Human Services Bldg, Bowling Green, OH 43403, USA
| | - Julia Bell
- College of Health and Human Services, Bowling Green State University, 223 Health and Human Services Bldg, Bowling Green, OH 43403, USA
| | - Melissa Burek
- College of Health and Human Services, Bowling Green State University, 223 Health and Human Services Bldg, Bowling Green, OH 43403, USA
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Sun C, Xing Y, Wen Y, Wan X, Ding Y, Cui Y, Xu W, Wang X, Xia H, Zhang Q, Yuan M. Association between career adaptability and turnover intention among nursing assistants: the mediating role of psychological capital. BMC Nurs 2023; 22:29. [PMID: 36732804 PMCID: PMC9894670 DOI: 10.1186/s12912-023-01187-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND High turnover intention of nursing assistants was detrimental to the sustainability of long-term care. Career adaptability is an important determinant in reducing turnover intention, but little research has explored the mechanism from the perspective of psychological capital. The aim of this study was to analyze the association between career adaptability and turnover intention and to examine the mediating role of psychological capital between career adaptability and turnover intention among nursing assistants in mainland China. METHODS A cross-sectional online study was conducted among 276 nursing assistants from eight nursing homes in Nanjing, China. The participants' career adaptability, psychological capital, and turnover intention were obtained. SPSS 26.0 and Amos 24.0 software were employed for statistical analysis. RESULTS Career adaptability was positively related to psychological capital and negatively linked to turnover intention (P < 0.01). Psychological capital played a fully mediating role (β = -0.085, P < 0.05) in the relationship between career adaptability and turnover intention, and the largest indirect effect was generated through the curiosity dimension. CONCLUSIONS The management of long-term care facilities should focus on assessing the level of career adaptability of nursing assistants. The overall improvement of career adaptability and psychological capital is conducive in reducing turnover intention. Targeted interventions are recommended to improve career adaptability and reduce turnover intentions by increasing career curiosity. Online career adaptability programs can be developed for nursing assistant students to improve their psychological capital and facilitate career transitions.
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Affiliation(s)
- Changxian Sun
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China ,grid.495415.8Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Yurong Xing
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Yuting Wen
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Xia Wan
- grid.89957.3a0000 0000 9255 8984The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Yaping Ding
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Yan Cui
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Wenhui Xu
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Xiaoxiao Wang
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Hongling Xia
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Qian Zhang
- grid.89957.3a0000 0000 9255 8984Nanjing Medical University, Nanjing, China
| | - Min Yuan
- grid.495415.8Jiangsu Vocational Institute of Commerce, Nanjing, China ,grid.443514.30000 0004 1791 5258Jinshen College of Nanjing Audit University, Nanjing, China
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Farrell TW, Butler JM, Towsley GL, Telonidis JS, Supiano KP, Stephens CE, Nelson NM, May AL, Edelman LS. Communication Disparities between Nursing Home Team Members. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5975. [PMID: 35627513 PMCID: PMC9141434 DOI: 10.3390/ijerph19105975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023]
Abstract
Optimal care in nursing home (NH) settings requires effective team communication. Certified nursing assistants (CNAs) interact with nursing home residents frequently, but the extent to which CNAs feel their input is valued by other team members is not known. We conducted a cross-sectional study in which we administered a communication survey within 20 Utah nursing home facilities to 650 team members, including 124 nurses and 264 CNAs. Respondents used a 4-point scale to indicate the extent to which their input is valued by other team members when reporting their concerns about nursing home residents. We used a one-way ANOVA with a Bonferroni correction. When compared to nurses, CNAs felt less valued (CNA mean = 2.14, nurse mean = 3.24; p < 0.001) when reporting to physicians, and less valued (CNA mean = 1.66, nurse mean = 2.71; p < 0.001) when reporting to pharmacists. CNAs did not feel less valued than nurses (CNA mean = 3.43, nurse mean = 3.37; p = 0.25) when reporting to other nurses. Our findings demonstrate that CNAs feel their input is not valued outside of nursing, which could impact resident care. Additional research is needed to understand the reasons for this perception and to design educational interventions to improve the culture of communication in nursing home settings.
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Affiliation(s)
- Timothy W. Farrell
- Division of Geriatrics, Spencer Fox Eccles School of Medicine, University of Utah, 30 N 1900 E, AB 193 SOM, Salt Lake City, UT 84132, USA;
- Geriatric Research, Education, and Clinical Center (GRECC), George E. Wahlen Veteran Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, USA
| | - Jorie M. Butler
- Division of Geriatrics, Spencer Fox Eccles School of Medicine, University of Utah, 30 N 1900 E, AB 193 SOM, Salt Lake City, UT 84132, USA;
- Geriatric Research, Education, and Clinical Center (GRECC), George E. Wahlen Veteran Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, USA
| | - Gail L. Towsley
- College of Nursing, University of Utah, 10 S 2000 E, Salt Lake City, UT 84112, USA; (G.L.T.); (J.S.T.); (K.P.S.); (C.E.S.); (N.M.N.); (L.S.E.)
| | - Jacqueline S. Telonidis
- College of Nursing, University of Utah, 10 S 2000 E, Salt Lake City, UT 84112, USA; (G.L.T.); (J.S.T.); (K.P.S.); (C.E.S.); (N.M.N.); (L.S.E.)
| | - Katherine P. Supiano
- College of Nursing, University of Utah, 10 S 2000 E, Salt Lake City, UT 84112, USA; (G.L.T.); (J.S.T.); (K.P.S.); (C.E.S.); (N.M.N.); (L.S.E.)
| | - Caroline E. Stephens
- College of Nursing, University of Utah, 10 S 2000 E, Salt Lake City, UT 84112, USA; (G.L.T.); (J.S.T.); (K.P.S.); (C.E.S.); (N.M.N.); (L.S.E.)
| | - Nancy M. Nelson
- College of Nursing, University of Utah, 10 S 2000 E, Salt Lake City, UT 84112, USA; (G.L.T.); (J.S.T.); (K.P.S.); (C.E.S.); (N.M.N.); (L.S.E.)
| | - Alisyn L. May
- College of Pharmacy, University of Utah, 30 S 2000 E, Salt Lake City, UT 84112, USA;
| | - Linda S. Edelman
- College of Nursing, University of Utah, 10 S 2000 E, Salt Lake City, UT 84112, USA; (G.L.T.); (J.S.T.); (K.P.S.); (C.E.S.); (N.M.N.); (L.S.E.)
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