Factors related to turnover intentions and work-related injuries and accidents among professional caregivers: a cross-sectional questionnaire study

BACKGROUND@#The Japanese health and welfare industry has a shortage of professional caregivers, and work-related accidents and injuries among this group are therefore especially critical issues. This study aimed to examine the factors associated with turnover intentions and work-related injuries and accidents among professional caregivers in Japan.@*METHODS@#Self-report questionnaires were distributed to care workers (N = 1396) at 26 geriatric-care facilities. The questionnaire addressed basic attributes, work and organizational characteristics, wage adequacy, and intrinsic motivations for work (e.g., "being suited to caring work"). Social-relational aspects of the work environment were assessed via three subscales of the Social Capital and Ethical Climate in the Workplace instrument (i.e., "Social Capital in the Workplace," "Exclusive Workplace Climate," and "Ethical Leadership"). Dependent variables were the experience of work-related accidents or injuries in the prior year and organizational and occupational turnover intentions. We used datasets of professional caregivers for analyses.@*RESULTS@#The response rate was 68% (N = 949). Among the 667 professional caregivers, 63% were female. On multivariable logistic regression analysis for work-related accidents and injuries for each sex, those with higher scores for "being suited to caring work" were found to experience significantly fewer work-related accidents and injuries (odds ratio [OR] = 0.78, p < 0.01) among female caregivers. Male caregivers who perceived an exclusive workplace climate experienced more work-related accidents and injuries (OR = 1.61, p < 0.01). However, experience of work-related accidents and injuries did not show significant relationships with organizational and occupational turnover intentions. Additionally, "being suited to caring work" (OR = 0.73, p < 0.01) and ethical leadership (OR = 0.76, p < 0.05) were found to be negatively associated with organizational turnover intentions. "Being suited to caring work" (OR = 0.61, p < 0.01), inadequacy of wage (OR = 2.22, p < 0.05), and marital status (OR = 2.69, p < 0.01) were also associated with occupational turnover intentions of professional caregivers.@*CONCLUSIONS@#These findings highlight the need to foster intrinsic motivations for work as well as providing a supportive and ethical work environment to reduce high turnover rates and work-related injuries and accidents among professional caregivers.

Effect of caregiver characteristics on dementia management strategies / Efeito das características dos cuidadores nas diferentes estratégias de gerenciamento da demência

ABSTRACT. Caregiving has an important influence on the prognosis of dementia, particularly regarding the management strategy implemented. Therefore, evaluating which characteristics of caregivers can influence the choice of a particular strategy for managing dementia is needed. Objective: To evaluate the association between characteristics of caregivers and their management strategies as applied to patients with dementia. Methods: A cross-sectional study involving 45 professional caregivers from two nursing homes in Porto Alegre, Brazil, was conducted. Age, gender, education, years as a caregiver, income, burden, depressive and anxiety symptoms and dementia management strategies were evaluated for all participants. Pearson's or Spearman's correlation tests were applied according to the variable distribution (parametric or non-parametric). Bivariate correlation analysis was applied. P<0.05 was considered statistically significant. Results: There was a significant and moderate positive correlation between burden measured by the Zarit Burden Interview and criticism measured by the Dementia Management Strategies Scale (Spearman's rho = 0.555, p < 0.001). No other correlations were observed. Conclusion: Among the caregiver characteristics that directly affect the approach to managing dementia, high caregiver burden was found to be associated with high criticism, an authoritative way of managing dementia. This exploratory study indicated that a possible way of decreasing negative dementia management is to reduce caregiver burden.

RESUMO. A forma de cuidar o paciente tem uma influência importante no prognóstico da demência, principalmente no que diz respeito às estratégias utilizadas por cuidadores para manejar sintomas comportamentais destes pacientes. Assim, faz-se necessário avaliar quais características dos cuidadores poderiam influenciar na escolha de uma estratégia específica para manejo da demência. Objetivo: Avaliar a correlação de variáveis dos cuidadores com as diferentes formas de manejo da demência. Métodos: Estudo transversal, com 45 cuidadores profissionais de duas instituições de longa permanência para idosos de Porto Alegre, Brasil. Idade, gênero, escolaridade, nível socioeconômico, anos de trabalho como cuidador, sobrecarga de cuidado, sintomas ansiosos e depressivos e estratégias de gerenciamento da demência foram avaliados. Foram utilizados os testes de correlação de Pearson ou Spearman, de acordo com a distribuição das variáveis (paramétricas ou não-paramétricas). Foi considerado como estatisticamente significativos valores de p < 0,05. Resultados: Houve correlação positiva moderada e significativa entre sobrecarga de cuidado pela Escala de Zarit e criticismo pela Escala de Estratégia de Gerenciamento da Demência (Spearman rho = 0,555, p < 0,001). Não foram observadas outras correlações. Conclusão: Entre as características dos cuidadores que afetam diretamente a forma de manejo da demência, percebemos que a sobrecarga de cuidado foi associada ao alto criticismo, uma forma autoritária de manejo da demência. Este estudo exploratório aponta que uma possível maneira de reduzir estratégias negativas de gerenciamento da demência é reduzir a sobrecarga do cuidador.