Bullying or violence during training and the risk of dropout from the eldercare sector 2 years later.

BACKGROUND: The proportion of old people in need of care is growing rapidly in most western societies, and there is a rising demand for qualified eldercare workers in the years to come. Hence, solutions to high turnover in the eldercare sector are becoming increasingly important. AIM: To test whether bullying, violence and/or threats of violence (violence) among health care trainees are predictors of subsequent dropout from the eldercare sector 2 years after graduation from college. METHODS: A questionnaire was given to all health care trainees in Denmark approximately 2 weeks before their graduation in 2004. Female respondents (N = 5000) were followed in national employment registers to see whether they had dropped out of the eldercare sector by the end of 2006. Logistic regression was used to model the outcome. RESULTS: Among the respondents, 5.5% had been bullied during the training period, 9.1% had been subjected to violence. Hereof, 1% reported exposure to both bullying and violence. At follow-up, 37% had dropped out of the eldercare sector. The odds of dropout were significantly associated with bullying, OR = 1.39 (95% CI: 1.08-1.79), but not with violence, OR = 0.89 (95% CI: 0.72-1.09). CONCLUSION: Being bullied while in training as a health care worker is a predictor of subsequent dropout from the eldercare sector.

Do lifestyle factors and general health predict dropout among recently qualified eldercare workers? A two-year follow-up study.

BACKGROUND: The eldercare sector in Denmark as in many industrialised countries is characterised by difficulties in retaining labour. Research suggests a possible imbalance between lifestyle and health among eldercare trainees and the demanding work encountered as eldercare employees. The aim of the present study was to determine the predictive effect of lifestyle and self-rated health on dropout from the Danish eldercare sector two years after qualification. METHODS: We included 4,526 female eldercare trainees in the analyses of lifestyle parameters and 5,023 in the analyses of self-rated health. The participants in this prospective study were recruited from 27 of the 28 Danish colleges for eldercare. We linked survey data with national register data to obtain information about labour market attachment two years after qualification. RESULTS: The results of the present study showed that the poorer self-rated health, the higher the risk for dropout from the labour market (p < 0.0001). However, the results were less consistent regarding the predictive effect of a detrimental lifestyle. We found that overweight/obesity (p = 0.0021 and p = 0.0012) as well as smoking (p = 0.0017) decreased the risk of dropout from eldercare into education. We found no support for increased likelihood of dropout among physically inactive. CONCLUSIONS: The results of the present study show that a poorer self-rated health is a predictor for dropout, not only from the eldercare two years after qualification, but from the labour market as a whole. However, the results were less consistent regarding the predictive effect of a detrimental lifestyle on dropout.

Are immigrants in the nursing industry at increased risk of bullying at work? A one-year follow-up study.

The purpose of this study was to explore whether (a) immigrant health care workers (HCW) are more at risk of bullying at work than Danish staff members, (b) this association is increased by previous exposure to bullying and (c) immigrants experience more bullying from supervisors, colleagues and clients/residents. We analyzed cross-sectional baseline data from 5,635 health care students of whom 10.4% were immigrants, and conducted a prospective analysis by following 3,109 of these respondents during their first year of employment. More than a third of the respondents had previous experiences with bullying. The baseline analyses showed that immigrants are more at risk of being bullied during both their theoretical education and trainee periods than their Danish co-students. At follow-up we found that 9.1% of the total cohort had been exposed to bullying at work during their first year of employment, hereof 1.8% frequently. "Non-Western" immigrants had a significantly higher risk of exposure to bullying at work during follow-up than the Danish respondents independent of previous experience with bullying. Danish and immigrant health care workers were more exposed to bullying from co-workers than from supervisors with no statistically significant difference between the Danes and the immigrant groups. Both "Western" and "non-Western" respondents were more at risk of bullying from clients/residents than the Danish respondents.

Are low back pain and low physical capacity risk indicators for dropout among recently qualified eldercare workers? A follow-up study.

BACKGROUND: A high job turnover and dropout among eldercare workers has led to a significant shortage of qualified manpower in the Danish eldercare sector. OBJECTIVES: The predictive effect of some non-work-related causes for leaving the eldercare sector 2 years after qualification, physical capacity, duration, and severity of previous low back pain, was investigated. DESIGN AND SETTING: A 2-year prospective cohort study of all the Danish eldercare workers, who finished their education during 2004 (n = 6347). Questionnaire data from 2004 were followed up by register data on attachment to labour market, educational status, and association to trade from Statistics Denmark in 2006. METHODS: Data on physical capacity, duration, and severity of low back pain the last 12 months among the female participants were analysed by multinomial logistic regression to estimate odds-ratios for being either in the eldercare sector, in other health- and welfare sectors, in all other sectors, under education, or outside labour market, 2 years after qualification. RESULTS: Disability due to and duration of low back pain were significant predictors for dropout from the eldercare sector 2 years after qualification. Low physical capacity was not. Data on duration of low back pain suggest a trend towards a dose-response relationship: The longer the duration of low back pain, the higher odds for dropout. CONCLUSIONS: Low back pain and disability due to low back pain during the last year of education were independent predictors for dropout from the eldercare sector 2 years after qualification. However, low self-rated physical capacity did not predict job dropout or turnover.

Psychological well-being as a predictor of dropout among recently qualified Danish eldercare workers.

BACKGROUND: The eldercare sector is characterized by a shortage of labour and a high turnover rate, which constitutes a major challenge for the ageing societies of western Europe. The aim of the present study was to investigate if a low level of psychological well-being at the time of graduation predicts dropout among eldercare workers two years later. METHODS: We included 4,968 female eldercare trainees in this prospective study, recruited from 27 of the 28 Danish colleges for eldercare. Psychological well-being in 2004 was measured with the five-item Mental Health Inventory (MHI-5) of the 36-item Short-Form Health Survey (SF-36). We linked the survey data with national register data to obtain information about labour market attachment two years after qualification. RESULTS: In 2006, 37% of all participants had left the eldercare sector. Compared to participants with high psychological well-being at baseline, participants with medium and low psychological well-being were more likely to dropout to sectors unrelated to health and welfare (odds ratio (OR) 1.40 (95% confidence interval (95% CI) = 1.06-1.85) and 1.66 (95% CI = 1.27-2.19), respectively). They were also more likely to drop out of the labour market (OR 1.48 (95% CI = 1.08-2.04) and 1.60 (95% CI = 1.12-2.20), respectively). Psychological well-being was not related to dropout to other health- and welfare sectors or dropout to further education. CONCLUSIONS: The fact that more than one third of all participants had left the eldercare sector two years after qualification demonstrates the importance of retention initiatives early in working life. In addition a focus on psychological well-being among eldercare workers should be considered.