title: Immigrant status and intention to leave of nursing assistants in U.S. nursing homes.
abstract: OBJECTIVE
  To better understand the characteristics and perceptions of immigrants working as nursing assistants in U.S. nursing homes and to determine whether immigrant status is linked to job turnover.
  
  
  METHODS
  Analysis of interview data from a nationally representative sample of nursing assistants working in U.S. nursing homes.
  
  
  METHODS
  Five hundred eighty-two nursing homes included in the 2004 National Nursing Assistant Survey.
  
  
  METHODS
  Two thousand eight hundred eighty-one nursing assistants.
  
  
  METHODS
  Proportion of respondents who were non-U.S. born or naturalized citizens and relationship between these characteristics and measures of job satisfaction and intention to leave within the subsequent year.
  
  
  RESULTS
  Fourteen percent (13.9%) of nursing assistants employed in U.S. nursing homes were immigrants. Immigrants tended to be better educated; more often male, nonwhite, and Hispanic; and concentrated in large, urban facilities than nonimmigrants. They reported feeling less respected by residents and families but not less respected by supervisors, and they were more likely to report intention to leave the job within 1 year. In multivariate analyses, demographic factors, length of time on the job, and noncitizen status were independently associated with plans to leave within a year.
  
  
  CONCLUSIONS
  Attention to the unique factors associated with immigrant status, such as the need to improve communication and garner respect from patients and families, can assist policy-makers, facility administrators, and medical directors in more effectively attracting, training, and supporting this growing segment of the nursing assistant labor pool.
authors.affiliation: Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina, USA. psloane@med.unc.edu
authors.forename: Philip D
authors.initials: PD
authors.lastname: Sloane
authors.forename: Christianna S
authors.initials: CS
authors.lastname: Williams
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005551:Foreign Professional Personnel / Q000193:education / Q000523:psychology* / Q000600:supply & distribution; D006801:Humans; D033182:Intention; D007400:Interprofessional Relations; D007588:Job Satisfaction; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009309:National Center for Health Statistics, U.S.; D009728:Nursing Assistants / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D009735:Nursing Homes; D010560:Personnel Selection; D010563:Personnel Turnover / Q000706:statistics & numerical data; D011368:Professional-Family Relations; D012111:Residence Characteristics; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce