title: Identifying work ability promoting factors for home care aides and assistant nurses.
abstract: BACKGROUND
  In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services.
  
  
  METHODS
  This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58) and assistant nurses (n = 79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately.
  
  
  RESULTS
  Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R2adj of 0.36, p < 0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R2adj of 0.29, p = 0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R2adj of 0.24, p = 0.003 for care aides), and also by sex and age for the assistant nurses (R2adj of 0.31, p < 0.001).
  
  
  CONCLUSIONS
  The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.
authors.affiliation: Department of Health Sciences, Luleå University of Technology, SE-97187 Luleå, Sweden. agneta.larsson@ltu.se
authors.forename: Agneta
authors.initials: A
authors.lastname: Larsson
authors.forename: Lena
authors.initials: L
authors.lastname: Karlqvist
authors.forename: Mats
authors.initials: M
authors.lastname: Westerberg
authors.forename: Gunvor
authors.initials: G
authors.lastname: Gard
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D018576:Home Health Aides / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000517:prevention & control*; D009728:Nursing Assistants / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control*; D060051:Occupational Injuries / Q000453:epidemiology / Q000517:prevention & control; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control