title: The joint relationship between organizational design factors and HR practice factors on direct care workers' job satisfaction and turnover intent.
abstract: BACKGROUND
  Human resource (HR) practices, such as training and communication, have been linked to positive employee job commitment and lower turnover intent for direct care workers (DCWs). Not many studies have looked at the combined interaction of HR practices and organizational structure.
  
  
  OBJECTIVE
  The aim of this study is to examine the relationship between organizational structure (centralization, formalization, and span of control) and HR practices (training, horizontal communication, and vertical communication) on DCW's job satisfaction and turnover intent.
  
  
  METHODS
  Data were collected from 58 long-term care facilities in five states. We used latent class analysis to group facility characteristics into three sets of combinations: "organic," "mechanistic," and "minimalist." We used multivariate regression to test the relationship of each of these groups on DCW's job satisfaction and turnover intent.
  
  
  RESULTS
  After controlling for state, organizational, and individual covariates, the organic group, which represents decentralized and less formalized structures and high levels of job training and communication, was positively related to job satisfaction and negatively related to intent to leave. On the other hand, the minimalist group, which is characterized by low levels of job-related training and communication, showed no significant differences from the mechanistic group (referent) on job satisfaction and intent to leave.
  
  
  CONCLUSIONS
  These findings imply that managers in long-term care facilities may want to consider adopting organic, decentralized structures and HR practices to retain DCWs.
authors.affiliation: Jungyoon Kim, PhD, is Assistant Professor, Department of Health Service Research & Administration, University of Nebraska Medical Center, Omaha. E-mail: jungyoon.kim@unmc.edu. Nizar Wehbi, MD, MPH, MBA, is Assistant Professor, Department of Health Service Research & Administration, University of Nebraska Medical Center, Omaha. E-mail: nizar.wehbi@unmc.edu. Jami L. DelliFraine, PhD, is Associate Professor, Division of Management, Policy, and Community Health, School of Public Health, University Texas Health Science Center at Houston. E-mail: jami.l.dellifraine@uth.tmc.edu. Diane Brannon, PhD, is Professor, Department of Health Policy & Administration, The Pennsylvania State University, University Park. E-mail: f8z@psu.edu.
authors.forename: Jungyoon
authors.initials: J
authors.lastname: Kim
authors.forename: Nizar
authors.initials: N
authors.lastname: Wehbi
authors.forename: Jami L
authors.initials: JL
authors.lastname: Dellifraine
authors.forename: Diane
authors.initials: D
authors.lastname: Brannon
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D058016:Health Facility Administration / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007588:Job Satisfaction; D008134:Long-Term Care / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D010559:Personnel Management / Q000379:methods*; D010563:Personnel Turnover / Q000706:statistics & numerical data; D013192:Staff Development