title: The effect of skill mix in non-nursing assistants on work engagements among home visiting nurses in Japan.
abstract: OBJECTIVE
  This study evaluated the effect of a skill-mix programme intervention on work engagement in home visiting nurses.
  
  
  BACKGROUND
  A skill-mix programme in which home visiting nurses are assisted by non-nursing workers is assumed to foster home visiting nurses' work engagement.
  
  
  METHODS
  Pre- and post-intervention evaluations of work engagement were conducted using self-administered questionnaires. A skill-mix programme was introduced in the intervention group of home visiting nurses. After 6 months, their pre- and post-intervention work engagement ratings were compared with those of a control group.
  
  
  RESULTS
  Baseline questionnaires were returned by 174 home visiting nurses (44 in the intervention group, 130 in the control group). Post-intervention questionnaires were returned by 38 and 97 home visiting nurses from each group. The intervention group's average work engagement scores were 2.2 at baseline and 2.3 at post-intervention; the control group's were 3.3 and 2.6. Generalised linear regression showed significant between-group differences in score changes.
  
  
  CONCLUSIONS
  The skill-mix programme might foster home visiting nurses' work engagement by improving the quality of care for each client. Future research is needed to explain the exact mechanisms that underlie its effectiveness.
  
  
  CONCLUSIONS
  In order to improve the efficiency of services provided by home visiting nurses and foster their work engagement, skill-mix programmes might be beneficial.
authors.affiliation: Department of Community Health Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Naruse
authors.forename: Atsuko
authors.initials: A
authors.lastname: Taguchi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kuwahara
authors.forename: Satoko
authors.initials: S
authors.lastname: Nagata
authors.forename: Mahiro
authors.initials: M
authors.lastname: Sakai
authors.forename: Izumi
authors.initials: I
authors.lastname: Watai
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Murashima
mesh_terms: D000328:Adult; D017028:Caregivers / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D004526:Efficiency; D006801:Humans; D007564:Japan; D008875:Middle Aged; D064691:Nurses, Community Health; D011795:Surveys and Questionnaires; D014937:Work / Q000523:psychology*
keywords: community care; nursing management; skill mix; work engagement