title: The relationship between small-scale nursing home care for people with dementia and staff's perceived job characteristics.
abstract: BACKGROUND
  Over the past few decades, new care models that are more resident-oriented and directed toward small-scale and homelike environments have been developed worldwide. The impact of these care models on the quality of life of residents has been studied. However, little research has been conducted to gain insight into how these new care models influence healthcare staff's work environment. This study focuses on the consequences of small-scale care on staff's perceived job characteristics.
  
  
  METHODS
  Data were derived from a sample of 136 Dutch living arrangements providing nursing home care for people with dementia (2008/2009), in which 1,327 residents and 1,147 staff participated. The relationship between two indicators of small-scale care (small-scale care characteristics and total number of residents with dementia in facility) and staff's job characteristics (job demands, decision authority, coworker and supervisor support) were studied with multilevel regression analyses. All analyses were adjusted for staff, resident, and living arrangement characteristics when needed.
  
  
  RESULTS
  Both indicators of small-scale care were associated with job demands; staff perceived less time and work pressure as more characteristics of small-scale care were integrated and the facility had less residents with dementia in total. Only one indicator was associated with decision authority. As more characteristics of small-scale care were integrated, staff's perceived decision authority was higher. No relationship was found with coworker and supervisor social support.
  
  
  CONCLUSIONS
  Knowing that job demands and decision authority are important predictors of job appraisal and well-being, our findings show that small-scale care could have a beneficial impact on healthcare staff's work environment.
authors: Netherlands Institute of Mental Health and Addiction, Program on Aging, P.O. Box 725, 3500 AS Utrecht, the Netherlands.
authors: B M
authors: BM
authors: Willemse
authors: Department of General Practice and Elderly Care Medicine and EMGO Institute for Health and Care Research, VU University Medical Center , De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
authors: M F I A
authors: MF
authors: Depla
authors: Netherlands Institute of Mental Health and Addiction, Program on Aging, P.O. Box 725, 3500 AS Utrecht, the Netherlands.
authors: D
authors: D
authors: Smit
authors: Netherlands Institute of Mental Health and Addiction, Program on Aging, P.O. Box 725, 3500 AS Utrecht, the Netherlands.
authors: A M
authors: AM
authors: Pot
mesh_terms: D040561:Assisted Living Facilities / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D001315:Australia; D003704:Dementia / Q000628:therapy*; D005260:Female; D006272:Health Facility Environment / Q000379:methods / Q000458:organization & administration; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D008134:Long-Term Care / Q000379:methods / Q000458:organization & administration; D008297:Male; D017146:Models, Organizational; D010559:Personnel Management