title: Rest break organization in geriatric care and turnover: a multimethod cross-sectional study.
abstract: BACKGROUND
  Various determinants of nurses' work motivation and turnover behavior have been examined in previous studies. In this research, we extend this work by investigating the impact of care setting (nursing homes vs. home care services) and the important role of rest break organization.
  
  
  OBJECTIVE
  We aimed to identify direct and indirect linkages between geriatric care setting, rest break organization, and registered nurses' turnover assessed over a period of one year.
  
  
  METHODS
  We designed a multimethod cross-sectional study.
  
  
  METHODS
  80 nursing units (n=45 nursing homes, n=35 home care) in 51 German geriatric care services employing 597 registered nurses.
  
  
  METHODS
  We gathered documentary, interview, and observational data about the organization of rest breaks, registered nurses' turnover, and additional organizational characteristics (type of ownership, location, nursing staff, clients, and client-to-staff-ratio).
  
  
  RESULTS
  The findings show that the rest break system in geriatric nursing home units is more regularly as well as collectively organized and causes less unauthorized rest breaks than in home care units. Moreover, the feasibility of collective rest breaks was, as predicted, negatively associated with registered nurses' turnover and affected indirectly the relation between care setting and registered nurses' turnover. Care setting, however, had no direct impact on turnover. Furthermore, registered nurses' turnover was higher in for-profit care units than in public or non-profit units.
  
  
  CONCLUSIONS
  This study reveals significant differences in rest break organization as a function of geriatric care setting and highlights the role of collective rest breaks for nursing staff retention. Our study underlines the integration of organizational context variables and features of rest break organization for the analysis of nursing turnover.
authors: Department of Psychology, TU Dresden, Germany. Electronic address: johannes.wendsche@tu-dresden.de.
authors: Johannes
authors: J
authors: Wendsche
authors: Department of Psychology, TU Dresden, Germany.
authors: Winfried
authors: W
authors: Hacker
authors: Department of Psychology, TU Dresden, Germany.
authors: Jürgen
authors: J
authors: Wegge
authors: Department of Psychology, TU Dresden, Germany.
authors: Nadine
authors: N
authors: Schrod
authors: Department of Psychology, TU Dresden, Germany.
authors: Katharina
authors: K
authors: Roitzsch
authors: Department of Psychology, TU Dresden, Germany.
authors: Anne
authors: A
authors: Tomaschek
authors: Department of Psychology, University of Geneva, Switzerland.
authors: Matthias
authors: M
authors: Kliegel
mesh_terms: D003430:Cross-Sectional Studies; D005851:Geriatric Nursing / Q000379:methods*; D007407:Interviews as Topic; D009735:Nursing Homes; D010067:Ownership; D010563:Personnel Turnover / Q000639:trends*; D014940:Work Schedule Tolerance
keywords: Care setting; Geriatric care; Home care; Nursing homes; Rest break schedules; Turnover; Type of ownership