title: Workplace violence against homecare workers and its relationship with workers health outcomes: a cross-sectional study.
abstract: BACKGROUND
  Consumer-driven homecare models support aging and disabled individuals to live independently through the services of homecare workers. Although these models have benefits, including autonomy and control over services, little evidence exists about challenges homecare workers may face when providing services, including workplace violence and the negative outcomes associated with workplace violence. This study investigates the prevalence of workplace violence among homecare workers and examines the relationship between these experiences and homecare worker stress, burnout, depression, and sleep.
  
  
  METHODS
  We recruited female homecare workers in Oregon, the first US state to implement a consumer driven homecare model, to complete an on-line or telephone survey with peer interviewers. The survey asked about demographics and included measures to assess workplace violence, fear, stress, burnout, depression and sleep problems.
  
  
  RESULTS
  Homecare workers (n = 1,214) reported past-year incidents of verbal aggression (50.3% of respondents), workplace aggression (26.9%), workplace violence (23.6%), sexual harassment (25.7%), and sexual aggression (12.8%). Exposure was associated with greater stress (p < .001), depression (p < .001), sleep problems (p < .001), and burnout (p < .001). Confidence in addressing workplace aggression buffered homecare workers against negative work and health outcomes.
  
  
  CONCLUSIONS
  To ensure homecare worker safety and positive health outcomes in the provision of services, it is critical to develop and implement preventive safety training programs with policies and procedures that support homecare workers who experience harassment and violence.
authors.affiliation: Research Data and Analysis Center, Center for Health Research, Portland, Oregon, USA. ginger.c.hanson@kpchr.org.
authors.forename: Ginger C
authors.initials: GC
authors.lastname: Hanson
authors.affiliation: Research Data and Analysis Center, Center for Health Research, Portland, Oregon, USA. nancy.perrin@kpchr.org.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Perrin
authors.affiliation: Labor Education and Research Center, University of Oregon, Portland, Oregon, USA. hmoss@uoregon.edu.
authors.forename: Helen
authors.initials: H
authors.lastname: Moss
authors.affiliation: Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA. naima.l@gmx.de.
authors.forename: Naima
authors.initials: N
authors.lastname: Laharnar
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA. nglass1@jhu.edu.
authors.forename: Nancy
authors.initials: N
authors.lastname: Glass
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D018576:Home Health Aides / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000706:statistics & numerical data*; D009922:Oregon / Q000453:epidemiology; D015995:Prevalence; D036301:Qualitative Research; D017406:Sexual Harassment; D017132:Workplace / Q000706:statistics & numerical data; D064450:Workplace Violence / Q000706:statistics & numerical data*