title: Care workers health in Swiss nursing homes and its association with psychosocial work environment: A cross-sectional study.
abstract: BACKGROUND
  Previous studies have demonstrated poor health of care workers in nursing homes. Yet, little is known about the prevalence of physical and mental health outcomes, and their associations with the psychosocial work environment in nursing homes.
  
  
  OBJECTIVE
  (1) To explore the prevalence of physical and mental health outcomes of care workers in Swiss nursing homes, (2) their association with psychosocial work environment.
  
  
  METHODS
  This is a secondary data analysis of the cross-sectional Swiss Nursing Home Human Resources Project (SHURP). We used survey data on socio-demographic characteristics and work environment factors from care workers (N=3471) working in Swiss nursing homes (N=155), collected between May 2012 and April 2013. GEE logistic regression models were used to estimate the relationship between psychosocial work environment and physical and mental health outcomes, taking into account care workers' age.
  
  
  RESULTS
  Back pain (19.0%) and emotional exhaustion (24.2%) were the most frequent self-reported physical and mental health. Back pain was associated with increased workload (odds ratios (OR) 1.52, confidence interval (CI) 1.29-1.79), conflict with other health professionals and lack of recognition (OR 1.72, CI 1.40-2.11), and frequent verbal aggression by residents (OR 1.36, CI 1.06-1.74), and inversely associated with staffing adequacy (OR 0.69, CI 0.56-0.84); emotional exhaustion was associated with increased workload (OR 1.96, CI 1.65-2.34), lack of job preparation (OR 1.41, CI 1.14-1.73), and conflict with other health professionals and lack of recognition (OR 1.68, CI 1.37-2.06), and inversely associated with leadership (OR 0.70, CI 0.56-0.87).
  
  
  CONCLUSIONS
  Physical and mental health among care workers in Swiss nursing homes is of concern. Modifying psychosocial work environment factors offer promising strategies to improve health. Longitudinal studies are needed to conduct targeted assessments of care workers health status, taking into account their age, along with the exposure to all four domains of the proposed WHO model.
authors.affiliation: Institute of Nursing Sciences, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. Electronic address: Suzanne.dhaini@unibas.ch.
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Dhaini
authors.affiliation: Institute of Nursing Sciences, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. Electronic address: Franziska.zuniga@unibas.ch.
authors.forename: Franziska
authors.initials: F
authors.lastname: Zúñiga
authors.affiliation: Institute of Nursing Sciences, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland; Claudiana, University of Applied Science, Lorenz-Böhler-Str. 13, I-39100 Bozen, Bolzano (BZ), Italy. Electronic address: Dietmar.ausserhofer@unibas.ch.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Ausserhofer
authors.affiliation: Institute of Nursing Sciences, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland; Inselspital Bern University Hospital, Nursing & Midwifery Research Unit, 3010 Bern, Switzerland. Electronic address: Michael.simon@unibas.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: Simon
authors.affiliation: Swiss Academy of Insurance Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. Electronic address: regina.kunz@usb.ch.
authors.forename: Regina
authors.initials: R
authors.lastname: Kunz
authors.affiliation: Institute of Nursing Sciences, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. Electronic address: Sabina.degeest@unibas.ch.
authors.forename: Sabina
authors.initials: S
authors.lastname: De Geest
authors.affiliation: Institute of Nursing Sciences, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. Electronic address: Rene.schwendimann@unibas.ch.
authors.forename: Rene
authors.initials: R
authors.lastname: Schwendimann
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011584:Psychology; D013557:Switzerland; D000078329:Workforce; D017132:Workplace; D055815:Young Adult
keywords: Care worker; Health; Nursing home; Work environment