title: Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey.
abstract: OBJECTIVE
  The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction.
  
  
  BACKGROUND
  Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff.
  
  
  METHODS
  A cross-sectional study based on two questionnaire surveys in 2014 and 2015.
  
  
  METHODS
  The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings.
  
  
  RESULTS
  Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree.
  
  
  CONCLUSIONS
  This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Erica E M
authors.identifier: http://orcid.org/0000-0002-3814-8487
authors.initials: EEM
authors.lastname: Maurits
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Anke J E
authors.initials: AJE
authors.lastname: de Veer
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.|Department of Sociology and Department of Human Geography, Utrecht University, Utrecht, The Netherlands.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.|Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
mesh_terms: D006699:Home Care Services; D006801:Humans; D007588:Job Satisfaction; D009426:Netherlands; D009740:Nursing Staff / Q000523:psychology*; D010344:Patient Advocacy; D010348:Patient Care Team; D017009:Professional Autonomy; D011795:Surveys and Questionnaires; D000078329:Workforce
keywords: autonomy; home care; job satisfaction; nurses; nursing assistants; professionalization; self-directed teams