Influence of organizational context on nursing home staff burnout: A cross-sectional survey of care aides in Western Canada.
OBJECTIVE
Our study examined care aide characteristics, organizational context, and frequency of dementia-related resident responsive behaviours associated with burnout. Burnout is the experience of emotional exhaustion, cynicism, and professional inefficacy. Care aide burnout has implications for turnover, staff health, and quality of care.


METHODS
We used surveys collected from 1194 care aides from 30 urban nursing homes in three Western Canadian provinces. We used a mixed-effects regression analysis to assess care aide characteristics, dementia-related responsive behaviours, unit and facility characteristics, and organizational context predictors of care aide burnout. We measured burnout using the Maslach Burnout Inventory, Short Form.


RESULTS
We found that care aides were at high risk for emotional exhaustion and cynicism, but report high professional efficacy. Statistically significant predictors of emotional exhaustion included English as a second language, medium facility size, organizational slack-staff, organizational slack-space, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of cynicism were care aide age, English as a second language, unit culture, evaluation (feedback of data), formal interactions, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of professional efficacy were unit culture and structural resources. Greater care aide job satisfaction was significantly associated with increased professional efficacy.


CONCLUSIONS
This study suggests that individual care aide and organization features are both predictive of care aide burnout. Unlike care aide or structural characteristics of the facility elements of the organizational context are potentially modifiable, and therefore amenable to intervention.
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Electronic address: sachambe@ualberta.ca.
Stephanie A
SA
Chamberlain
Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada. Electronic address: gruneir@ualberta.ca.
Andrea
A
Gruneir
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Electronic address: mhoben@ualberta.ca.
Matthias
M
Hoben
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: jasquires@ohri.ca.
Janet E
JE
Squires
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Electronic address: greta.cummings@ualberta.ca.
Greta G
GG
Cummings
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Electronic address: carole.estabrooks@ualberta.ca.
Carole A
CA
Estabrooks
D000328:Adult; D002055:Burnout, Professional; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009728:Nursing Assistants / Q000523:psychology*; D009735:Nursing Homes; D000078329:Workforce; D055815:Young Adult
Long-term care; Nursing home; Professional burnout; Social environment