The psychosocial work environment of staff is associated with satisfaction with care among older persons receiving home care services

Good working conditions are specifically important for overall satisfaction, assessment of treatment by staff and sense of security.

Older persons in Sweden are increasingly encouraged to continue living at home and if necessary, be supported by home care services (HCS). Studies have examined whether the work environment of staff has an impact on the experiences and wellbeing of older persons in residential care facilities, but few have examined such associations in HCS. This study examined associations between home care staff’s perceptions of their psychosocial work environment and satisfaction with care among older people receiving HCS. The setting was 16 HCS work units. Two surveys were conducted, one on psychosocial working conditions of staff, one on satisfaction of older persons receiving HCS. For each work unit, data on individual satisfaction was matched to average values concerning psychosocial work conditions. Outcomes analyzed with linear regressions were overall satisfaction and indices regarding assessment of performance of services, contact with staff, and sense of security. The index on treatment by staff was analyzed with ordered logistic regressions. Cluster correlated standard errors clustering on work units were used. Results showed that good working conditions were important for satisfaction with care, specifically overall satisfaction, treatment by staff, and sense of security. The most important psychosocial work factors were work group climate, sense of mastery, job control, overall job strain, frustrated empathy, balancing competing needs, balancing emotional involvement, and lack of recognition. Receiving more HCS hours was associated with stronger relationships between working conditions and satisfaction with care, especially with overall satisfaction and treatment by staff as outcomes. Managers and policymakers for home care need to acknowledge that the working conditions of home care staff are crucial for the satisfaction of older persons receiving HCS, particularly those receiving many HCS hours. Psychosocial work factors together with job strain factors are areas to focus on to improve working conditions for staff and outcomes for older persons.