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Faculty of Science | Department of Psychology | Working Group „Knowledge-Thinking-Acting“ (Sen.-Prof. Dr. Winfried Hacker) cooperation projekt: Sen.-Prof.

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Präsentation zum Thema: "Faculty of Science | Department of Psychology | Working Group „Knowledge-Thinking-Acting“ (Sen.-Prof. Dr. Winfried Hacker) cooperation projekt: Sen.-Prof."—  Präsentation transkript:

1 Faculty of Science | Department of Psychology | Working Group „Knowledge-Thinking-Acting“ (Sen.-Prof. Dr. Winfried Hacker) cooperation projekt: Sen.-Prof. Dr. Winfried Hacker Prof. Dr. Matthias Kliegel Prof. Dr. Jürgen Wegge Impact of work organization and task characteristics on strain and turnover in geriatric care 16th Congress of European Association of Work and Organizational Psychology Münster, Symposium: “Promoting work ability and health in nursing” Nadine Schrod Johannes Wendsche Katharina Roitzsch Winfried Hacker Paulina Bilinska Jürgen Wegge This study was supported by research grants of the German Research Foundation (DFG, HA 2249/17-1, WE 1504/12-1, KL 2303/7-1)

2 1. Introduction  demographic change in Germany leads to drastic challenges for geriatric care system  number of high-maintenance people rises ( German Federal Statistical Office, 2010 )  average age of geriatric nurses rises as well  fewer trainees are being applicable to replace (Blum et al., 2006)  high physical and mental strain as well as increasing workload in the setting of geriatric care (Hasselhorn, & Müller, 2005; Glaser, & Höge, 2005)  high rates of sickness and turnover (Behrens et al., 2009)  turnover is especially high for young nurses (Chan et al., 2012)  high turnover = high costs and impaired care quality (Hayes et al. 2012) 2

3 1. Introduction 3 Starting time9 month later18 month later Objektive und subjektive Analyse des Arbeitsplatzes und der Arbeitstätigkeit (1. Mitarbeiterbefragung) Subjektive Analyse des Arbeitsplatzes und der Arbeitstätigkeit (2. Mitarbeiterbefragung) Subjektive Analyse des Arbeitsplatzes und der Arbeitstätigkeit (3. Mitarbeiterbefragung) Objective and subjective analysis of work organization and task characteristics (t 1 )  gathering:  documentary,  interview and  observational data Subjective analysis of work organisation and task characteristics Analysis of multiple individual resources lab study Subjective analysis of work organization and task characteristics (t 2 )  Organizational and individual determinants to preserve geriatric nurses‘ health and work ability  Current time: 2011 – 2014 (36 month)

4 Research Questions  Are there differences in task and work organization characteristics regarding care settings und type of ownership?  differences due to care setting are already known (Nübling et al., 2010; Hasselhorn et al., 2003)  differences due to type of ownership: no distinct results / lack of research  Does care setting or type of ownership influence perceived strain and turnover? Nursing homes vs. home care  more psychosocial and physical demands (Nübling et al., 2010)  more patients with higher care levels ( GFSO, 2013 )  more symptoms of burnout, less reported health (Hasson et al., 2008; Nübling et al., 2010)  no difference in reported intention to leave (Nübling et al., 2010; Hasselhorn et al., 2003) For- profit vs. non-profit/private organization  turnover rates are higher in private care services (Castle, & Engberg, 2006; Dill et al., 2010) 4

5 2. Methods Procedure and participants  cross-sectional study design age: M = 39,54 SD = 11,60 gender: women = 87,1%, men = 12,9 % 5 Geriatric care institutions home care N=30 N=24 team 1 team 2 nursing homes N=40 N=45 Institutions N = 54 Teams / Wards N = n Qualified nurses N = n N=188 N=117 ward 1 ward 2 1 2n 1 2n ev. hier noch Daten Gesamtsample???

6 6 2. Methods Measures – part 1  different aspects of task and work organisation were analyzed with a multi-source criteria-oriented screening-instrument  Guideline: “Objective Analysis, Assessment and (Re-)Design of Geriatric Care”  based on ISO EN 6385 (2004)  behaviorally anchored, ordinal scales  gathering documentary, interview, and observational data 1.Documentary data (e.g., shift schedule) 3. observational data (registered nurses) 2. Interview data (supervisor, head nurse)

7 2. Methods Measures – part 2  questionnaire data  intention to leave the workplace  intention to leave the profession  emotional exhaustion (MBI-D-GS, Maslach) Hier noch rein: Autoren, Itemanzahl, Cronbachs Alpha Data analysis  Mann–Whitney test  Regression analyses 7

8 3. Results Differences in work organisation and task characteristics regarding care setting 8 work organisation characteristics task characteristics U = 625,5* U = 615,75* U = 620* U = 605,5** U = 626,5** U = 338*** U = 647,5** U = 760* U = 698* Note. N = 85 (n inpatient = 45, n outpatient = 40); *p ≤.05, p** ≤.01, p*** ≤.001. home care vs. nursing homes sind die Begriffe more optimal

9 3. Results Differences in work and task characteristics regarding type of ownership 9 work organisation characteristics task characteristics U = 618,5* U = 563** Note. N = 85 (n for-profit = 31, n non-for-profit = 54); *p ≤.05, p** ≤.01, p*** ≤.001. siehe vorherige Folie

10 3. Results 10 Relationship between care setting / type of ownership and actual turnover rate Relationship between care setting / type of ownership and reported emotional exhaustion / intention to leave controlled for age and gender For-profit

11 4. Conclusions and Discussion  results indicate an objectively better designed work and task organisation in  home care wards  non-for-profit care setting  but overall need for improvement  in line with the objective findings:  qualified nurses working in outpatient care teams have stronger intention to leave their workplace  higher acutal turnover behavior in for-profit care institutions  Conclusion: the combination of non-for-profit care setting and inpatient care institutions seems to be a risk factor for intention to leave and actual turnover Limitations  cross-sectional study design  analyses of longitudinal data are pending  next step: conduction of multilevel-analyses  identification of quality criteria of the screening-instrument are pending 11

12 interessant: Divergenz zwischen objektiven und subjektiven Daten und Ursachen von Unterschieden care setting: viele Unterschiede im Aufgaben und Organisationsprofil aber keine Unterschiede in obj. Turnover, jedoch in subj. TI type of ownership: kaum Unterschiede im Aiufagben- u organisationsprofil und subj. TI, aber im obj. Turnover –Organisationskontext in Turnovermodelle mit aufnehmen –sowohl obj. als auch subj. Datenerfassung wichtig

13 Faculty of Science | Department of Psychology | Working Group „Knowledge-Thinking-Acting“ (Sen.-Prof. Dr. Winfried Hacker) cooperation projekt: Sen.-Prof. Dr. Winfried Hacker Prof. Dr. Matthias Kliegel Prof. Dr. Jürgen Wegge Thank you for your kind attention! Dipl.-Psych. Nadine Schrod Research Assistant  TU Dresden Fachrichtung Psychologie Arbeitsgruppe „Wissen-Denken-Handeln“ Objekt Falkenbrunnen Dresden  0351 –  0351 –  Dipl.-Psych. Nadine Schrod Dipl.-Psych. Paulina Bilinska Dipl.-Psych. Johannes Wendsche Sen.-Prof. Dr. Winfried Hacker Prof. Dr. Jürgen Wegge Dipl.-Psych. Katharina Roitzsch

14 References Behrens, J., Horbach, A., & Müller, R. (2009). Forschungsstudie zur Verweildauer in Pflegeberufen in Rheinland-Pfalz (ViPb) – Abschlussbericht. Mainz: Ministerium für Arbeit, Soziales, Gesundheit, Familie und Frauen Rheinland-Pfalz. Blum, K., Isfort, M., Schilz, P., & Weidner, F. (2006). Pflegeausbildung im Umbruch: Pflegeausbildungsstudie Deutschland (PABiS). Düsseldorf: Deutsche Krankenhaus- Verlagsgesellschaft. Castle, N. G., & Engberg, J. (2006). Organizational characteristics associated with staff turnover in nursing homes. The Gerontologist, 46(1), 62–73. Chan, Z. C. Y., Tam, W. S., Lung, M. K. Y., Wong, W. Y., & Chau, C. W. (2012). A systematic literature review of nurse shortage and the intention to leave. Journal of Nursing Management. Advance online publication. DIN EN ISO 6385 (2004). Grundsätze der Ergonomie für die Gestaltung von Arbeitssystemen. Berlin: Beuth. Dill, J. S., Craft Morgan, J., & Konrad, T. R. (2009). Strengthening the Long-Term Care Workforce: The Influence of the WIN A STEP UP Workplace Intervention on the Turnover of Direct Care Workers. Journal of Applied Gerontology, 29(2), 196–214. Glaser, J., & Höge, T. (2005). Probleme und Lösungen in der Pflege aus Sicht der Arbeits- und Gesundheitswissenschaften. Berlin: Bundesanstalt für Arbeitsschutz und Arbeitsmedizin. Hasselhorn, H.M. & Müller, B.H. (2005). Arbeitsbelastung und -beanspruchung bei Pflegepersonal in Europa - Ergebnisse der NEXT-Studie. In Badura, B., Schellschmidt, H., & Vetter, C. (Hrsg.), Fehlzeiten-Report 2004 (S ). Berlin: Springer. 14

15 References Hasson, H., & Arnetz, J. E. (2008). Nursing staff competence, work strain, stress and satisfaction in elderly care: a comparison of home-based care and nursing homes. Journal of Clinical Nursing, 17(4), 468–481. Nübling, M., Vomstein, M., Schmidt, S. G., Gregersen, S., Dulon, M., & Nienhaus, A. (2010). Psychosocial work load and stress in the geriatric care. BMC Public Health, 10, 428. Statistische Ämter des Bundes und der Länder (Hrsg.) (2010). Demografischer Wandel in Deutschland – Auswirkungen auf Krankenhausbehandlungen und Pflegebedürftige im Bund und in den Ländern. Wiesbaden: Statistisches Bundesamt. 15


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