Abstract

Background: The social and healthcare services are transition in Finland. The increasing number of older people and the shortage of the long-term care workforce have framed an unwanted scenario of the future. Working environment (ergonomics, stress related to information systems, stress related to patients, role conflicts) as well as care quality can have significant effects on turnover and the assessment to work until retirement among workers in long-term care.

Objectives: This study examined the association of age, sex, different care services (home-care, institutional care and assisted living facilities) and working environment related factors with turnover and the assessment to work until retirement.

Methods: An electronic survey was carried out for personnel in services for older people. All care organizations that provided older people care were invited to participate to the survey. The number of employees was 2076 by 180 units. The professions include home care workers and nurses and their superiors. Analyses of covariance were used to examine the associations of independent variables with turnover and to an assessment to work until retirement. The turnover was asked “I am often considering quitting this work” and ranging from 1, never, to 5, very often. The assessment of retirement was asked “Do you think you can work until the retirement age?” and rated on a Likert scale ranging from 1,yes, to 5, absolute not. The ergonomics and stress related to patients were both measured with three items, stress related to information systems items with two items, and role conflicts with seven items and rated on a Likert scale.

Results: Up to 30% of workers in home care agree that they have turnover intentions. These proportions were lower among workers in institutional care and assisted living facilities (11-16%).

The work environment related factors that were associated with turnover were poor ergonomics (F=19.60, p <0.001), stress related to patients (F=6.65, p<0.001) higher level of role conflicts (F=147.44, p<0.001) and lower quality of care (F=50.24, p<0.001). In the same model working in home-care was associated with higher level of turnover (F= 12.63, p<0.001). Working in home-care was associated with high intention to retirement (F= 8.46, p<0.001) and of the work environment factors only poor ergonomics (F= 108.92, p<0.001), higher level of role conflicts (F=44.49, p<0.001) and lower quality of care (F= 31.89, p<0.001) were associated. Conclusions: The National target programme for the long-term care increases home care and diminishes institutional care. These results show that for workers home care may be work-place that pushes workers to think to quit or they have worries how to manage to work until the retirement age. In other studies improving the work environment and fair management has been shown to be a successful strategy against nurses’ turnover.