Registered Nurses
Conditions
Keywords
Shortened Working Hours, Elderly Care, Home Care, Work Life Balance
Brief summary
Elderly care and municipal home care have and are facing several challenges with an increasing number of elderly people and fewer people of working age. In addition, welfare staff also have more sick days on average than other areas. Stress, mental ill health and intention to leave work are common. Furthermore, there is a national and international shortage of staff and especially a shortage of specialist nurses, e.g., elderly care and primary care. Strengthening the positive aspects will be central and creating good conditions for staff and thus hopefully also better care and welfare. A sustainable working life where the staff thrive, experience learning, meaning, well-being, good structural conditions, work-life balance and want to stay in the long term. In one of the municipalities in this research project, they will introduce shortened working hours for registered nurses. A shortened working hours (reduced full-time standard by 3.25 hours/week with maintained salary) during a one-year pilot project for nurses in elderly care and municipal home care. Current full-time standard 38.25 hours/week. The municipality has initiated, decided and will implement the changes and the researchers are asked to follow the project. Nurses from the municipality implementing reduced working hours and nurses from municipalities without changed working hours will be invited to participate in the study. The nurses will answer a questionnaire before and after the changes (6 and 12 months after the first data collection). The overall aim of the research is to investigate registered nurses' experiences of their work environment, health, well-being and intention to quit/remain, as well as the quality of care, nurse turnover and sick leave. To study the relationship between shortening working hours or not, nurses' assessments of the work environment, intention to quit/remain, health, well-being and quality of care. The main research questions are: * What are the relationships over time between working hours reduction or not, sociodemographic factors, nurse-rated work environment, intention to quit/remain, health, well-being and nurse-rated quality of care (follow-up after 12 months)? * What changes occur over time in nurses' assessments of work environment, intention to quit/remain, health, well-being and quality of care, and are there any differences compared to a comparison group/municipalities?
Detailed description
The research project has a prospective design and all nurses (approximately 40) in the municipality where the working hours reduction is implemented will be asked to participate, as well as all nurses in five comparison municipalities (approximately 150). Data analysis: For the correlation analyses, bivariate correlation analyses and regression analyses (univariate and multiple) or Generalized Estimating Equations (GEE) will be used. GEE to take clustering into account. For the comparative tests, t-test or ANOVA/ANCOVA will be used or equivalent non-parametric tests if the data is not normally distributed. To study relationships in a multiple linear regression analysis, 50+8\*m (people) are required, where m is the number of variables included in the relationship analysis. In this case, investigators expect to use approximately 5-10 explanatory variables, one of which is working time reduction or not, i.e. approximately 90-130 participants. Investigators will invite approximately 190 nurses and expect that some nurses will decline or drop out over time.
Interventions
OTHERShortened working hours
In one of the municipalities in this research project, they will introduce shortened working hours for registered nurses. A shortened working hours (reduced full-time standard by 3.25 hours/week with maintained salary) during a one-year pilot project for nurses in elderly care and municipal home care. Current full-time standard 38.25 hours/week. The municipality has initiated, decided and will implement the changes and the researchers are asked to follow the project.
Sponsors
University of Gavle
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Registered nurses working in elderly care or in municipal home care.
Exclusion criteria
* Registered nurses on long-term leave.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Well-being - Work-life balance - dimension "work interference with personal life" | Data collection before the changes (pre-), and then 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | A scale will be used for nurses' self-rated work-life balance - "the 17-item work/non-work interference and enhancement scale", response options 5-grade 1) not at all to 5) almost always. Four dimensions: work interference with personal life, personal life interference with work, work enhancement of personal-life, and personal life enhancement of work. For this outcome, it is the dimension "work interference with personal life" and higher scores represent imbalance/an undesirable outcome. |
| Well-being - Work-life balance - dimension "work enhancement of personal life" | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | A scale will be used for nurses' self-rated work-life balance - "the 17-item work/nonwork interference and enhancement scale", response options 5-grade 1) not at all to 5) almost always. Four dimensions: work interference with personal life, personal life interference with work, work enhancement of personal life, and personal life enhancement of work. For this outcome, it is the dimension "work enhancement of personal life" and higher scores represent balance/a desirable outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Well-being - Work-life balance - dimension "personal life enhancement of work" | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | A scale will be used for nurses' self-rated work-life balance - "the 17-item work/nonwork interference and enhancement scale", response options 5-grade 1) not at all to 5) almost always. Four dimensions: work interference with personal life, personal life interference with work, work enhancement of personal life, and personal life enhancement of work. For this outcome, it is the dimension "personal life enhancement of work" and higher scores represent balance/a desirable outcome. |
| Well-being - Recovery experience | Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection). | The Recovery Experience Questionnaire will be used , response options 5-grade Likert-scale, item scores are averaged and higher scores represent a better recovery experience. |
| Well-being - Thriving | Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection). | The 10-item Thriving scale will be used to measure thriving, 5-point response alternatives. For total score the mean is calculated and a higher score represent higher thriving. |
| Well-being - Intention to quite/leave the job | Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection). | One question on intention to leave from the Satisfaction with work questionnaires, 'Have you recently seriously considered quitting your job on the unit because you don't enjoy it?', with response alternatives 1) No, 2) Yes, but I have not done anything and 3) Yes, and I have taken action. |
| Well-being - Intention to remain at this workplace | Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection). | 1 study specific question "Is it your intention to stay at this workplace?" Response options (…) yes (…) no |
| Well-being - Job satisfaction | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | The 4-item Brief index of affective job satisfaction will be used, response options 1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree. Items are averaged to get the total score and higher scores represent higher job satisfaction |
| Well-being - Life satisfaction | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | 1 item from the Life satisfaction questionnaire will be used, 7-grade response alternatives (1. Very low to 7. Very high) and higher scores representing better life satisfaction. |
| Health - Stress symptoms | Data collection before the changes (pre-) and 12 months after the first data collection (post data collection). After 6 months, nurses from the municipality with reduced working hours will answer 1 question about tiredness from the stress scale. | Stress symptoms will be measured using the Psychosomatic health aspects scale, one factor 10 items. Response alternatives are 5-grade \[1) very often, 2) Quite often 3) Sometimes 4) Seldom 5) Never\]. Scores from the ten items are averaged for factor score, and higher scores represent more stress symptoms. |
| Health - Sleep quality | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | 1 question about sleep quality from the Satisfaction with work questionnaires: "Overall, how do you rate your sleep quality?" 5-grade response alternatives from 1) Very bad to 5) Very god |
| Health - Depression symptoms | Data collection before the changes (pre-), and 12 months after the first data collection (post data collection). | The Patient health questionnaire-2 will be used that gives a score for depression 0-6, higher score more depressive symptoms, each item rated from 0 "not at all" to 3 "nearly every day". |
| Health - Anxiety symptoms | Data collection before the changes (pre-), and 12 months after the first data collection (post data collection). | The Generalized anxiety disorder scale -2 will be used that gives a score for anxiety 0-6, higher score more anxiety symptoms, each item rated from 0 "not at all" to 3 "nearly every day". |
| Health - Burnout | Data collection before the changes (pre-), and 12 months after the first data collection (post data collection). | The factor burnout from the Copenhagen psychosocial questionnaire III will be used, four items that are averaged, response alternatives on a 5-point scale from 1. All the time to 5. Not at all. Higher scores representing a better outcome. |
| Work environment - Work situation | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | 1 item from the Life satisfaction questionnaire will be used, 7-grade response alternatives from 1. Very unhappy to 7. Very happy and higher scores representing a better work situation "How do you like your work situation?" |
| Work environment - Structural conditions/empowerment | Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection). | To measure structural conditions/empowerment the 19-item Condition of work effectiveness scale-II will be used. The total score for the scale range from 6 to 30, higher scores representing better structural conditions. Response alternatives for each item are 5-grade (1. None to 5. A lot). |
| Work environment - Quantitative demands | Data collection before the changes (pre-), and 12 months after the first data collection (post data collection). | The factor quantitative demands from the Copenhagen psychosocial questionnaire III will be used, three items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a better outcome. |
| Work environment - Emotional demands | Data collection before the changes (pre-), and 12 months after the first data collection (post data collection). | The factor emotional demands from the Copenhagen psychosocial questionnaire III will be used, three items that are averaged with response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a better outcome. |
| Work environment - Work pace | Data collection before the changes (pre-), and 12 months after the first data collection (post data collection). | The factor work pace from the Copenhagen psychosocial questionnaire III will be used, two items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a better outcome. |
| Work environment - Social support from colleagues | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | The factor social support from colleagues from the Copenhagen psychosocial questionnaire III will be used, two items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a worse outcome. |
| Work environment - Social community at work | Data collection before the changes (pre-) and 12 months after the first data collection (post data collection). | The factor social community at work from the Copenhagen psychosocial questionnaire III will be used, three items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a worse outcome. |
| Work environment - Commitment to the organization | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | The factor commitment to the organization from the Copenhagen Psychosocial Questionnaire III will be used, three items that are averaged, response alternatives on a 5-point scale. Higher scores mean a worse outcome. |
| Quality of care - Nurse satisfaction with given care | Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection). | The Nurse Satisfaction with Given Care Scale will be used. Response alternatives are 7-grade Likert scale (1. Not at all to 7. To a very high extent). For total score, the item scores are averaged, with higher scores representing greater satisfaction. |
| Well-being - Stress, work-life balance and recovery | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | An index of three study specific items with 7-grade response options from 1) not true at all to 7) completely true, higher scores representing less stress, better balance and recovery |
| Quality of care - Productivity and efficient work | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | An index of 2 study-specific items with 7-grade response options from 1) not true at all to 7) completely true, higher scores better productivity |
| Health - sick days | Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses. | In the survey, a question about the number of sick days - open-ended response option where the number of sick days is stated. |
Countries
Sweden
Contacts
CONTACTMaria Engström, Professor, PhD
CONTACTCharlotte Roos, PhD
PRINCIPAL_INVESTIGATORMaria Engström, PhD Professor
University of Gävle
Outcome results
None listed