Identifying work-related factors associated with work-family conflict of care workers in nursing homes: A cross-sectional study.

AIMS: To investigate which work-related factors are associated with work-family conflict of care workers in nursing homes, this study aimed to: (a) describe the prevalence of work-family conflict of care workers in nursing homes and (b) assess the association of work-related factors with work-family conflict. DESIGN: Cross-sectional multicentre sub-study based on data from the Swiss Nursing Homes Human Resources Project 2018. METHODS: Data were collected between September 2018 and October 2019. Work-family conflict of care workers was assessed with the Work-Family Conflict Scale (range 1-5). Prevalence was described in percentages. We used multilevel linear regression to assess the association of time-based factors (working overtime or during one's free time, employment percentage, presenteeism, shift working) and strain-based factors (staffing adequacy, leadership support) with work-family conflict. RESULTS: Our study sample consisted of 4324 care workers working in a total of 114 nursing homes. Overall, 31.2% of respondents stated to have experienced work-family conflict (>3.0 on the Work-Family Conflict Scale). The overall mean score of the study sample for work-family conflict was 2.5. Care workers experiencing presenteeism 10 or more days per year showed the highest scores for work-family conflict (mean: 3.1). All included predictor variables were significant (p < .05). CONCLUSION: Work-family conflict is multifactorial. Possible intervention points to tackle work-family conflict could be strengthening care workers' influence in planning work schedules, enabling flexible planning to ensure adequate staffing, lowering presenteeism and implementing a supportive leadership style. IMPACT: Care workers' jobs become less desirable when workplace demands interfere with family life. This study highlights the multifaceted nature of work-family conflict and suggests intervention options to prevent care workers from experiencing work-family conflict. Action is needed at nursing home and policy level.

Institutional Factors Associated with Residents' Malnutrition in Nursing Homes: A Cross-Sectional Study.

OBJECTIVES: Malnutrition is frequent in older adults, associated with increased morbidity, mortality, and higher costs. Nursing home residents are especially affected, and evidence on institutional factors associated with malnutrition is limited. We calculated the prevalence of malnutrition in Swiss nursing home residents and investigated which structure and process indicators of nursing homes are associated with residents' malnutrition. DESIGN: Subanalysis of the Swiss Nursing Homes Human Resources Project 2018, a multicenter, cross-sectional study conducted from 2018 to 2019 in Switzerland. SETTING AND PARTICIPANTS: This study included 76 nursing homes with a total of 5047 residents. METHODS: Malnutrition was defined as a loss of bodyweight of ≥5% in the last 30 days or ≥10% in the last 180 days. Binomial generalized estimating equations (GEE) were applied to examine the association between malnutrition and structural (staffing ratio, grade mix, presence of a dietician, malnutrition guideline, support during mealtimes) and process indicators (awareness of malnutrition, food administration process). GEE models were adjusted for institutional (profit status, facility size) and specific resident characteristics. RESULTS: The prevalence of residents with malnutrition was 5%. A higher percentage of units per nursing home having a guideline on prevention and treatment of malnutrition was significantly associated with more residents with weight loss (OR 2.47, 95% CI 1.31-4.66, P = .005). Not having a dietician in a nursing home was significantly associated with a higher rate of residents with weight loss (OR 1.60, 95% CI 1.09-2.35, P = .016). CONCLUSIONS AND IMPLICATIONS: Having a dietician as part of a multidisciplinary team in a nursing home is an important step to address the problem of residents' malnutrition. Further research is needed to clarify the role of a guideline on prevention and treatment of malnutrition to improve the quality of care in nursing homes.