Shortened Working Hours for Registered Nurses in Elderly Care and Municipal Home Care - How is it Linked to Nurse-rated Work Environment, Work-life Balance and Well-being?
Overview
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- University of Gavle
- Enrollment
- 190
- Locations
- 1
- Primary Endpoint
- Well-being - Work-life balance - dimension "work interference with personal life"
Overview
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.
Study Design
- Study Type
- Observational
- Observational Model
- Other
- Time Perspective
- Prospective
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Registered nurses working in elderly care or in municipal home care.
Exclusion Criteria
- •Registered nurses on long-term leave.
Arms & Interventions
Registered nurses working in elderly care and/or municipal home care
Registered nurses in elderly care and/or municipal home care with shortened 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.
Intervention: Shortened working hours (Other)
Outcomes
Primary Outcomes
Well-being - Work-life balance - dimension "work interference with personal life"
Time Frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). (6-months only nurses in the group with shortened working hours, 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 interference with personal life" and higher scores represent imbalance/an undesirable outcome.
Well-being - Work-life balance - dimension "work enhancement of personal-life"
Time Frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). (6-months only nurses in the group with shortened working hours, 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.
Well-being - Work-life balance - dimension "work interference with personal life"
Time Frame: 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"
Time Frame: 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 Outcomes
- 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). (At the 6-monthsdata collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- Well-being - Thriving(Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).)
- 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).)
- 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).)
- Well-being - Job satisfaction(Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- Well-being - Life satisfaction(Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- Health - Sleep quality(Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- Work environment - Work situation(Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- 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). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- 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). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- 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).)
- 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). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- 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). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- Health - sick days(Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). (At the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.))
- Well-being - Recovery experience(Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).)
- 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.)
- Health - Depression symptoms(Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).)
- Health - Anxiety symptoms(Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).)
- Health - Burnout(Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).)
- Work environment - Structural conditions/empowerment(Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).)
- Work environment - Quantitative demands(Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).)
- Work environment - Emotional demands(Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).)
- Work environment - Work pace(Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).)
- Work environment - Social community at work(Data collection before the changes (pre-) and 12 months after the first data collection (post data collection).)
- 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.)
- 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.)
- 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.)
- 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.)
- 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.)
- 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.)
- 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.)
- 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.)
- 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.)
- 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.)
Investigators
Maria Engström
Professor
University of Gavle