Work stress among nursing home care attendants in Taiwan: A questionnaire survey

Background: Care attendants constitute the main workforce in nursing homes, but their heavy workload, low autonomy, and indefinite responsibility result in high levels of stress and may affect quality of care. However, few studies have focused of this problem. Objectives: The aim of this study was to examine work-related stress and associated factors that affect care attendants in nursing homes and to offer suggestions for how management can alleviate these problems in care facilities. Methods: We recruited participants from nine nursing homes with 50 or more beds located in middle Taiwan; 110 care attendants completed the questionnaire. The work stress scale for the care attendants was validated and achieved good reliability (Cronbach's alpha = 0.93). We also conducted exploratory factor analysis. Results: Six factors were extracted from the work stress scale: insufficient ability, stressful reactions, heavy workload, trouble in care work, poor management, and working time problems. The explained variance achieved 64.96%. Factors related to higher work stress included working in a hospital-based nursing home, having a fixed schedule, night work, feeling burden, inconvenient facility, less enthusiasm, and self-rated higher stress. Conclusion: Work stress for care attendants in nursing homes is related to human resource management and quality of care. We suggest potential management strategies to alleviate work stress for these workers.