Violence, Harassment, and Turnover Intention in Home and Community Care: The Role of Training.

Background: Violence and harassment affect healthcare workers' well-being and career decisions in the home and community care sector.

Purpose: The objective of this study is to assess the role of training in alleviating the relationship between violence and harassment at work and turnover intention among personal support workers (PSWs).

Methodology/approach: Cross-sectional survey data from 1401 PSWs in Ontario, Canada are analyzed with structural equation modeling.

Community-based personal support workers' satisfaction with job-related training at the organization in Ontario, Canada: Implications for future training.

Background And Aims: Complexity of community-based homecare for older adults has increased significantly in the past decade in Ontario, Canada. Personal support workers (PSWs), who are unregulated and vary in formal education, provide the majority of community homecare work for increasingly complex clients. This paper seeks to understand community-based PSWs' satisfaction with opportunities for job-related training at their employing organization to provide the skills and knowledge to meet the demands of their evolving role.

"It's More than Just Needing money": The Value of Supporting Networks of Care.

It is well established in research, practice, and policy that unpaid caregivers (family and friends of people with care needs) experience stress in their role. Supports that have been put in place by policy planners and program developers to support caregivers may not be accessed by caregivers at all or may do little to reduce their stress. Accessing personal resources (education, finances), in addition to social resources (individual connections) and societal resources (community supports) are critical in fostering resilience in caregivers (helping them adapt to stress and adversity).

The influence of autonomy on personal support workers' job satisfaction, capacity to care, and intention to stay.

Using survey data collected in Ontario, Canada, we explore the impacts of autonomy on community-based Personal Support Workers' intrinsic job satisfaction, capacity to care for and about clients, and intention to continue working in home care. Autonomy was measured as "freedom to decide how to do your job" and "working on your own." Findings show that freedom to do your job and working on your own are both positively associated with job satisfaction and capacity to care, and indirectly increase intention to stay through their relationships with job satisfaction and capacity to care.

Health and safety matters! Associations between organizational practices and personal support workers' life and work stress in Ontario, Canada.

Background: The home and community care sector is one of the fastest growing sectors globally and most prominently in mature industrialized countries. Personal support workers (PSWs) are the largest occupational group in the sector. This paper focuses on the emotional health of PSWs working in the home and community care sector in Ontario, Canada.

Primary care physicians' perspectives on facilitating older patients' access to community support services: Qualitative case study.

Objective: To understand how family physicians facilitate older patients' access to community support services (CSSs) and to identify similarities and differences across primary health care (PHC) models.

Design: Qualitative, multiple-case study design using semistructured interviews.

Setting: Four models of PHC delivery, specifically 2 family health teams (FHTs), 4 non-FHTs family health organizations, 4 fee-for-service practices, and 2 community health centres in urban Ontario.

Primary Health Care Providers' Perspectives: Facilitating Older Patients' Access to Community Support Services.

The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs.

The CHAP-EMS health promotion program: a qualitative study on participants' views of the role of paramedics.

Background: Expanded roles for paramedics, commonly termed community paramedicine, are becoming increasingly common. Paramedics working in community paramedicine roles represent a distinct departure away from the traditional emergency paradigm of paramedic services. Despite this, little research has addressed how community paramedics are perceived by their clients.

Implementing Montessori Methods for Dementia™ in Ontario long-term care homes: Recreation staff and multidisciplinary consultants' perceptions of policy and practice issues.

Montessori-based activities use a person-centred approach to benefit persons living with dementia by increasing their participation in, and enjoyment of, daily life. This study investigated recreation staff and multidisciplinary consultants' perceptions of factors that affected implementing Montessori Methods for Dementia™ in long-term care homes in Ontario, Canada. Qualitative data were obtained during semi-structured telephone interviews with 17 participants who worked in these homes.

Home Care Workers' Skills in the Context of Task Shifting: Complexities in Care Work.

Task shifting, which involves the transfer of care work from regulated health-care professionals to home care workers (HCWs), is a strategy to ensure the efficient delivery of home care services in Canada and internationally. Using a feminist political economy approach, this paper explores the effects of task shifting on HCWs' skills. Task shifting may be understood as a form of downward substitution-and an effort to increase control over workers while minimizing costs-as some of health-care professionals' responsibilities are divided into simpler tasks and transferred to HCWs.

Task shifting in the provision of home and social care in Ontario, Canada: implications for quality of care.

Growing healthcare costs have caused home-care providers to look for more efficient use of healthcare resources. Task shifting is suggested as a strategy to reduce the costs of delivering home-care services. Task shifting refers to the delegation or transfer of tasks from regulated healthcare professionals to home-care workers (HCWs).

Task shifting policy in Ontario, Canada: does it help personal support workers' intention to stay?

The objective of this paper is to analyze the impact of task shifting policy on personal support workers' (PSWs) intention to stay in home care. Data were collected through interviews with 46 home care staff of a large home care organization in Ontario, Canada. Interviews were transcribed, coded, and a thematic analysis was conducted using a qualitative software package.

Health and disability as determinants for involuntary retirement of people with disabilities.

The association of health and disability factors on the perception of involuntary retirement in Canada was investigated with a multivariate logistic regression analysis of the 2006 Participation and Activity Limitation Survey data. The study investigated the role that choice or control plays in the decision to retire. Study participants were adults, with disabilities, aged 45 to 74 and who retired during the period 2001-2006.

Identifying research priorities in long term care homes.

Concerns about the quality of care in long term care (LTC) homes range from inadequate daily care to understaffing and insufficient funding. LTC decision makers are challenged to keep up with the changing demographics of residents admitted to LTC who have increasingly complex care needs. Decisions regarding LTC policies and procedures need to be informed by research that identifies the most effective and efficient care practices.

Flexible employment and nurses' intention to leave the profession: The role of support at work.

Objectives: The objectives of this paper are to examine (1) the association between flexible employment and nurses' intention to leave the profession, and (2) whether or not support at work mediates the association between flexible employment and nurses' intention to leave the profession. Flexible employment is analyzed objectively using non-permanent contract, part-time employment status, casual employment status, involuntary hours and on-call work, and subjectively using job insecurity. Support at work refers to organizational, supervisor and peer support.

Office home care workers' occupational health: associations with workplace flexibility and worker insecurity.

Office home care workers provide support to visiting staff, although their work tends to be invisible in many respects. This paper focuses on managers, supervisors, coor dinators, case managers and office administrative staff in home care. We examine the effects of workplace flexibility and worker insecurity on office home care workers' occupational health, particularly their self-reported stress and musculoskeletal disorders.

Older adults' awareness of community health and support services for dementia care.

ABSTRACTThe article examines where older adults seek help in caring for a parent with dementia and the factors associated with their identification of community health and support services as sources of assistance. The authors conducted telephone interviews, using random digit dialing, of 1,152 adults aged 50 and over in the city of Hamilton. Respondents received a vignette that raised issues related to parental dementia.

Casualized employment and turnover intention: home care workers in Ontario, Canada.

The purpose of this paper is to examine the associations between casualized employment and turnover intention in home care. Casualized employment refers to employment conditions of non-permanent contracts, part-time or casual hours, involuntary hours, on-call work, split shifts, pay per visit, and hourly pay with variable hours. Casualized employment also refers to perceived employment insecurity and labour market insecurity.

The gender wealth gap:structural and material constraints and implications for later life.

Wealth is an important measure of economic well-being, because while income captures the current state of inequality, wealth has the potential for examining accumulated and historically structured inequality. This presentation documents the extent of gender inequality in wealth for Canadian women and men aged 45 and older. The analysis uses data from the 1999 Canadian Survey of Financial Security, a large nationally representative survey of household wealth in Canada.

The impact of implementing managed competition on home care workers' turnover decisions.

This paper addresses the question: Did the implementation of managed competition in Ontario increase turnover in home care agencies? This question is addressed through a case study analysis of the impacts of tendering on the exiting home care labour force from three non-profit home care agencies during the period 1997 to 2001 in a mid-sized city in Ontario. These agencies provided 85% of the market share in 1996. Findings showed that 52% of the nurses and personal support workers (PSWs) left their agency over the five-year period.

Retaining nurses in their employing hospitals and in the profession: effects of job preference, unpaid overtime, importance of earnings and stress.

The purpose of this paper is to examine the effects of job preference, unpaid overtime, importance of earnings, and stress in retaining nurses in their employing hospitals and in the profession. Data come from our survey of 1396 nurses employed in three teaching hospitals in Southern Ontario, Canada. Data are analyzed first for all nurses, then separately for full-time, part-time, and casual nurses.

Full-time or part-time work in nursing: preferences, tradeoffs and choices.

Nursing human resources are limited; thus, effective deployment of personnel is essential to optimize staff capacity. The nursing profession competes for staff in environments where human capital is at a premium. To maximize recruitment and retention, it is imperative that nurses' work preferences be taken into account.

The interplay between women's life course work patterns and financial planning for later life.

In order to gain a comprehensive understanding of the interplay between women's life course work patterns and their financial planning for later life, we examined data from semi-structured interviews with retired women (n = 28) aged 59 to 92. The majority of women disrupted their careers at some point in time, for an average of 14 years, primarily for child-rearing responsibilities. We found that financial preparedness and income security in later life are structured by women's life course work patterns.

Reflexive planning for later life.

Informed by Giddens' (1991) concept of reflexive life planning and the notion of later life as a time of increasing social and financial risk, this research explores the idea of reflexive planning for later life. We utilize a conceptual model that incorporates three types of planning for later life: public protection, self-insurance, and self-protection. Drawing on qualitative, life-history data from a study of 51 mid-life and older Canadians, we examined whether individuals recognized the risks associated with later life, and if so, how far these recognitions entered into the preparations people made for their futures.