School of Psychology, University of Queensland, St Lucia, Queensland, Australia.
Centre for Business and Organisational Psychology, School of Psychology, University of Queensland, St Lucia, Queensland, Australia.
Gerontologist. 2023 Jul 18;63(6):1012-1027. doi: 10.1093/geront/gnac039.
Within residential aged care settings, reduced quality of care (QoC), abuse, and neglect have been global phenomena which require urgent intervention. As the reported rate of these problems is much higher in aged care compared to hospital settings, we investigated whether differing job design characteristics between the 2 settings might explain the difference.
We used a meta-analysis to compare differences in the relationships between high job demands, low job resources, and job strain with QoC and counterproductive work behaviors (CWBs) across aged care and hospital settings.
Data were extracted from 42 studies (n = 55 effects). QoC was negatively correlated with high job demands (ρ¯ = -0.22, 95% confidence interval [CI]: -0.29, -0.15, k = 7), low job resources (ρ¯ = -0.40, 95% CI: -0.47, -0.32, k = 15), and job strain (ρ¯ = -0.32, 95% CI: -0.38, -0.25, k = 22), CWBs had a positive relationship with job demands (ρ¯ = 0.35, 95% CI: 0.10, 0.59, k = 3) and job strain (ρ¯ = 0.34, 95% CI: 0.13, 0.56, k = 6). The association between poor QoC and low job resources was stronger in aged care (r = -0.46, 95% CI: -0.55, -0.36, k = 8) than in hospital settings (r = -0.30, 95% CI: -0.41, -0.18, k = 7).
Our findings suggest that relationships between low job resources and poor QoC are exacerbated in residential aged care contexts. To improve care outcomes, stakeholders should improve job resources such as skill discretion, supervisory supports, and increased training and staffing levels in residential aged care.
在养老院环境中，服务质量下降、虐待和忽视是全球性问题，需要紧急干预。由于这些问题在养老院的报告率远高于医院，我们研究了这两种环境之间不同的工作设计特征是否可以解释这种差异。
我们使用荟萃分析比较了养老院和医院环境中高工作需求、低工作资源和工作压力与服务质量和反生产工作行为（CWBs）之间关系的差异。
从 42 项研究中提取数据（n = 55 项效应）。服务质量与高工作需求（ρ¯ = -0.22，95%置信区间[CI]：-0.29，-0.15，k = 7）、低工作资源（ρ¯ = -0.40，95% CI：-0.47，-0.32，k = 15）和工作压力（ρ¯ = -0.32，95% CI：-0.38，-0.25，k = 22）呈负相关，CWBs 与工作需求（ρ¯ = 0.35，95% CI：0.10，0.59，k = 3）和工作压力（ρ¯ = 0.34，95% CI：0.13，0.56，k = 6）呈正相关。在养老院中，服务质量差与低工作资源之间的关联（r = -0.46，95% CI：-0.55，-0.36，k = 8）强于医院（r = -0.30，95% CI：-0.41，-0.18，k = 7）。
我们的研究结果表明，低工作资源与服务质量差之间的关系在养老院环境中更加恶化。为了改善护理结果，利益相关者应改善工作资源，如技能裁量权、监督支持以及增加养老院的培训和人员配备水平。
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