Work Organization, Economic Inequality, and Depression among Nursing Assistants: A Multilevel Modeling Approach

To investigate the relationships among the nursing home work environment, emotional strain, and depression in Nursing Assistants in Ohio and West Virginia, this cross-sectional study was conducted with 395 Nurse Assistants in 49 nursing homes in Ohio and West Virginia. Organizational attributes were measured independently at the individual and organizational levels. Multilevel modeling techniques were used to analyze the data. Our methods examined nursing home organizational structure (ownership type, managerial style), and work organization (emotional strain) was examined in relation to the prevalence of depression among nursing assistants. Our findings suggest workplace emotional strain and age are associated with increased odds of depression. Implications of our work include that work in nursing homes for the environment it fosters has a strong effect on emotional strain and depression among Nursing Assistants.

[1]  Meg Johantgen,et al.  Staffing and worker injury in nursing homes. , 2005, American journal of public health.

[2]  P. Landsbergis,et al.  The Changing Organization of Work and the Safety and Health of Working People: A Commentary , 2003, Journal of occupational and environmental medicine.

[3]  B. Silverstein,et al.  Predictors of shoulder and back injuries in nursing home workers: a prospective study. , 2002, American journal of industrial medicine.

[4]  D. Himmelstein,et al.  Does Investor-Ownership of Nursing Homes Compromise the Quality of Care? , 2002, International journal of health services : planning, administration, evaluation.

[5]  C. Muntaner,et al.  Socioeconomic status and depressive syndrome: the role of inter- and intra-generational mobility, government assistance, and work environment. , 2001, Journal of health and social behavior.

[6]  D. Himmelstein,et al.  Does investor ownership of nursing homes compromise the quality of care? , 2001, American journal of public health.

[7]  C. Ohlson,et al.  Stress Markers in Relation to Job Strain in Human Service Organizations , 2001, Psychotherapy and Psychosomatics.

[8]  William J. Scanlon,et al.  Nursing Workforce: Recruitment and Retention of Nurses and Nurse Aides Is a Growing Concern. Testimony before the Committee on Health, Education, Labor and Pensions, U.S. Senate. , 2001 .

[9]  B. D. Sypher,et al.  Seeking Emotional Labor , 2000 .

[10]  Richard B. Freeman,et al.  What Workers Want , 2000 .

[11]  M. Kivimäki,et al.  Organizational and individual factors affecting mental health and job satisfaction: a multilevel analysis of job control and personality. , 2000, Journal of occupational health psychology.

[12]  J. Pearson,et al.  The relationship between staff empathy and depressive symptoms in nursing home residents , 2000 .

[13]  R. Turner,et al.  The stress process and the social distribution of depression. , 1999, Journal of health and social behavior.

[14]  Jan A. Landeweerd,et al.  Comparing Group and Individual Level Assessments of Job Characteristics in Testing the Job Demand-Control Model: A Multilevel Approach , 1999 .

[15]  Phil A. Silva,et al.  Low Socioeconomic Status and Mental Disorders: A Longitudinal Study of Selection and Causation during Young Adulthood1 , 1999, American Journal of Sociology.

[16]  R. Kessler,et al.  Social class, assets, organizational control and the prevalence of common groups of psychiatric disorders. , 1998, Social science & medicine.

[17]  Cary L Cooper,et al.  The price of stress. , 1998, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[18]  M. Marmot,et al.  Explaining social class differences in depression and well-being , 1997, Social Psychiatry and Psychiatric Epidemiology.

[19]  C. Muntaner,et al.  Does organization matter? A multilevel analysis of the demand-control model applied to human services. , 1997, Social science & medicine.

[20]  P. Buerhaus,et al.  Managed care and the nurse workforce. , 1996, JAMA.

[21]  B. Rogers National Occupational Research Agenda , 1996, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[22]  J. Banaszak-Holl,et al.  Factors associated with nursing home staff turnover. , 1996, The Gerontologist.

[23]  C. Muntaner,et al.  Psychosocial work environment in human service organizations: a conceptual analysis and development of the demand-control model. , 1996, Social science & medicine.

[24]  M. D. Sovie Nursing Staff in Hospitals and Nursing Homes: is it Adequate? a review and commentary. , 1996, Nursing outlook.

[25]  R. Moos,et al.  Effects of work stressors and work climate on long-term care staff's job morale and functioning. , 1996, Research in nursing & health.

[26]  J. Cohen-Mansfield Stress in Nursing Home Staff: A Review and a Theoretical Model , 1995 .

[27]  U. Rout,et al.  Occupational stress amongst care staff working in nursing homes: an empirical investigation. , 1994, Journal of clinical nursing.

[28]  Bruce G. Link,et al.  Socioeconomic Status and Depression: The Role of Occupations Involving Direction, Control, and Planning , 1993, American Journal of Sociology.

[29]  Steven L. Sauter,et al.  Work and Well-Being: An Agenda for the 1990s , 1992 .

[30]  Steven L. Sauter,et al.  Prevention of work-related psychological disorders. A national strategy proposed by the National Institute for Occupational Safety and Health (NIOSH). , 1990, The American psychologist.

[31]  Randy Hodson,et al.  The Social Organization of Work. , 1990 .

[32]  P. Landsbergis Occupational stress among health care workers: A test of the job demands-control model , 1988 .

[33]  Robert Karasek,et al.  Job decision latitude and mental strain: Implications for job redesign , 1979 .

[34]  L. Radloff The CES-D Scale , 1977 .

[35]  L. Derogatis,et al.  The SCL-90 and the MMPI: A Step in the Validation of a New Self-Report Scale , 1976, British Journal of Psychiatry.

[36]  Carmi Schooler,et al.  Occupational experience and psychological functioning: An assessment of reciprocal effects. , 1973 .

[37]  Lois E. Tetrick,et al.  Handbook of occupational health psychology , 2003 .

[38]  W. Eaton,et al.  Psychosocial work environment and depression: epidemiologic assessment of the demand-control model. , 2000, American journal of public health.

[39]  T. Snijders,et al.  A multilevel analysis of the demands--control model: is stress at work determined by factors at the group level or the individual level? , 2000, Journal of occupational health psychology.

[40]  Thomas N. Bradbury,et al.  Social Support in Marriage , 1996 .

[41]  G. S. Wunderlich,et al.  Nursing Staff in Hospitals and Nursing Homes: Is It Adequate? , 1996 .

[42]  N. Chappell,et al.  Nursing assistant burnout and the cognitively impaired elderly. , 1994, International journal of aging & human development.

[43]  R. Kessler,et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. , 1994, Archives of general psychiatry.

[44]  C. Muntaner,et al.  Dimensions of the psychosocial work environment in a sample of the US metropolitan population , 1993 .

[45]  Shelley E. Taylor,et al.  Victims' perceptions of social support: what is helpful from whom? , 1990, Journal of personality and social psychology.