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Insights into the work lives of health support workers in Canada

2014 Conference Presentation

Workforce Canada

1 September 2014

Insights into the work lives of health support workers in Canada

Whitney Berta, University of Toronto, Canada
Liane Ginsburg, University of Toronto, Canada
Audrey Laporte, University of Toronto, Canada
Jennifer Baumbusch, University of Toronto, Canada
Colin Reid, University of Toronto, Canada


Objective: We undertook psychometric testing of items relating to the work attitudes and work outcomes of Health Support Workers (HSWs) – Personal Support Workers and Health Care Aides caring for seniors in their homes and community, and in nursing homes – working in two Canadian Provinces (Ontario and British Columbia). Work attitudes examined include work empowerment, organizational citizenship behaviour, work engagement, and job satisfaction; work outcomes include turnover intention and burnout.

Data & Methods: Scales with good psychometric properties have been developed for the work attitudes and work outcomes in which we are interested, however these have been developed for use in contexts other than health care, or for health care contexts and workers other than HSWs in long term care, and home and community care. Through cognitive debriefing with 21 HSWs working in Ontario and British Columbia, we undertook linguistic validation (to ensure content validity) of items relating to work attitudes and work outcomes. Using the alternative item wording supplied through this process, we prepared and administered a pilot survey to an additional 250 HSWs working in Ontario and British Columbia. The pilot survey yielded important information on item/question comprehension, time taken to complete, and usability. It also afforded sufficient data to conduct a factor analysis, and generate alphas.

Results: Our factor analysis of the pilot survey data demonstrates factor structures consistent with those found in other study settings. A number of the measures of work outcomes and work attitudes are significantly correlated, confirming relationships observed in other work settings, and suggesting to us useful avenues of future research that may be of utility to administrators grappling with issues of high turnover and burnout among these workers.

Policy Implications: While HCAs deliver most of the direct care to nursing home residents, they are an understudied group of workers in Canada and elsewhere (Castle, 2008; Williams et al., 2009; Faul et al., 2010; Lum et al., 2010). Most research to date has focused on examinations of the impact of nursing care on resident outcomes (see Alameddine et al., 2006). Very little is known about the relationships among worker characteristics (including training/preparation), the context/work structure in which HCAs work, and worker attitudes (e.g., quality of work like, job satisfaction, work engagement, and organizational commitment) that have been shown in other contexts (both within and outside of health care) to influence key work outcomes, like individual performance and turnover intention. Our work offers early, novel insights into the relationships between the work attitudes and work outcomes of this understudied workforce. The results of our survey pilot have informed the development of a more comprehensive HSW Worklife Survey that will be administered to 100,000 HSWs working in the Province of Ontario over Spring 2015. The HSW Worklife Survey will explore the relationships between work attitudes, work outcomes, demographic characteristics, characteristics of the HSW work environment, and job characteristics.