The association between nursing home staff mix, residents’ quality of life and employees’ strain

BACKGROUND AND PURPOSE: In investigating associations between structural variables of nursing homes like staff mix with outcomes related to residents and caregivers, the main focus up to now was predominantly on quality of care, while resident’s quality of live (QoL) and strain of professional caregivers are far less investigated outcomes. In the PERLE-study these relevant outcomes are analyzed. METHODS: The sample used for analysis consisted of N=195 employees and N=215 proxy rated residents out of 21 nursing homes in the German region Baden-Württemberg. Data was collected using two separate cross-sectional online surveys. Head managers were asked for structural data. The survey for the employees focussed on their experienced work-related strain. The employees were also asked to rate Kane & Kane’s ten dimensions of QoL for specific residents as a proxy. Strain was measured using four scales of the „Beanspruchungsscreening für Humandienstleistungen“ (BHD). Data was analyzed using linear mixed-effects models, accounting for the multilevel structure of the data. RESULTS: The analysis of the nullmodels showed that only the two levels nursing home and individual were discriminable but not the level team/ ward. Intraclass correlations (ICC) for the facility level were 20.67% for QoL, and 11.8%-23.0% for the BHD outcomes. Linear mixed-effects models that account for independent variables, especially staff mix, are currently analyzed. CONCULUSIONS: ICCs show that the main source of variance is the individual and not the nursing home. Therefore, when addressing QoL or strain, the focus of interventions should be rather on the individuals than on structural changes.