Predictors of Job Satisfaction and Intent to Leave among Home Health Workers: An Analysis of the National Home Health Aide Survey. Multivariate Analyses: Job Satisfaction

08/14/2015

Results of the multinomial logistic regression based on a weighted sample of 119,500 aides in the analytical sample are presented in Table 3. This analysis tests two models: model I excludes variables based on worker perceptions that were suspected to be endogenous with job satisfaction (HHA feels valued by organization, Aide feels involved in challenging work, Aide feels trusted with patient care decisions, Aide feels confident in ability to do job, Time for ADLs, Satisfaction with hours, Aide feels respected by supervisor, Aide feels respected by patients), while model II includes these variables.

For each model, the effect of independent variables on the odds of being extremely satisfied versus dissatisfied, and the effect of independent variables on the odds of being somewhat satisfied versus dissatisfied are estimated. As shown in Table 2, job satisfaction was associated with worker characteristics, home care structure and policies, perceived workplace characteristics and perceived job stressors.

Worker Characteristics: Neither age nor race or Hispanic/Latino ethnicity were found to be associated with job satisfaction after other factors were accounted for. In model II, workers lacking a High School Diploma or a GED were found to have significantly lower satisfaction than workers with some college or higher, and being the only worker in a household with dependent children was associated with higher odds of being somewhat satisfied versus dissatisfied in model II. Household poverty status was not associated with job satisfaction in either model. Having received formal training was associated with higher satisfaction, though the odds ratio was not statistically significant for model II (extremely satisfied versus dissatisfied).

Perceived Workplace Characteristics: The odds of being satisfied with one’s job were significantly associated with a worker’s feeling of being respected by one’s supervisor and valued by one’s organization after other factors were accounted for. Perceptions of being involved in challenging work were significantly associated with higher job satisfaction, although the odds of being extremely satisfied with one’s job were higher among those that “somewhat agreed” (OR=16.79) compared to those that “strongly agreed” (OR=9.36) that their work was challenging. Being trusted to make patient care decisions and feeling respected by patients were not significantly associated with job satisfaction.

Compensation: After other factors were accounted for, hourly wage was inversely associated with satisfaction in model II, with the odds of being extremely satisfied lower for those with higher wages. Also important for job satisfaction was having a pension or retirement plan available. Interestingly, not knowing if a pension or retirement plan was available was significantly correlated with higher satisfaction, but only for the model II. Having health insurance was not associated with satisfaction, nor was paid sick leave, paid holidays, paid personal or vacation time available, or reporting a pay raise in the past year (not presented). Workers in agencies that reported having career ladder positions for aides, a form of advancement potential, were found to have significantly lower odds of being extremely satisfied versus dissatisfied.

Job Stressors or Demands: Workers who experienced an on-the-job injury in the past 12 months were found to have significantly lower odds of being extremely satisfied in model I, but not in model II. In model II, aides who report working full-time and wanting fewer hours had greatly reduced odds of being extremely or somewhat satisfied (0.04 and 0.08, respectively) than those who reported their hours were “about right.” Working more than one job and time for assisting patients with ADLs were not correlated with satisfaction.

Agency Structure and Policies: Workers who report being encouraged by their agencies to discuss patient care with family have significantly higher odds of being extremely satisfied in both models. Agency ownership was also associated with satisfaction. Aides in standalone for-profit agencies report significantly lower satisfaction than those in not-for-profit agencies, though the odds ratio is not significant for model I extremely satisfied versus not extremely satisfied. Aides working for agencies located in counties classified as “Neither” (i.e., rural) or “Micropolitan” had higher odds of being satisfied, but the odds ratios did not achieve statistical significance.

Economic and Sociopolitical Factors: State unemployment rates were negatively correlated with the odds of being somewhat satisfied versus dissatisfied in model I only.

TABLE 3. Multivariate Analysis of Job Satisfaction

  Model I Model II
Extremely Satisfied vs. Dissatisfied (OR) Somewhat Satisfied vs. Dissatisfied (OR) Extremely Satisfied vs. Dissatisfied (OR) Somewhat Satisfied vs. Dissatisfied (OR)
Intercept 4.75 (0.23-99.88) 15.14 (0.72-318.6) 0.01* (0-0.35) 0.42 (0.01-27.05)
On-the-job injury in past 12 months Yes 0.32* (0.13-0.80) 0.79 (0.29-2.16) 0.58 (0.19-1.76) 1.29 (0.45-3.68)
Aide encouraged by agency to talk with patient's family Yes 2.88* (1.57-5.30) 1.72 (0.96-3.05) 2.37* (1.08-5.21) 1.34 (0.66-2.76)
Consistency of patient
assignment
Same patients (REF=combination) 1.77 (0.34-9.26) 1.79 (0.35-9.11) 1.69 (0.48-5.97) 1.56 (0.49-4.91)
Patients change (REF=combination) 1.1 (0.16-7.55) 1.73 (0.28-10.74) 1.37 (0.20-9.52) 1.61 (0.30-8.72)
Received formal training Yes 3.18* (1.23-8.22) 2.64* (1.14-6.14) 1.89 (0.75-4.78) 2.52* (1.03-6.19)
Career ladder positions available in agency for aides Yes 0.30* (0.11-0.85) 0.41 (0.13-1.33) 0.20* (0.06-0.64) 0.37 (0.11-1.28)
Health insurance offered at agency Yes 0.90 (0.27-2.97) 0.40 (0.13-1.29) 1.01 (0.22-4.51) 0.41 (0.11-1.61)
Pension or retirement plan
available at agency
Yes (REF=No) 4.74* (1.77-12.74) 4.22* (1.49-11.94) 4.97* (1.43-17.26) 4.64* (1.48-14.52)
Don't know (REF=No) 3.20 (0.67-15.41) 3.50 (0.73-16.80) 11.70* (1.48-92.23) 8.08* (1.10-59.33)
HHA feels valued by organization Very much (REF=Somewhat/ not at all)     10.37* (4.42-24.32) 1.99 (0.81-4.90)
Aide feels involved in challenging
work
Strongly agree (REF=Somewhat/ strongly disagree)     9.36* (3.24-27.07) 4.89* (1.86-12.88)
Somewhat agree (REF=Somewhat/ strongly disagree)     16.79* (4.65-60.69) 18.08* (5.60-58.37)
Aide feels trusted with patient care
decisions
Strongly agree (REF=Somewhat/ strongly disagree)     2.61 (0.68-10.02) 1.36 (0.40-4.64)
Somewhat agree (REF=Somewhat/ strongly disagree)     5.62* (1.02-31.07) 5.76* (1.32-25.18)
Aide feels confident in ability to do job Strongly agree (REF=Somewhat/ strongly disagree)     1.39 (0.41-4.71) 1.58 (0.53-4.68)
Somewhat agree (REF=Somewhat/ strongly disagree)     1.18 (0.21-6.60) 1.68 (0.41-6.81)
Time for ADLs More than enough time (REF=Enough time)     1.38 (0.40-4.71) 1.62 (0.52-5.11)
Not enough time (REF=Enough time)     0.35 (0.07-1.90) 0.38 (0.12-1.22)
Satisfaction with hours PT, want more hours (REF=Hours about right)     0.65 (0.19-2.19) 1.29 (0.43-3.84)
PT/fewer hours OR FT/more hours (REF=Hours about right)     0.59 (0.24-1.46) 0.56 (0.22-1.40)
FT, fewer hours (REF=Hours about right)     0.04* (0.01-0.17) 0.08* (0.02-0.33)
Aide feels respected by supervisor A great deal (REF=Somewhat or not at all)     16.52* (6.00-45.53) 3.94* (0.02-0.33)
Aide feels respected by patients A great deal (REF=Somewhat or not at all)     0.90 (0.25-3.18) 0.91 (0.26-3.20)
Aide's poverty status <100% FPL (REF=Over 300% FPL) 0.47 (0.12-1.83) 0.44 (0.11-1.72) 0.31 (0.07-1.28) 0.39 (0.11-1.36)
100-199% FPL (REF=Over 300% FPL) 0.56 (0.17-1.80) 0.50 (0.16-1.63) 0.47 (0.18-1.18) 0.41 (0.16-1.05)
200-299% FPL (Ref=Over >300% FPL) 0.92 (0.31-2.77) 0.64 (0.21-1.97) 0.78 (0.26-2.34) 0.49 (0.18-1.34)
Only worker with dependent children Yes 1.30 (0.38-4.45) 2.07 (0.61-7.03) 3.78 (0.98-14.54) 5.19* (1.58-17.05)
Education No diploma/GED (REF=Some college) 0.30 (0.06-1.53) 0.31 (0.07-1.43) 0.08* (0.01-0.45) 0.13* (0.02-0.71)
HS Grad or GED (REF=Some college) 1.64 (0.74-3.68) 0.89 (0.41-1.92) 1.00 (0.36-2.80) 0.58 (0.22-1.53)
Ownership of agency Chain-affiliated for- profit (REF=Not-for- profit/other) 0.72 (0.28-1.83) 1.00 (0.36-2.73) 1.56 (0.56-4.35) 2.01 (0.70-5.81)
Standalone for- profit (REF=Not-for- profit/other) 0.42 (0.17-1.09) 0.29* (0.10-0.82) 0.38* (0.16-0.90) 0.26* (0.10-0.66)
Aide works more than 1 job Yes 0.69 (0.27-1.73) 0.60 (0.26-1.41) 0.92 (0.38-2.23) 0.68 (0.30-1.52)
Age <30 (REF=55 and over) 0.61 (0.19-1.94) 1.00 (0.32-3.13) 0.36 (0.11-1.22) 0.67 (0.22-2.11)
30-54 (REF=55 and over) 0.72 (0.35-1.47) 0.81 (0.34-1.92) 0.71 (0.27-1.85) 0.63 (0.24-1.67)
Race Other (REF=White only) 1.93 (0.50-7.52) 1.41 (0.42-4.81) 2.15 (0.60-7.76) 2.28 (0.72-7.20)
Black/African- American only (REF=White Only) 1.13 (0.46-2.76) 1.91 (0.90-4.05) 0.61 (0.25-1.50) 1.44 (0.66-3.13)
Hispanic/Latino Yes 1.32 (0.29-6.08) 1.53 (0.36-6.46) 1.90 (0.55-6.59) 1.94 (0.61-6.15)
MSA status of agency Neither (REF=Metropolitan) 1.85 (0.34-10.04) 1.17 (0.21-6.41) 2.83 (0.97-8.27) 2.00 (0.66-6.10)
Micropolitan (REF=Metropolitan) 2.97 (0.92-9.60) 4.83 (1.43-16.37) 1.71 (0.38-7.79) 3.59 (0.75-17.11)
Computed hourly wage 0.95 (0.89-1.02) 0.99 (0.93-1.06) 0.92* (0.85-0.99) 0.97 (0.90-1.03)
State unemployment rate, 2007 0.75 (0.50-1.13) 0.64* (0.43-0.94) 1.05 (0.73-1.53) 0.80 (0.54-1.18)

 

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