Factors associated with Finnish home care workers job satisfaction

Abstract Background In Finland, home care is seen as a primary form of care for older people. However, rising numbers of clients with increasingly complex conditions have led to deteriorated working conditions and poor job satisfaction among home care staff. In this study, we examined if greater amount of direct care time, higher team autonomy, number of unique clients, and client’s need for care are associated with job satisfaction. Methods Data for the study was collected in October 2021. The amount of direct care and number of unique clients were obtained from a staff time measurement in home care units. The level of team autonomy was obtained from a survey sent to managers of participating organizations. Demographic information and a score for job satisfaction were retrieved from a survey for workers in the participating organizations. Client’s need for care was based on Resident Assessment Instrument (RAI). Data was analyzed using multiple linear regression. Results The number of respondents was 387, of which the majority were practical nurses 307 (79%). Higher team autonomy was associated with better job satisfaction, whereas higher number of unique clients and higher amount of direct care time were associated with poorer job satisfaction. The models were adjusted with clients’ care needs, but these effects will be further examined. Conclusions The results demonstrated that the workers are more satisfied if there is enough time to perform the work, they have adequate number of clients, and teams have autonomy over their work. This seems to be the case despite the level of clients’ need for care, however this needs further analysis. By increasing job satisfaction, better retention of care workers and attraction of care work might be achieved. Key messages • Higher team autonomy is associated with care worker’s job satisfaction. • Enhancing care continuity is important, therefore, when planning home care workers’ workday, it is important to consider that the workers could work with clients they know.


Background:
Migration of health professionals is one of the key challenges for many healthcare systems.In Poland this phenomenon is still under-researched.The aim of our study was to explore the estimated trends and directions of emigration among Polish health professionals.

Methods:
The research was based on the data analysis of specifying the number of people who applied for the certification of their professional qualifications (the right to practice a profession) at five national registers maintained by chambers of health professionals: 1) doctors and dentists, 2) nurses and midwives, 3) physiotherapists; 4) pharmacists and 5) laboratory diagnosticians.The gathered data reported information which allows for an approximate determination of how many professionals are considering a decision to migrate from Poland.Additionally exploration of data from the European Commission Regulated Profession Database in the EU Single Market was performed.Results: About 7-9% of Polish doctors and nurses have applied for certificates, which confirm their right to practice their profession in other European countries.The number of such certificates applied for by physiotherapists is also worrying.Emigration among pharmacists and laboratory diagnosticians is rather marginal.The biggest number of certificates, was issued to health professionals in the years 2004-2007, right after Poland joined the EU.In the period 2008-2015 the trend was not constant and it was related to the healthcare reform and changes in health professionals' remuneration.Since 2016 the number of health workers applying for the certificates is by to a certain extent falling.The main destination of Polish emigrants were and are: United Kingdom, Germany, Sweden, Spain, Ireland, and EFTA countries (Norway, Switzerland).

Conclusions:
Implementation of a mechanism for monitoring emigration is necessary, but systemic improvement of working conditions in Polish healthcare system is also needed.

Key messages:
The emigration, especially of young generations of medical staff, causes significant problems for the Polish healthcare system.
More in-depth research on migration of health professionals is necessary.
Abstract citation ID: ckac131.375Factors associated with Finnish home care workers job satisfaction

Background:
In Finland, home care is seen as a primary form of care for older people.However, rising numbers of clients with increasingly complex conditions have led to deteriorated working conditions and poor job satisfaction among home care staff.In this study, we examined if greater amount of direct care time, higher team autonomy, number of unique clients, and client's need for care are associated with job satisfaction.

Methods:
Data for the study was collected in October 2021.The amount of direct care and number of unique clients were obtained from a staff time measurement in home care units.The level of team autonomy was obtained from a survey sent to managers of participating organizations.Demographic information and a score for job satisfaction were retrieved from a survey for workers in the participating organizations.Client's need for care was based on Resident Assessment Instrument (RAI).Data was analyzed using multiple linear regression.

Results:
The number of respondents was 387, of which the majority were practical nurses 307 (79%).Higher team autonomy was associated with better job satisfaction, whereas higher number of unique clients and higher amount of direct care time were associated with poorer job satisfaction.The models were adjusted with clients' care needs, but these effects will be further examined.

Conclusions:
The results demonstrated that the workers are more satisfied if there is enough time to perform the work, they have adequate number of clients, and teams have autonomy over their work.This seems to be the case despite the level of clients' need for care, however this needs further analysis.By increasing job satisfaction, better retention of care workers and attraction of care work might be achieved.

Key messages:
Higher team autonomy is associated with care worker's job satisfaction.
Enhancing care continuity is important, therefore, when planning home care workers' workday, it is important to consider that the workers could work with clients they know.
Abstract citation ID: ckac131.376Multiprofessional teamwork in Finnish health and social service centers, experiences of managers

Background:
Health and social service centers are developed for the first contact points in Finland.Long waiting times, shortage of staff and lack of coordination have been major problems in primary care.As a solution, multiprofessional teams and better collaboration between professionals have been built.This study explores, how the teams work and what challenges they have.

Methods:
The study is based on 16 interviews (25 managers) in 5 health and social services centers.County provided specialized care in the whole area as well as primary services in two centers, one center was provided by a municipality, and two by a private firm.The managers were asked about work organization, their experiences of the team model and about well-being of employees.The interviews were analyzed using content analysis.

Results:
The managers saw the team work as functioning rather well.They also highlighted effective digital services and task shifting.Easy consultation of GP' was important as nurses were the first contact for clients in phone.In this call, the client' case was tried to be handled as far as possible.The competences of new professionals, such as social workers or psychiatric nurses had high value for the team.But the service processes and teambuilding were in progress.Working in mutual facilities and easy consultation of professionals was seen important.In most organizations clients were separated to different teams based on their service needs (acute or chronic conditions), or earlier