Dr. Grace Sembajwe, a professor at the CUNY Graduate School of Public Health and Health Policy and colleagues around the country examined supporting employees’ work-family needs. The research is published in Social Science and Medicine.
[Photo: Dr. Grace Sembajwe]
The researchers analyzed qualitative and quantitative data from U.S.-based employees in 30 long-term care facilities. Their analysis of semi-structured interviews from 154 managers informed qualitative analyses. Quantitative data included 1,214 employees’ scoring of their supervisors and their organizations on family supportiveness (individual scores and aggregated to facility level), and three outcomes: care quality indicators assessed at facility level; employees’ dichotomous survey response on having additional off-site jobs; and proportion of employees with additional jobs at each facility. Thematic analyses revealed that managers operated within the constraints of an industry that simultaneously employs low-wage employees with multiple work-family challenges, and has firmly institutionalized goals of prioritizing quality of care and minimizing labor costs. Managers universally described providing work-family support and prioritizing care quality as antithetical to each other. Multivariable linear regression analysis of facility-level data revealed that higher family-supportive supervision was associated with significant decreases in residents’ incidence of all pressure ulcers (-2.62%) and other injuries (-9.79%). Higher family-supportive organizational climate was associated with significant decreases in all falls (-17.94%) and falls with injuries (-7.57%). Managers’ concerns about additional jobs were not entirely unwarranted: multivariable logistic regression of employee-level data revealed that among employees with children, having family-supportive supervision was associated with significantly higher likelihood of additional off-site jobs, but family-supportive organizational climate was associated with lower likelihood. However, proportion of workers with additional off-site jobs did not significantly predict care quality at facility levels. Although managers perceived providing work-family support and ensuring high care quality as conflicting goals, results suggest that family-supportiveness is associated with better care quality.