Workplace violence against homecare workers and its relationship with workers health outcomes: a cross-sectional study

Abstract

Background: Consumer-driven homecare models support aging and disabled individuals to live independently through the services of homecare workers. Although these models have benefits, including autonomy and control over services, little evidence exists about challenges homecare workers may face when providing services, including workplace violence and the negative outcomes associated with workplace violence. This study investigates the prevalence of workplace violence among homecare workers and examines the relationship between these experiences and homecare worker stress, burnout, depression, and sleep.

Methods: We recruited female homecare workers in Oregon, the first US state to implement a consumer driven homecare model, to complete an on-line or telephone survey with peer interviewers. The survey asked about demographics and included measures to assess workplace violence, fear, stress, burnout, depression and sleep problems.

Results: Homecare workers (n = 1,214) reported past-year incidents of verbal aggression (50.3% of respondents), workplace aggression (26.9%), workplace violence (23.6%), sexual harassment (25.7%), and sexual aggression (12.8%). Exposure was associated with greater stress (p < .001), depression (p < .001), sleep problems (p < .001), and burnout (p < .001). Confidence in addressing workplace aggression buffered homecare workers against negative work and health outcomes.

Conclusions: To ensure homecare worker safety and positive health outcomes in the provision of services, it is critical to develop and implement preventive safety training programs with policies and procedures that support homecare workers who experience harassment and violence.

Figure 1

Theoretical model of the relationships between forms of workplace aggression work and health outcomes.

Figure 2

Effects of verbal aggression and confidence on burnout. Note. Lines are plotted at + and – 1 SD above and below the means for confidence. Regression formula: Burnout = 10.6 + 17.0(verbal aggression)-8.5(confidence)-5.6(verbal aggression*confidence)-.1(age) + 1.5(education) + .2(tenure) + .1(hours) + 2.1(additional jobs), R² = .2.

Figure 3

Effects of workplace aggression and confidence on stress. Note. Lines are plotted at + and – 1 SD above and below the means for confidence. Regression formula: stress = 30.0 + 13.3(workplace aggression)-6.8(confidence)-6.5(workplace aggression*confidence)-.2(age) + .7(education), R² = .2.