Health of health care workers in Canadian nursing homes and pediatric hospitals: a cross-sectional study

Abstract

Background: Poor health of health care workers affects quality of care, but research and health data for health care workers are scarce. Our aim was to compare physical/mental health among health care worker groups 1) within nursing homes and pediatric hospitals, 2) between the 2 settings and 3) with the physical/mental health of the Canadian population.

Methods: Using cross-sectional data collected as part of the Translating Research in Elder Care program and the Translating Research on Pain in Children program, we examined the health of health care workers. In nursing homes, 169 registered nurses, 139 licensed practical nurses, 1506 care aides, 145 allied health care providers and 69 managers were surveyed. In pediatric hospitals, 63 physicians, 747 registered nurses, 155 allied health care providers, 49 nurse educators and 22 managers were surveyed. After standardization of the data for age and sex, we applied analyses of variance and general linear models, adjusted for multiple testing.

Results: Nursing home workers and registered nurses in pediatric hospitals had poorer mental health than the Canadian population. Scores were lowest for registered nurses in nursing homes (mean difference -4.4 [95% confidence interval -6.6 to -2.6]). Physicians in pediatric hospitals and allied health care providers in nursing homes had better physical health than the general population. We also found important differences in physical/mental health for care provider groups within and between care settings.

Interpretation: Mental health is especially poor among nursing home workers, who care for a highly vulnerable and medically complex population of older adults. Strategies including optimized work environments are needed to improve the physical and mental health of health care workers to ameliorate quality of patient care.

Figure 1

Physical health (A) and mental health (B) of selected health care workers in nursing homes, and physical health (C) and mental health (D) of selected health care workers in pediatric hospitals. Error bars represent 95% confidence intervals (CIs). Note: allied = allied health care providers, LPN = licensed practical nurses, MD = mean difference (mean for reference minus mean for comparison), RN = registered nurse, SF-8 = 8-item Short Form Health Survey.

Figure 2

Physical health (A) and mental health (B) of registered nurses (RNs), allied health care providers (allied) and managers in nursing homes and pediatric hospitals. Error bars reflect 95% confidence intervals (CIs). Note: MD = mean difference (mean for nursing homes minus mean for pediatric hospitals), SF-8 = 8-item Short Form Health Survey.