The effects of stress, role ambiguity, and social support on burnout among home health aids caring for the frail elderly: "Toward the prevention of maltreatment"

Abstract

The need for long-term care services has been increasing rapidly, and a continuous increase is expected for several decades. Home health aides who provide services such as assistance with Activities of Daily Living (ADLs) and homemaker chores are critical to the success of home-based, long-term care. It is imperative that these services be of the highest quality. Burnout has been found to be a serious problem among human service workers, but has not been empirically studied among home health aides caring for the frail elderly. Burnout can lead to poor quality care including maltreatment of patients (Pillemer, 1988); burned-out workers are less efficient, and turnover is high. In order to improve quality of care in home health care, we need to begin examining factors that predict burnout in home health aides. The purpose of this study was to explore how job role ambiguity, perceived stress and social support affect burnout among home health aides. The three components of the Maslach Burnout Inventory (Emotional Exhaustion, Depersonalization and Personal Accomplishment) were used to measure burnout. The Depersonalization scale had low reliability (Cronbach's Alpha =.36), so it was not used as a dependent measure. Fifteen home health care agencies participated in the study, yielding a sample size of 117 home health aides. Generally, the home health aides were African-American women, unmarried, with 13 years of education. The respondents had been employed as home health aides for an average of 8 years working 36 hours per week. Cross-sectional data were obtained by interviewer administered questionnaires. Multivariate analyses supported the hypotheses that job role ambiguity, perceived stress and social support (social network) had direct relationships to burnout (one or both of the subscales of the MBI). Age and education also showed significant relationships to burnout. A buffering relationship between social network, perceived stress and Personal Accomplishment was found. Results suggest that stress, social network, age and education are important when examining the effects of burnout among home health aides. Results imply that interventions to reduce stress and that target specific home health aides based on age and education level need to be implemented.