[Factors affecting quality of working life among caregivers in care facilities for the elderly]

Theshortage of caregivers in care facilities has become a problem in Japan. Building a comfortable workplace and improving the quality of working life (QWL) of caregivers are essential. However, the factors of QWL that should be prioritized remain unclear. The purpose of this study was to identify the major factors currently affecting the QWL of caregivers in care facilities for the elderly and recognize the priorities that should be addressed.

A questionnaire survey targeting administrators and caregivers working in care facilities for the elderly was conducted from October to December in 2018. In total, 1,000 care facilities located throughout Japan were selected via random sampling. Eight caregivers who differed by sex, age, and years of experience were selected from each facility (a total of 8,000 caregivers). A logistic regression analysis was used to analyze the association between QWL and the factors affecting it.

Ultimately, data from 504 facilities and 3,478 caregivers were included in the analysis. Human relationships (OR: 3.92, 95% CI: 3.09-4.97) had the highest odds ratio in terms of caregivers' QWL, followed by the number of workers (OR: 3.69, 95% CI: 2.56-5.32), communication (OR: 3.42, 95% CI: 2.66-4.40), support from the facility (OR: 3.37, 95% CI: 2.69-4.23), working hours or time off (OR: 3.20, 95% CI: 2.53-4.04), and discretion of responsibility level (OR: 3.09, 95% CI: 2.46-3.88). In contrast, salary (OR: 2.81, 95% CI: 2.19-3.61) was associated with QWL but the association was lower than that of human relationships and the other factors. Lower back pain among caregivers was also associated with QWL.

Findings of this study show that improvement in human relationships is the primary factor for improved QWL among caregivers in care facilities. Thus, it should be prioritized. Secondary factors that affect QWL are the number of workers, communication, support from the facility, working hours or time off, and discretion of responsibility level. Considering the reasons for caregivers' dissatisfaction, improving their QWL requires promoting the exchange of information with superiors and colleagues. It also involves consulting with persons in charge about working hours, time off, and mental health. Salary is related to QWL but is less important than the aforementioned factors. The prevention of lower back pain, however, contributes to improving QWL.