Staff turnover intention at long-term care facilities: Implications of resident aggression, burnout, and fatigue

Elsie YAN, Debby WAN, Louis TO, Haze K.L. NG, Daniel W.L. LAI, Sheung-Tak CHENG, Timothy KWOK, Edward M.F. LEUNG, Vivian W.Q. LOU, Daniel FONG, Habib CHAUDHURY, Karl PILLEMER, Mark LACHS

Research output: Contribution to journalArticlespeer-review

Abstract

Objectives: Staff shortages and the high turnover rate of nursing assistants pose great challenges to long-term care. This study examined the effects of aggression from residents of long-term care facilities, burnout, and fatigue on staff turnover intention. The findings will help managers to devise effective measures to retain their staff. 

Design: Cross-sectional descriptive study design. 

Setting and Participants: A total of 800 nursing assistants were recruited from 70 long-term care facilities using convenience sampling. 

Methods: The participants were individually interviewed and provided information about their turnover intention, resident aggression witnessed and experienced, self-efficacy, neuroticism, burnout, fatigue, and personal and facility characteristics. 

Results: Hierarchical multiple regression analysis revealed that the size and organizational practices of long-term care facilities were not associated with staff turnover intention. Staff who spent less time in the industry reported witnessing resident-to-resident aggression, experienced resident-to-staff aggression, reported high levels of burnout, had acute or chronic fatigue, and had low levels of inter-shift recovery were more likely than others to report a high turnover intention. 

Conclusions and Implications: Staff turnover poses great challenges to staff, residents, and organizations. This study identified important factors that may help support staff in long-term care facilities. Specific measures, such as person-centered care to diminish resident aggression by addressing residents’ unmet needs, work-directed programs to mitigate burnout and improve staff mental health, and flexible schedules to prevent fatigue should also be advocated to prevent staff turnover. Copyright © 2023 The Authors.

Original languageEnglish
Pages (from-to)396-402
JournalThe Journal of Post-Acute and Long-Term Care Medicine
Volume25
Issue number3
Early online dateNov 2023
DOIs
Publication statusPublished - Mar 2024

Citation

Yan, E., Wan, D., To, L., Ng, H. K. L., Lai, D. W. L., Cheng, S.-T., Kwok, T., Leung, E. M. F., Lou, V. W. Q., Fong, D., Chaudhury, H., Pillemer, K., & Lachs, M. (2024). Staff turnover intention at long-term care facilities: Implications of resident aggression, burnout, and fatigue. The Journal of Post-Acute and Long-Term Care Medicine, 25(3), 396-402. https://doi.org/10.1016/j.jamda.2023.10.008

Keywords

  • Staff turnover
  • Resident aggression
  • Long-term care

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