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Effects of Cooperative Membership and Participation in Decision Making on Job Satisfaction of Home Health Aides
Abstract
PurposeThis paper examines job satisfaction and participation in decision making in three home health aide facilities with different organizational structures (worker-owned for-profit, for-profit with no participation or ownership by workers, and nonprofit).
Design/methodology/approachMore than 600 surveys were completed by home health aides across the three facilities. The author also engaged in participant observation during training sessions and other meetings and conducted a small number of interviews with caregivers and agency management.
FindingsHome health aides at the worker-owned, participative decision making organization were significantly more satisfied with their jobs than those at the other agencies. Results for the other agencies were not significantly distinguishable from one another.
Research limitations/implicationsThis study involved respondents from one of each type of business. A study across several of each type of organization would allow more focus on the effects of the structural characteristics of the organizations.
Practical implicationsIn the United States, the work that home health aides perform provides a valuable service to society. On behalf of caregivers and those for whom they provide care, conditions of the work need improvement. If participative democratic workplaces provide better outcomes, they should receive more attention from lawmakers, the business community, and researchers.
Social implicationsThis research highlights the working conditions of the people (primarily women) who perform this work. The poor compensation received is a reminder of inequality in opportunity for some workers and of the value placed on this type of caring labor.
Originality/valueThis research is unique in its focus on work environment and outcomes in home health care across nonprofit, for-profit, and worker-owned for-profit organizations. The findings of different job satisfaction outcomes from the others in the worker-owned organization and similar outcomes in the nonprofit and conventional for-profit organizations are also unique.
... A more recent study specifically compares job satisfaction in worker cooperatives versus traditional businesses in the home health care industry. This study finds significantly higher rates of job satisfaction among the members of a worker cooperative than in both a for-profit company and a nonprofit company that are similarly situated (Berry, 2013). In fact, not only is job satisfaction higher in the cooperative (a mean of 4.49 on a scale of 1-5, with 5 as the highest, as compared to 3.11 at the for-profit and 3.38 at the nonprofit), but the standard deviation at the cooperative is smaller (0.853 vs. 1.129 and 1.054, respectively), meaning that there was less variation. ...
Work may provide subsistence, but for most people it is a necessary evil. For communities, businesses lie at the heart of our economic system, but often come with negative externalities. This article considers whether worker cooperatives will tend to have more positive impacts on the happiness of their workers and of the community than do traditional businesses. Worker cooperatives are businesses, but they are rooted in the community. Based on the work of 19th‐century political economist William Thompson, I examine what I call the alignment thesis, which suggests that the democratic and ownership structure of cooperatives will align the interests of the enterprise with that of the workers and the community beyond. I explore this question both analytically and by reviewing the existing empirical literature. I find that the impact on workers is generally positive, mostly because of the establishment of democratic control, better working conditions and job security, but it is limited where social inequalities that disadvantage women and people of color are replicated in the cooperative. The larger community impacts, however, are less certain, because worker cooperatives do not necessarily alter the logic of capitalist production for exchange. I conclude with thoughts for further research.
... It's even possible that "shared values" created organizational discourses that, as some studies suggest, implicitly excluded or disenfranchised members of subordinated groups (Kasmir 1996;Kleinman 1996;Scott 2005). Other scholarship views active address of difference and even conflict as a necessary (if not sufficient) condition for the success of demographically heterogeneous worker cooperatives (Hoffmann 2005;Meyers 2006;Miller 2011;Berry 2013;Sobering, Thomas, and Williams 2014)-a finding echoed in studies of social justice nonprofit organizations (Sirianni 1993;Ostrander 1999;Scott 2005). Key to these studies is an understanding of how democratic control operates within a population that self-defines as diverse. ...
Two major shifts in contemporary work organizations—“employee participation” and “diversity management”—have typically been studied in isolation from one another. Building on theoretical work by Acker (2006a,b), we ask how the interaction of these two constructs has affected the pursuit of workplace democracy at two worker cooperatives in Northern California. Using qualitative methods, we find that distinct “diversity regimes” have emerged at these establishments, substantially affecting the configurations of inequality that evolved. We distinguish two types of diversity regimes—“utilitarian” and “communitarian”—which operate either to obscure the workings of inequality or to foster attention to their presence. Our results suggest that how sociodemographic differences are managed has material consequences for the development of egalitarian structures at work.
Il libro sviluppa una teoria della rivoluzione come atto di emancipazione delle classi subalterne e una visione della storia come un lungo processo di espansione della libertà. Dopo aver ricostruito nei primi due capitoli alcuni fatti riguardanti i regimi d’oppressione e i movimenti di liberazione verificatisi nella storia, nei successivi due vengono elaborati i concetti di libertà e autonomia, che definiscono le motivazioni dei rivoluzionari. Altri due capitoli affrontano i problemi dell’azione collettiva, separando il comportamento ordinario, che si risolve nell’adattamento all’ordine costituito, dal comportamento sovversivo, che genera i movimenti di contestazione. I due capitoli finali descrivono alcune istituzioni di un sistema politico ed economico post-capitalistico in cui si realizza la “vera democrazia” nella sfera politica e il “lavoro libero e associato” nella sfera economica. È un modello di società tutt’altro che utopistico, poiché quelle istituzioni possono essere realizzate qui e ora, date le conoscenze tecnologiche esistenti.
This paper explores the implications for economic analysis, societal well-being, and public policy of the movement of care services (such as child and elder care) from home to market. A broad empirical overview sets the stage for the argument that this process cannot be properly evaluated using only a priori judgments about the suitability of marketization. The context in which markets operate is crucial, and while the growth of market provision poses some risks, it also offers some potential benefits.
Exploiting a unique data set created in 1999 on a sample of 228 public, nonprofit, and for-profit organizations operating in the social service sector, and on 2,066 workers, the article tests whether workers' satisfaction and loyalty to the organization is influenced by workers' motivations and by the incentive mixes offered by different organizational forms. As for satisfaction, intrinsic and relational attitudes toward work exert the greatest influence, whereas workers motivated by economic interests are less satisfied. As for loyalty to the organization, satisfaction with economic and process-related aspects of the job appear to have the greatest impact. The behavior of nonprofit organizations, which form the largest part of the sample, is consistent with these results. The specific strength of their incentive mix is represented by worker involvement and other process-related aspects of the job. By contrast, workers in public bodies are the least satisfied, higher monetary incentives notwithstanding.
This study presents a model linking personal and job-related factors to job satisfaction, job commitment, and turnover, Responses from the staff of six nursing homes and 12 community facilities serving older adults were included. Using a modified version of the causal model of turnover developed by Price and Mueller, three sets of predictors were tested to explain the causes for turnover: personal characteristics, job characteristics, and attitudes. The best predictor of turnover was the employee's intention to leave, followed by the length of employment (shorter), and age (younger). Intention to leave was, in turn, predicted by age (younger), length of employment (shorter), job dissatisfaction, and the type of agency for which the employee worked (community). Dissatisfaction seems to be a major factor that results in a desire to leave the job and may lead to either turnover or continued dissatisfaction with the job. Implications for enhancing employee morale and reducing job turnover are discussed.
The present study examined the impact participation in decision-making (PDM) had on the relationship between perceptions of organizational politics and expressions of job satisfaction among 1251 public sector employees. We hypothesized that perceptions of organizational politics would reduce job satisfaction and that the detrimental effect of poltics on job satisfaction would be weakest among workers who engage in consensus decision-making with their supervisors. We used confirmatory factor analyses to determine whether the variables used in this study reflected distinct constructs. Then, we used correlational analysis and hierarchical moderated multiple regression analyses to test the hypotheses. Results indicated that the variables reflected distinct constructs and confirmed the hypotheses. Examination of the interaction indicated that the effect of PDM on job satisfaction was robust at high levels of perceived politics.
The historical relationship between capital and labor has evolved in the past few decades. One particularly noteworthy development is the rise of shared capitalism, a system in which workers have become partial owners of their firms and thus, in effect, both employees and stockholders. Profit sharing arrangements and gain-sharing bonuses, which tie compensation directly to a firmâs performance, also reflect this new attitude toward labor. Shared Capitalism at Work analyzes the effects of this trend on workers and firms. The contributors focus on four main areas: the fraction of firms that participate in shared capitalism programs in the United States and abroad, the factors that enable these firms to overcome classic free rider and risk problems, the effect of shared capitalism on firm performance, and the impact of shared capitalism on worker well-being. This volume provides essential studies for understanding the increasingly important role of shared capitalism in the modern workplace.
This research is an examination of job satisfaction and turnover among nursing assistants employed in nursing homes. Using a statewide sample with 550 nursing assistants responding, the results indicated that 60% were satisfied with their jobs and 30% planned to quit. The nursing assistants participating in this study identified the relationship with the resident as the most important work issue, and their major reason for staying in the job. They were most dissatisfied with pay, benefits, and recognition and appreciation. Although the respondents were dissatisfied with benefits and salary, these work issues could not explain overall satisfaction or turnover. The multivariate analysis confirmed that professional growth and involvement in work-related decisions, supervision, and management keeping employees informed were significantly related to both turnover and overall satisfaction.
The relationship between job satisfaction of nurse aides and intent to leave and actual turnover after 1 year is examined.
Data came from a random sample of 72 nursing homes from 5 states (Colorado, Florida, Michigan, New York, and Oregon). From these nursing homes, we collected 1,779 surveys from nurse aides (a response rate of 62%). We used a job satisfaction instrument specifically developed for use with nurse aides, as well as previously validated measures of intent to leave and turnover. We used ordered logistic regression and logistic regression to examine the data.
High overall job satisfaction was associated with low scores on thinking about leaving, thinking about a job search, searching for a job, and turnover. In examining the association between the job satisfaction subscales and intent to leave and turnover, we found that high Work Schedule subscale scores, high Training subscale scores, and high Rewards subscale scores were associated with low scores on thinking about leaving, thinking about a job search, searching for a job, and turnover. High scores on the Quality of Care subscale were associated with low turnover after 1 year.
These results are important in clearly showing the relationship between job satisfaction and intent to leave and turnover of nurse aides. Training, rewards, and workload are particularly important aspects of nurse aides' jobs.
The present study examined the impact participation in decision-making (PDM) had on the relationship between perceptions of organizational politics and expressions of job satisfaction among 1251 public sector employees. We hypothesized that perceptions of organizational politics would reduce job satisfaction and that the detrimental effect of poltics on job satisfaction would be weakest among workers who engage in consensus decision-making with their supervisors. We used confirmatory factor analyses to determine whether the variables used in this study reflected distinct constructs. Then, we used correlational analysis and hierarchical moderated multiple regression analyses to test the hypotheses. Results indicated that the variables reflected distinct constructs and confirmed the hypotheses. Examination of the interaction indicated that the effect of PDM on job satisfaction was robust at high levels of perceived politics.
Objectives. During the past 7 years there has been a significant increase in the use of the Medicare home health benefit. In this article, the authors document trends in the use of the benefit and develop multivariate models to identify the factors that explain state variation in its use. Methods. To develop quantitative models, the authors collected state information on all variables for each of 3 years: 1991, 1992, and 1993. The authors chose to focus on those variables that had been found to be significant in other research as well as those that we posited would likely influence utilization. The authors tested similar sets of explanatory variables for each year of the analysis. The unit of analysis is the "state" and depending on data availability, the number of states included in the analyses range from between 46 to 49. (Arizona does not have a state Medicaid program.) Results. The authors' analysis shows that interaction exists between state policies and use of the benefit. Utilization is higher in states that face greater fiscal pressure concerning their Medicaid budgets; the lack of state personal care programs increases Medicare use, and, when Medicaid home health expenditures decline, the number of Medicare home health care users increases. There is also an inverse relationship between the number of long-term care and skilled nursing facilities in a state and the use of the benefit. Thus, for some, the benefit serves as a substitute for long-term care needs and, for others, for postacute care needs. Conclusions. The overlap between the population served and the services provided by state programs and Medicare has given states and providers an opportunity to leverage Federal dollars in lieu of state program dollars. As the Federal government attempts to control expenditure growth, policy-makers must be mindful of how state actions can influence the level and type of Federal expenditures.
Purpose
Regulatory frameworks in Australia encourage employee participation in decision making (PDM) on the basis that participation benefits work effort, job satisfaction and commitment. Although the literature supports this premise, there is little evidence that patterns of causal inference in the relationship are clearly understood. This study aims to examine for structural and causal inference between PDM and the work environment over time.
Design/methodology/approach
Structural equation modeling was used to examine longitudinal, matched sample data for causal inferences.
Findings
The paper finds that participation in decision making appears to promote job satisfaction and commitment, whereas task variety and work effort foster participation.
Research limitations/implications
The use of quantitative, self report data, small samples and cross industry data as well as possible overlap between commitment foci may limit the transferability of the findings. It is also important to note causality is merely inferred.
Practical implications
Although participation in decision making positively influences work effort, autonomy and commitment, practitioners need to be mindful of keeping a balance between employee and employer needs. Job satisfaction and commitment are at risk in the long term if participation is viewed merely as a survival strategy for coping with work effort and task variety.
Originality/value
The paper examines inferred causality within a participative decision‐making framework and addresses the previously neglected need for multi‐site and longitudinal studies.
Through a sweeping analytical narrative, from the Great Depression of the 1930s to the Great Recession of today, Caring for America shows how law and social policy shaped home care into a low-wage job, stigmatized as part of public welfare, primarily funded through Medicaid, and relegated to the bottom of the medical hierarchy. Care work became a job for African American and immigrant women that kept them in poverty, while providing independence from institutionalization for needy elderly and disabled people. But while the state organized home care, it did not do so without eliciting contestation and confrontation from the citizens themselves who gave and received it. Authors Eileen Boris and Jennifer Klein trace the intertwined, sometimes conflicting search of care providers and receivers for dignity, self-determination, security, and personal and social worth. This book highlights social movements of senior citizens for disability rights and independent living, the civil rights organizing of women on welfare and domestic workers, the battles of public sector unions, and the unionization of health and service workers. It rethinks the history of the American welfare state from the perspective of care work, all the while re-examining the strategies of the U.S. labor movement in terms of a growing care work economy. An unprecedented study, Caring for America serves as a definitive historical account of how public policy has impacted major modern movements and trends in class, race, and gender politics in the United States.
The purpose of this study was to investigate (a) whether certified nursing assistants (CNAs) are more committed to nursing home jobs when they perceive their jobs as enhanced (greater autonomy, use of knowledge, teamwork), and (b) whether CNA job commitment affects resident satisfaction.
A qualitative exploration of management philosophy and practice and of CNAs' views of their jobs in 18 Massachusetts nursing homes formed the basis for a survey administered to 255 CNAs in 15 homes. A quality-of-life questionnaire was administered to 105 residents. Logistic regression accounting for clustering estimated the effect of personal characteristics, satisfaction with tangible job rewards, and aspects of job design on CNAs' intent to stay in current jobs. A general linear model estimated the effect of job commitment on residents' satisfaction with their relationship to nursing staff.
After we accounted for satisfaction with wages, benefits, and advancement opportunities, good basic supervision was most important in affecting CNAs' intent to stay in their jobs. Job enhancements were not significantly related to intent to stay. Residents were more satisfied with their relationships to nursing staff and their quality of life on units where a higher proportion of CNAs were committed to their jobs.
The finding that greater job commitment of CNAs is associated with better quality of relationships and life for residents implies that better jobs lead to better care. Culture change transformation that increases CNA autonomy, knowledge input, and teamwork may not increase workers' commitment to jobs without improvements in basic supervision.
During the past 7 years there has been a significant increase in the use of the Medicare home health benefit. In this article, the authors document trends in the use of the benefit and develop multivariate models to identify the factors that explain state variation in its use.
To develop quantitative models, the authors collected state information on all variables for each of 3 years: 1991, 1992, and 1993. The authors chose to focus on those variables that had been found to be significant in other research as well as those that we posited would likely influence utilization. The authors tested similar sets of explanatory variables for each year of the analysis. The unit of analysis is the "state" and depending on data availability, the number of states included in the analyses range from between 46 to 49. (Arizona does not have a state Medicaid program.)
The authors' analysis shows that interaction exists between state policies and use of the benefit. Utilization is higher in states that face greater fiscal pressure concerning their Medicaid budgets; the lack of state personal care programs increases Medicare use, and, when Medicaid home health expenditures decline, the number of Medicare home health care users increases. There is also an inverse relationship between the number of long-term care and skilled nursing facilities in a state and the use of the benefit. Thus, for some, the benefit serves as a substitute for long-term care needs and, for others, for postacute care needs.
The overlap between the population served and the services provided by state programs and Medicare has given states and providers an opportunity to leverage Federal dollars in lieu of state program dollars. As the Federal government attempts to control expenditure growth, policy-makers must be mindful of how state actions can influence the level and type of Federal expenditure.
This article examines changes in clients served by home health agencies, and how changes are related to recent health care trends and local market structure. Two types of explanatory factors are examined: organizational measures and market factors. A theoretical model of isomorphism is tested, considering the effects of privatization within the context of the growth of chains and multifacility systems. Findings show that (a) system members are more likely than nonmembers to show increases in clients of all ages; (b) for-profits that are not system members are more likely to have increases in total clientele and in clients age 65-74, whereas for-profits' changes in clientele age 85 or over depends on their system membership--increasing among nonmembers, decreasing among members; and (c) agencies in states with home health "certificate of need" (CON) are more likely to have increases in clients age 65-74 and 85 and over. The results for total clientele and those age 65-74 support an isomorphism hypothesis.
Three hundred forty-nine full-time nursing assistants (NAs) in 5 PACE programs and their neighboring nursing homes were surveyed to assess job satisfaction. There were no significant differences between NAs in the two models of care with respect to demographics, job description, or importance placed on job elements. Job satisfaction, however, was higher among the PACE NAs. PACE NAs reported a significantly higher prevalence of the chance to form close relationships with patients, variety, respect for suggestions by people who make decisions about patient care, the chance to use one's own judgment, the chance to discuss patients with other team members, and respect for choices in assignment type.
The following report offers an initial exploration of home care and its distinctive ethical problems, particularly in the area of autonomy and allocation, and specifically with regard to the frail elderly...The principal source of the report was a...research project of The Hastings Center and the Division of Legal and Ethical Issues in Health Care at Montefiore Medical Center. This project was part of a...program in which the Retirement Research Foundation supported...research projects on the autonomy of the elderly in long term care... Additional material...comes from a Hastings Center project... This earlier project involved a comparative study of home care for the elderly and community-based care of the mentally ill. It provided an initial exploration of many of the ethical issues crucial to this report....
The purpose of this study was to examine whether job characteristics, the work environment, participation in quality improvement activities and facility quality improvement environment predicted employee commitment and job satisfaction in nursing homes, and whether those same predictors and commitment and satisfaction predicted turnover intention. A total of 6,584 nursing home employees from 76 nursing homes in a midwestern state participated. A self-administered questionnaire was used to collect the data. The results supported the hypotheses that job and organizational factors predicted commitment and satisfaction while commitment and satisfaction predicted turnover intentions. The implications for retaining nursing home employees are discussed.
Non-profit firms are often seen as workplaces where people not only work for money, but also find substantial satisfaction in the kind of work they do. Studies looking at compensating wage differentials, however, have only found limited support for this notion. In this paper, a novel approach is undertaken to compare the utilities of non-profit and for-profit employees, by using measures of job satisfaction. The results show that in both the United States and Great Britain over the 1990's, non-profit workers were generally more satisfied with their jobs than for-profit workers. The robustness of the results is explored in detail, and implications for the governance of non-profit firms are shortly discussed. Copyright 2005 Blackwell Publishing Ltd..