AN UNEQUAL WORK ENVIRONMENT: NURSING HOME STAFF PERCEPTIONS OF UNIT ORGANIZATIONAL CONTEXT
Bibliographic record
Abstract
Abstract The organizational context in nursing homes is associated with quality of care and residents’ quality of life. Our objective was to examine nursing home staff perceptions of unit organizational context. We conducted a secondary analysis of cross-sectional data. Participants were 3765 unregulated (health care aides (HCAs)) and 1130 regulated staff (managers, registered nurses, registered psychiatric nurses (RN/RPNs) and licensed practical nurses (LPNs)) from 91 nursing homes in Western Canada. We measured nursing home staff’s perceptions of organizational context via the Alberta Context Tool (ACT), comprised of ten concepts: leadership, culture, evaluation, social capital, formal interactions, informal interactions, organizational slack (staff, space, time). Differences between groups were examined via one-way ANOVA. Managers reported significantly higher organizational context scores compared to all other staff members in care homes, followed by RN/RPNs. LPNs and HCAs reported the lowest scores. Specifically, LPNs reported the lowest scores on all organizational context measures except for structural resources and organizational slack space, for which HCAs reported the lowest scores. HCAs reported higher scores than LPNs on unit leadership, culture, evaluation, social capital. When compared with managers and RN/RPNs in the nursing home, LPNs reported the lowest SF-8 mental health scores (49.30 (10.05)) and HCAs reported the lowest physical health scores (48.53 (8.16)). Our work demonstrates the need for improvement of staffing and time for staff in nursing homes. Specific attention is needed to focus on modifiable organizational unit context factors for LPNs and HCAs, who are responsible for providing the majority of the direct care for residents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".