Publications by authors named "Laura D Aloisio"

7 Publications

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Individual and organizational factors of nurses' job satisfaction in long-term care: A systematic review.

Int J Nurs Stud 2021 Nov 26;123:104073. Epub 2021 Aug 26.

University of Ottawa - School of Nursing, Ottawa Hospital Research Institute, General Campus, 501 Smyth Rd, Box 711, Ottawa, ON K1H 8L6, Canada. Electronic address:

Background: In long-term care facilities, nurses' job satisfaction predicts staff turnover, which adversely affects resident outcomes. Thus, it is important to develop a comprehensive understanding of factors affecting nurses' job satisfaction in long-term care facilities.

Objectives: To analyze factors associated with job satisfaction among nurses in nursing homes from individual and organizational perspectives utilizing a deductive approach.

Design: Systematic literature review SETTING: Nursing homes.

Participants: Registered nurses and licensed practical nurses in nursing homes.

Methods: A systematic literature review of seven online databases (EMBASE, CINAHL, PsychINFO, MEDLINE, PubMed, Scopus, and Web of Science) to July 23, 2020 was conducted. Studies were included if they examined factors associated job satisfaction in the target population and setting. Decision rules on how to determine factors important to nurse job satisfaction were developed a priori. Two team members independently screened the publications for inclusion, extracted data, and assessed included publications for methodological quality; conflicts were resolved through a consensus process and consultation of the third senior team member when needed.

Results: Twenty-eight studies were included. Of these, 20 studies were quantitative, 6 were qualitative, and 2 were mixed methods. Factors associated with job satisfaction were grouped into two categories: individual and organizational. Individual factors significantly associated with job satisfaction were age, health status, self-determination/autonomy, psychological empowerment, job involvement, work exhaustion, and work stress. Individual factors identified as not important or equivocal were gender and experience as a nurse/in aged care. No organizational factors were identified as important for nurses' job satisfaction. Facility ownership, supervisor/manager support, resources, staffing level, and social relationships were identified as equivocal or not important. Findings from qualitative studies identified relationship with residents as an important factor for job satisfaction.

Conclusions/implications: Factors identified as important to nurses' job satisfaction differ from those reported among care aides in nursing homes and nurses employed in acute care settings, suggesting that there is a need for unique approaches to enhance nurses' job satisfaction in nursing homes.
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http://dx.doi.org/10.1016/j.ijnurstu.2021.104073DOI Listing
November 2021

To whom health care aides report: Effect on nursing home resident outcomes.

Int J Older People Nurs 2021 Jul 11:e12406. Epub 2021 Jul 11.

Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Introduction: Health care aides (personal support workers and nursing assistants) provide ~80%-90% of direct care to residents in nursing homes; it is therefore important to understand whether supervision of health care aides affects quality of care. We sought to determine whether health care aide reporting practices are associated with resident outcomes in nursing homes.

Design And Methods: We conducted a cross-sectional secondary analysis of survey data of 3991 health care aides from 322 units in 89 nursing homes in Western Canada. We then linked resident data from the Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0 database to care aide surveys at the unit level. We used hierarchical mixed models to determine if the proportion of health care aides reporting to a respective nursing leader role was associated with 13 practice sensitive quality indicators of resident care.

Results: Most health care aides reported to a registered nurse (RN, 44.5%) or licenced practical nurse (LPN, 53.3%). Only 2.2% of health care aides reported to a care manager and were excluded from the analysis. Resident outcomes for only declining behavioural symptoms were more favourable when a higher proportion of health care aides (on a unit) reported to RNs, β = -0.004 (95% CI -0.006, -0.001, p = .004). The remaining indicators were not affected by care aide reporting practices.

Discussion And Implications: Resident outcomes as evaluated by the indicators appear largely unaffected by care aide reporting practices. LPNs' increasing scope of practice and changing work roles and responsibilities in nursing homes across Western Canada may explain the findings.
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http://dx.doi.org/10.1111/opn.12406DOI Listing
July 2021

Factors affecting job satisfaction in long-term care unit managers, directors of care and facility administrators: A secondary analysis.

J Nurs Manag 2019 Nov 2;27(8):1764-1772. Epub 2019 Oct 2.

University of Ottawa-School of Nursing, Ottawa, ON, Canada.

Aim: To identify demographic-, individual- and organisational-level predictors of job satisfaction among managers in residential long-term care (LTC) facilities.

Background: Job satisfaction predicts turnover among managers in LTC settings. However, factors affecting job satisfaction among LTC facility managers remain poorly understood.

Methods: A secondary analysis of data from Phase 2 of the Translating Research in Elder Care programme including 168 managers (unit managers, directors of care and facility administrators) from 76 residential LTC homes in three Canadian provinces. Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale was used to measure job satisfaction. Predictors of job satisfaction determined using general estimating equations.

Results: The efficacy subscale of burnout was positively predicted job satisfaction at the individual level (B = .104, p = .046). At the organisational level, social capital (B = .224, p = .018), adequate orientation (B = .166, p = .015) and leadership (B = .155, p = .018) were associated with higher job satisfaction.

Conclusions: These data suggest that improving LTC managers' self-perceived efficacy, leadership, social capital and adequate orientation may enhance their job satisfaction.

Implications For Nursing Management: Predictors of managers' job satisfaction are modifiable and therefore may be amenable to intervention.
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http://dx.doi.org/10.1111/jonm.12871DOI Listing
November 2019

Factors Associated With Nurses' Job Satisfaction In Residential Long-term Care: The Importance of Organizational Context.

J Am Med Dir Assoc 2019 12 6;20(12):1611-1616.e4. Epub 2019 Aug 6.

University of Ottawa, School of Nursing, Ottawa, Ontario, Canada.

Objectives: We examined demographic, individual, and organizational context factors associated with nurses' job satisfaction in residential long-term care (LTC) settings. Job satisfaction has implications for staff turnover, staff health, and quality of care.

Design: A cross-sectional analysis of survey data collected in the Translating Research in Elder Care program.

Setting And Participants: N = 756 nurses (registered nurses: n = 308; licensed practical nurses: n = 448) from 89 residential LTC settings in 3 Western Canadian provinces.

Methods: We used a generalized estimating equation model to assess demographic, individual, and organizational context factors associated with job satisfaction. Job satisfaction was measured using the Michigan Organizational Assessment Questionnaire Job Satisfaction Scale.

Results: Demographic, individual, and organizational context factors were associated with job satisfaction among nurses in residential LTC settings. At the demographic level, hours worked in 2 weeks (B = 0.002, P = .043) was associated with job satisfaction. At the individual level, emotional exhaustion-burnout (B = -0.063, P = .02) was associated with lower job satisfaction, while higher scores on empowerment (meaning) (B = 0.140, P = .015), work engagement (vigor) (B = 0.096, P = .01), and work engagement (dedication) (B = 0.129, P = .001) were associated with higher job satisfaction. With respect to organizational context, culture (B = 0.175, P < .001), organizational slack-space (eg, perceived availability and use of adequate space; B = 0.043, P = .040), and adequate orientation (B = 0.092, P < .001) were associated with higher job satisfaction.

Conclusions And Implications: We identified previously unexamined modifiable organizational features (organizational slack-space and adequate orientation) as factors associated with LTC nurses' job satisfaction in the Canadian context. Our findings support future efforts to improve job satisfaction through improvements in organizational space and provision of adequate workplace orientation.
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http://dx.doi.org/10.1016/j.jamda.2019.06.020DOI Listing
December 2019

Understanding context: A concept analysis.

J Adv Nurs 2019 Dec 4;75(12):3448-3470. Epub 2019 Sep 4.

School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Victoria, Australia.

Aims: To conduct a concept analysis of clinical practice contexts (work environments) in health care.

Background: Context is increasingly recognized as important to the development, delivery, and understanding of implementation strategies; however, conceptual clarity about what comprises context is lacking.

Design: Modified Walker and Avant concept analysis comprised of five steps: (1) concept selection; (2) determination of aims; (3) identification of uses of context; (4) determination of its defining attributes; and (5) definition of its empirical referents.

Methods: A wide range of databases were systematically searched from inception to August 2014. Empirical articles were included if a definition and/or attributes of context were reported. Theoretical articles were included if they reported a model, theory, or framework of context or where context was a component. Double independent screening and data extraction were conducted. Analysis was iterative, involving organizing and reorganizing until a framework of domains, attributes. and features of context emerged.

Result: We identified 15,972 references, of which 70 satisfied our inclusion criteria. In total, 201 unique features of context were identified, of these 89 were shared (reported in two or more studies). The 89 shared features were grouped into 21 attributes of context which were further categorized into six domains of context.

Conclusion: This study resulted in a framework of domains, attributes and features of context. These attributes and features, if assessed and used to tailor implementation activities, hold promise for improved research implementation in clinical practice.
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http://dx.doi.org/10.1111/jan.14165DOI Listing
December 2019

Attributes of context relevant to healthcare professionals' use of research evidence in clinical practice: a multi-study analysis.

Implement Sci 2019 05 22;14(1):52. Epub 2019 May 22.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Background: To increase the likelihood of successful implementation of evidence-based practices, researchers, knowledge users, and healthcare professionals must consider aspects of context that promote and hinder implementation in their setting. The purpose of the current study was to identify contextual attributes and their features relevant to implementation by healthcare professionals and compare and contrast these attributes and features across different clinical settings and healthcare professional roles.

Methods: We conducted a secondary analysis of 145 semi-structured interviews comprising 11 studies (10 from Canada and one from Australia) investigating healthcare professionals' perceived barriers and enablers to their use of research evidence in clinical practice. The data was collected using semi-structured interview guides informed by the Theoretical Domains Framework across different healthcare professional roles, settings, and practices. We analyzed these data inductively, using constant comparative analysis, to identify attributes of context and their features reported in the interviews. We compared these data by (1) setting (primary care, hospital-medical/surgical, hospital-emergency room, hospital-critical care) and (2) professional role (physicians and residents, nurses and organ donor coordinators).

Results: We identified 62 unique features of context, which we categorized under 14 broader attributes of context. The 14 attributes were resource access, work structure, patient characteristics, professional role, culture, facility characteristics, system features, healthcare professional characteristics, financial, collaboration, leadership, evaluation, regulatory or legislative standards, and societal influences. We found instances of the majority (n = 12, 86%) of attributes of context across multiple (n = 6 or more) clinical behaviors. We also found little variation in the 14 attributes of context by setting (primary care and hospitals) and professional role (physicians and residents, and nurses and organ donor coordinators).

Conclusions: There was considerable consistency in the 14 attributes identified irrespective of the clinical behavior, setting, or professional role, supporting broad utility of the attributes of context identified in this study. There was more variation in the finer-grained features of these attributes with the most substantial variation being by setting.
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http://dx.doi.org/10.1186/s13012-019-0900-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530177PMC
May 2019

Individual and organizational predictors of allied healthcare providers' job satisfaction in residential long-term care.

BMC Health Serv Res 2018 06 25;18(1):491. Epub 2018 Jun 25.

School of Nursing, University of Ottawa, Roger Guindon Hall Room 3051, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.

Background: Job satisfaction is a predictor of intention to stay and turnover among allied healthcare providers. However, there is limited research examining job satisfaction among allied health professionals, specifically in residential long-term care (LTC) settings. The purpose of this study was to identify factors (demographic, individual, and organizational) that predict job satisfaction among allied healthcare providers in residential LTC.

Methods: We conducted a secondary analysis of data from Phase 2 of the Translating Research in Elder Care program. A total of 334 allied healthcare providers from 77 residential LTC in three Western Canadian provinces were included in the analysis. Generalized estimating equation modeling was used to assess demographics, individual, and organizational context predictors of allied healthcare providers' job satisfaction. We measured job satisfaction using the Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale.

Results: Both individual and organizational context variables predicted job satisfaction among allied healthcare providers employed in LTC. Demographic variables did not predict job satisfaction. At the individual level, burnout (cynicism) (β = -.113, p = .001) and the competence subscale of psychological empowerment (β = -.224, p = < .001), were predictive of lower job satisfaction levels while higher scores on the meaning (β = .232, p = .001), self-determination (β = .128, p = .005), and impact (β = .10, p = .014) subscales of psychological empowerment predicted higher job satisfaction. Organizational context variables that predicted job satisfaction included: social capital (β = .158, p = .012), organizational slack-time (β = .096, p = .029), and adequate orientation (β = .088, p = .005).

Conclusions: This study suggests that individual allied healthcare provider and organizational context features are both predictive of allied healthcare provider job satisfaction in residential LTC settings. Unlike demographics and structural characteristics of LTC facilities, all variables identified as important to allied healthcare providers' job satisfaction in this study are potentially modifiable, and therefore amenable to intervention.
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http://dx.doi.org/10.1186/s12913-018-3307-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019323PMC
June 2018
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