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Emotional demands and the risks of depression among homecare workers in the USA

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Abstract

Purpose

Homecare workers’ diversity of emotional demands and their relation to mental health problems have not yet been fully explored. The purpose of this study is to investigate the types of emotional demands on homecare workers and the association of these demands with depression.

Method

Data were collected from two surveys of a random sample of 1,599 homecare workers (June 2003–September 2003 and December 2003–February 2004). Depression was assessed using a 20-item RCES-D screening scale.

Results

Homecare workers appeared to have a variety of emotional demands: unfair treatment, client’s family abuse, unmet care needs, client health, and emotional suppression. In general, homecare workers were more likely to be exposed to their client health and emotional suppression (mean scores = 1.46–3.07) than to be exposed to unmet care needs, unfair treatment, and client’s family abuse (mean scores = 1.02–1.38). After adjusting for potential confounders, four emotional-demand factors (excluding the client health factor) were significantly associated with a high risk of subthreshold depression at Wave 1. In particular, the factor “unmet care needs” was an essential predictor of 6-month subthreshold depression at Wave 2.

Conclusion

This study illustrated the diversity of emotional demands among homecare workers and their association with depression. Our mixed findings regarding the cross-sectional and longitudinal analyses suggested that further research should refine the measurement of emotional demands and their relationship with mental health among homecare workers.

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References

  • Aderson NR (2008) Safe in the city. Home Healthc Nurse 26(9):534–540

    Article  Google Scholar 

  • Bakker AB, Demerouti E (2007) The job demands-resources model: state of the art. J Manag Psychol 22(3):309–328

    Article  Google Scholar 

  • Bonde JP (2008) Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occup Environ Med 65(7):438–445

    Article  CAS  Google Scholar 

  • Christiansen RH, Nielsen HO (2007) Survey highlights rise in psychosocial demands at work. Trends in working conditions 2000–2005. European foundation for the improvement of living and working conditions, Dublin

  • Cousineau MR (2000) Providing health insurance to IHSS providers (home care workers) in Los Angeles County. California HealthCare Foundation, Los Angeles

    Google Scholar 

  • Covinsky KE, Newcomer R, Fox P, Wood J, Sands L, Dane K, Yaffe K (2003) Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. J Gen Intern Med 18(12):1006–1014

    Article  Google Scholar 

  • Denton M, Zeytinoglu IU, Davies S (2003) Organizational change and the health and well being of home care workers. In: Denton M (ed) Social and economic dimensions of an aging population research papers. McMaster Univeristy Soical Sciences, Hamilton

    Google Scholar 

  • Denton MA, Zeytinoglu IU, Davies S, Hunter D (2006) The impact of implementing managed competition on homecare workers’ turnover decisions. Healthc Policy 4:106–123

    Google Scholar 

  • Eaton WW (2001) Center for epidemiologic studies depression scale-revised (CESD-R). In: VandeCRek L, Jackson TL (eds) Innovations in clinical practice. Professional Pesource Exchange, Sarasota, pp 295–297

    Google Scholar 

  • Eaton WW, Muntaner C, Smith C, Tien A (1999) The revised center for epidemiologic Studies Depression Scale (RCES-D). In: Maruish ME (ed) The use of psychological assessment for treatment planning and outcome assessment. Lawrence Erlbaum Associates, Mahwah, NJ, pp 363–378

    Google Scholar 

  • Ebenstein H (1998) They were once like us: learning from homecare workers who care for the elderly. J Gerontol Soc Work 30(3/4):191–201

    Google Scholar 

  • Eustis N, Kane R, Fischer L (1993) Home care quality and the home care worker: beyond quality assurance as usual. Gerontol 33(1):64–73

    Article  CAS  Google Scholar 

  • Findorff MJ, McGovern PM, Wall M, Gerberich SG, Alexander B (2004) Risk factors for work related violence in a health care organization. Inj Prev 10(5):296–302

    Article  CAS  Google Scholar 

  • Fitzwater ED, Gates DE (2000) Violence and home care: a focus group study. Home Healthc Nurse 18(9):596–605

    Article  CAS  Google Scholar 

  • Fleming G, Taylor BJ (2007) Battle on the home care front: perceptions of home care workers of factors influencing staff retention in Northern Ireland. Health Soc Care Comm 15(1):67–76

    Google Scholar 

  • Frith H, Kitzinger C (1998) Emotion work’ as a participant resource: a feminist analysis of young women’s talk-in-interaction. Sociology 32(2):299–320

    Article  Google Scholar 

  • Grandey A (2000) Emotional regulation in the workplace: a new way to conceptualize emotional labour. J Occup Health Psychol 5:95–110

    Article  CAS  Google Scholar 

  • Gross JJ (2001) Emotion regulation in adulthood: timing is everything. Curr Dir Psychol Sci 10:214–219

    Article  Google Scholar 

  • Hayashi R, Gibson JW, Weatherley RA (1994) Working conditions in home care: a survey of Washington state’s home care workers. Home HealthC Serv Q 14(4):37–48

    Article  CAS  Google Scholar 

  • Hochschild AR (1983) The managed heart: commercialization of human feeling. University of California Press, Berkley

    Google Scholar 

  • Kadushin G, Egan M (2006) Unmet patient need in home care under managed care. J Gerontol Soc Work 47(3–4):103–120

    Article  Google Scholar 

  • Kendler KS, Karkowski LM, Prescott CA (1999) Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry 156(6):837–841

    CAS  Google Scholar 

  • Kesselring A, Krulik T, Bichsel M, Minder C, Beck J, Stuck A (2001) Emotional and physical demands on caregivers in home care to the elderly in Switzerland and their relationship to nursing home admission. Eur J Public Health 11(3):267–273

    Article  CAS  Google Scholar 

  • Kessler RC (1998) The effects of stressful life events on depression. Annu Rev Psychol 48:191–214

    Article  Google Scholar 

  • Kim IH, Geiger-Brown J, Trinkoff A, Muntaner C (2010) Physically demanding workloads and risks of musculoskeletal disorders in homecare workers in the USA. Health Soc Care Comm 18(5):445–455

    Article  Google Scholar 

  • Kruml S, Geddes D (2000) Exploring the dimensions of emotional labor: the heart of Hochschild’s work. Manage Commun Q 14(1):8–49

    Article  Google Scholar 

  • Lewig KA, Dollard MF (2003) Emotional dissonance, emotional exhaustion and job satisfaction in call centre workers. Eur J Work Organ Psychol 12(4):366–392

    Article  Google Scholar 

  • Miller K, Birkholt M, Scott C, Stage C (1995) Empathy and burnout in human service work: an extension of a communication model. Commun Res 22:123–147

    Article  Google Scholar 

  • Montgomery AJ, Panagopolou E, Benos A (2005) Emotional labour at work and at home among Greek health-care professionals. J Health Organ Manage 19:395–408

    Article  Google Scholar 

  • Muntaner C, Li Y, Xue X, Thompson T, Chung H, O’Campo P (2006) County and organizational predictors of depression symptoms among low-income nursing assistants in the USA. Soc Sci Med 63(6):1454–1465

    Article  Google Scholar 

  • Muthén B, Kaplan D (1985) A comparison of some methodologies for the factor analysis of non-normal Likert variables. Brit J Math Stat Psy 38(2):171–189

    Article  Google Scholar 

  • Naring G, van Droffelaar A (2007) Incorporation of emotional labor in the Demand-Control-Support Model: the relation with emotional exhaustion and personal accomplishment in Nurses In: Charmine EJ, Hatel W, Ashkanasy NM, Zerbe WJ (eds), Functionality, intentionality and morality. Emerald Group Publishing Limited, Bingley, pp 221–236

  • Netterstrøm B, Conrad N, Bech P, Fink P, Olsen O, Rugulies R (2008) The relation between work-related psychosocial factors and the development of depression. Epidemiol Rev 30(1):118–132

    Article  Google Scholar 

  • Olsson E, Ingvad B (2001) The emotional climate of care-giving in home-care services. Health Soc Care Comm 9(6):454–463

    Article  CAS  Google Scholar 

  • Rae HM (1998) Managing feelings: caregiving as emotion work. Res Aging 20(1):137–160

    Article  Google Scholar 

  • Schermelleh-Engel K, Moosbrugger H, Muller H (2003) Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measure. Meth Psycho Res Online 8(2):23–74

    Google Scholar 

  • Söderfeldt B, Söderfeldt M, Jones K, O’Campo P, Muntaner C, Ohlson CG, warg LE (1997) Does organization matter? A multilevel analysis of the demand-control model applied to human services. Soc Sci Med 44(4):527–534

    Article  Google Scholar 

  • Steinberg RJ, Figart DM (1999) Emotional demands at work: a job content analysis. Annals 561:177–191

    Article  Google Scholar 

  • Suhr D (2003) Reliability, exploratory & confirmatory factor analysis for the scale of athletic priorities. In :Proceedings of the Twenty-eight Annual SAS Conference (SUGI 28), pp 274–28

  • Tepper K, Hoyle RH (1996) Latent variable models of need for uniqueness. Multivar Behav Res 31(4):467–494

    Article  Google Scholar 

  • van Daalen G, Willemsen TM, Sanders K, van Veldhoven MJPM (2009) Emotional exhaustion and mental health problems among employees doing “people work”: the impact of job demands, job resources and family-to-work conflict. Int Arch Occup Environ Health 82:291–303

    Article  Google Scholar 

  • van Vegchel N, de Jonge J, Söderfeldt M, Dormann C, Schaufeli W (2004) Quantitative versus emotional demands among Swedish human service employees: moderating effects of job control and social support. Int J Stress Manage 11(1):21–40

    Article  Google Scholar 

  • Wieclaw J, Agerbo E, Mortensen P, Burr H, Tuchsen F, Bonde J (2008) Psychosocial working conditions and the risk of depression and anxiety disorders in the Danish workforce. BMC Public Health 8(1):280. doi:10.1186/1471-2458-8-280

    Article  Google Scholar 

  • Williams J, Lyons B, Rowland D (1997) Unmet long-term care needs of elderly people in the community: a review of the literature. Home HealthC Serv Q 16(2):93–119

    Article  CAS  Google Scholar 

  • Zapf D (2002) Emotion work and psychological well-being: a review of the literature and some conceptual considerations. Hum Resour Manage R 12:237–268

    Article  Google Scholar 

  • Zapf D, Vogt C, Seifert C, Mertini H, Isic A (1999) Emotion work as a source of stress. The concept and development of an instrument. Eur J Work Organ Psychol 8(3):371–400

    Google Scholar 

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Acknowledgments

We would like to acknowledge Jeanne Geiger-Brown, Patricia Patchet-Golubev, and Tom Beechinor, who provided help and support. The Ontario Ministry of Health and Long Term Care provided support to CAMH for funding for fellows and infrastructure. The views expressed [here] do not necessarily reflect those of the Ministry of Health and Long Term Care.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, ON, Canada

    Il-Ho Kim & Samuel Noh

  2. Bloomberg School of Nursing, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Carles Muntaner

  3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Samuel Noh

Authors
  1. Il-Ho Kim
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  2. Samuel Noh
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  3. Carles Muntaner
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Correspondence to Carles Muntaner.

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Kim, IH., Noh, S. & Muntaner, C. Emotional demands and the risks of depression among homecare workers in the USA. Int Arch Occup Environ Health 86, 635–644 (2013). https://doi.org/10.1007/s00420-012-0789-x

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  • DOI: https://doi.org/10.1007/s00420-012-0789-x

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