Promoting a safety climate and safety activities for health and work ability in home care services workers

Purpose: The present study aims to describe home care service workers' perceptions of safety climate and safety activities at work as well as working conditions, self-efficacy, and health and work ability. Relevance: High frequencies of work-related musculoskeletal disorders and injuries and low prevalence of sustainable work ability in home care services workers are of great concern. They are to provide high quality services to an increasingly proportion of elderly people living in private homes. In order to promote health and safety for the home care workers, increased focus should be on organisational, psychosocial and physical factors contributing to a healthy working environment. Participants: 158 nursing assistants and nursing aides divided in 18 work units participated in this study. They all met the criterion of having worked in the same home care services unit in the last 6 months. Their mean age was 46 years, the majority were women, and the distribution of nursing aides and nursing assistants was about 40/60%. Methods: This study is based on cross-sectional data gathered in February 2009 in home care services in a municipality in the North of Sweden. All the home-care work units shared the experiences of using a model for participatory risk management in home care services. Data were obtained through a comprehensive self-administered questionnaire, covering working conditions, safety climate, safety activities, self-efficacy, health and work ability. Analysis: Descriptive statistics as well as data on between-group differences are analysed. Results: In general, the results showed fairly good levels of safety climate but only moderate levels of safety activities and of perceived safety grade at work. These variables differed significantly between work units. Environmental barriers, such as lack of time and equipment, were given as reasons for not complying with safety rules or participating in proactive risk assessment. Besides a high frequency of musculoskeletal symptoms and high physical exposure at work, the home care workers in general reported being in good health and with good work ability. They also expressed high decision making latitude, skill discretion, social support and self-efficacy. Conclusions: To promote health and safety for the home care workers, interventions could build on the high levels of safety climate and proactive activities in single work units, proposing good solutions and safe behaviour. Focus need to be placed on improved safety climate, communication and coordination with all professionals forming the home care services setting. Also, on individuals' and work units' awareness of safe behaviour and on alternatives of actions in critical risk situations at work. This may act preventive on musculoskeletal well-being and a good working environment. Implications: There need to be an increase in means given to physical therapists in occupational health services, to work with these issues. The ergonomic skills and the safety climate of the front-line home care services workers need to be addressed, as well as the organisational prerequisites for workplace safety and health.RR-PO-210-6-Thu Professional practice - Occupational healthGodkänd; 2011; 20111019 (agnlar)Hälsa och säkerhet i vård- och socialt servicearbete, i ett samhällsperspekti