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Job satisfaction, strain and stress of conscience among nurse assistants working in residential care for older people


Summary, in English

The overall aim of the thesis was to investigate and explore job satisfaction, strain and stress of conscience (SC) among nurse assistants (NAs) working in residential care for older people. The thesis had a descriptive, cross-sectional and correlational design and

consisted of one paper where qualitative methodology was used and three where quantitative methodology was used. The qualitative study (I) was based on six focus group interviews with NAs (n=36) and the quantitative studies (II-IV) were based on questionnaires. A total of 225 NAs participated in studies II-III and a sub sample of these NAs (n=114) participated in study IV. All data was collected in the south of Sweden. A conventional content analysis was used for exploring the NAs’ experiences of job satisfaction (I), and descriptive and analytical statistics were used in order to investigate and explore associations of job satisfaction (II), strain/SC (III) and associated variables. In addition the psychometric properties in terms of the construct validity, data quality and reliability were investigated for the instruments used as dependent variables (IV). The results showed that the NAs’ job satisfaction and strain/SC constitute a complex web of interrelated aspects. Study I showed that the NAs’ job satisfaction was based on the encounter with the residents and their next of kin and the ability to establish significant relationships with them. They also experienced job satisfaction when they had the prerequisites to use and develop their competence and when they worked in a harmonious and inspiring environment. In studies II and III a positive caring climate was associated with high levels of job

satisfaction and inversely to low levels of strain/SC. In addition the extent of personalizing care, amount of organizational and environmental support and, leadership also contributed to positive as well as negative aspects of their wellbeing. Furthermore, health complaints showed to be related to negative affectivities of work. The psychometric properties of the instruments used in studies II-IV showed varying strengths and weaknesses (IV) and further development is thus needed. In conclusion, getting the prerequisites for providing high quality care, a positive caring climate, a high extent of personalizing care, a high amount of organizational and environmental support and last but not least having leaders and managers with good leadership characteristics appears to be important for the NAs’ wellbeing at work.







Lund University Faculty of Medicine Doctoral Dissertation Series






Department of Health Sciences, Lund University


  • Health Sciences


  • Job satisfaction
  • strain
  • stress
  • stress of conscience
  • nurse assistants
  • residential care
  • long-term care
  • quality of care
  • leadership
  • person-centred care
  • caring climate
  • health complaints
  • psychometric properties




  • Older people's health and Person-Centred care


  • ISSN: 1652-8220
  • ISBN: 978-91-87651-07-6


7 december 2013




SSSH-salen (H01), Health Science Center (HSC), Baravägen 3, Lund