Country: USA Sample size: n = 255 Subjects: CNAs employed in 14 residential care facilities
Questionnaire
Social organizational variables: number of beds, occupancy rate, immediate supervisor status, NA employment status, CNA overtime hours, NA night shift, nursing director length of employment, nursing director professional membership, administrator education, proportion of Medicaid residents, proportion of Medicare residents, number of children living with NA, CNA satisfaction with religious life Work role relations variables: positive and negative resident relations, positive and negative supervisor relations, positive and negative visitor relations CNA job stress
Quinn and Staines Job Satisfaction Scale
= 0.76
Not reported
Weak
Allensworth-Davies [47], Health Care Management Review (2007)
Cross-sectional survey (single group)
Country: USA. Sample size: n = 135 Subjects: NAs at 4 new England’s residential care facilities
Questionnaire
(i) Workplace cultural competency (ii) Age (iii) Racioethnicity (iv) Autonomy
General satisfaction scale from the Job Diagnostics Survey (5 items)
Not reported
Not reported
Weak
Berg [48], Scandinavian Journal of Rehabilitation Medicine (1976)
Cross-sectional survey (single group)
Country: Sweden Sample size: n = 233 Subjects: CNAs in one geriatric LTC hospital (20 wards)
Questionnaire
(i) Determinants for the mean scores of the seven scales (one of them “satisfaction with the work itself”): age, length of employment, and training course passed yes/no (ii) Determinants for the overall JS question (the seven questionnaire scales): (1) satisfaction with the work itself, (2) perceived strain, (3) adjustment to geriatric work, (4) relation with colleagues and supervisors, (5) perceived need for info., (6) perceived demand for physical and psychic strength, and (7) perceived need for education
53 items (7 scales) in the entire questionnaire; 4 items in one scale were related to JS
Country: USA. Sample size: n = 188 (sample size reduced to 88 in regression due to application of the listwise procedure) Subjects: CNAs (number of residential care facilities not reported)
Questionnaire
(i) Intervention: training (ii) Regression: tested knowledge of how to perform care tasks, perceived knowledge of how to perform care tasks, sex, age, education, length of employment, race, and degree of religiosity
Each of the 3 items were borrowed from the JS scale developed by Kahn (1964) [50]
Not reported
Not reported
Weak
Braun [51], Journal of Elder Abuse and Neglect (1997)
Before-and-after
Country: USA Sample size: n = 105 Subjects: CNAs (number of NHs not reported)
Questionnaire
Elder abuse and neglect prevention training (locally developed program consisting of videos, booklet, and interactive workshop)
Asked to rate their level of JS on a scale from 1 to 10
Country: USA Sample size: n = 2,254 Subjects: CNAs within 516 NHs
Computer-assisted telephone interviewing (CATI) system where interviewers asked questions over the telephone (Data from the existing National Nursing Assistant Survey and National Nursing Home Survey)
Fixed effects work-related factors Level 1 (individual CNA) Supportive supervision, perception of being valued, work-related injury, hourly wage, employee benefits, health insurance Level 2 (residential care facilities) Bed sizes, for-profit/nonprofit, location (metropolitan, micropolitan, rural), percent of Medicare residents, percent of Medicaid residents, RN HPPD, LPN HPPD, CNA HPPD Personal factors Age (years), white/nonwhite, education level (high school or less), number of jobs in the past 5 years (0–5+)
A single-item measure for an overall measure of JS. The item was scored using a 4-point Likert-type scale, ranging from 1 (extremely dissatisfied) to 4 (extremely satisfied)
Not reported
Not reported
High moderate
Cready [54], Journal of Gerontological Nursing (2008)
Cross-sectional (single group)
Country: USA Sample size: n = 434 Subjects: HCAs and nurses from 10 NHs
Questionnaire
Empowerment (low, medium, or high)
Not reported—authors stated that “when available, items were taken from previous studies [55]”
Country: USA Sample size: n = 349 Subjects: CNAs in 10 NHs (5 PACE, 5 non-PACE)
Questionnaire
(i) Demographics (age, education, experience with elderly in childhood) (ii) Job description (iii) Working in PACE versus regular residential care facilities
(i) Minnesota Satisfaction Questionnaire (ii) Two questions rated on a scale from 1–5 on: (iii) “how satisfied they were with their current job” (iv) “how likely they were to leave their job in the next year”
Country: USA Sample size: n = 138 Subjects: NAs from 45 NHs
Questionnaire
Fifteen items broken down into four groups: (i) Supervision (having necessary supplies; enough time; amount of work manageable; access to necessary info; knowing how supervisor is evaluating you; not knowing what supervisor expects; being sure of what supervisor wants; conflicting orders from people in authority) (ii) Personal recognition (supervisor asks for your opinion; others care how well you do your job) (iii) Family/work conflict (job interferes with family life; family life interferes with job) (iv) Qualifications (wish for more training; feel qualified)
Modification of Kahn et al. (1964) [50] Job Satisfaction Scale
α = 0.74
Not reported
Low moderate
Gittell [58], Human Resource Management Journal (2008)
Cross-sectional survey (single group)
Country: USA Sample size: n = 252 Subjects: CNAs from 2 specific units at 15 different LTC facilities (10 nonprofit and 5 for-profit)
Questionnaire
(i) Demographics (ii) Facility characteristics (size and ownership) (iii) Relational coordination (communication and relationships)
One JS item “overall, how satisfied are you with your job?”
Not reported
Not reported
Low moderate
Goldwasser [59], Journal of Mental Health and Aging (1996)
RCT (with four groups)
Country: USA Sample size: n = 27 Subjects: CNAs in one LTC facility
Questionnaire
(i) Model of care (reminiscence versus present focused) (ii) Present during resident interviews versus not present during interviews
Short form of the Minnesota Satisfaction Questionnaire (20 items)
Internal consistency coefficients of the subscales range from 0.80 s to 0.90 s
Not reported
Weak
Grieshaber [60], The Health Care Supervisor (1995)
Cross-sectional survey design (2 groups)
Country: USA Sample size: n = 79 Subjects: CNAs
Questionnaire
(i) Facility type (urban versus suburban) (ii) Age (iii) Education (iv) Job tenure (v) Occupation tenure
Short form of the Minnesota Satisfaction Questionnaire
Reliable in other studies, but no numbers were reported
Country: USA Sample size: n = 148 Subjects: CNAs from 10 NHs
Questionnaire
(i) Motivation factors: achievement, recognition, work itself, responsibility, possibility of growth, and advancement (ii) Hygiene factors: salary, technical supervision, company policy, interpersonal relationships with peers, interpersonal relationships with supervisors, working conditions, security, status, personal life, and interpersonal relationship with nurse
Modified version of the JS instrument developed by Kroen which incorporates motivation/hygiene theory
JS scale has a reliability of 0.84 and the JDS scale has a reliability of 0.79 (as tested by Kroen)
Country: USA Sample size: n = 60 Subjects: CNAs from 12 residential care facilities
Questionnaire
(i) Service quality (ii) Psychological empowerment
The Benjamin Rose Job Satisfaction Survey (JSS; 18 items)
α = 0.93 (overall score)
Not reported
Low moderate
Kovach [9], Research in Gerontological Nursing (2010)
Cross-sectional survey (single group)
Country: USA Sample size: n = 177 Subjects: CNAs in 3 residential care facilities
Questionnaire
(i) Personality traits, for example, adjustment, prudence, likeability, being excitable, being dutiful (ii) Job performance
The General Job Satisfaction Scale (5 items)
The internal consistency of the GJS for this sample was 0.57
Prior evidence of construct validity: negative relations to organizational size and positive relations with job level, tenure, performance, and motivational fit with work
Country: Taiwan Sample size: n = 114 Subjects: NAs from 28 residential care facilities
Questionnaire
(i) Organizational empowerment (ii) Demographic variables, for example, nationality, age, marital status, educational level, work duration at a facility
Short form of the Minnesota Satisfaction Questionnaire (MSQ; 20 items)
α = 0.87 (overall score)
Not reported
Low moderate
Lerner [65], Journal of Nursing Administration (2011)
Cross-sectional survey (single group)
Country: USA. Sample size: n = 556 Subjects: NAs from 12 skilled nursing facilities
Survey pre- and postintervention
(i) Skilled nursing facility site (ii) Age (iii) Gender (iv) Education (v) Years of experience (vi) Self-esteem (vii) Self-efficacy (viii) Outcome expectations for performance of restorative care activities (ix) Observed performance of restorative activities
Job attitude scale (17 items) measuring 5 components; pay factors, organizational factors, task requirements, job status, and autonomy Response options range from 1 (strongly disagree) to 5 (strongly agree)
Not reported
Validity in previous studies by significant relation between its scores and scores of the Minnesota Satisfaction Scale
Country: Taiwan Sample size: n = 244 Subject: CNAs from 17 residential care facilities
Questionnaire
(i) Marital status (ii) Full time versus part time (iii) Length of tenure (iv) Feelings toward the job (v) Intention to quit (vi) JS Facet 2 (work performance and rewards)
Designed by author according to relevant theoretical literatures and addressed 5 main dimensions of job satisfaction
α = 0.81
Not reported
High moderate
McGilton [67],
Journal of Nursing Administration (2007)
Cross-sectional survey (single group)
Country: Canada Sample size: n = 222 Subjects: CNAs in 10 LTC facilities
Questionnaire
(i) CNA characteristics (age, gender, education, experience working in LTC, ethnicity [origin of birthplace, Canadian versus non-Canadian and first language, English versus non-English]) (ii) Job stress (iii) Supervisory support
Nursing Job Satisfaction Scale (42 items)
α = 0.89 (total scale) α = 0.88–0.95 (subscales)
Not reported
High moderate
Parmelee [68], Journal of American Medical Directors Association (2009)
Cross-sectional survey (single group)
Country: USA Sample size: n = 188 Subjects: NAs registered at the 2006 conference of the National Association of Health Care Assistants
Questionnaire
(i) Perceived barriers to job performance (ii) Teamwork (iii) Job stress (iv) Respect (v) Workload (vi) Exclusion (vii) New NAs
Benjamin Rose Institute Nurse Assistant Job Satisfaction Scale (18 items)
α = 0.95
Not reported
High moderate
Parsons [33], Journal of Gerontological Nursing (2003)
Cross-sectional survey (single group)
Country: USA Sample size: n = 550 Subjects: HCAs from 70 LTC facilities
Questionnaire
(i) Demographics: age, race, sex, marital status, education and education goals, family responsibilities, work characteristics (does not specify what) (ii) Seven factors: (1) task rewards, (2) social rewards, (3) supervision, (4) benefits, (5) personal opportunity, (6) coworker support, (7) salary and management keeping employees informed (iii) Turnover
Developed their own: overall satisfaction (3 items)
Not reported
Not reported
Weak
Proenca [69], Academy of Management Annual Meeting Proceedings (2008)
Cross-sectional survey (single group)
Country: USA Sample size: n = 129 Subjects: CNAs from 6 residential care facilities
Subscales from the Job Diagnostic Survey and the Michigan Org. Assessment Questionnaire were used to measure job satisfaction and turnover intentions
α’s >0.80
Not reported
Low moderate
Purk [70], Journal of Housing for the Elderly (2006)
Cross-sectional survey (single group)
Country: USA Sample size: n = 34 Subjects: CNAs from 5 facilities
Questionnaire
(i) Pay, promotion, supervision, work on present job, people at work (ii) Perceived emotional and physical stress (iii) Intent to quit within the next 3 months (iv) Intent to quit within the next year
The Job Descriptive Index (JDI) and the Job in General Scale (JIG)
Not reported
Not reported
Weak
Ramirez [71], Journal of Mental Health and Aging (1998)
Cross-sectional survey (single group)
Country: USA Sample size: n = 337 Subjects: HCAs from 20 residential care facilities
Structured (face-to-face interviews)
Work related demands and stressors (i) NA workload (ii) NA perceived bias (iii) Work environment evaluation Work resources (i) NA training (ii) Work-related support Individual resources Years working as a NA SCU Assignment
Adaption of Cantor and Chichin Job Satisfaction Scale (5 items)
Internal consistency coefficient for the 5-item set was 0.41 in this study
Convergence validity: “prior use of the NAJAS in a sample of 286 certified nurse aides resulted in findings similar to those found by other measures of job satisfaction”
High moderate
Snow [74], Nursing Homes/Long Term Care Management (2007)
Cross-sectional survey (single group)
Country: USA Sample size: n = 121 Subjects: HCAs at assisted living and skilled nursing facilities
Questionnaire
(i) Pursuing education (ii) Expansion of scope of practice
Country: USA Sample size: n = 66 Subjects: CNAs, 5 RNs, and 1 administrator in one residential care facility
Questionnaire
Leadership characteristics of administrators and registered nurses: (i) Modeling the way (ii) Inspiring a shared vision (iii) Challenging the process (iv) Enabling others to act (v) Encouraging the heart
The Benjamin Rose Nurse Assistant Job Satisfaction Survey
Country: USA Sample size: n = 185 Subjects: HCAs and charge nurses from one residential care facility
Questionnaire
(i) Demographic variables (age, education, number of years since training, years of experience) (ii) Job performance variables (iii) Absenteeism variables (iv) Variables of perceptions of the work environment
The Job Descriptive Index (JDI) and the Job in General Scale (JGS) and 2 items from the Quality of Employment survey (QES) measuring overall JS
Quasi-experimental (nonequivalent control group design with pre- and posttest)
Country: USA Sample size: n = 178 Subjects: CNAs from 2 residential care facilities
Questionnaire
Recognition and rewards training program
The Nurse Assistant Assessment Survey Instrument: Job Satisfaction which was developed by Iowa CareGivers Association and Hill Simonton Bell (1998) (48 items)
Mixed methods (before-and-after with small amount of qualitative data)
Country: USA Sample size: not reported Subjects: work teams of 5 residential care facilities with intervention implemented and 5 work teams from 5 other residential care facilities as control
Quantitative: questionnaires Qualitative: (i) Participating observations, of over 270 CNA team meetings (ii) Examination of weekly team-meeting summaries for management and management’s responses
Empowerment
Index in CNA survey (details of items not reported)
CNA survey indices ranged from 0.60 to 0.85 (specific index for JS not reported)
Factor analysis to determine items in all survey indices
Country: USA Sample size: n = 43 Subjects: management staff members and DCWs in 2 ALFs
(i) Participant observation (ii) In-depth and informal interviews
(i) No predefined individual variables (ii) Open-ended interviews were used to find out what individual variables are important from the participants’ perspectives
Participant observations and qualitative interviews
N/A
N/A
Strong
Bye [82], Nursing Homes and Senior Citizen Care (1987)
Qualitative cross-sectional interview
Country: USA Sample size: n = 30 Subjects: NAs from 3 residential care facilities
Semistructured cross-sectional interview study
(i) No predefined individual variables (ii) Open-ended interviews were used to find out what individual variables are important from the participants’ perspectives
Asked participants for their subjective perceptions of what satisfied them in their jobs
N/A
N/A
Weak
Karner [83], Journal of Gerontological Nursing (1998)
Qualitative cross-sectional ground theory
Country: USA Sample size: 17 Subjects:CNAs (article focused on CNAs but respondents included other staff members)
Semistructured guided intensive interviews
(i) No predefined individual variables (ii) Open-ended interviews were used to find out what individual variables are important from the participants’ perspectives
Asked participants for their subjective perceptions of what impacts their satisfaction
Country: Australia Sample size: n = 13 Subjects: CNAs (plus 9 RNs and 5 ENs)
Focus group interviews
(i) No predefined individual variables (ii) Open-ended focus groups were used to find out what individual variables are important from the participants’ perspectives
Focus groups: subjective views and opinions of the interviewed individuals or group meanings, respectively
Mixed methods: qualitative long interview study with survey
Country: USA Sample size: n = 14 Subjects: CNAs of one residential care facility
Semistructured, open-ended interviews
(i) No predefined individual variables (ii) Open-ended interviews were used to find out what individual variables are important from the participants’ perspectives
Asked participants for their subjective perceptions of what satisfied them in their jobs. Started with 2 open-ended job satisfaction questions
Mixed methods: before-and-after with small amount of qualitative data
Country: USA Sample size: not reported Subjects: CNAs
Quantitative: questionnaires Qualitative: (i) Participating observations, of over 270 CNA team meetings (ii) Examination of weekly team-meeting summaries for management and management’s responses
Empowerment
Index in CNA survey (details of items not reported)
CNA survey indices ranged from 0.60 to 0.85 (specific index for JS not reported)
Factor analysis to determine items in all survey indices
Weak
These studies are listed as both quantitative and qualitative as they employed a mixed methods study design. The overall study design is quasi-experimental. The explanatory variables from these studies used in our analysis are the independent variables, not the experimental variable(s). ALF: assisted living facility, CNA: certified nursing assistant, DCW: direct care worker, EN: enrolled nurses, HCA: health care aides, HPPD: hours per patient day, JS: job satisfaction, LTC: long-term care, NA: nursing assistant, PACE: Program of All-Inclusive Care for the Elderly, RN: registered nurse, and SCU: special care unit.
