Exploring the Role of Client Death Support in Home Care Workers' Grief, Stress, and Job Satisfaction

这个指导研究科学家发展奖（K 01）的目的是帮助我成为一个 独立的职业健康研究人员，使用多学科的社会科学方法进行 使低收入工人受益的干预研究;在这种情况下，家庭护理工作者（HCW）。保护和 促进大量且迅速增加的HCW人口的健康对于我们的卫生系统至关重要 提供所需护理的能力。对这一人群来说，一个持续的、不可避免的、未解决的压力源是 客户死亡。本研究将采用深入的多方法研究设计来描述HCW的来源 以及在客户死亡后使用的支持类型;以测试客户死亡支持与 减少悲伤困扰，减少感知压力，提高工作满意度;并制定可行的 以工作场所为基础的干预，以增加客户的死亡支持。分析将集中在一个不同的样本， 从纽约市的两家大型家庭护理机构招募的讲英语的HCW采取不同的 客户死亡支持的方法。这项研究将提供洞察客户死亡支持的哪些方面 与减少悲伤和压力，增加工作满意度有关，因此是重要的一步， 朝着减少医务工作者职业压力和人员流动的长期目标努力。K 01的训练 将使我1）发展职业压力理论的专业知识，2）获得职业技能， 流行病学和生物统计学，3）深入了解悲伤理论，4）掌握以下技能 心理测量和因素分析。我的职业发展计划包括具体的课程，会议， 指导阅读，研讨会，动手实践，并与由专家组成的团队进行量身定制的指导， 家庭护理劳动，悲伤，工作压力，职业流行病学，因素分析和回归。这个项目是 与NIOSH在医疗保健和社会援助部门的优先事项保持一致，鼓励 提案侧重于家庭环境，以及健康工作设计和福利跨部门（具体而言， 工作组织和压力相关障碍的战略目标1）。该项目也符合NIOSH的 R2 P倡议，它与家庭护理机构合作，并积极寻求将研究结果转化为 可行的干预想法，并得到关键利益攸关方的投入。我这项研究的主要目标是 未来R 01的基础，以开发和评估多方面的客户死亡支持干预，以减少 HCW悲伤和压力，提高工作满意度。产出将包括至少5篇同行评审文章， 至少3次会议演讲，以及客户死亡支持的新措施。中期成果将 包括文献中的引用，以及支持雇主机构，工会， 研究人员实施制定的干预措施。通过以下方式获得的新技能和经验 这个K 01将帮助我实现我的职业目标，成为一名独立的职业健康研究人员 进行创新的干预导向混合方法研究。

The purpose of this Mentored Research Scientist Development Award (K01) is to help me become an independent occupational health researcher who uses multidisciplinary social science methods to conduct intervention research benefitting low-income workers; in this case, home care workers (HCWs). Protecting and promoting the health of the large and rapidly expanding population of HCWs is essential to our health system's ability to provide needed care. One persistent, unavoidable, and unaddressed stressor for this population is client death. The proposed study will use an in-depth, multimethod study design to describe HCWs' sources and types of support used after client death; to test the hypotheses that client death support is associated with reduced grief distress, reduced perceived stress, and increased job satisfaction; and to develop feasible workplace-based intervention to increase client death support. Analyses will focus on a diverse sample of English-speaking HCWs recruited from two large home care agencies in New York City taking different approaches to client death support. This research will provide insight into which aspects of client death support are associated with reduced grief and stress, and increased job satisfaction, and thus is an important step toward a long-term goal of reducing occupational stress and turnover among HCWs. The training from this K01 will allow me to 1) develop expertise in theories of occupational stress, 2) acquire skills in occupational epidemiology and biostatistics, 3) develop an in-depth understanding of grief theories, and 4) acquire skills in psychometrics and factor analysis. My career development plan includes specific coursework, conferences, directed readings, seminars, hands-on practica, and tailored mentoring with a team comprised of experts in home care labor, grief, work stress, occupational epidemiology, factor analysis, and regression. This project is strongly aligned with NIOSH's priorities in the Healthcare and Social Assistance sector, which encourages proposals focused on home settings, and the Healthy Work Design and Well-Being cross-sector (specifically, Strategic Goal 1 for Work Organization and Stress Related Disorders). This project also aligns with NIOSH's R2P Initiative in that it partners with home care agencies and actively seeks to translate research findings into feasible intervention ideas, with input from key stakeholders. My primary goal for this research is to lay a solid foundation for a future R01 to develop and evaluate a multifaceted client death support intervention to reduce HCW grief and stress and increase job satisfaction. Outputs will include at least 5 peer-reviewed articles, at least 3 conference presentations, and new measures of client death support. Intermediate outcomes will include citations in the literature, as well as supporting the efforts of employer agencies, unions, and researchers to implement the intervention ideas developed. The new skills and experience acquired through this K01 will help me to achieve my career goal of becoming an independent occupational health researcher who conducts innovative intervention-oriented mixed methods research.