1. WHAT CAN WE LEARN FROM COMPARING JOB AUTONOMY OF ASSISTIVE PERSONNEL IN SIX COUNTRIES? RE-IMAGING LONG-TERM RESIDENTIAL CARE; AN INTERNATIONAL STUDY OF PROMISING PRACTICES (FUNDED BY THE SOCIAL SCIENCES AND RESEARCH COUNCIL OF CANADA – MAJOR COLLABORATIVE RESEARCH INITIATIVE -MCRI) BY PREETI ZANWAR (USA), KATE LAXER (CANADA), SUZANNE DAY (CANADA), FRODE JACOBSEN (NORWAY), LIZ LLOYD (UK), MONIKA GOLDMANN (GERMANY), MARTA SZEBEHELY (SWEDEN), JACQUELINE CHOINIERE (CANADA), PAULINE VAILLANCOURT ROSENAU (USA) PRESENTED BY PAULINE ROSENAU PANEL ON PROFESSIONAL/NON-PROFESSIONAL WORK MCRI CONFERENCE, BERGEN, NORWAY MAY 14, 2014 1

2. WHY STUDY AUTONOMY OF ASSISTIVE PERSONNEL Job Autonomy  Important Social Determinant of Health  Health of workers  Happiness of workers  Overall Wellbeing  Quality higher  Productivity greater Lack of Job Control / Job Flexibility  Stress, Mental disorders, Depression, Anxiety  Risk for Coronary heart disease, musculoskeletal injuries  Low job satisfaction 2

3. 3 Source: Karasek & Theorell, 1990, p. 66

4. MULTIPLE METHODS  On site visits  Nursing home records  Training manuals, organizational charts  Staff data (training level, demographics, absentee rates, turnover information)  Interviews - nursing home executive officers, medical directors, nursing staff, assistive personnel, all support staff.  Observation of assistive personnel (on all shifts - day and night)  Data to supplemental case study material: -Organisation for Economic Co-Operation and Development (OECD) databases -National databases of all six countries -Comparative Perspectives on Precarious Employment Database (CPD) 4

5. PRELIMINARY FINDINGS Based on  U.S. and Canada: complete  Britain and Norway: in process, site visit complete  Germany, and Sweden: to be completed in late May 2014 Workers value autonomy : signifies trust and respect Formal Institutional level policies – wide variation Implementation of policies – theoretical Policies trickle down to workers  Same institution, different reports…. Why?  Imperfect or incomplete implementation?  differential application?  Role of perception 5

6. CONCLUSION Autonomy is desirable and can be beneficial for individual workers and institutions However, it goes against dominant management philosophy in place for decades  Autonomy is viewed as power  Power is assumed to be zero-sum  Dispersing power is viewed as a “loss” Benefits of worker autonomy to institution are underestimated  Cost to institution of autonomy is low  Important for attracting employees 6

7. LIMITATIONS  Generalizability  Autonomy not measured  Health outcomes for individual workers not measured 7

8. ACKNOWLEDGEMENTS Co-Authors Preeti Zanwar (USA) Kate Laxer (Canada) Suzanne Day (Canada) Frode Jacobsen (Norway) Liz Lloyd (UK) Monika Goldmann (Germany) Marta Szebehely (Sweden) Jacqueline Choiniere (Canada) 8