‘Process-Related Incentives' Help Explain Job Satisfaction Among Nursing Home Social Service Directors

Purpose: Nursing home staff turn-over is a serious problem (Castle, 2009) which can contribute to poor resident care and poor quality of life. Recruiting and retaining well qualified social workers can contribute to improved resident care, especially psychosocial care. Turn-over is more likely among employees who are dissatisfied with their job. Italian scholars, Carlo Borzaga and Ermanno Tortia (2006) propose a model to explain job satisfaction in human services as well as loyalty to organizations. Their model specifies three types of incentives which are related to job satisfaction: “self-regarding incentives,” “process-related incentives” and “other-regarding incentives.” In this study, we test one aspect of the model—process-related incentives-- using a nationally representative sample of nursing home social service directors. Process-related incentives include: leaders' recognition of employee's contributions, flexible working hours, autonomy in working activities, and utilization of professional skills. The hypothesis is: the social service directors' job satisfaction in nursing homes is positively related to the set of “process-related incentives.” The findings can be used to identify changes that could improve the job satisfaction.

Method: This study uses data from a nationally-representative cross-sectional quantitative survey of 1,071 nursing home social service directors. The purpose of the 2006 survey was to characterize the nursing home social service work force. The response rate was 53%. Women comprise 93% of the sample, most respondents (89.6%) reported their race as white, 47.8% held BSW and MSW. In this paper, only full-time employees are included (n= 1,065). The dependent variable is social service directors' job satisfaction, measured using the survey question “To what extent do you agree with the following statement, ‘I am thriving in my job'.” Possible responses are in likert form ranging from “strongly disagree” to “strongly agree.” We used proxy measures from the survey as independent variables representing process-related incentives in a multiple regression equation.

Results: Regression analyses reveal support for the hypothesis, i.e., that the set of process-related incentive variables has statistically significant effects on nursing home social service directors' job satisfaction. The adjusted R2 is 23%, indicating that almost one-fourth of the variation in job satisfaction can be explained by process incentives. Each of the independent variables is significant in the regression equation, with the variable “autonomy in working activities” having the strongest effect on job satisfaction when controlling for the effects of the other variables (the standard beta=.192, p<.001). Implications: Evidence from this national survey supports the Borzaga & Tortia model of job satisfaction, and underscores the importance of process-related incentives such as recognition from one's boss and job autonomy. Findings suggest that one way to retain nursing home social service directors is to improve job satisfaction through “process-related incentives.” Our next step is to test the other two sets of incentives and determine the extent to which all three factors explain the variation in job satisfaction among nursing home social service directors.