Home health aides’ experiences of their occupational health: a qualitative meta-synthesis

Abstract Objective: The need for home care services is rapidly growing due to an increasing elderly population, earlier discharge from hospital and clients’ preference of being treated at home. While this need increases, there is high sickness absence among home health aides, and research show that home health aides have one of the highest probabilities of being granted a disability pension. A high prevalence of musculoskeletal disorders has been reported in occupations with physically demanding work, and this aspect is a major health problem among home health aides. Studies have shown that home health aides find their work stressful, physically demanding and exhausting. The objectives of this study were to summarise peer-reviewed literature on how home health aides experience their occupational health and conduct an ethnographic meta-synthesis with the aim of identifying and describing key concepts across studies. Methods: A qualitative ethnographic meta-synthesis was used to develop new insights into home health aides’ occupational experiences. By using this method, we directed attention to the interpretation of studies, development of concepts and expansion and specification of theories that concern these concepts. The first author conducted searches in the electronic databases CINAHL, MEDLINE and PsycINFO. Results: This meta-synthesis includes 27 articles. The review of these sources identified four key concepts as important to gain an understanding of occupational health among home health aides: exposure to physical demands , physical environmental factors , organisational conditions of employment and psychosocial working environment . Conclusion: The findings in this synthesis are consistent with previous research showing that occupational health among home health aides is a complex phenomenon. Specifically, physical, psychosocial and psychological exposure aspects have potential negative and positive effects on home health aides’ occupational health. In order to increase employee’s well-being, create a healthier workplace that provides well-functioning and high-quality home care services and cope with future health challenges, more investigations into the organisation of home care are needed.