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Country of origin and racio-ethnicity: Are there differences in perceived organizational cultural competency and job satisfaction among nursing assistants in long-term care?

Allensworth-Davies, Donald; Leigh, Jennifer; Pukstas, Kim; Geron, Scott Miyake; Hardt, Eric; Brandeis, Gary; Engle, Ryann L.; Parker, Victoria A.

doi: 10.1097/01.HMR.0000296788.31504.b7

Background: Long-term care facilities nationwide are finding it difficult to train and retain sufficient numbers of nursing assistants, resulting in a dire staffing situation. Researchers, managers, and practitioners alike have been trying to determine the correlates of job satisfaction to address this increasingly untenable situation. One factor that has received little empirical attention in the long-term care literature is cultural competence. Cultural competence is defined as a set of skills, attitudes, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations.

Purpose: To examine organizational cultural competence as perceived by nursing assistants and determine if this was related to differences in job satisfaction across countries of origin and racio-ethnic groups.

Methods: Primary data collected from a cross-section of 135 nursing assistants at four New England nursing homes. Demographics, perceptions of organizational cultural competence, and ratings of job satisfaction were collected. A multivariate, generalized linear model was used to assess predictors of job satisfaction. A secondary analysis was then conducted to identify the most important components of organizational cultural competency.

Results: Perception of organizational cultural competence (p = .0005) and autonomy (p = .001) were the strongest predictors of job satisfaction among nursing assistants; as these increase, job satisfaction also increases. Neither country of origin nor racio-ethnicity was associated with job satisfaction, but racio-ethnicity was associated with perceived organizational cultural competence (p = .05). A comfortable work environment for employees of different races/cultures emerged as the strongest organizational cultural competency factor (p = .04).

Recommendations: Developing and maintaining organizational cultural competency and employee autonomy are important managerial strategies for increasing job satisfaction and improving staff retention. Toward this end, creating a comfortable work environment for employees of different races/cultures is an integral part of the process. Managerial recommendations are discussed.

Donald Allensworth-Davies, MSc, is Research Manager, Data Coordinating Center, Boston University School of Public Health, Massachusetts. E-mail:

Jennifer Leigh, PhD, is Clinical Psychologist, Newton-Wellesley Eating Disorders and Behavioral Medicine, Massachusetts.

Kim Pukstas, PhD, is Research Associate, Muskie School of Public Service, Institute for Public Sector Innovation, Maine.

Scott Miyake Geron, MSW, PhD, is Director and Associate Professor, Institute for Geriatric Social Work, Boston University School of Social Work, Massachusetts.

Eric Hardt, MD, is Clinical Director, Geriatrics Section, Boston Medical Center, Massachusetts.

Gary Brandeis, MD, is Associate Professor of Medicine, Boston University School of Medicine, Massachusetts.

Ryann L. Engle, MPH, is Research Health Scientist, Center for Organization, Leadership and Management Research, VA Boston Healthcare System, Massachusetts.

Victoria A. Parker, DBA, is Assistant Professor, Health Policy and Management, Boston University School of Public Health, and Research Scientist, Center for Organization, Leadership and Management Research, VA Boston Healthcare System, Massachusetts.

© 2007 Lippincott Williams & Wilkins, Inc.