Race, immigration status and job satisfaction among certified nursing assistants

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University of Alabama Libraries

Certified Nursing Assistants (CNAs) provide up to 90% of direct care to long-term care residents. Unfortunately, CNAs have an extraordinarily high turnover rate that is accompanied by low levels of work satisfaction. A largely qualitative body of literature has indicated that perceived lack of respect and perceived discrimination drive job satisfaction differently in CNAs of different race/ethnicity. This quantitative study examined CNA job satisfaction with an emphasis on race, immigration status, dementia training, respect, and perceived discrimination. Secondary data analysis of the National Nursing Assistant Survey used information from 3,017 nursing assistants in 1,500 nursing facilities, including data on training, supervision, client relationships, and workplace environment. This study looked at a sample of 2,352 participants; 61.3% were Non-Hispanic Whites (NHWs) and 31.4% were African Americans (AAs); 89% were US born citizens, 4.2% immigrants, and 6.8% citizens through naturalization. Path analyses indicated that race predicts job satisfaction, and that both respect and discrimination partially mediate that association. This pattern of findings was consistent across both racial groups. These effects varied with age. Immigration status and dementia training were hypothesized to moderate these effects by improving understanding of problem behavior, yet neither hypothesis was supported. These results highlight the complex nature of CNA job satisfaction in long-term care.

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Psychology, Nursing, Gerontology