Differences in the temporal patterns of occupational time on feet and sitting between homecare and nursing home workers.

Abstract

Background: Eldercare work is physically demanding, which may contribute to high rates of sickness absence. Understanding the temporal patterns of time on feet and sitting, the latter assumed to represent recovery, and how they depend on organizational and individual factors is key to a better work organization that can effectively promote health, but this has not been studied before.

Aim: To describe temporal patterns of time on feet and sitting among homecare and nursing home workers and examine their associations with setting, job demands and resources, job title, and age.

Methods: Swedish homecare (n = 101) and nursing home (n = 73) workers wore accelerometers for 7 consecutive days to assess physical behaviors. Short (≤5 min), moderate (>5 to ≤30 min), and long (>30 min) bouts of time on feet and sitting were identified, with their relative distribution expressed in 5 ratios and analyzed using compositional data analysis procedures. Workers also completed a questionnaire on job organizational factors (job demands and resources) and individual factors (job title and age). MAN(C)OVA models were used to analyze differences in behaviors between eldercare settings, with organizational and individual factors being added in 2 consecutive models. Univariate analyses followed the multivariate models.

Results: Homecare and nursing home workers spent most of the workday on their feet (51.9% and 56.9%, respectively). The only statistically significant difference between settings was that homecare workers spent 30.1% less time sitting in long bouts relative to moderate and short compared to nursing home workers (P = 0.011), and this difference remained after adding covariates. Higher age was associated with more time on feet relative to sitting (P = 0.002, η2 = 0.06) and more time on feet in long bouts relative to moderate and short bouts (P = 0.001, η2 = 0.06) with medium effect sizes, as well as to more time on feet in moderate bouts relative short bouts (P = 0.011, η2 = 0.04), and less sitting in long bouts relative to moderate and short bouts (P = 0.019, η2 = 0.03) with small effect sizes.

Conclusions: Temporal patterns varied by setting and age, with homecare workers sitting less in long bouts than nursing home workers, and older workers spending more time on feet than younger workers. These findings suggest that work setting and worker characteristics are associated with temporal patterns of physical behavior, although most effects were small-to-moderate and their practical relevance remain uncertain and warrants further study.