Background and objectives Due to a rapidly ageing population, homecare (HC) aide is one of the fastest growing occupations in the USA. Exposures to occupational safety and health (OSH) hazards are challenging to evaluate in complex home-based care environments and among a mobile, socially diverse workforce. This presentation demonstrates how qualitative and quantitative research methods complement each other when assessing and characterising (i) multiple OSH hazards (ii) possible interventions, and (iii) dimensions of HC work that impact both HC aide and patient safety.
Methods In Massachusetts, USA, we conducted 12 focus groups with HC aides and 26 in-depth interviews with HC agency managers, labour unionists, workers’ compensation representatives, and HC clients. All focus groups and interviews were audio-recorded and transcribed verbatim. Structured, computer-assisted thematic analysis of all transcripts was performed and the results guided a cross-sectional survey questionnaire design administered among HC aides (n = 1,249). Nine post-survey focus groups and seven interviews interpreted the quantitative survey findings and then informed a laboratory-based experimental design study to assess musculoskeletal strain in the use of assistive slide board devices among HC aides (N = 16).
Results The qualitative and quantitative data showed that the most concerning OSH exposures among HC aides were client handling and mobility tasks associated with back injuries and other musculoskeletal disorders (MSDs), verbal abuse, falls inside and outside the home, clients on oxygen addicted to smoking, second-hand smoke, bloodborne pathogens, and use of strong cleaning chemicals. Ergonomic assistive devices to prevent MSDs and in-service trainings were assessed as the most promising short-term interventions. Post-survey focus groups and interviews provided interpretation of the quantitative exposure estimates, possible determinants, and recommendations for future research.
Conclusions Combined qualitative and quantitative research techniques provide complementary data for more comprehensive characterisation of OSH exposures and intervention opportunities in complex work environments with a mobile, socially-diverse workforce.
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