Factors influencing home care workers’ loyalty in long-term nursing services

Given the high prevalence of clinical disease and disability among elderly individuals, there is an ever-greater demand for social care services. Despite this demand, the elder care sector has the largest labor shortage levels among all front-line providers of long-term care services. Strategies to reduce turnover and improve employee loyalty have therefore become an important issue. The purpose of this study is to identify the factors that affect the loyalty of home care workers. Following a literature review, wedetermined four independent variables—job satisfaction, work engagement, organizational citizenship behavior (OCB) and transformational leadership—and investigated their relevance to, and ability to predict, home care workers’ employee loyalty. A total of 455 home care workers participated in the anonymous survey. The results of multiple regression analysis indicate that the adjusted coefficient of determination (R2) of the model explained 65.6% of the variance of the dependent variable, showing high explanatory capacity. The influences of the four independent variables on employee loyalty were all significant and positive, with the greatest impact on employee loyalty being exerted by OCB (Adjusted ß = 0.400), followed by job satisfaction and then transformational leadership. The three hierarchical regression models provided evidence for the partial mediating effect of job satisfaction, work engagement and OCB between transformational leadership and employee loyalty. Our findings suggest that managers of home care institutions should adopt a transformational leadership style to motivate home care workers’ job satisfaction, work engagement and OCB. Such an environment not only help retain employee but also attract more young people to join the ranks of the home care profession, which will help solve fundamental short-staffing problems.