Covid-19 in private nursing homes: results of a questionnaire on working conditions and perceived health of care workers

Caregivers in nursing homes face with difficult working conditions which result in health problems. The occurrence of the Covid-19 pandemic has reinforced the difficulties encountered. The pandemic led to the exposure to a new and unknown risk for professionals and residents, associated with changes in practices in an emergency and in uncertainty. International studies have shown the consequences of the pandemic on the psychological health of carers. Few of these studies specifically address the health of nursing home workers associated with working conditions during the pandemic. The objectives of this study are: (1) to describe the perceived working conditions of care assistants, nurses and nurse coordinators in private French nursing home during the pandemic period; (2) to evaluate the perceived health of these professionals during this period; (3) to identify the links between the evaluation of working conditions and perceived health; (4) to determine, among these factors, the predictors of the deterioration of their perceived health. A questionnaire, based on a literature review and interviews with professionals in the sector, was distributed in France between mid-October and mid-December 2020. Data collected concerned care workers and nursing home characteristics and working conditions perception. The perceived health is assessed with the standardised perceived health scale integrated into the SATIN questionnaire completed by feelings about the evolution of their overall health compared to the pre-pandemic period. The responses of 458 carers, including 269 care assistants, 115 nurses and 74 nurse coordinators, were analysed. The descriptive results highlight the overall pandemic situation and the variety of working conditions in different nursing home. Among participants, 28% had a "poor" perceived health, 50% "average" and 22% "good". Fifty per cent of respondents felt that their overall health was worse than before the pandemic. Among the many working conditions correlated with the perceived health of caregivers, the factors predicting the variation in the perceived health score diverge according to the occupation. These results highlight the need for priority actions in terms of information and training, recognition and means to protect oneself and do quality work, taking into account specificities related to the profession.