文摘
The purpose of this present study was to examine the direct and indirect effects between the organizational structure of a long-term care facility, the amount of volunteers at the facility, the activities in which volunteers engage while at the facility and daily average number of hours care staff spend with nursing home residents. The time care staff spends with residents has been directly linked to the quality of care provided by the facility. This time is measured by calculating nursing hours per patient and it includes only nursing staff hours. The data for this study come from the National Nursing Home Survey NNHS) – 2004, sample size of 1,174. Using exploratory SEM ESEM) and confirmatory factor analysis CFA) two underlying latent factors for types of volunteer activities were revealed, i.e., Volunteer Provides Socialization and Volunteer Provides Staff Support. A subsequent SEM analysis revealed a number of causal links between these two types of volunteer activities with other predictors and the final outcome variable of quality of care. Socialization activities had a negative direct effect on nursing hours per patient and staff support activities had a positive direct effect on nursing hours per patient. Organizational structure was represented by the exogenous variables, type of ownership, facility belongs to a chain of nursing homes, primary source of payment, Medicare or Medicaid) and the number of beds in the facility. Whether the facility belongs to a chain or not was not significantly related to either of the two factors of types of volunteer activities, i.e., socialization or staff support. However, the type of ownership, i.e., for profit versus nonprofit had positive direct effects on both the frequency of volunteer visits and the size of the volunteer pool indicating that nonprofit facilities are more likely to have larger volunteer pools and more frequent volunteer visits. Additionally, nonprofit facilities are more likely to use their volunteers in staff support roles such as conducting clerical duties, helping at mealtime, and providing personal cares. For-profits are more likely to use their volunteers in socialization activities such as game playing, conducting religious services and making social visits.