ArticleInternational journal for equity in health2025
Breaking the cycle: how Spain's dependency care system creates occupational inequalities in geriatric nursing assistants and the need for reform.
Article in International journal for equity in health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Work motivation profiles and work engagement among nursing assistants in Chinese aged care institutions: a cross-sectional latent profile analysis.International journal of nursing studies advances · 2026Article
- Essential, Yet Precarious, Mistreated, Sick and Medicalized: A Sequential Explanatory Mixed-Methods Study on Homecare Aides in Spain.American journal of industrial medicine · 2026Article
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6 authors.
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Abstract
backgroundThe implementation of Spain's Dependency Law aimed to enhance care for those with dependency needs. However, its focus on privatized service provision has raised concerns about potential inequalities in working conditions for geriatric nursing assistants working in long-term care, particularly regarding resources, workload, and labour protections between public and private ownership. This study aims to explore the employment conditions, working conditions and health status of geriatric nursing assistants in Spanish nursing homes, specifically examining the potential impact of facility ownership type.
methodsWe conducted a descriptive cross-sectional study including geriatric nursing assistants working in nursing homes in Spain in the year 2022. The final sample consisted of 344 nursing assistants recruited using the snowball and self-selection sampling methods. Data were collected using a computerized, self-administered questionnaire. The variables studied encompassed employment and working conditions and health-related factors, including physical and mental health status assessed using 12-Item Short Form Health Survey (SF-12v1), physical activity levels, and characteristics of back pain. To examine the association between the descriptive variables and facility ownership, Poisson regression models with robust variance were fitted.
resultsNursing assistants in private nursing homes were significantly more likely to report worse working and health-related conditions (aPR = 1.19, 95% CI: 1.07-1.32) compared to those in public facilities. For example, only 22.6% of public workers felt they lacked time for tasks, compared to 48.2% in private nursing homes. Similarly, emotional exhaustion was more prevalent among private staff (86.6% vs. 71.7%).
conclusionsThe results highlight the negative impact of neoliberal policies, particularly the privatization of nursing homes, on the working conditions of geriatric nursing assistants, exacerbating health inequalities. A shift towards a community-based care model with increased public investment is essential to improve working conditions, promote healthy aging, and enhance the quality of care provided by nursing assistants.
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