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Abstract
State Tested Nursing Assistants (STNAs) within for-profit skilled nursing facilities (SNFs) are integral direct care workers providing care to the growing older adult population. For-profit SNFs continue to face increased demand for STNAs coupled with high turnover and low retention. Guided by the Self-Determination Theory and using a cross-sectional design, intrinsic factors thought to predict STNAs’ intent to stay in their positions were studied. Based on existing literature and previously collected qualitative data, standardized measures were combined to examine psychosocial well-being, basic psychological need (BPN) fulfillment, organizational factors, and intent to stay among STNAs in for-profit SNFs. A random sample of STNAs was recruited from the Ohio Nurse Aide Registry to complete an 88-item online questionnaire. The 32 respondents were primarily white females between 25 and 54 years old who had worked as an STNA for 6 years or more. Descriptive analyses indicated moderate levels of BPN fulfillment and low levels of organizational citizenship behavior, affective commitment, self-esteem, and intent to stay. A statistically significant relationship between STNAs’ affective commitment and organizational citizenship behaviors (β=.579, p=.001) was found. Multiple linear regression revealed that autonomy was the single statistically significant predictor of intent to stay (β=.200 p=.028). Results suggest that supporting relationship building among supervisors and STNAs, emphasizing teamwork among peers, and enabling STNAs to experience autonomy through organizational involvement may positively impact retention behaviors, workplace motivation, and ultimately enable quality care for the aging population.
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