High workload and its connection to health-related quality of life among in-home care workers in northern Sweden during the Covid-19 pandemic.

BACKGROUND

The main aim of this study is to investigate the connection between a high workload and health-related quality of life among in-home care workers in northern Sweden during the COVID-19 pandemic. We also investigate whether social support and control at work can prevent poor health due to high workload.

METHODS

A cross-sectional survey was conducted during the pandemic, with 629 (response rate 33 per cent) of an estimated 1,900 in-home care workers responding. Results were compared with a nearly identical survey conducted prior to the pandemic in which 1,154 (response rate 58 per cent) of an estimated 2000 in-home care workers responded. Psychosocial factors were measured using QPSNordic and health-related quality of life using EuroQol 5 Dimensions (EQ-5D). EQ-5D responses were translated into quality-adjusted life year (QALY) scores. Propensity scores were used with absolute risk differences.

RESULTS

During the pandemic, staff with high workload had a statistically significantly (6.2%) lower QALY score (confidence interval 2.2%-10.3%) compared to staff with a normal workload. This was also the case for the usual activities and the anxiety/depression dimensions of EQ-5D. These risk differences were greater, but not statistically significant, during the pandemic than before. The combination of a normal workload and a high degree of control over one's work appeared to protect against a low QALY score, while social support at work did not seem to be protective.

CONCLUSIONS

High workload is related to poorer health-related quality of life. This is mainly attributable to anxiety/depression. In-home care organisations need to manage workload better to prevent poor health among staff during strained situations such as a pandemic. The results of our study indicate that in-home care organisations should increase their readiness to promote opportunities for staff to maintain a high degree of control over their work, in order to counteract variations in workload that ultimately appear to have a negative impact on HRQoL.