Aim

To summarize the literature on quantitative measures of physical demands in eldercare, with attention to differences between temporary and permanent workers, and to identify gaps to guide future physiological research.

Methods

We searched Scopus, Web of Science, and PubMed for English and Swedish peer-reviewed studies on physical demands in eldercare. Risk of bias was assessed, and descriptive data extracted.

Results

We identified 37 relevant articles where physical demands were assessed via self-report (n = 23), biomechanical modeling (n = 6), and direct measurement (n = 8). Risk of bias assessment showed generally insufficient descriptions of study settings and poor descriptions of instruments assessing physical demands. Workers reported physical demands ranging from 40 to 98% maximum (different scales across studies). Biomechanical models showed peak forces in the lower back up to 5092 N during lifts and transfers. Direct measurements indicated that workers spent half to two-thirds of the day on feet, had oxygen uptakes 0.59–0.63 L/min, and mean heart rates 89–107 bpm across the workday. No study provided estimates specifically for temporary workers.

Conclusion

Results suggested that eldercare work is perceived as demanding by the workers, who spend considerable time on feet, and that it comprises tasks with high spinal loads, but shows low cardiovascular demands. These findings offer a foundation for future studies exploring the short- and long-term physiological implications of occupational exposure in eldercare, including the effect of targeted interventions. Future studies are also needed that consider physical exposure differences between homecare and nursing home settings and between permanent and temporary workers, preferably using direct measurements.

Introduction. Eldercare organizations face high sickness absence rates and staff turnover and rely heavily on temporary workers to fill staffing gaps. Temporary workers may experience differences in job demands and resources compared to permanent workers, but this has been largely understudied.

Aim. To compare perceived job demands and resources between permanent and temporary Swedish eldercare workers.

Methods. Permanent and temporary eldercare workers in a Swedish municipality were invited to answer a digital survey on work environment conditions. Differences between permanent and temporary workers in job demands and resources were analyzed using multivariate analysis of variance adjusted for age, sex, place of birth, and percent of full-time work and univariate analyses were conducted to consider differences in specific factors.

Results. 1076 permanent and 675 temporary workers received the survey and the final study sample included 451 permanent and 151 temporary workers. Multivariate analyses revealed that temporary workers reported statistically significant lower job demands compared to permanent workers, but no statistically significant differences in resources were found between the groups. Univariate analyses showed that temporary workers reported lower quantitative demands, perceived exertion, and time spent bending forward, than permanent workers. These data suggest comparable support across groups, but a higher workload among permanent workers.

Conclusion. Our findings indicate that temporary workers experienced lower job demands than permanent workers, but that no notable difference was found in resources. Interventions aimed at distributing job demands more evenly among eldercare workers with different employment forms may be necessary.

Background

Eldercare work is physically demanding, which may contribute to high rates of sickness absence. Understanding the temporal patterns of time on feet and sitting, the latter assumed to represent recovery, and how they depend on organizational and individual factors is key to a better work organization that can effectively promote health, but this has not been studied before.

Aim

To describe temporal patterns of time on feet and sitting among homecare and nursing home workers and examine their associations with setting, job demands and resources, job title, and age.

Methods

Swedish homecare (n = 101) and nursing home (n = 73) workers wore accelerometers for 7 consecutive days to assess physical behaviors. Short (≤5 min), moderate (>5 to ≤30 min), and long (>30 min) bouts of time on feet and sitting were identified, with their relative distribution expressed in 5 ratios and analyzed using compositional data analysis procedures. Workers also completed a questionnaire on job organizational factors (job demands and resources) and individual factors (job title and age). MAN(C)OVA models were used to analyze differences in behaviors between eldercare settings, with organizational and individual factors being added in 2 consecutive models. Univariate analyses followed the multivariate models.

Results

Homecare and nursing home workers spent most of the workday on their feet (51.9% and 56.9%, respectively). The only statistically significant difference between settings was that homecare workers spent 30.1% less time sitting in long bouts relative to moderate and short compared to nursing home workers (P = 0.011), and this difference remained after adding covariates. Higher age was associated with more time on feet relative to sitting (P = 0.002, η2 = 0.06) and more time on feet in long bouts relative to moderate and short bouts (P = 0.001, η2 = 0.06) with medium effect sizes, as well as to more time on feet in moderate bouts relative short bouts (P = 0.011, η2 = 0.04), and less sitting in long bouts relative to moderate and short bouts (P = 0.019, η2 = 0.03) with small effect sizes.

Conclusions

Temporal patterns varied by setting and age, with homecare workers sitting less in long bouts than nursing home workers, and older workers spending more time on feet than younger workers. These findings suggest that work setting and worker characteristics are associated with temporal patterns of physical behavior, although most effects were small-to-moderate and their practical relevance remain uncertain and warrants further study.