Table 1 Study variables and measurements

Outcome variables

 Job dissatisfaction

Single self-developed item assessing care workers’ satisfaction with their job [23, 28]

4-point Likert-type scale ranging from 1 ‘very satisfied’ to 4 ‘very unsatisfied’ dichotomized into ‘satisfied (1–2)’ vs. ‘dissatisfied (3–4)’

 Emotional exhaustion

Single item from the Maslach Burnout Inventory assessing how often care workers felt emotionally exhausted from their work [24]

7-point Likert-type scale ranging from ‘never’ to ‘daily’ dichotomized into ‘few times a month or less often (0–4)’ vs. ‘once a week or more often (5–7)’

 Intention to leave the current job

3 items assessing care workers’ turnover intention (“currently looking for another job”, “often thinking about quitting current job”, “probably looking for a job next year”) [9, 26, 27]

Sum over the three items each rated on a 5-point Likert-type agreement scale ranging from ‘strongly disagree (0)’ to ‘strongly agree (4)’; summarized over the three items and dichotomized into ‘no intention (0)’ vs. ‘intention to leave the current job (1–12)’; Cronbach’s α (in this study) = 0.89

 Intention to leave the profession

Single self-developed item assessing if care workers intended to leave the profession and to take a job outside nursing [23, 28]

5-point Likert-type agreement scale ranging from ‘strongly disagree’ (0) to ‘strongly agree’ (4) dichotomized into ‘no intention (0–3)’ vs. ‘intention to leave the profession (4–5)’

Explanatory variables

 Care workers’ administrative burden

Mean score of the 6-items on care worker’s burden related to six administrative tasks [17, 18]

4-point Likert-type scale ranging from 1 ‘weak’ to 4 ‘strong’;

Cronbach’s α (in this study) = 0.83

Control variables

 Facility characteristics

  Language region

Nursing homes in the German- or French-speaking region

1 = German-speaking

2 = French-speaking

  Nursing home size

The facility's size, based on the number of long-term beds

1 = Small (< 50 beds)

2 = Medium (50–100 beds)

3 = Large (> 100 beds)

  Ownership status

The type of nursing home based on financing

1 = Public

2 = Private subsidized

3 = Private

 Unit characteristics

  Full-time equivalent per 100 beds

Full-time equivalent positions divided by number of beds, multiplied by 100

Number

  Skill mix level

Percentage of all full-time equivalents per unit who are registered nurses

Number

 Work environment

  Leadership

5-item “Nurse manager ability, leadership, and support of care workers” subscale of the Practice Environment Scale–Nursing Work Index, assessing direct supervisors in terms of the support they provided, their competency, back-up in decision-making, praise and recognition given, and the use of mistakes as learning opportunities rather than criticisms [29]

4-point Likert-type scale from 1 ‘strongly disagree’ to 4 ‘strongly agree’;

Scale built with mean over items;

Cronbach’s α (in this study) = 0.86

  Staffing and resources adequacy

3-item subscale “Staffing and resources adequacy” of the Practice Environment Scale–Nursing Work Index, assessing whether there was enough time and opportunity to discuss resident care problems, enough qualified personnel to provide quality resident care, and enough staff to get the work done [29]

4-point Likert-type scale ranging from 1 ‘strongly disagree’ to 4 ‘strongly agree’;

Scale built with mean over items;

Cronbach’s α (in this study) = 0.75

  Implicit rationing of nursing care

Mean score of the 21-item Basel Extent of Rationing of Nursing Care-Nursing Home version [30]

5-point Likert-type scale with the following response options: 0 ‘activity was not necessary’, 1 ‘never’, 2 ‘seldom’, 3 ‘sometimes’, or 4 ‘often’;

Cronbach’s α (in this study) = 0.93

 Care workers’ socio-demographic/professional characteristics

  Gender

Care worker gender

1 = Female

2 = Male

  Age

Care worker age in years

Years (in six categories)

  Educational background

Care worker professional education

1 = Registered nurse

2 = Licensed practical nurse

  Tenure in current facility

Care worker tenure in current facility

Years (in three categories)

  Employment level

Care worker employment level

% of employment (20–100), grouped in three categories for reporting

  Main shift

Shift care worker most often works

1 = Regular change of shifts

2 = Day or evening shift

3 = Night shift

  Working overtime

Frequency care worker works more than 30 min overtime

1 = Almost every shift

2 = Once a week

3 = Less frequently