Navigating Work Stress: A Qualitative Descriptive Exploratory Study of Health Care Aides’ Experiences in Assisted Living Facilities

Abstract

Introduction: Health care aides (HCAs) provide the majority of direct, hands-on care to residents in assisted living facilities (ALFs), yet the specific work-related stress experienced by this workforce remains poorly characterized in the Canadian literature. This study aimed to explore how HCAs working in ALFs experience, interpret, and manage work-related stress. Methods: A descriptive exploratory qualitative design was used. Fourteen HCAs employed across three ALFs operated by a not-for-profit organization in two Southern Alberta communities were recruited through purposive sampling supplemented by snowball referral. Semi-structured, face-to-face interviews were conducted by the researcher, audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis, informed by the transactional model of stress and coping and the job demands-resources model. Results: Four interconnected themes were generated: understanding and experiencing work stress; the genesis of work stress; consequences of work stress on HCAs’ lives; and navigating and coping with work stress. Organizational factors, workload, staffing shortages, leadership, and workplace relationships, emerged as the most frequently described sources of stress, alongside resident- and family-related stressors, including workplace violence. Coping strategies ranged from social support and self-care to maladaptive behaviors such as substance use and absenteeism. Participants described an ideal workplace as one characterized by approachable and appreciative leadership, adequate staffing, dedicated physical space for staff, and regular opportunities for communication with management. Conclusion: This study offers valuable insights into how HCAs perceive and cope with work stress in ALFs. By specifically focusing on this underexamined group the findings contribute a distinctive perspective to existing literature. Employers and service providers can utilize these insights to recognize and address stressors, thereby improving working conditions and the overall well-being of HCAs. This improvement, in turn, positively impacts the quality of care provided to ALF residents. Further research is recommended to delve deeper into the unique experiences of work stress among HCAs and their coping mechanisms.

Keywords: Assisted living facilities, Health care aides, Occupational stress, Coping, Qualitative research, Thematic analysis