Purpose: The purpose of this work was to examine how structural factors, residents' needs for physical and psychosocial assistance, and the work stressors experienced by employees are related to the quality of life of elderly residents in long-term care.
Design and methods: Cross-sectional survey data were collected from 1,194 employees and 1,079 relatives of residents in 107 residential-home units and health-center bed wards. Data were analyzed using multilevel modeling.
Results: The majority of differences in both employees' and relatives' perceptions of residents' quality of life across units could be explained by work stressors such as time pressure. Large unit size was related to both increased time pressure among employees and reduced quality of life of residents.
Implications: Long-term care units are encouraged to review their practices so that employee well-being is supported. Attention also should be focused on unit size, as small units appear better able to help employees cope with work stress, resulting in better quality of life for residents.