Reciprocity in Staff/Resident Interactions in Nursing Homes

The study was developed to examine the extent to which nursing assistants in nursing homes recognized the reciprocation needs of residents. Social Exchange Theory provided the framework for explaining the need for reciprocity in relationships, and caring behaviors of residents were used to demonstrate reciprocity. Subjects were 206 nursing assistants from five metropolitan area nursing homes who volunteered to complete a questionnaire including ten items on observed caring behaviors and 23 items on the attitudes of nursing assistants toward caring behaviors. The study was a nonexperimental design that was primarily descriptive, utilizing measures of central tendency and variability for data analysis. ANOVA was used to examine possible relationships between demographic variables and attitudes toward indicators of reciprocity. Subjects were primarily female (87%), 35 years of age or younger, and slightly over half were Caucasians, with African Americans, Asians, Hispanics and Native Americans also represented. Most had completed high school, had worked in their present institution five years or less, and worked a total of ten years or less in nursing homes. Data analysis showed that formal mechanisms for teaching reciprocity needs of nursing home residents to nursing assistants did not exist in the five nursing homes. Nursing assistants do observe a variety of caring behaviors on the part of residents and view these behaviors more positively than negatively. More tend to view caring behaviors as a means to achieving reciprocity than do not, but they do not create the opportunity for residents to engage in caring behaviors. Attitudes about caring behaviors were significantly related to race, educational level and time employed in the nursing home, but not related to age, sex, or total time worked in nursing homes. Since ability to reciprocate in relationships is important to well being, inservice education should be implemented that would assist nursing assistants to understand social exchange and its relationship to communication theory. Nursing assistants should be helped to identify exchange resources possessed by residents and determine how they might encourage these resources in a meaningful, appropriate manner.