Work-family conflict and health among caregivers in skilled nursing facilities: The role of sleep

Background and Objective: Managing work and family responsibilities is often difficult and impacts employees' health. In particular, work-family conflict is associated with sleep disorders. In addition, sleep quantity and quality are associated with employee physical health and psychosocial well-being. However, little is known about the role of sleep in the relationship between work-family conflict and health. This cross-sectional study examined work-family conflict, sleep, and health in clinical caregivers in U.S. skilled nursing facilities. Methods: Self-administered questionnaires were collected from NAs, LPNs, and RNs in 15 nursing facilities located in Maryland and the New England area between January, 2008, and October, 2009. Work-family conflict was assessed with three items derived from the Work Interference with Family Scale. Health was assessed by the Short Form-12 Health Survey (possible range 0-100). Sleep quantity and quality were assessed. Results: Linear regression modeling produced decreases in both physical health (β=-2.7, 95% CI=-3.5 – -1.9) and mental health (β=-3.5, 95% CI=-4.4 – -2.6) with every unit increase in work-family conflict, after controlling for age, gender, race, marital status, and shift work. Both sleep quantity and quality were associated with work-family conflict and with health. Sleep quantity and quality each partially mediated the association between work-family conflict and mental health (by 11.3% and by 19.3%, respectively). Conclusions: This study suggests that work-family conflict greatly impacts health and that sleep plays a significant role in translating work-family conflict into adverse mental health effects. Future workplace interventions must address work-family conflict and improve the sleep of formal caregivers.