Quality of Work Life in Long-Term Care

Project funded from April 2023 – March 2027

To date:
54 care homes randomly selected and recruited
Over 1000 care aides interviewed
Over 800 regulated staff surveyed


Now Hiring:
Postdoctoral Fellows interested in supporting our research and scholarly activities


An Underrepresented, Undervalued Workforce: Understanding and Supporting Quality of Work Life in Long-term Care

Long-term care (LTC) is an essential component of the health system, yet often undervalued. Before the pandemic, concerns existed about care staff’s high risk of burnout, poor physical and mental health and low job satisfaction. The pandemic placed additional stress on this workforce, leading to serious staff shortages and increasing concerns about staff health and well-being. Our study seeks to understand how the conditions of work in LTC may affect the conditions of care of the residents. We will be assessing how work environment impacts the quality of work life (QWL) of staff in LTC and ultimately, resident quality of care outcomes in Atlantic Canada.
This study is being led by Dr. Janice Keefe, Mount Saint Vincent University, and co-led by Dr. Rick Audas, Dr. Carole Estabrooks, Dr. Rose McCloskey, and Dr. Gail Tomblin-Murphy with participation of co-investigators from different university and disciplines and sector and decision maker collaborators. Keefe and colleagues were awarded a $2.1 million CIHR project grant for the multi-site study.



This project is an Atlantic Canadian research collaboration to build evidence to understand, support and manage the LTC workforce.  We will conduct a survey about staff’s physical and mental health, and key features about their work environment. We will examine the relationship between staff QWL and resident outcomes by linking staff survey results with resident assessment data. Linking data will help us understand if or how the working environment affects the quality of care received by LTC residents.




This project extends research happening in Western Canada through the Translating Research in Elder Care (TREC) program. Research will take place in the four Atlantic Canadian provinces – Nova Scotia (NS), New Brunswick (NB), Prince Edward Island (PEI), and Newfoundland and Labrador (NL). We will survey 25% of eligible homes in each province with over sampling in NL and PEI to obtain a minimum of 8 homes per province. We will hear from a mix of staff including care aids, nurses, allied health, and managers.



This project is funded from April 2023 to March 2027. Data collection with staff working in LTC will take place October 2023 – June 2024. InterRAI data will also be collected to be linked to staff working conditions to understand the relationship of work environment on resident quality of care. After data collection is complete, data will be cleaned and analyzed. Dissemination activities for the project include publishing in academic journals, presentations at scholarly conferences, and webinars. Throughout the project there will be frequent knowledge translation and engagement opportunities to share findings and invite feedback including summary findings shared to each LTC home, webinar presentations, workshops, and a regional summit.

Project Activities:


The Atlantic region currently has limited data to understand LTC staff quality of work life and what can be done to support these staff. The results from this study will help employers and government better support the overall health and well-being of LTC staff. Ultimately, our project will provide evidence to support improvements for LTC staff, by enabling knowledge users to consider tangible interventions to improve staff QWL, their work environment and ultimately, the quality of care for residents.


Paula Richardson, Atlantic Region Project Manager
Email: arcltc@msvu.ca
Telephone: 902-457-6235

Emily Hubley, Nova Scotia and Prince Edward Island HUB Coordinator
Email: Emily.Hubley1@msvu.ca

Marlene Robichaud, New Brunswick HUB Manager
email: marlene.robichaud@unb.ca

Emily Doyle, Newfoundland & Labrador HUB Coordinator & acting Manager
email: g23ecd@mun.ca

Our Thanks

This study is funded by Canadian Institutes of Health Research (CIHR) with partner funding from Research Nova Scotia (RNS), Newfoundland and Labrador Center of Applied Research (NLCAHR), Health PEI, Research New Brunswick and Nova Scotia Health.

Research Team

Dr. Janice Keefe, MSVU

Dr. Rick Audas, NLCAHR at MUN






Dr. Carole Estabrooks, UofA





Dr. Rose McCloskey, UNB





Dr. Gail Tomblin-Murphy, NS Health


Dr. Marilyn Hodgins, UNB

Dr. Adrian MacKenzie, NS Dept Health





Dr. Caitlin McArthur, Dal







Dr. Kathleen Norman, NSHealth

Dr. Lori Weeks, Dal







Dr. Robert Wilson, MUN

NS Health, PEI Health, NL Health & Community Services, NL Eastern Health, NS Seniors & LTC, NS Department of Health and Wellness, Nursing Homes of Nova Scotia Association, New Brunswick Association of Nursing Homes, PEI Long-Term Care

Atlantic Region Manager: Paula Richardson







Nova Scotia/Prince Edward Island HUB: Emily Hubley, Field Survey Coordinator




NB HUB: Marlene Robichaud, Manager





Katie Edgar, Field Survey Coordinator





Emily Doyle, Newfoundland & Labrador, HUB Manager/Coordinator, Memorial University

Amber Duynisveld, Mount Saint Vincent University





Callie Tompson, Mount Saint Vincent University

Project Updates

May 2024

· 1109 care aides interviewed and 950 regulated staff surveyed

· Principal Investigators will be meeting next month to discuss Y2 timelines and work plans

· We’re recruiting postdoctoral fellows to join our team. For more information, please see our listing <ARC-LTC-Postdoctoral Fellow>.

· We’re looking expand our project trainee network at all levels, if interested please contact arcltc@msvu.ca for more information.

April 2024

· Recruitment completed for 54 randomly selected care homes across Atlantic Canada

· 988 care aides interviewed and 628 regulated staff surveyed.

March 2024

· 43/54 care homes have been recruited across Atlantic Canada

· 636 Interviews with care aides have been completed by interviewers

· 288 Online surveys have been completed by regulated staff (Nurses, Managers & Allied Health Professionals.


· Principal Investigators and Co-Investigators met to discuss project timelines, finalized surveys, and plans for promotion, building research capacity, and dissemination.


· Ethics approval received from ethics Board of Record (MSVU)

June-August 2023

· Project submitted to ethics Board of Record (MSVU), Health PEI, and UNB

· Hiring and staff training for all HUBS

May 2023

· Atlantic Research Project Manager hired

May 2024

· Data collection started in French/bilingual care homes
· Data collection completed in 11/12 English care homes
· Total surveys completed 161 CAs; 173 Regulated

April 2024

· Recruitment completed for all 18 care homes (12 English & 6 French/Bilingual).

· Data collection completed in 8 English care homes

· Total surveys completed 161 CAs; 161 Regulated

March 2024

· All 6 randomly select French care homes have been recruited.

· The Translating Research in Elder Care (TREC) staff surveys are being translated to French for data collection starting April/May 2024.

· Data collection completed in 3 care homes

· Total surveys completed: 94 CA, 71 Regulated

February 2024

· All 12 randomly selected English care homes have been recruited.

· Data collection completed in a total of 2 care homes.

· Total surveys completed: 34 CA, 22 Regulated

· Pre-data collection & In-person site visits are in-progress for remaining recruited homes.

· Site recruitment of 6 randomly selected French care homes begins.

January 2024

· Data collection completed in first English care home.

· Total surveys completed: 14 CA, 17 Regulated

December 2023

· First care homes recruited.

· Data collection scheduled to start January 2024.

November 2023

· Ethics Approval received from UNB.

· Site recruitment of 12 randomly selected English care homes begins.

October 2023

· Project submitted to UNB ethics for approval.

· French translation process begins for TREC staff surveys.

May 2024

· Data collection completed in 3/8 care homes
· Total surveys completed 118 CAs; 170 Regulated

April 2024

· Data collection starts

· All 8 homes recruited and scheduled for data collection

· Total surveys completed: 35 CA, 62 Regulated

March 2024

· RPAC approval received

· Recruitment of the 8 randomly care homes started.

January 2024

· MUN ethics approval granted

November 2023

· Project submitted to MUN for ethics approval

May 2024

Nova Scotia:
· Data collection completed in 12/20 homes
· Total surveys completed: 704 CAs, 405 Regulated
· Finished data collection for province
· Total surveys completed: 228 CAs, 102 Regulated

April 2024

Nova Scotia:

· 20/20 homes recruited

· 429 CAs, 199 Regulated


Prince Edward Island:

· Data collection completed in 8/8 homes

· 228 CAs, 99 Regulated

March 2024

Nova Scotia:

· Data collection in 8 homes

· Total surveys completed: 204 CA, 110 Regulated

· 17/20 homes recruited.

Prince Edward Island:

· Data collection complete in 2 homes

· Total surveys completed: 212 CA, 96 Regulated

· 8/8 homes recruited

February 2024

Nova Scotia

· Data collection completed in 7 homes

· Total surveys completed: 200 CA, 99 Regulated

· 14/20 homes recruited


Prince Edward Island

· Data collection completed in 1 home

· Total surveys completed: 61 CA, 35 Regulated

· 8/8 homes recruited

January 2024

Nova Scotia

· Data collection completed in 6 homes

· Total surveys completed: 198 CA, 98 Regulated

· 14/20 homes recruited


Prince Edward Island

· 8/8 homes recruited and scheduled for data collection for March & April

December 2023

Nova Scotia

· Data collection completed in 3 homes

· Total surveys completed: 70 CA, 30 Regulated

· 14/20 homes recruited


Prince Edward Island

· 5/8 homes recruited

· Data collection scheduled to start in February

November 2023

· DC training is completed


Nova Scotia

· 12/20 homes recruited

· Total surveys completed: 22 CA, 10 Regulated

· Data collection starts in first home

· In-person site visits start


Prince Edward Island

· 2/8 homes recruited

October 2023

Nova Scotia

· 4/20 homes recruited


Prince Edward Island

· Ethics approval granted from Health PEI

· First PEI homes contacted for facility recruitment


September 2023

· Interviewer training starts

Nova Scotia

· Ethics approval granted from MSVU

· First NS homes contacted for facility recruitment


Prince Edward Island

· Project submitted to Health PEI for ethics approval


August 2023

· Recruitment of Interviewers (Data Collectors)


July 2023

· NS/PEI HUB Coordinator hired