Factors of concern and reluctance to accept foreign care workers in native care workers in geriatric facilities: A questionnaire-based cross-sectional study

Abstract Background Owing to a shortage of care workers because of rapid population aging, geriatric care facilities hiring foreign care workers (FCWs) have increased in many countries. To resolve potential obstacles for FCWs’ acceptance and retention, we aim to clarify the acceptance of FCWs and the factors influencing native care workers’ concerns and reluctance towards FCWs. Methods Self-report questionnaires were distributed to all care workers (N = 1,060) in 30 geriatric residential care facilities in Japan (response rate = 71%). The questionnaire covered basic attributes, work and organisational characteristics, wage adequacy perceptions, concerns, ideas towards accepting FCWs, work environment assessment scales, and job stressors. We used data from 589 participants (67.2% women, Mage = 42.63 ± 12.16 years) for analysis, and a multivariable logistic regression analysis focusing on participants who worked in facilities without FCWs was conducted. Results The ratio of concerns and reluctance regarding acceptance of FCWs among native care workers showed a significant difference by the presence of FCWs at a facility, while basic attributes, work and organisational characteristics, and wage adequacy did not show any significant differences between the facilities. The multivariate logistic regression analyses for participants without FCWs revealed that those who were in managerial positions (odds ratio [OR] = 1.99), perceived wage inadequacy (OR = 1.75), and more job stressors (OR = 1.13) were more likely to have concerns about FCWs as compared to their counterparts. Those who worked more than 50 hours per week on average (OR = 0.30) and perceived higher ethical leadership (OR = 0.75) were less likely to be reluctant towards FCWs’ acceptance as compared to their counterparts. When the variable of concerns was entered the equation, those who expressed concerns were more likely be reluctant (OR = 3.50), while the significance of working hours remained constant (OR = 0.28), and the significance level of ethical leadership decreased (OR = 0.78). Conclusions To formulate strategies to accept FCWs in facilities, countermeasures towards pre-existing issues such as work conditions, leadership, and native care workers’ concerns are required.