The Shared Experience of Care: A Social Identity Approach to Understanding the Motivation of People who Work in Social Care.
Thesis or dissertation
University of Exeter
Widely viewed as under-valued and under-paid, yet sentimentalized as working more for love than money, the social care workforce is a fundamental economic and social resource; the importance of which is growing in line with the rapidly aging, global and national population (Care Quality Commission, 2012; DoH 2009; International Helptheaged, 2013). Classic motivation theories, which focus on economic and individualistic work motives, fail to fully account for the high rates of satisfaction and commitment among care workers, (Skills for Care 2007, 2013; Stevens et al 2010). Yet a growing body of empirical research demonstrates that health and social care workers’ motivation is related to patient/client satisfaction and wellbeing (Maben et al., 2012). Moreover the quality of the relationship between the carer and client contributes to the motivation and the wellbeing of both (Wilson, 2009; Wilson et al., 2009). Therefore this thesis seeks to better understand the collective and relational aspects of care workers’ motivation. It does this by detailing a program of research which examines care workers motivations through a social identity lens that asks ‘what’s in it for us’ as well as ‘what’s in it for me’ (Haslam 2004). A social identity perspective on motivation focuses on how workers experience themselves and their work at a personal, relational and organizational level (Ashforth et al 2008; Ellemers et al., 2004). In doing so it offers a multi-dimensional, theoretical framework through which to understand the dynamics of care workers’ motivations. Moreover, this framework offers an empirically proven psychological framework for explaining why adopting a relationship-centered approach to care is pivotal for organizations to achieve a compassionate care culture. The first study explored care workers’ experience of work and inquired about what they did and why it mattered to them. Semi-structured interviews were conducted with 19 care workers who worked in residential and domiciliary care settings. A thematic analysis of the transcripts identified four overarching themes that contributed to care workers’ motivation, those of fulfillment’, ‘belonging’, ‘valuing’ and ‘pride’. These motives were found to be actualized in their shared experience of caring, particularly with clients and also with co-workers and as an organizational member. The findings of the study shed light on the content of care workers’ personal, relational and social identities and the interactions between them. Care workers primarily emphasized the meaningfulness of their work in terms of its caring nature. They expressed this is terms of their personal attributes, their relational role with clients and their perceptions of how the organisation treated them. This led us to hypothesize that their identification with the organisation is likely to increase to the extent they feel the organisation ‘cares’. Indeed to build on and harness care workers’ identities at work, the findings suggest that organisations need to place care workers’ relationships with clients at the heart of what they do. The second study was a longitudinal quantitative analysis of care workers’ motivations which consolidated and extended the findings of the first study. It had two parts, the first part was an examination of how care workers’ motivations are shaped by their sense of identity, and the second part tested how a professionalization intervention affected their motivation. To achieve this we administered an organisational survey at two time points, one year apart (T1 n = 643, T2 n = 1274, T1 & T2 n = 204). Analaysis of the survey responses assessed what it was that incentivized care workers (love and/or money), the relationship of this to work outcomes (i.e. job satisfaction, pride, stress, turnover intentions and positivity about professionalisation) and the extent to which it was affected by patterns of identification. We also examined variation in responses over time as a function of whether or not people had undertaken professional qualifications in the intervening period (so that, in effect, undertaking a qualification constituted an experimental treatment). This meant that the study had a quasi-experimental design in which we could examine the putative impact of exposure to a professionalisation intervention on organizational identification and motivation (for a similar logic see Lim & Putnam, 2010). In line with the five main hypotheses that were generated from the findings of Study 1 and from predominant findings in organisational and social identity research; the results showed first (H1), that care workers’ collective identification with different groups at work, was positively related to their motivation (Ellemers et al., 2004). More specifically, their work motivation was predicted by their identification with (a) the people they care for (client identification), and (b) the care organization they work for (organisational identification). Furthermore, although care workers indicated strongest identification with clients, it was their identification with the organisation that was the most proximal indicator of increased motivation. Second (H2 & H3), although care workers were most incentivized by their relationships with clients and the least incentivized by the pay; the extent to which either led to improved work outcomes was mediated by client and organisational identification. Where being incentivized by relationships with clients led to improved work outcomes, client identification predicted organisational identification, whereas client identification played a lesser role in mediating the likelihood of being incentivized by pay leading to improved work outcomes. In addition (H4), care workers’ identity varied as a function of the work context. More specifically, whether they worked in residential / nursing home care or in domiciliary care affected the nature and extent of their relational identification with their clients and the congruence between client identification and organizational identification (Ashforth et al 2008, Haslam et al 2003). Finally (H5), care workers’ motivations were enhanced by the professionalization intervention of undertaking a qualification, to the extent that it built on and maintained meaningful work-related identities. In particular, the results showed that, care workers’ motivation increased as a result of undertaking a qualification to the extent that the training increased identification with the organisation and other groups at work (Pidd 2004). Study 3 further investigated the effects of identification on motivation, learning and performance by examining the likelihood of professionalisation training being transferred to the workplace. A 2 × 2 longitudinal study evaluated the effects of a new generic professionalisation (NGP) training program, that tapped into distal work identities, and a standard localized professionalisation (SLP) training program, which spoke more to localised identities, on participants’ identification and motivation at work. Overall the findings indicated that compared to the NGP, the SLP (H1) maintained and strengthened participants’ work identification. Furthermore compared to the SLP, the NGP was associated with (H2) a reduction in trainees’ perception of the relevance and usefulness of the training, (H3) a reduction in motivation to enact the training, and (H4) a reduction in trainees’ immersion in the program. Moreover the findings demonstrated that (H5) the reduction in motivation to transfer learning associated with the NGP relative to the SLP, was explained by the reduction in identification it engendered, which in turn reduced participants’ sense of relatedness within the training context. These findings imply that learning is more likely to be applied when it (a) has relevance to identities which are more meaningful to participants, in this case local identities, (b) is delivered by people with whom care workers identify, (c) is validated by others in the workplace environment with whom the participants’ identify. Taken together, this program of research demonstrates that care workers’ motivations can be understood through a social identity perspective that incorporates the collective, relational and personal dimensions of providing care. It concludes by considering how organisations can tap into, harness, strengthen and develop care workers’ identification at work as a means of enhancing their motivation and retaining professional care staff. Through bridging theoretical and applied concerns, this research has wide-reaching implications for developing and maintaining compassionate work cultures within care organisations and other helping professions.
ESRC / CASE Award and the Somerset Care Group
PhD in Psychology