Drivers of attractiveness and decent work in self-organizing nursing teams: a vignette study in home care

Purpose Inspired by the Buurtzorg model, this study aimed to examine how the characteristics of self-organizing nursing teams and conventional job attributes affect job attractiveness and work-related strain in home care nursing. Design/methodology/approach We conducted a standardized online survey of 98 home care nurses in Germany, including an item-based section and a factorial survey (vignette study). Hypothetical job descriptions with systematically varied job characteristics were presented, and the resulting data were analyzed using random effects models with clustered standard errors. Findings Self-organizing team characteristics, such as nursing autonomy, flat hierarchies and participatory scheduling, did not significantly enhance job attractiveness or reduce job strain. Besides, speech-to-text documentation had a negative effect on job attractiveness and job-related strain. However, conventional job attributes, particularly workload reduction and high wages, significantly improved job attractiveness and reduced strain. Working hours had mixed effects, increasing attractiveness and physical strain. Strong heterogeneity emerged with individual factors, such as age, parental responsibilities and gender affecting job assessment. Originality/value Our study challenges the assumption that innovative organizational models inherently improve job conditions in home care. The study results emphasize work intensity and wages as important drivers of job attractiveness and well-being, raising concerns about the premature introduction of advanced digital tools, such as speech-to-text documentation. Individualized job designs, targeted training and regulatory support are essential for fostering decent work in home care.