Structural quality and nurse health in children's day care facilities

Project No. FF-FP 0318


completed 12/2012


The research project "STEGE - Strukturqualität und Erzieherinnengesundheit in Kindertageseinrichtungen" (Structural features of Quality in Early Child Care and Teaching Staff Health) investigates empirically the relations between structural characteristics of quality, the perception of stress and resources as well as positive and negative health consequences. The study consists in part of quantitative data based on questionnaires of 2.744 early childcare teachers and directors of early childcare provisions from 809 institutions, a representative sample of the German federal state North Rhine-Westphalia. The other part of the study generated qualitative data from 14 problem-centered interviews with early childcare professionals.
1. Conception of causal relations of various features of structural quality, health burdens and resources of nurses,
measuring of the positive and negative impact of strain under consideration of intervening variable and individual, organisational and corporative level (Analyses).
2. Definition of key data for the design of an occupational safety and health management. (Intervention)
According to the common German labor protection strategy (GDA) this project contributes to the maintenance and reinforcement of the employability of skilled pedagogic workers in children's day care facilities.


The first aim is reached through a standardized written questionnaire and deepening interviews. The sampling is based on the universe of all facilities covered by Unfallkasse NRW. Within a sampled unit a minimum of 50% of the skilled pedagogic workers are polled.
Working on the second aim is started after the first aim is reached. The focus lies on key data for the prevention of work related health hazards.


The study supports the notion that the health status of child care teaching staff and directors is quite poor and that structural parameters of quality highly correlate with the ability to work: poor structural parameters yield poor work ability amongst teachers and directors. The risk of limited work ability measured by the Work Ability Index (WAI-Netzwerk, 2012) increases 2,5 fold amongst this sample compared to colleagues working under good structural conditions.
In comparison, early childcare workers show a significantly poorer health status compared to women of the same age and education within the German population, and they suffer more frequently from permanent limitations because of health problems in their everyday life. The most frequent poor health indicators are musculoskeletal conditions, lung conditions, neurological illnesses and psychological problems.
Especially challenging stress factors include first and foremost insufficient structural parameters such as inadequate financial resources, work space and equipment, poor ergonomic work conditions, time pressure, continuously rising work demands, noise stress, low salaries, insufficient chances for promotion, lack of high social reputation and physically demanding work. In addition, personal factors such as risky work-related behavior and experience patterns (A - excessive work involvement and B - burnout) as well as stress within the private life also account for poor health conditions.
Protective factors emerged as well, such as good team atmosphere, autonomy in decision making, physical movement during working hours, high level of professional gratification including renumeration, security in the work place and being valued. In addition, personal factors such as private social support, frequent and regular sport activity during leisure time, non-smoking, normal weight and work related behavior and experience pattern G (health promotional relationship towards work) as well as pattern S (self-care) played an important role.
Based on the results from this study, decisions taken by the UK regarding health promotional strategies can be empirically justified. The data of this study can be used for generating prevention strategies targeting specific groups in relation to the work conditions, health risks and health conditions and in order to reduce the accident rate (e.g. through more staff). Also, physical and psychological capability of pedagogic staff can be improved. This study, in support of the goals of GDA, makes a contribution to maintaining and strengthening the employability of this professional group and serves to support general health promotional goals.
It depicts starting points for Occupational Health Management, looking at the setting "early child care" as a Healthy Organization, which continues to develop by actively promoting healthy relationships and behavior patterns. Practical interventions are suggested at four levels: the level of politics and society, the level of child care providers, the level of directors of early childcare centers and the level of pedagogic staff. For each of the levels topics and approaches are identified and goals formulated.

Last Update:

12 Apr 2013


Financed by:
  • Deutsche Gesetzliche Unfallversicherung e. V. (DGUV)
Research institution(s):
  • Unfallkasse NRW
  • Alice Salomon Hochschule Berlin


Type of hazard:

questions beyond hazard-related issues


Arbeitsschutzmanagement, Gesundheitsförderung

Description, key words:

Structural quality, nurse health, children's day care facilities