Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Social Work


According to the US census bureau there are approximately 15,500,000 million Americans over the age of 65 years in 2015. As the population ages and prepares to die, people will need access to quality hospice and end-of-life care. Key to delivery of quality care is experienced hospice social workers. Multiple regression and mediation analysis were applied to explain the path relationships involving the variables of spiritual well-being, an innovative operationalization of the concept of team regard, job satisfaction and turnover intentions of hospice social workers in Medicare-certified hospice programs in the state of Illinois. Other variables in this study included economic satisfaction, external opportunity, age and tenure. Additionally, the mediating role of job satisfaction was examined.

This mixed methods research utilized online survey (n = 111) and individual interviews (nine of the respondents participated in in-depth interviews). The demographics of the sample were overwhelmingly Caucasian (94%), 45 years of age, Christian (71%) women (93%) holding an MSW degree (90%). Forty-seven percent have worked < 5 years in the hospice field. Data from the qualitative interviews informed the understanding of the definition, importance and influence of team regard on hospice social worker turnover intention. Two theories guide this study: existential theory and Paul Wong’s meaning management theory. Mediation models presented proved significant. This sample of hospice social workers scored high in spiritual well-being (86%) as determined by the Spiritual Health and Life Orientation Measure (Gomez & Fisher, 2003, 2005). Ninety-six percent were high or very high in team regard. Twenty-five percent were at moderate or high risk of leaving their organization. The research demonstrated that the relationship between spiritual well-being and turnover intention is mediated by job satisfaction. Additionally, team regard is mediated through job satisfaction but also significantly directly influences turnover intention. This research identifies the importance of team regard and spiritual well-being and its overall influence of job satisfaction and turnover intention.

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Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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