Japanese Journal of Social Welfare, 62 (5), 15–25 2022

Original Article

Depressive Tendency among Care Workers in Long-Term Care Facilities
for Older Adults and the Predictive Eﬀects of the COVID-19 Pandemic
in Japan: From the Viewpoint of Workplace Social Capital
Keishi Ebisawa1, 2, *, Kazuhiro Uchida3 and Hiroko Kase3
1

Graduate School of Human Sciences, Waseda University, Tokyo, Japan
Department of Sociology, Peking University, Beijing, China
3
Faculty of Human Sciences, Waseda University, Tokyo, Japan
2

Abstract Objectives: This study aims to clarify the state of depressive tendencies among care
workers in long-term care facilities for older adults during the COVID-19 pandemic and examine
the eﬀect of workplace social capital. Methods: In March 2021, when the second state of emergency was declared in metropolitan areas, we conducted an online survey of care workers in longterm care facilities. Participants included 2,658 qualiﬁed care workers who provided care services
directly to older adults. Results: Hierarchical linear regression analysis showed that the increase inworkload and tension at work due to the COVID-19 pandemic had a signiﬁcant positive eﬀect on
depressive tendencies among care workers. It also showed that workplace social capital had asigniﬁcant negative eﬀect on depressive tendencies. Conclusion: The results indicate that
increased workload and tension among care workers due to the pandemic are associated withdepressive tendencies. These results suggest that workplace social capital plays an important role
in reducing depressive tendencies.
Key words: COVID-19, certiﬁed care worker, long-term care, facility, depressive tendency,
workplace social capitalI.

Introduction

COVID-19 has spread worldwide and poses a
serious threat to human health. On January 30,
2020, the World Health Organization (WHO)declared that the outbreak constituted a publichealth emergency of international concern(WHO, 2020a). In Japan, the ﬁrst state of emergency declaration was issued for seven prefectures on April 7 and was expanded nationwide on
April 16. However, despite various measures toprevent the spread of the virus, the second stateof emergency declaration was issued for four
* Correspondence address: Waseda University, Mikajima
2–579–15, Tokorozawa, Saitama 359–1192, Japan
E-mail: keishiebisawa@toki.waseda.jp(Received September 30, 2021; accepted March 3, 2022)

prefectures on January 8, 2021, and extended to
11 prefectures thereafter. Furthermore, the emergency period was extended twice, and the second
declaration was canceled on March 21.
The crises caused by the pandemic have been
revealed slowly, with prolonged recovery. One
such crisis is the increasing danger to psychological health (WHO, 2020b). This is a serious
problem in Japan. The number of applications
for occupational compensation insurance formental disorders in 2020 was 2,051, accounting
for 72.4% of all applications (Ministry of Health,Labour and Welfare, 2021). According to the
middle classiﬁcation by industry, the numbers ofworker claims and payment decisions for social
insurance, social welfare, and long-term care
(LTC) services were 275 and 79, respectively.

16

K. Ebisawa, K. Uchida and H. Kase

However, there is little evidence to support themental health of care workers during the pandemic.
According to a survey conducted in 2019,95.3% of the 5,400 respondents who work inlong-term care facility services had concerns,
anxieties, or dissatisfaction with their work.
Moreover, 79.2% of them had worries, anxieties,
or dissatisfaction associated with diﬃcult relationships with colleagues or their supervisors(Care Work Foundation, 2021). Therefore,
human relationships in the workplace havebecome a major issue for Japanese care workers.
Diﬀerences in values and diﬃculties in collaborating with colleagues present other signiﬁcantstressors for care workers (Furukawa, 2015).
Stress responses such as depression are negative emotions caused by stressors. In Kosugi etal.ʼs (2004) psychological workplace stressmodel, the quality and quantity of workplacestressors are expressed as a stress response
through the reduction eﬀect of coping, including
individual resources, such as social support.
Matsuda & Tayama (2012) state that negative
life events (activating events) are fundamental,
and depressive feelings (consequences) are triggered through cognitive processes.
Research on stress among care workers inJapan dates back to the 1980s when many studies
were conducted. According to one report, stressis more common in interpersonal support work
(Masuda et al., 2003). Studies have shown thatcare workers experience intense stress (Ogawa &Nagata, 2007; Hayashi et al., 2010). Speciﬁcally,
care workers in long-term care facilities are more
prone to depression than those in other types ofcare services (Harada & Miyawaki, 2013). A follow-up study in the public sector showed that theonset of depression and recovery is associatedwith psychosocial factors in the workplace (Tatsuse et al., 2019).
As a countermeasure, it is important to reducestressors in the workplace with the support of asupervisor and improve social skills and workersʼ
ability to respond to older adults (Usami et al.,2018). In addition to the stress highlighted in thepast, government support for long-term care providers was less than that for medical institutions
during the COVID-19 pandemic (Dominelli etal., 2020). Long-term care facilities for older
adults are not only exposed to the threat of infectious diseases but also an increased burden on
care workers. Therefore, there is a strong need tounderstand the mental health situation of care
workers and establish more eﬀective measures torelieve depressive tendencies. Considering theissues related to relationships among care workers and the importance of team approaches inlong-term care services, we focused on social
capital. Social Capital has proven to reduce therisk of depression (Kouvonen et al., 2008;
Oksanen et al., 2010) and veriﬁed the negative
predictive eﬀect on depression among facility
care workers.
Social capital (SC) refers to characteristics
such as networks, norms, and social trust that
promote cooperation for coordination and mutual
beneﬁt within a community or group (Putnam,1995). Several studies have reported an association between social capital and health. Social
capital structure is a determinant of population
health, and strengthening social capital is an
important method for reducing health-relatedsocioeconomic disparities (Wilkinson, 2005). Ina cross-sectional study in the United States, compared to states with high social capital, the odds
ratio of normal or low self-rated health in stateswith low social capital was 1.41 (Kawachi,
1999). In a cross-sectional study in Hungary,social capital was signiﬁcantly associated withmortality due to the lack of societal support
among men and the perception of the principles
of mutualism among women (Skrabski et al.,2003). A mixed study of caregivers in Peru andVietnam found that the perception of the concept
of community diﬀered greatly depending on cultural and geographical norms (Silva et al., 2006).
The mainstream evaluation of community
social capital has been applied to workplaces todetermine the reliability and validity of the workplace social capital (WSC) scale, which consistsof eight items (Kouvonen et al., 2006). This scaleDepressive Tendency and the Predictive Eﬀects of the COVID-19 Pandemic in Japanis widely used in occupational stress research(Oksanen et al., 2013). Kouvonen et al. (2006)
considered workplace social capital a multifaceted concept. It includes reciprocity in the workplace, mutual aid, and cooperative interpersonal
relationships that transcend diﬀerences in position, ﬁnding that networks and norms are particularly common components. The deﬁnition of
workplace social capital in this study complies
with that of Kouvonen et al. (2006). In a prospective cohort study of the public sector in Finland, workers with lower social capital weremore likely to be diagnosed with depression(Kouvonen et al., 2008). The rate was 20–50%
higher than that of workers with higher workplace social capital scores. In a study in Iran, theprevalence of psychological distress was 2.11
times (95%) higher among employees with low
individual-level workplace social capital and2.64 times higher among those with low unitlevel workplace social capital (Firouzbakht et al.,2018). Hence, high workplace social capital isassociated with a reduced risk of psychologicaldistress. Furthermore, the promotion of workplace social capital is a means of decreasing
mental health risks among workers in their workplace. Although a systematic review of the association between social capital and mental healthshowed that mental health has improved overtime, the evidence remains inadequate (Flores etal., 2018). A study in Japan showed that workplace social capital is a protective factor against
the risk of deterioration in a major depressive
episode (MDE) (Sakuraya et al., 2017).
Previously, no study has focused on the association between depressive tendencies and workplace social capital among care workers in longterm care services for older adults in Japan.
Therefore, we investigated depressive tendencies
in long-term care workers during the COVID-19
pandemic when some areas were under a second
state of emergency. In this study, based on thepsychological workplace stress model, we clariﬁed depressive tendency as a stress response andexamined the predictive factors among facility
care workers. In addition, we tested the eﬀects of17

workplace social capital as a coping measure,based on the hypothesis that it has a negative
predictive eﬀect on depressive tendencies among
long-term care workers, even during the pandemic. These ﬁndings should provide evidence
for understanding the actual depressive levels ofcare workers during this historic pandemic andexamining measures to reduce them. If highworkplace social capital is associated with areduction in depressive tendency, interventions
from a workplace social capital perspective will
be an eﬀective measure for health promotion
among care workers.
II.

Materials and methods

1．Participants
We conducted an online survey from March
10 to 16, 2021, when the second state of emergency was declared in four prefectures. Participants were registered members of an online survey company. A total of 15,938 members werelisted as certiﬁed care workers with a national
qualiﬁcation (Kaigofukushishi) or as related
medical workers living in Japan. The online survey company contacted registrants to complete
the survey and ceased recruitment when the total
number of participants reached the target number. We screened them using the following criteria.
(a) working in a long-term care facility for older
adults(b) handling direct care for older adults
Based on these criteria, the number of valid
responses was 2,704. We used data from 2,658
individuals and excluded outliers based on
DFBETAs. The average age of the participants
was 47.3 years (range: 20–74 years, SD＝10.0
years), and 59.9% were women.
2. Measures
2.1. Objective variable
For the objective variable, we used the Toho
University Self-Rating Questionnaire for Depression (SRQ-D), whose reliability and validity
have been veriﬁed by Abe et al. (1972). It was

18

K. Ebisawa, K. Uchida and H. Kase

devised to screen for mild and masked depression. The SRQ-D scale includes 18 items, and nopoints were added to Questions 2, 4, 6, 8, 10, and
12. The scale was evaluated using a 4-point Likert scale (0＝ “No,”... 3＝ “Always”). In the analysis, according to the SRQ-Devaluation criteria,
16 points or more out of 36 is rated as 1 “depressive tendency” (844, 31.8%), and less than 16
points are rated as 0 “no depressive tendency.” The
total scores were used for regression analysis.
2.2. Explanatory variables
The explanatory variables included demographics, education, employment, facility status,
and items related to pandemic and workplacesocial capital. Demographic variables included
age, sex, education, marital status, and self-rated
health. Education was divided into 1 “more thanfour-year college” or 0 “less than four-year college.” Employment variables included types of
employment, presence or absence of job position, number of years worked at their current
facility, average working hours per day including
overtime, and average number of night shifts permonth. Employment types were divided into regular (full-time) and non-regular, including parttime, contract, dispatched, and temporary
employees. Leaders, chiefs, section chiefs, andmanagers were included in descending order.
The status of the facility includes the number ofstaﬀ members, number of residents, and population size of the city, town, or village in which thefacility is located. Locations are deﬁned as “large
cities,” ordinance-designated cities as “small andmedium-sized cities” for cities with a populationof around 100,000, and “towns and villages” forless than that.
The most important explanatory variables inthis study were related to the COVID-19 pandemic and workplace social capital. These
include whether the facility is located in the area
under the second state of emergency declaration.
It also includes how the area relates to the situation of care workers inside and outside the facility. The four prefectures under the declaration
during the survey period, Tokyo, Saitama,

Kanagawa, and Chiba, were designated as 1
“emergency state area,” and the others were designated as 0 “non-emergency state area.” nonemergency state areas. The situation inside andoutside care work consisted of three questions:“Has the workload increased consequent to the
COVID-19 pandemic?” “Have you been feelingincreasingly tense during work due to the
COVID-19 pandemic?” and “Have you refrained
from going out to prevent COVID-19 infections?” The questions were answered using aﬁve-point Likert scale (0＝ “strongly disagree,”...
4＝ “strongly agree”). In the analysis, those who
answered 4 (“strongly agree”) and 3 (“agree a little”) were deﬁned as 1, “perceived eﬀect,” andthe others were rated as 0, “no eﬀect.”
Regarding the workplace social capital scale,
we used the Japanese version of a scale developed by the Finnish Public Sector Study (FPSS)
and validated by Kouvonen et al. (2006) to assess
social capital at the individual-level. Table 1 presents the eight items on the scale. Odagiri et al.
(2010) veriﬁed its reliability and validity inJapan. The workplace social capital scale consists of eight items, and responses are given on a
5-point rating scale (0＝ “strongly disagree,” ... 4＝ “strongly agree”). This scale was designed tomeasure both the cognitive and structural elements of social capital. In this study, based on
the veriﬁcation results of Kouvonen et al. (2006)
and the factor analysis results obtained using the
maximum likelihood method with ProMax rotation, the average value of the eight items wascalculated without classiﬁcation by elements ormorphological types. To examine the internalconsistency of the scale, we calculated Cronbachʼs α coeﬃcient, which showed a high valueof 0.95.
3.

Statistical analysis
A chi-square test and t-test were performed to
examine the relationship between the explanatory variables and depressive tendencies. To verify the factors related to depressive tendency andcalculate the eﬀect size (β) of diﬀerent models, ahierarchical linear regression analysis was con-

Depressive Tendency and the Predictive Eﬀects of the COVID-19 Pandemic in Japan
Table 119

Workplace Social Capital Item
Items

Item 1.
Item 2.
Item 3.
Item 4.
Item 5.
Item 6.
Item 7.
Item 8.

Our supervisor treats us with kindness and consideration.
Our supervisor shows concern for our rights as an employee.
We have a ʻwe are togetherʼ attitude.
People keep each other informed about work-related issues in the work unit.
People feel understood and accepted by each other.
Do members of the work unit build on each otherʼs ideas in order to achieve the best possible outcome?
People in the work unit cooperate in order to help develop and apply new ideas.
We can trust our supervisor.

1＝fully disagree; indicative of low social capital; 5＝fully agree; indicative of high social capital; except item 7, where
1＝very little, 5＝very much.
From Kouvonen A, Kivimäki M, Vahtera J, et al. (2006). Psychometric evaluation of a short measure of social capital atwork. BMC Public Health 6: 251.

ducted with the SRQ-D score as the objective
variable. In Model 1, the demographic variables
were input as covariates. In Model 2, the variables related to employment status were input. In
Model 3, the variables related to the facilities
where care workers were engaged were input. In
Model 4, variables related to COVID-19 wereused as inputs. Lastly, in Model 5, we inputted
workplace social capital and veriﬁed its explanatory eﬀect.
This correlation was conﬁrmed to exclude theeﬀect of the variance inﬂation factor (VIF). The
intraclass correlation coeﬃcient (ICC) of thedepressive tendency score was 0.1 or less within
prefectures. The signiﬁcance level was 0.05
(both sides), and IBM SPSS Statistics for Windows version 27.0 (IBM Japan, Tokyo) was used
for this analysis.
III.

Ethical approval

This study was approved by the Ethics Review
Committee of the Human Sciences ResearchCenter of Waseda University (approval number:2020-374). The online survey was conducted
after clearly stating that cooperation in this survey was voluntary and that the data were limited
to research using anonymously processed information on the ﬁrst screen. The questionnaire provided consent to participate in the survey.

IV.

Results

1. Depressive tendency and explanatory
variables
The mean SRQ-D score was 13.1 (SD＝7.0).
According to a survey by Matsuda & Tayama(2012) using the same scale, the mean score was
12. 3, and vocational school students in Japan
were 10.98 (SD＝6.15). According to the survey
results of Kimura et al. (2016), the score of 168
Japanese working adults was 9.2 (SD＝4.3). The
depression score among care workers in the
COVID-19 group exceeded these scores by two
or more points. The mean workplace social capital score in this survey was 2.16 (SD＝0.94).
According to a survey by Iida et al. (2020), using
the same scale, the mean score among 317 Japanese healthcare workers was 3.72 (SD＝0.7).
According to research by Oksanen et al. (2011),
the score among 28,043 public-sector employees
in Finland was 3.59 (SD＝0.65). The workplacesocial capital score among care workers in the
COVID-19 group was below this score by one ormore points.
Table 2 presents the distribution and results of
the relationship between depressive tendencies
and each explanatory variable in care workers.
Regarding the demographic variables, younger
people were signiﬁcantly more likely to be
depressed. Those who had no spouse or
answered that their health status was poor and1) χ2 test (both sides), † : t-test2) *: p ＜.05, **: p ＜.01, ***: p ＜.001(n＝2,658)

workplace social capital

related factors of the COVID-19 pandemic

self-restraint in going out

increase in tension during work

increase in work load

number of staﬀ
number of residents
emergency state area

facility status

middle manager or supervisor

employment typeyears of working at current place
working hours for day shift
number of night shifts per month
population

employment

self-rated healthmarital state

educationage
sex

mean±SD
women
men
above university
under university
with spouse
without spouse
goodnormalpoor
full-time
part-time
yesnomean±SD
mean±SD
mean±SDlarge city
small/medium cityvillage/ town
mean±SD
mean±SD
yes
no
yes
no
yes
no
yes
no
mean±SD

Diﬀerences in Depressive Tendency and Each Explanatory Variable

demographic

Table 2depressive tendency
yes
no
(n)
(n)
%
%
45.3
±9.2
48.2
±10.2
(492)
(1100)
58.3
60.6
(352)
(714)
41.7
39.4
(175)
(406)
20.7
22.4
(669)
(1408)
79.3
77.6
(363)
(956)
43.0
52.7
(481)
(858)
57.0
43.0
(107)
(527)
12.7
29.1
(414)
(1103)
49.1
60.8
(323)
(184)
38.3
10.1
(654)
(1260)
77.5
69.5
(190)
(554)
22.5
30.5
(228)
(433)
27.0
23.9
(616)
(1381)
73.0
76.1
6.0
±3.5
6.2
±3.4
7.8
±2.2
7.5
±2.2
3.8
±3.3
3.5
±3.4
(182)
(480)
21.6
26.5
(528)
(1105)
62.6
60.9
(134)
(229)
15.9
12.6
59.2 ±31.6 55.9
±32.1
57.4 ±32.3 56.9
±32.4
(201)
(476)
23.8
26.2
(643)
(1338)
76.2
73.8
(532)
(988)
63.0
37.0
(312)
(826)
37.0
63.0
(588)
(1101)
69.7
60.7
(256)
(713)
30.3
39.3
(663)
(1428)
78.6
78.7
(181)
(386)
21.4
21.3
1.9
±1.0
2.3
±0.9
9.49

0.01

20.02

1461

1

1

1

2656
2656
1

− 2.47− 0.38
1.79
17.27

1606
2656
1702
2

1

1

2

1

1

1808
1

df

1.25
− 3.33− 1.86
10.26

3.05

18.42

317.6

21.64

0.91

7.47
1.32

t valueChi-square or

***

***

***

*

*
**

*

***

***

***

***

†

†

†

†

†

†

†

20
K. Ebisawa, K. Uchida and H. Kase

Depressive Tendency and the Predictive Eﬀects of the COVID-19 Pandemic in Japan

were more likely to be depressed. Regular
employees or those who had worked for fewer
years at their current facility were signiﬁcantly
more likely to have depressive tendencies. Additionally, those who worked more night shifts permonth showed a signiﬁcant tendency toward
depression. When the population in the facility
location was small, there was a tendency toward
depression among the care workers. Regarding
pandemic-related factors, those who reported anincrease in workload and tension tended to besigniﬁcantly depressed. The group with a low
depressive tendency had signiﬁcantly higher
social capital scores than the other groups.
2.

Factors related to depressive tendency
To examine the eﬀects of the factors related todepressive tendency, we performed a hierarchicallinear regression analysis with the depressivescore as the objective variable. Table 3 presents
the results of the analysis. As a result of inputting
demographic, employment, facility status, andvariables related to COVID-19 in order from
Models 1 to 4, the F values showed a downward
trend. However, the value increased in the ﬁnal
model (Model 5) with workplace social capital as
an input. In Model 5, the explanatory variables
that were positively associated with depressive
tendency included poor self-rated health,increased tension during work, number of facility
staﬀ, middle managers or supervisors, increased
workload, and location in towns and villages, indescending order of eﬀect size. The variables
that were negatively related were age, good selfrated health, workplace social capital, marital
status, and years of employment at the current
facility.
V.

Discussion

In this study, we conducted an online survey toanalyze depressive tendencies among care workers in long-term care facilities for older adults
during the COVID-19 pandemic. The results
showed that depressive tendencies were low
when self-rated health was good. Suzuki (2006)

21

showed that many psychological factors are
involved in subjective symptoms that are closely
related to depressive tendencies. Matsubara &Inoue (2019) analyzed 339 Japanese junior highschool teachers and found a signiﬁcant relationship between mental health and all social capital,
including bonding, bridging, and linking. In thisregard, it has been highlighted that when care
workers encounter psychological stress, theycannot always control their emotions throughself-care. However, those around them noticesigns of stress and can support the self-care process (Sasaki & Kitamura, 2017).
Regarding employment, a signiﬁcant positive
association between job position (middle manager or supervisor) and depressive tendencies
was identiﬁed. This result is consistent with theﬁndings of Harada & Miyawaki (2013). However, no signiﬁcant association with full-time job
status was found despite a previous study reporting that full-time employees were more stressedthan part-time employees (Fukunaga, 2000).
Full-time employment is represented by longer
working hours, leading part-time workers, andhaving more responsibility for the quality ofcaregiving for older adults. However, the results
showed that job positions were related toincreased depressive tendencies. Workers in thisposition are considered more likely to be
depressed because of their direct responsibility to
implement new protection procedures against
COVID-19 to save the lives of older adults andworkers. In addition, there may be many opportunities to perform non-standard tasks, which
may manifest as excessive burdens under thesecircumstances (Ogawa & Nagata, 2007).
In terms of facility status, depressive tendencies tended to increase in facilities with more
staﬀ. Additionally, working in facilities in towns
and villages was positively related to depressive
tendencies. In areas with small populations,health-related resources and long-term care services are limited. Furthermore, it is often thecase that the necessary services cannot be completed or provided within the area. Therefore,
they may experience problems diﬀerent from

workplace social capital
.215
.213

R2

adjusted R2

1) β: Standard partial regression coeﬃcient，R2: Coeﬃcient of determination2) *: p ＜.05, **: p ＜.01, ***: p ＜.001

.215

.218

67.25 ***

.219

.223

50.59 ***

− 0.028

number of staﬀ

number of residents

0.069 **

.229

.235

42.64 ***

− 0.026

.247

.253

44.55 ***

− 0.142 ***− 0.0100.049 *
0.101 ***

− 0.010− 0.0070.045 *
0.092 ***

− 0.0310.037 *
0.066 **

− 0.020

0.015

0.031

− 0.046 *0.063 ***

− 0.0120.292 ***

− 0.066 ***− 0.159 ***0.006− 0.005− 0.177 ***βModel5− 0.030

0.037 *
0.069 **

− 0.021− 0.018
0.033

0.018

0.031

0.014

0.032

0.049 **
− 0.050 **0.052 **

− 0.005

0.322 ***

− 0.066 ***− 0.177 ***0.008− 0.004− 0.177 ***βModel 4

− 0.038 *− 0.0050.330 ***

− 0.067 ***− 0.175 ***

0.011

0.001

− 0.177 ***βModel 3

population (large city＝1)
population (village/town＝1)

increase in tension during work (yes＝1)
self-restraint in going out (yes＝1)(n＝2,658)

0.048 *
− 0.0280.008

120.91 ***0.332 ***

0.333 ***

0.029

COVID-19

F value− 0.063 ***− 0.175 ***− 0.065 ***− 0.173 ***
0.005

0.007

0.006

average number of night shifts per month

emergency state area（yes＝1）
increase in work load (yes＝1)

the pandemic of− 0.179 ***− 0.186 ***
0.003

β

β
− 0.009

Model 2Model 1average working hours for day shift per day

years of working at current place

employment type (full-time＝1)
middle manager or supervisor (yes＝1)

related factors offacility status

employment

self-rated health (good＝1)
self-rated health (poor＝1)

Education (above uni＝1)
marital state (with spouse＝1)Age
sex (female＝1)

Associated Factors of Depressive Tendency

demographic

Table 322
K. Ebisawa, K. Uchida and H. Kase

Depressive Tendency and the Predictive Eﬀects of the COVID-19 Pandemic in Japan

those of large cities, aﬀecting their depressive
tendencies.
Regarding the COVID-19 pandemic variables,
the main subject of this study, the tendency
toward depression increased with an increase inworkload or feeling tense. Koura (2003) statedthat the stressor most frequently experienced bycare workers is the quantitative workload. However, there were no signiﬁcant diﬀerences in theareas subject to the second state of emergency
and refraining from going out. It is possible thatwork hours are long and free time outside ofwork is limited. Model 4 shows that when controlling for other variables, care workers withincreased workload had a higher depressive tendency than those without. Additionally, thedepressive tendency of care workers withincreased tension at work was higher than those
without increased tension. This shows that theincreased workload and tension caused by the
pandemic increases the depressive tendency ofcare workers. However, the institution being in
the declaration area or whether individual activities are restricted after work does not aﬀect care
workersʼ depressive tendency. In addition, Model
5 with workplace social capital as the input,
appeared to be more eﬀective than the previous
model based on the F value. The negative predictive eﬀect of workplace social capital on depressive tendencies during COVID-19 has been clariﬁed. In this regard, Kouvonen et al. (2006)
considered that workplace social capital relies
heavily on informal and routine face-to-faceinteractions with supervisors, colleagues, andsubordinates, highlighting its importance. As
shown in this study, it is thought that factors thatcomprise workplace social capital, such as thesupervisorʼs response, strengthening the sense ofcollaboration and information sharing in theworkplace, and respecting and helping eachother, lead to a reduction in depressive tendency.
Conversely, when cooperating in providing
long-term care at a facility, it is essential to communicate with colleagues. However, when asupervisor's understanding of the ﬁeld is insuﬃcient, it leads to stress among care workers

23(Ogawa & Nagata, 2007). To reduce such stress,
opportunities for supervisors to listen to the concerns of their subordinates have been proposed(Hotta, 2009). Similarly, as shown in this study,
those who had a job with care responsibility during the pandemic tended to be depressed. Furthermore, there was assumed to be a limit to consideration for subordinates and the exercise ofleadership. Therefore, it is important for people
around supervisors, including subordinates, tounderstand and support people in such a position.
During the COVID-19 pandemic, a methodology
for constructing and strengthening linking social
capital, reﬂecting cooperative interpersonal relationships that transcend diﬀerences in positions,is urgently needed.
VI.

Conclusion

In this study, we conducted an online surveyof certiﬁed care workers in long-term care facilities. The results suggest that the depressive tendency of care work was signiﬁcantly associatedwith increased workload and work tension during the COVID-19 pandemic. Additionally, itestablished that workplace social capital reduced
depressive tendency among care workers evenduring the pandemic.
Limitations
In this study, we used an online survey. Presenting the advantages and disadvantages of
online surveys, Wright (2005) argued that many
online services oﬀer access to specialized or
hard-to-reach populations based on self-reported
data. However, there is no guarantee that participants provide accurate demographic or characteristic information. To avoid this problem, wechose Intage Research, a company that regularly
administers the participantsʼ email lists. However, the subjects were limited to end-users using
PCs or smartphones, who were relatively literate
and had access to information technology. Selfselection bias is another limitation of online surveys (Thompson et al., 2003).
This is a meaningful survey from the perspec-

24

K. Ebisawa, K. Uchida and H. Kase

tive of the protection of residents and care workers in facilities for older adults; however, it does
not include those with moderate or severe
depressive tendencies. Thus, it is likely that thesurvey did not include those who need to beinvestigated and supported. The possibility ofconfounding bias and unobserved variables cannot be ruled out. In addition, because the analysis
results are based on a cross-sectional survey,
building a causal model through a longitudinalsurvey is required in future research.
Acknowledgments
This study was conducted as part of the 2020
Research Project of the Human Sciences
Research Center at Waseda University, Japan. No
COI status was disclosed in this study.
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