1
|
Wu J, Igarashi A, Suzuki H, Matsumoto H, Kugai H, Takaoka M, Yamamoto-Mitani N. Effects of a dementia educational programme using virtual reality on nurses in an acute care hospital: A pre-post comparative study. Int J Older People Nurs 2024; 19:e12616. [PMID: 38769648 DOI: 10.1111/opn.12616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 03/08/2024] [Accepted: 04/28/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Poor awareness of dementia care by healthcare professionals affects the quality of care for people living with dementia in acute care settings. OBJECTIVES This study examined the effectiveness of a virtual reality-based educational programme for dementia for nurses working in acute care hospitals in Japan. METHODS A dementia education programme for nurses was designed. The programme comprised short movies, virtual reality videos based on the short movies, a lecture, discussions and role-playing based on the experimental learning model. Virtual reality video content was created to promote empathy for people living with dementia through a first-person experience of dementia. The educational programme involved nurses working in an acute care hospital in the Tokyo Metropolitan area. Before and after the programme, we employed structured questionnaires using validated instruments to assess participants' attitudes towards people living with dementia, their intentions of helping behaviour and their confidence in providing dementia care. RESULTS Seventy-six nurses participated in and completed the pre- and post-tests. The mean age was 34.9 ± 9.2 years, and 90.8% of the participants were female. A paired t-test showed significant before-after improvement in the participants' attitudes towards people living with dementia (41.9 ± 5.1 vs. 44.5 ± 4.8), intentions of helping behaviour towards people living with dementia (10.8 ± 2.5 vs. 12.8 ± 2.1) and confidence in providing dementia care (25.9 ± 6.7 vs. 29.2 ± 6.0). CONCLUSION The programme effectively improved nurses' attitudes towards people living with dementia and confidence in providing dementia care in acute care settings. Future research is important to explore the long-term effects of this programme and its effects on actual dementia care. IMPLICATIONS FOR PRACTICE The dementia education programme may promote person-centred care in acute hospitals. Future studies should consider the provision of more flexible programs so that nurses can more easily participate in them.
Collapse
Affiliation(s)
- Jinyan Wu
- Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruno Suzuki
- Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Hiroshige Matsumoto
- Department of Community Health Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruna Kugai
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manami Takaoka
- Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
2
|
Antipas H. Interventions for mitigating occupational stress for professional dementia caregivers in residential aged care: A systematic review with meta-analysis. DEMENTIA 2024; 23:292-311. [PMID: 38069510 PMCID: PMC10807264 DOI: 10.1177/14713012231220963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Occupational stress in professional dementia caregivers in residential aged care facilities has adverse effects on care quality, caregivers' health, and workforce sustainability. The purpose of this study was to examine the evidence regarding interventions to mitigate occupational stress for this population. METHODS A systematic review of CINAHL, PsycINFO, PubMed and MEDLINE databases was conducted to identify original RCT research reporting on stress interventions, published in English between 1995 and March 2022. Search results were screened by two independent reviewers. Quality and risk of bias were appraised using the Downs and Black Checklist and Risk of Bias by two reviewers. Meta-analysis and subgroup analysis examined the pooled intervention effects on stress compared to control. RESULTS 10 studies met the inclusion criteria, and these reported on 15 interventions and 28 outcomes from 92 facilities, involving 1,397 caregivers. We found a small and insignificant effect of interventions on caregiver stress (g = -.27, p = .16). Heterogeneity was partially explained by subgroup analysis. Interventions can mitigate stress and burden not attributed to client behaviour (n = 3) (g = -.85, p < .001), and improve caregivers' self-efficacy (n = 4) (g = -.35, p = .07). We were unable to determine the most effective type of intervention, although organisation focused interventions showed the greatest potential (g = -.58, p = .08). CONCLUSION Interventions that improve caregivers' personal and organisational resources can reduce non-client associated stress and burden and increase self-efficacy. Aged care providers are recommended to prioritise education with organisational support interventions. Research on longitudinal effects and high-risk caregivers is required. Limitations are discussed. PROSPERO REGISTRATION NUMBER CRD42022313715 (registered April 2022).
Collapse
Affiliation(s)
- Hayley Antipas
- Creative Arts and Music Therapy Research Unit, Faculty of Fine Arts and Music, The University of Melbourne, Australia
| |
Collapse
|
3
|
Gurtmann S, Schwahn C, Krüger M, Janowitz D, Pilz K, Biffar R, Grabe HJ, Söhnel A. Proposing a communication module to enhance dental students' attitudes towards people with dementia: Phase 1 of a curriculum revision study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:251-258. [PMID: 37550952 DOI: 10.1111/eje.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/17/2023] [Accepted: 07/08/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION The number of mentally altered patients a dentist meets in practice is increasing and interaction with them can be very challenging. As a baseline for an interventional study, we want to assess the attitude of dental students and identify areas of improvement in patient communication. This work compares the attitude of dental students towards people suffering from dementia to the attitudes of trained medical caregivers and the general population. Our aim is to use the results to assess the need for training in communicating with mentally altered patients. MATERIALS AND METHODS Fourth-year dental students attended two lectures on dementia given by a psychiatrist as part of the geriatric dentistry lecture and were questioned afterwards using the Dementia Attitude Scale. In 2016 and 2017, 73 students at the University of Greifswald were interviewed. The response rate was 84%. Using a factor analysis, the Dementia Attitude Scale's validated questions were interpreted and compared with data from nursing staff from Switzerland and the USA. RESULTS The factor analysis of the data showed the same two-factor loadings as the comparative groups, and that dental students' attitude is more comparable to the general population than to medically trained nursing staff. CONCLUSION Given the results, we conclude that the implementation of a communication module can serve in improving the attitude of dental students towards patients with dementia.
Collapse
Affiliation(s)
- Sonja Gurtmann
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Markus Krüger
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Kristin Pilz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Reiner Biffar
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Hans-J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Andreas Söhnel
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
4
|
Shier V, Bae-Shaaw YH, Sood N, Lekovitch C, Chew F, Leland NE. The Impact of State Dementia Training Requirements for Nursing Homes on Antipsychotic Medication Use. J Am Med Dir Assoc 2024; 25:209-214.e1. [PMID: 38008125 DOI: 10.1016/j.jamda.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES Nursing home (NH) staff often report not having adequate dementia-specific knowledge to effectively care for these residents. Between 2011 and 2019, 9 states in the United States implemented dementia training requirements for NH staff. This study evaluated whether the state-mandated dementia training for NH staff was associated with improving resident outcomes. DESIGN Compared trends in antipsychotic medication before and after implementation of state training requirements to trends in states without requirements. SETTING AND PARTICIPANTS NHs. METHODS Data from Care Compare for NHs and LTCFocus were linked to state policy data. We excluded 14 states that had implemented training requirements before the start of the study period in 2011. We estimated difference-in-differences models that compared trends in antipsychotic medication use before and after implementation of training requirements in states that have newly implemented requirements to trends in states without requirements. We also investigated whether the impact of training was larger in states with more stringent training requirements (eg, specifying a minimum number of training hours) and in NHs with a special care unit for dementia and examined similar analyses for restraint use and falls. RESULTS We found that training requirements were associated with a 0.59-percentage point reduction (95% CI -0.91 to -0.27) in antipsychotics use. Effects were larger in NHs with a special care unit for dementia and in states that had stricter training requirements. We also found that training requirements were associated with a 0.17-percentage point reduction (95% CI -0.26 to -0.07) in restraint use measure and had no impact on falls. CONCLUSIONS AND IMPLICATIONS State requirements for NH staff dementia training were associated with a small, but significant, reduction in the use of antipsychotic medication and physical restraints.
Collapse
Affiliation(s)
- Victoria Shier
- Schaeffer Center for Health Policy & Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA.
| | - Yuna H Bae-Shaaw
- Titus Family Department of Clinical Pharmacy, USC Mann School of Pharmacy and Pharmaceutical Sciences, University of California, Los Angeles, CA, USA
| | - Neeraj Sood
- Schaeffer Center for Health Policy & Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
| | - Cara Lekovitch
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Felicia Chew
- Department of Occupational Therapy, Thomas Jefferson University, Pittsburgh, PA, USA
| | - Natalie E Leland
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
5
|
Cruise CE, Celis S, Lashewicz BM. "I haven't really gone through things like this": Young long-term care workers' experiences of working during the COVID-19 pandemic. Work 2024:WOR230437. [PMID: 38189722 DOI: 10.3233/wor-230437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Long-term care (LTC) facilities were hard hit by the COVID-19 pandemic in Canada. Using life course theory concepts, we looked for conditions that led to worker moral distress -i.e. pain or anguish over not being able to take right action - and how life stage may influence experiences. OBJECTIVE To illuminate the experiences of adults under the age of 30 who stepped into, and/or persevered in, working in LTC during the pandemic, recognizing that this emerging workforce represents the future of LTC in Canada. METHODS This secondary analysis uses interview data from a sub-sample of 16 young workers between 18 and 29 years of age who had been working in Canadian LTC facilities for between 8 months and 7 years. RESULTS Young workers expressed feeling guilt about mourning the loss of socially significant milestones as these milestones paled by comparison to the loss of life and consequences of resident isolation they witnessed at work. To manage feelings of moral distress, young workers attempted to maintain high standards of care for LTC residents and engaged in self-care activities. For some workers, this was insufficient and leaving the field of LTC was their strategy to respond to their mental health needs. CONCLUSION The life stage of young LTC workers influenced their experiences of working during the COVID-19 pandemic. Interventions are needed to support young workers' wellbeing and job retention.
Collapse
Affiliation(s)
- Cera E Cruise
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Sofia Celis
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Bonnie M Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| |
Collapse
|
6
|
Tsatali M, Angelidou IA, Tsolaki M, Teichmann B. The Dementia Knowledge Assessment Scale, the Knowledge in Dementia Scale, and the Dementia Knowledge Assessment Tool 2: Which Is the Best Tool to Measure Dementia Knowledge in Greece? J Alzheimers Dis Rep 2023; 7:1377-1393. [PMID: 38225968 PMCID: PMC10789284 DOI: 10.3233/adr-230161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/26/2023] [Indexed: 01/17/2024] Open
Abstract
Background Measuring dementia knowledge can be a valuable tool for assessing the effectiveness of dementia awareness activities, identifying the potential benefits of dementia training programs, and breaking down common myths and stereotypes about dementia. Objective To compare the psychometric properties of three widely used dementia knowledge tools, the Dementia Knowledge Assessment Tool 2 (DKAT2-G), the Dementia Knowledge Assessment Scale (DKAS-G), and the Knowledge in Dementia Scale (KIDE-G) in the Greek adult population. Methods A convenience sample of 252 participants from the general population completed the survey online. Statistical analyses included Cronbach's internal reliability, retest reliability, factor analysis, concurrent and construct validity, and floor and ceiling effects. Results The DKAS-G had the most appropriate reliability levels (Cronbach's alpha = 0.845; retest reliability = 0.921), whereas the DKAT2-G had satisfactory indexes (Cronbach's α= 0.760; retest reliability = 0.630). The KIDE-G showed unsatisfactory reliability (Cronbach's α= 0.419; retest reliability = 0.619). Construct validity was confirmed for all questionnaires, showing that all of them detected participants with pre-existing knowledge of dementia. Confirmatory factor analysis revealed a four-factor model for the DKAS-G and proposed the removal of 5 items. Floor and ceiling effects were found for the DKAT2-G and the KIDE-G, mainly among those who had previously participated in dementia training. Conclusions The DKAS-G was found to have the highest levels of reliability and validity. The results prove that the DKAS-G meets the requirements for measuring dementia knowledge and evaluating dementia training programs in health professionals, caregivers, and the general population.
Collapse
Affiliation(s)
- Marianna Tsatali
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), Thessaloniki, Greece
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Department of Psychology, School of Humanities and Social Sciences, University of Western Macedonia, Kozani, Greece
| | | | - Magda Tsolaki
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), Thessaloniki, Greece
- Center for Interdisciplinary Research and Innovation, Laboratory of Neurodegenerative Diseases, Aristotle, University of Thessaloniki (CIRI-AUTh), Thessaloniki, Greece
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
7
|
Korbus H, Hildebrand C, Schott N, Bischoff L, Otto AK, Jöllenbeck T, Schoene D, Voelcker-Rehage C, Vogt L, Weigelt M, Wollesen B. Health status, resources, and job demands in geriatric nursing staff: A cross-sectional study on determinants and relationships. Int J Nurs Stud 2023; 145:104523. [PMID: 37327686 DOI: 10.1016/j.ijnurstu.2023.104523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/14/2023] [Accepted: 05/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND According to current estimates, the number of people needing care will double in the next 40 years. It is expected that between 130,000 and 190,000 additional nurses will be needed by 2030 in Germany. Physical and psychological burdens associated with nursing in long-term care facilities can develop into serious health risk factors and significantly impact occupational factors such as absenteeism, especially when linked to difficult working conditions. However, demands and resources specific to the nursing profession have not been analyzed extensively to preserve and promote nurses' workability and health adequately. OBJECTIVE Our study aimed to examine the extent to which perceived health among geriatric nursing staff in Germany is predicted by personal resources, job demands, and job resources. In addition, we analyzed the impact of different behavior and experience patterns on these relationships. DESIGN, SETTING, AND PARTICIPANTS An observational study was conducted between August 2018 and February 2020 in 48 nursing home facilities with 854 staff members in Germany as part of the project 'PROCARE - Prevention and occupational health in long-term care'. METHODS The survey contained instruments that measure workplace exposure, musculoskeletal complaints, physical and mental well-being, chronic stress, and work-related behavior and experience patterns. In addition, health-related information on physical activity and nutrition was collected. Data were analyzed using structural equation modeling. RESULTS The combined physical and mental workload for geriatric nurses is very high, with 75 % showing chronic stress. In the overall model, job and personal resources have a stronger association with mental health than physical health, while job demands have an equal impact on mental and physical health. Coping behavior also plays an important key role that should be assessed and considered. A behavior and experience risk pattern (health-endangering) is more strongly associated with a lower health status than a health-promoting behavior pattern. Results of the multigroup test showed that work-related behavior and experience patterns significantly moderate the relationship between physical health and mental health (χ2 = 392/p ≤ .001/df = 256/RMSEA = 0.028/CFI = 0.958/TLI = 0.931). Only 43 % show a health-friendly coping pattern. CONCLUSIONS Our findings underline the importance of holistic health promotion, which not only aims at changes at the behavioral level and the development of coping strategies but also takes on the task of reducing the workload and including measures to improve the working climate. TRIAL REGISTRATION NUMBER DRKS.de (DRKS00015241); August 9, 2018. TWEETABLE ABSTRACT Healthier coping patterns can benefit geriatric nurses' health. However, this is not a substitute for improving working conditions.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Daniel Schoene
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | | | - Lutz Vogt
- Goethe Universität Frankfurt am Main, Germany
| | | | | |
Collapse
|
8
|
Chen Z, Highfill C. Emotional Stress Experience of Care Professionals for Older Adults with Dementia: A Qualitative Interpretive Meta-synthesis. SOCIAL WORK IN PUBLIC HEALTH 2023; 38:235-247. [PMID: 36166601 DOI: 10.1080/19371918.2022.2128138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Emotional stress is a common problem for many professionals in dementia care. Although a plethora of quantitative studies have examined the factors that affect care professionals' emotional stress, little qualitative research has provided in-depth understanding of professional stress experiences. To magnify the voices of professionals who share their experiences of stress in caring for older adults with dementia, a qualitative interpretive meta-synthesis of five qualitative studies was conducted. Guided by Pearlin's stress process model, four themes were identified: (1) emotional attachments to older adults with dementia; (2) difficulties in dementia care; (3) stressful working environment; and (4) conflicts with family members of older adults with dementia. Findings further highlighted that professionals' genuine concern for the well-being of older adults with dementia reinforced the perception of stressors identified in each of the preceding themes. These results could inform the improvements of emotional support for care professionals in practice and policy arenas.
Collapse
Affiliation(s)
- Zhirui Chen
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Christine Highfill
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| |
Collapse
|
9
|
McKenna M, Brown LJ, Muller C, Vikram A, Berry K. The impact of psychosocial training on staff attitudes towards people living with dementia: A systematic review. Int J Older People Nurs 2023; 18:e12528. [PMID: 36748262 DOI: 10.1111/opn.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/20/2022] [Accepted: 01/07/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND As the prevalence of dementia increases, the need for appropriately trained and skilled care teams also increases. Staff attitudes towards people living with dementia have a significant impact on caregiving behaviours and staff and resident outcomes. Training within care settings is a potential way of improving staff attitudes towards residents in their care. OBJECTIVES This review aimed to (i) assess the effectiveness of psychosocial training in improving care staff attitudes towards dementia; and (ii) examine the content and focus of training. METHOD The review was conducted following PRISMA guidance and the protocol was registered on PROSPERO prior to conducting the review. A comprehensive search of peer-reviewed literature was undertaken using CINAHL, Medline and PsycINFO from inception to March 2021. All papers were evaluated using a quality appraisal tool. RESULTS Ten studies met inclusion criteria and were of variable quality. However, six studies found significant improvements in staff attitudes towards dementia following staff training. The studies varied in terms of training focus and included behavioural, communication and cognitive-based approaches. CONCLUSIONS Staff training could be an effective method of improving staff attitudes towards dementia in care settings. Further research adopting high-quality randomised controlled designs to further explore staff attitudes following psychosocial training would make a valuable contribution to the literature base.
Collapse
Affiliation(s)
- Megan McKenna
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | | | | | | | - Katherine Berry
- University of Manchester, Manchester, UK.,Greater Manchester Mental Health Care NHS Foundation Trust, Manchester, UK
| |
Collapse
|
10
|
Rantapää M, Virtanen IA, Pekkala S. Formal caregivers' perceptions of everyday interaction with Deaf people with dementia. Clin Gerontol 2023:1-14. [PMID: 36639979 DOI: 10.1080/07317115.2023.2167623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Deteriorating interactive ability of people with dementia challenges formal caregivers. In Finland, Deaf people with advanced dementia may live in a nursing home designed for their care where the staff use Finnish Sign Language (FiSL). This study describes the perceptions of formal caregivers, focusing on the challenges, how they solve the challenges, and what support they need to improve interaction with Deaf residents. METHODS Semi-structured interviews with 13 formal caregivers who work with Deaf people with dementia were conducted and analyzed using qualitative content analysis. A purposive sampling was used. RESULTS Three key themes were challenges in interaction, strategies in supporting interaction, and support for coping. Caregivers perceived challenges in interaction caused by linguistic changes, deteriorating physical mobility and memory, and Deaf residents' behavioral challenges. Caregivers supported Deaf residents by learning to know them and using personal and linguistic strategies. Support for coping comprised supporting family members and other caregivers. CONCLUSIONS Efficient skills in sign language (SL) and knowledge of dementia are essential in interacting with Deaf residents and to build interpersonal relationships for care. CLINICAL IMPLICATIONS Supporting Deaf residents requires learning the way they interact which can be achieved over time.
Collapse
Affiliation(s)
- Minna Rantapää
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Sieppijarvi, Finland
| | | | - Seija Pekkala
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Sieppijarvi, Finland
| |
Collapse
|
11
|
Hu R, Lai B, Ma W, Zhang Y, Deng Y, Liu L, Lv Z, Chan C, Zhang F, Tao Q. How formal caregiver's BPSD knowledge influences positive aspects of caregiving: the mediating role of attitude and the moderating role of self-efficacy. BMC Geriatr 2022; 22:731. [PMID: 36064326 PMCID: PMC9444087 DOI: 10.1186/s12877-022-03417-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background The current study investigated the relationship between behavioural and psychological symptoms of dementia (BPSD) knowledge and positive aspects of caregiving (PAC), in addition, how caregiving attitude and self-efficacy mediate or moderate this relationship. Methods Two hundred twenty-nine formal caregivers (51males and 178females) who has worked in nursing homes for more than a month were recruited.With a cross-sectional, face-to-face survey, structural questionnaires were implemented to evaluate formal caregiver’s BPSD knowledge, attitude, self-efficacy and PAC.A 13-item self-developed questionnaire was used to assess caregiver’s BPSD knowledge about disease characteristics, care and risks, and treatment needs. Dementia attitude, self-efficacy and positive aspects of caregiving were measured by dementia attitude scale, the General self-efficacy scale, and Chinese version of positive aspects of caregiving respectively. Model 5 in the PROCESS micro was employed in order to verify the mediating effect of attitude and the moderating effect of self-efficacy on the relationship between BPSD knowledge and PAC. Results The results showed that greater BPSD knowledge was associated with increased PAC, and this relationship was fully mediated by increased friendly attitude toward people with dementia. Moreover, direct effect was moderated by self-efficacy, and that only among those with high self-efficacy, the direct effect of BPSD knowledge was found on promoting PAC. Conclusions By elucidating the knowledge-attitude-practice pathway in handling patient’s BPSD, the current study extends existing literature and provides insights for developing psychoeducation programs among formal caregivers.
Collapse
Affiliation(s)
- Rui Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Basic Medicine, Guangdong Province, Jinan University, Guangzhou, 510632, China
| | - Bingbing Lai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Basic Medicine, Guangdong Province, Jinan University, Guangzhou, 510632, China
| | - Wenhao Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Basic Medicine, Guangdong Province, Jinan University, Guangzhou, 510632, China
| | - Yuan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.,Division of Medical Psychology and Behavior Science, School of Basic Medicine, Guangdong Province, Jinan University, Guangzhou, 510632, China
| | - Yujiao Deng
- Home for the Aged Guangzhou, Guangzhou, China
| | - Lianqi Liu
- Department of Rehabilitation, Psychiatric Hospital of Guangzhou Civil Affairs Bureau, Guangzhou, China
| | - Zeping Lv
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - Chetwyn Chan
- Department of Psychology, the Education University of Hong Kong, Hong Kong, Hong Kong
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China. .,Division of Medical Psychology and Behavior Science, School of Basic Medicine, Guangdong Province, Jinan University, Guangzhou, 510632, China.
| | - Qian Tao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China. .,Division of Medical Psychology and Behavior Science, School of Basic Medicine, Guangdong Province, Jinan University, Guangzhou, 510632, China. .,Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China. .,Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Science, Qingdao, China.
| |
Collapse
|
12
|
Teichmann B, Gkioka M, Kruse A, Tsolaki M. Informal Caregivers' Attitude Toward Dementia: The Impact of Dementia Knowledge, Confidence in Dementia Care, and the Behavioral and Psychological Symptoms of the Person with Dementia. A Cross-Sectional Study. J Alzheimers Dis 2022; 88:971-984. [PMID: 35723101 PMCID: PMC9484115 DOI: 10.3233/jad-215731] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Dementia is rapidly increasing worldwide due to demographic aging. More than two-thirds of patients are cared by family members. The quality of care depends on the caregivers' attitude toward dementia influencing patient care decisions. OBJECTIVE The aim of this study is to examine the factors that influence the caregivers' attitude and whether there is an association between participation in a psycho-educational program and attitude. METHODS We performed a cross-sectional study using a structured closed-ended questionnaire to retrieve socio-demographic information from caregivers and the persons with dementia (N = 86). The study included validated scales such as the Dementia Attitude Scale, the Dementia Knowledge Assessment Tool 2, the Positive Aspects of Caregiving, the Zarit Burden Interview, the Confidence in Dementia Scale, and Spielberger's State-Trait Anxiety Inventory, as well as a neuropsychological battery to assess the condition of people with dementia. RESULTS Our final model explains 55.6% of the total variance and shows a significant correlation of five factors with attitude toward dementia: confidence, behavioral and psychological symptoms of dementia, anxiety as a trait, positive aspects of caregiving, and dementia knowledge. The caregivers who participated in a psycho-educational program showed a significantly more positive attitude toward dementia, better dementia knowledge, higher confidence in dementia care, and lower anxiety as a state. CONCLUSION The strong correlation of attitude and knowledge, as well as confidence in dementia care, supports the tripartite model of attitude, which hypothesizes the interrelation of affect, cognition, and behavior.
Collapse
Affiliation(s)
- Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Mara Gkioka
- Network Aging Research, Heidelberg University, Heidelberg, Germany.,School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Kruse
- Institute for Gerontology, Heidelberg University, Heidelberg, Germany
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| |
Collapse
|
13
|
Delivering person-centred palliative care in long-term care settings: is humanism a quality of health-care employees or their organisations? AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Reflecting on sustained calls for patient-centredness and culture change in long-term care, we evaluated the relative importance of personal and organisational predictors of palliative care, hypothesising the former as weaker predictors than the latter. Health-care employees (N = 184) from four Canadian long-term care homes completed a survey of person-centred care, self-efficacy, employee wellbeing and occupational characteristics. Using backward stepwise regression models, we examined the relative contributions of these variables to person-centred palliative care. Specifically, blocks of variables representing personal, organisational and occupational characteristics; palliative care self-efficacy; and employee wellbeing were simultaneously regressed on variables representing aspects of person-centred care. The change in R2 associated with the removal of each block was examined to determine each block's overall contribution to the model. We found that occupational characteristics (involvement in care planning), employee wellbeing (compassion satisfaction) and self-efficacy were reliably associated with person-centred palliative care (p < 0.05). Facility size was not associated, and facility profit status was less consistently associated. Demographic characteristics (gender, work experience, education level) and some aspects of employee wellbeing (burnout, secondary trauma) were also not reliably associated. Overall, these results raise the possibility that humanistic care is less related to intrinsic characteristics of employees, and more related to workplace factors, or to personal qualities that can be cultivated in the workplace, including meaningful role engagement, compassion and self-efficacy.
Collapse
|
14
|
Kirkham J, Shorey CL, Iaboni A, Quirt H, Grigorovich A, Astell A, Lin E, Maxwell CJ. Staff perceptions of the consequences of COVID-19 on quality of dementia care for residents in Ontario long-term care homes. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5725. [PMID: 35510483 PMCID: PMC9087411 DOI: 10.1002/gps.5725] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/20/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The first wave of the COVID-19 pandemic necessitated extensive infection control measures in long-term care (LTC) and had a significant impact on staffing and services. Anecdotal reports indicate that this negatively affected LTC residents' quality of care and wellbeing, but there is scarce evidence on the effects of COVID-19 on quality of dementia care in LTC. METHODS From December 2020 to March 2021, we conducted a cross-sectional online survey among staff who worked in LTC homes in Ontario, Canada. Survey questions examined staffs' perceptions of the impact of COVID-19 on dementia quality of care during the initial wave of the COVID-19 pandemic (beginning 1 March 2020). RESULTS There were a total of 227 survey respondents; more than half reported both worsened overall quality of care (51.3%) and worsening of a majority of specific quality of care measures (55.5%). Measures of cognitive functioning, mobility and behavioural symptoms were most frequently described as worsened. Medical and allied/support staff had the highest odds of reporting overall worsened quality of care, while specialized behavioural care staff and those with more experience in LTC were less likely to. LTC home factors including rural location and smaller size, staffing challenges, higher number of outbreaks and less COVID-19 preparedness were associated with increased odds of perceived worsening of quality of dementia care outcomes. CONCLUSIONS These findings suggest that COVID-19 pandemic restrictions and related effects such as inadequate staffing may have contributed to poor quality of care and outcomes for those with dementia in LTC.
Collapse
Affiliation(s)
- Julia Kirkham
- Department of PsychiatryCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Carrie L. Shorey
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Andrea Iaboni
- KITE‐Toronto Rehabilitation InstituteUniversity Health NetworkTorontoOntarioCanada,Department of PsychiatryTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Hannah Quirt
- KITE‐Toronto Rehabilitation InstituteUniversity Health NetworkTorontoOntarioCanada
| | - Alisa Grigorovich
- Recreation and Leisure StudiesBrock UniversitySt CatharinesOntarioCanada
| | - Arlene Astell
- KITE‐Toronto Rehabilitation InstituteUniversity Health NetworkTorontoOntarioCanada,Department of PsychiatryTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Esther Lin
- Department of PsychiatryCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Colleen J. Maxwell
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada,School of PharmacyUniversity of WaterlooWaterlooOntarioCanada
| |
Collapse
|
15
|
McKenna M, Brown LJE, Berry K. Formulation‐led care in care homes: Staff perspectives on this psychological approach to managing behaviour in dementia care. Int J Older People Nurs 2022; 17:e12465. [PMID: 35403365 PMCID: PMC9541292 DOI: 10.1111/opn.12465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 01/11/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022]
Abstract
Introduction Design Method Results Conclusion Implications for Practice
Collapse
Affiliation(s)
- Megan McKenna
- Division of Psychology and Mental Health School of Health Sciences Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - Laura J. E. Brown
- Division of Psychology and Mental Health School of Health Sciences Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - Katherine Berry
- Division of Psychology and Mental Health School of Health Sciences Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| |
Collapse
|
16
|
Zhao Y, Liu L, Ding Y, Shan Y, Chan HYL. Translation and validation of Chinese version of sense of competence in dementia care staff scale in healthcare providers: a cross-sectional study. BMC Nurs 2022; 21:35. [PMID: 35093043 PMCID: PMC8801082 DOI: 10.1186/s12912-022-00815-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/19/2022] [Indexed: 11/24/2022] Open
Abstract
Background Healthcare providers’ dementia-care competence is crucial for quality dementia care. A reliable and valid instrument is needed to assess the gaps in their dementia-care competence, and thereby identifying their educational needs. Therefore, this study aims to translate the 17-item Sense of Competence in Dementia Care Staff (SCIDS) scale into Chinese (SCIDS-C) and to validate the SCIDS-C among Chinese healthcare providers. Methods The translation procedure followed the modified Brislin’s translation model. A cross-sectional survey was conducted using the translated version. The validity, including content validity, confirmatory factor analysis, concurrent validity and known-groups validity, was tested. Reliability in terms of internal consistency and test-retest reliability with a 2-week interval was evaluated. Results A total of 290 healthcare providers in 12 nursing homes and a hospital completed the survey. The scale-level content validity index was .99. The confirmatory factor analysis model marginally supported the original 4-factor structure. Positive but weak correlations were noted between the total score of the SCIDS-C and that of the Dementia Knowledge Assessment Scale (r = .17, p = .005) and Approaches to Dementia Questionnaire (r = .22, p < .001), suggesting acceptable concurrent validity. Differences between health professionals and care assistants were significant in two subscales scores. The internal consistency of the scale was high, with Cronbach’s α of .87. Test-retest reliability was demonstrated with intra-class correlation coefficient of 0.88. Conclusions The SCIDS-C demonstrated acceptable reliability and validity although the known-groups validity between health professionals and care assistants was not fully established. It can be used to measure the level of sense of competence and as an outcome measure in educational intervention aiming at improving dementia care among Chinese healthcare providers. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00815-3.
Collapse
|
17
|
Zimmerman S, Carder P, Schwartz L, Silbersack J, Temkin-Greener H, Thomas KS, Ward K, Jenkens R, Jensen L, Johnson AC, Johnson J, Johnston T, Kaes L, Katz P, Klinger JH, Lieblich C, Mace B, O'Neil K, Pace DD, Scales K, Stone RI, Thomas S, Williams PJ, Williams KB. The Imperative to Reimagine Assisted Living. J Am Med Dir Assoc 2021; 23:225-234. [PMID: 34979136 DOI: 10.1016/j.jamda.2021.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
Assisted living (AL) has existed in the United States for decades, evolving in response to older adults' need for supportive care and distaste for nursing homes and older models of congregate care. AL is state-regulated, provides at least 2 meals a day, around-the-clock supervision, and help with personal care, but is not licensed as a nursing home. The key constructs of AL as originally conceived were to provide person-centered care and promote quality of life through supportive and responsive services to meet scheduled and unscheduled needs for assistance, an operating philosophy emphasizing resident choice, and a residential environment with homelike features. As AL has expanded to constitute half of all long-term care beds, the increasing involvement of the real estate, hospitality, and health care sectors has raised concerns about the variability of AL, the quality of AL, and standards for AL. Although the intent to promote person-centered care and quality of life has remained, those key constructs have become mired under tensions related to models of AL, regulation, financing, resident acuity, and the workforce. These tensions have resulted in a model of care that is not as intended, and which must be reimagined if it is to be an affordable care option truly providing quality, person-centered care in a suitable environment. Toward that end, 25 stakeholders representing diverse perspectives conferred during 2 half-day retreats to identify the key tensions in AL and discuss potential solutions. This article presents the background regarding those tensions, as well as potential solutions that have been borne out, paving the path to a better future of assisted living.
Collapse
Affiliation(s)
- Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Paula Carder
- Institute on Aging, College of Urban and Public Affairs and School of Public Health, Oregon Health and Science University-Portland State University, Portland, OR, USA
| | - Lindsay Schwartz
- Center for Health Policy Evaluation in Long-Term Care, American Health Care Association/National Center for Assisted Living, Washington, DC, USA
| | - Johanna Silbersack
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Helena Temkin-Greener
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Kali S Thomas
- US Department of Veterans Affairs Medical Center, and Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | - Kimberly Ward
- Cecil G. Sheps Center for Health Services Research and Schools of Social Work and Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Liz Jensen
- Direct Supply Innovation & Technology Center, Milwaukee, WI, USA
| | - Alfred C Johnson
- National Association for Regulatory Administration, Madison, WI, USA
| | | | | | - Loretta Kaes
- American Assisted Living Nurses Association, Napa Valley, CA, USA
| | - Paul Katz
- Department of Geriatrics, College of Medicine, Florida State University, FL, USA
| | | | | | - Beth Mace
- National Investment Center for Seniors Housing and Care, Annapolis, MD, USA
| | | | - Douglas D Pace
- Mission Partnerships, Alzheimer's Association, Washington, DC, USA
| | | | | | | | | | | |
Collapse
|
18
|
Fadayevatan R, Rahimi M, Abedi H. Care Process in Iranian Nursing Homes: A Grounded Theory Study. J Caring Sci 2021; 10:160-168. [PMID: 34849360 PMCID: PMC8609117 DOI: 10.34172/jcs.2021.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/02/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction: The need and use of long-term care services for older people has increased with their rising population and there is little information about the state of serving in nursing homes. This study aimed to identify the caring process in Iranian nursing homes.
Methods: This qualitative study was conducted in three Iranian nursing homes using grounded theory approach. The participants included 28 individuals (14 older people and 14 caregivers). The data were collected using unstructured interviews up to data saturation, and analyzed by constant comparative method.
Results: Fragmented care emerged as the core variable. The main factor for developing the core variable was ‘experience-based caring’. Other factors included ‘inappropriate structure for care’ as contextual factors in the nursing homes environment and ‘keeping instead of caring’, ‘dismal life’, and ‘up and down of the path’ as strategies and consequences.
Conclusions: The most common type of care was the routine and unplanned one with focusing on physical aspects. To improve a delivery care system for older people in nursing homes, proposing a care plan with focus on an integrated model of care in nursing homes, provision of instructions for treatment, as well as supervision and training caregivers to provide better care are necessary
Collapse
Affiliation(s)
- Reza Fadayevatan
- Department of Gerontology, Iranian Research Center of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Majid Rahimi
- Department of Health Education and Promotion, Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Heidarali Abedi
- Department of Nursing, Isfahan Branch, Islamic Azad University, Khorasghan, Iran
| |
Collapse
|
19
|
Martín J, Padierna Á, Villanueva A, Quintana JM. Evaluation of the mental health of care home staff in the Covid-19 era. What price did care home workers pay for standing by their patients? Int J Geriatr Psychiatry 2021; 36:1810-1819. [PMID: 34251057 PMCID: PMC8420212 DOI: 10.1002/gps.5602] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/07/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The characteristics of this pandemic increase the potential psychological impact on care homes workers (CHWs). The aims of this study were to analyse the mental health and health-related quality of life (HRQoL) of a broad sample of CHWs in Spain and to identify potential factors that have a significant effect on their mental health and HRQoL. METHOD This descriptive study comprised 210 CHWs who completed the Generalized Anxiety Disorder 7-item Scale, the Patient Health Questionnaire-9, the Impact Event Scale-Revised, the Insomnia Severity Index, and the Health-related Quality of Life Questionnaire. Sociodemographic and clinical data in relation to COVID-19 were also recorded. Descriptive statistics, univariable analysis and multivariable linear regression models were applied to identify factors associated with mental health and HRQoL. RESULTS Of total, 86.19% of participants were female; 86.67% were aged under 55 years; 11% were physicians and 64.19% were nurses or auxiliaries; 77.62% have themselves tested positive for Covid-19; and 67.94% of CHWs have directly treated patients with Covid-19. 49.28% had clinical depression; over half (58.57%) had clinical anxiety; 70.95% had clinical stress; and 28.57% had clinical insomnia. Increased use of tranquilizers/sedatives appears to be an explanatory variable of suffering greater anxiety, depression, stress and insomnia, and of having a worse HRQoL amongst our CHWs. CONCLUSIONS Our study confirms that symptomatology of anxiety, depression, stress, insomnia and HRQoL were affected amongst CHWs during the Covid-19 pandemic.
Collapse
Affiliation(s)
- Josune Martín
- Research UnitGaldakao‐Usansolo HospitalGaldakaoSpain,Kronikgune Institute for Health Services ResearchBarakaldoSpain,Health Services Research on Chronic Diseases Network—REDISSECGaldakaoSpain
| | - Ángel Padierna
- Department of PsychiatryGaldakao‐Usansolo HospitalGaldakaoSpain
| | - Ane Villanueva
- Research UnitGaldakao‐Usansolo HospitalGaldakaoSpain,Kronikgune Institute for Health Services ResearchBarakaldoSpain
| | - José M. Quintana
- Research UnitGaldakao‐Usansolo HospitalGaldakaoSpain,Health Services Research on Chronic Diseases Network—REDISSECGaldakaoSpain
| |
Collapse
|
20
|
Boumans J, van Boekel L, Kools N, Scheffelaar A, Baan C, Luijkx K. How staff characteristics influence residential care facility staff's attitude toward person-centered care and informal care. BMC Nurs 2021; 20:217. [PMID: 34724935 PMCID: PMC8559399 DOI: 10.1186/s12912-021-00743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Staff members, and their attitudes, are crucial for providing person-centered care in residential care facilities for people with dementia. However, the literature on the attitudes of nursing staff regarding person-centered care is limited. The objective of this study is to explore the association between staff characteristics (age, education level, years of work experience and function, i.e., care or welfare) and staff attitudes toward perceived person-centered care provision and including informal caregivers in the caregiving process in residential care facilities. METHODS A convenience sample of 68 care staff - nurses and nurse assistants - welfare staff members - activity counselors, hostesses, and living room caretakers - of two residential care facilities filled out a questionnaire. Staff attitudes regarding perceived person-centered care were measured with the Person-centered Care Assessment Tool (P-CAT). Staff attitudes regarding informal care provision were measured with the Attitudes Toward Families Checklist (AFC). Multiple linear regression analysis explored the association between variables age, work experience, education, and function (care or welfare). RESULTS A higher age of staff was associated with a more negative attitude toward perceived person-centered care and informal care provision. Welfare staff had a more negative attitude toward the inclusion of informal caregivers than care staff. The perceived person-centered care provision of the care and welfare staff was both positive. Work experience and education were not associated with perceived person-centered care provision or informal care provision. CONCLUSION This study is one of the first to provide insight into the association between staff characteristics and their attitude toward their perceived person-centered care provision and informal care provision. A higher age of both the care and welfare staff was associated with a more negative attitude toward their perceived person-centered care and informal care provision. Welfare staff had a less positive attitude toward informal care provision. Additionally, future studies, also observational studies and interview studies, are necessary to collect evidence on the reasons for negative attitudes of older staff members towards PCC and informal care giving, to be able to adequately target these reasons by implementing interventions that eliminate or reduce these negative attitudes.
Collapse
Affiliation(s)
- Jogé Boumans
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands.
| | - Leonieke van Boekel
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Nathalie Kools
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Aukelien Scheffelaar
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Caroline Baan
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| | - Katrien Luijkx
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000, LE, Tilburg, the Netherlands
| |
Collapse
|
21
|
Rippon D, McDonnell A, Bristow M, Smith MA, McCreadie M, Wetherell MA. Elevated levels of hair cortisol concentrations in professional dementia caregivers. Stress 2021; 24:945-951. [PMID: 34392773 DOI: 10.1080/10253890.2021.1968821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Providing care for people with dementia can be a highly stressful profession. Hair Cortisol Concentration (HCC) levels have been used as a biological marker for HPA axis activity to demonstrate that informal caregivers of people with dementia could be vulnerable to chronic stress. The current study aimed to progress the findings of research conducted with informal caregivers and is the first study to assess HCC as a biological indicator of stress in professional carers of people with dementia. HCC levels were compared between 32 professional dementia caregivers (30 females with a mean age of 45.83 and 2 males with a mean age of 24.50), 45 employees working in higher education settings (42 females with a mean age of 38.66 and 3 males with a mean age of 31.89) and 88 undergraduate students (67 females with a mean age of 24.04 and 21 males with a mean age of 23.91). Analysis of HCC was used to assess HPA axis activity over 1 month. A one-way ANCOVA, with age and gender being included as covariates, revealed that higher levels of HCC were observed in professional dementia carers than people who worked within higher education settings and undergraduate students. The results indicated that professional dementia caregivers may experience stress to the extent of activating biological stress responses at a greater frequency in comparison to people who work in higher education and undergraduate students. However, no significant differences were observed in the perceived stress levels reported across dementia caregivers, professionals working in higher education, and undergraduate students. These findings highlight the requirement to ascertain the extent to which work-related tasks or other factors, specific to the profession of caring for people with dementia, could elicit heightened HPA stress reactivity.
Collapse
Affiliation(s)
- Daniel Rippon
- School of Health and Life Sciences, Department of Psychology, University of Northumbria at Newcastle, Newcastle upon Tyne, UK
| | | | - Matt Bristow
- Faculty of Science and Engineering, Division of Psychology, Anglia Ruskin University, Cambridge, UK
| | - Michael A Smith
- School of Health and Life Sciences, Department of Psychology, University of Northumbria at Newcastle, Newcastle upon Tyne, UK
| | | | - Mark A Wetherell
- School of Health and Life Sciences, Department of Psychology, University of Northumbria at Newcastle, Newcastle upon Tyne, UK
| |
Collapse
|
22
|
Bluth K, Lathren C, Silbersack Hickey JVT, Zimmerman S, Wretman CJ, Sloane PD. Self-compassion training for certified nurse assistants in nursing homes. J Am Geriatr Soc 2021; 69:1896-1905. [PMID: 33837539 PMCID: PMC8273132 DOI: 10.1111/jgs.17155] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND/OBJECTIVES Certified nursing assistants (CNAs) who work in nursing homes (NHs) face significant work and personal stress. Self-compassion training has been shown to decrease stress postintervention in previous studies among healthcare providers and those in helping professions. This study examines the feasibility, acceptability, and preliminary outcomes of self-compassion training to address CNA stress and well-being. DESIGN Pre-post intervention. SETTING Three mid-size, nonprofit NHs in North Carolina. PARTICIPANTS Thirty CNAs, with a mean age of 49, 96% of whom were female, and 83% black/African American. INTERVENTION In one NH, participants received an 8-week, 2.5-h/session (20 h total) group intervention. At the time of recruitment for NHs 2 and 3, a briefer format (6-week, 1-h/session; 6 h total) became available and was preferred by CNAs, thus both NHs 2 and 3 participants received a 6-h group intervention. All interventions occurred in meeting rooms within participating NHs during shift changes. MEASUREMENTS Intervention attendance, retention, and acceptability; self-compassion, stress, burnout, depression, and attitudes toward residents with dementia, and job satisfaction pre-, post-, 3-month post-, and 6-month postintervention were assessed. RESULTS Attendance and program satisfaction were high, and attrition was low for both training formats. Self-compassion was significantly improved at all time periods (p < 0.001), and stress and depression improved significantly through 3 months (p < 0.05), but not 6 months. No statistically significant change in job satisfaction was noted. CONCLUSION Self-compassion interventions are feasible and acceptable for CNAs working in NHs and show promise for managing stress and improving well-being and compassion toward residents. The briefer 6-h format may maximize participation, while still providing benefits.
Collapse
Affiliation(s)
- Karen Bluth
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill, NC
| | - Christine Lathren
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Sheryl Zimmerman
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Christopher J. Wretman
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Philip D. Sloane
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
23
|
Effects on staff outcomes and process evaluation of the educating nursing staff effectively (TENSE) program for managing challenging behavior in nursing home residents with dementia: A cluster-randomized controlled trial. Int J Nurs Stud 2021; 120:103982. [PMID: 34171518 DOI: 10.1016/j.ijnurstu.2021.103982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/30/2021] [Accepted: 05/08/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Challenging behavior is prevalent in people with dementia residing in nursing homes and places a high burden on the nursing staff of dementia special care units. This study evaluates an educational program for nursing staff for managing challenging behavior: The Educating Nursing Staff Effectively (TENSE) program. This program can be tailored to care organizations' wishes and needs and combines various learning styles. OBJECTIVE The aim of this cluster-randomized controlled trial was to examine the short-term (3 months) and long-term (9 months) effects of the TENSE training program on experienced stress, work contentment, and stress reactions at work in nursing staff working in dementia special care units. DESIGN Cluster-randomized controlled trial. METHODS Nursing staff members of 18 dementia special care units within nine nursing homes from different Netherlands regions were randomized into an intervention (n = 168) or control (n = 129) group. The TENSE program consisted of a three-day training course and two follow-up sessions after three and six months, respectively. The primary outcome was stress experienced by nursing staff measured with the Utrecht Burnout Scale - C. Secondary outcomes were work contentment and stress reactions at work. Furthermore, process evaluation data on the reach of and compliance with the program and the program's feasibility and relevance were collected. Data were collected between November 2012 and November 2014. RESULTS In general, the participants appreciated the quality and relevance of the TENSE training and evaluated the content of the training as beneficial. The TENSE training had no effect on the components of experienced stress, i.e., emotional exhaustion (p = 0.751), depersonalization (p = 0.701), and personal accomplishment (p = 0.182). Furthermore, no statistically significant effects of the intervention on work contentment and stress reactions at work were found. CONCLUSIONS The TENSE training program did not have an effect on experienced stress, work contentment, nor stress reactions at work of nursing staff working in dementia special care units. In future studies, more focus on practicing new skills seems needed. TRIAL REGISTRATION NTR (Dutch Trial Registration) number NTR3620.
Collapse
|
24
|
Osakwe ZT, Ikhapoh I, Arora BK, Fleur-Calixte RS. Perception of Home Healthcare Nurses toward Persons with Dementia. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2021. [DOI: 10.1177/1084822320963086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to describe the perception of home healthcare (HHC) nurses toward persons with dementia (PWD). Using a cross-sectional survey design, data were collected from 225 registered nurses at 11 home care agencies across 7 states in the U.S. A web based modified Approaches to Dementia (ADQ) was used to assess nurses’ perception of person-centeredness. Most of the respondents were female (91.6%). Overall, greater years of experience as a registered nurse and age (<40 years) were associated with higher mean person-centeredness scores. Efforts to improve patient-centered dementia care in the HHC setting may need to be tailored to unique groups of HHC nurses.
Collapse
|
25
|
Isaac V, Kuot A, Hamiduzzaman M, Strivens E, Greenhill J. The outcomes of a person-centered, non-pharmacological intervention in reducing agitation in residents with dementia in Australian rural nursing homes. BMC Geriatr 2021; 21:193. [PMID: 33743597 PMCID: PMC7980426 DOI: 10.1186/s12877-021-02151-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 03/11/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There is limited best- practice evidence to address behavioral and psychiatric symptoms for those with dementia in Australian rural nursing homes. This study aims to evaluate the outcomes of a person-centered, non-pharmacological dementia care model, 'Harmony in the Bush', based on the Progressively Lowered Stress Threshold principles and person-centered music in rural Australia. METHODS A quasi-experimental (nonrandomized, pre-post) intervention study was conducted in five rural nursing homes in Queensland and South Australia. Seventy-four residents with dementia participated in this intervention study, which yielded a sample power of 80%. Eighty-seven staff completed the Caregiver Stress Inventory at pre-post four-weeks of intervention. Staff training workshops focused on the theory of the Progressively Lowered Stress Threshold principles and delivery of person-centered care plan with integrated music intervention. We used reported changes in agitation of the residents, measured using Cohen- Mansfield Agitation Inventory, and staff's caregiving stress, using Caregivers Stress Inventory. This study adheres to the CONSORT guidelines. RESULTS Mean age of residents with dementia was 82.4 (7.7) years and 69% were females. The mean age of admission was 80.1(8.4) years. Baseline measures indicated that 32.7% had mild- severe pain and 30.5% reported mild-severe sadness. The results showed statistically significant decline in aggressive behaviors, physically non-aggressive behaviors, verbally agitated behavior and hiding and hoarding. There was similar reduction in staff stress in the domains of aggressive behaviors, inappropriate behaviors, resident safety, and resource deficiency. CONCLUSIONS The Harmony in the Bush model is effective in reducing agitation among dementia residents with significant reduction in staff stress levels in nursing homes in rural Australia. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry (ANZCTR) on 20/2/2018 (Registration No: ACTRN12618000263291p). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374458.
Collapse
Affiliation(s)
- Vivian Isaac
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia.
| | - Abraham Kuot
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia
| | - Mohammad Hamiduzzaman
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia
| | - Edward Strivens
- James Cook University & Clinical Director, Older Persons Health Services, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, 4870, Australia
| | - Jennene Greenhill
- Rural and Remote Health South Australia, College of Medicine and Public Health, Flinders University, Po Box 852, Ral Ral Avenue, Renmark, SA, 5341, Australia
| |
Collapse
|
26
|
Montaner X, Tárrega S, Moix J. [Psychological flexibility, burnout and job satisfaction in dementia care workers]. Rev Esp Geriatr Gerontol 2021; 56:144-151. [PMID: 33608164 DOI: 10.1016/j.regg.2020.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The clinical complexity of dementia, its physical burden, and the potential assaults associated with psychological and behavioral symptoms, could put healthcare workers working with dementia at high risk of burnout. Certain attitudes toward dementia and certain coping styles may be a protective factor against the stress experienced by these workers. On the other hand, it has been shown that a coping style based on psychological flexibility can prevent the development of burnout in the workplace. The present study analyzes the relationship between levels of burnout, psychological flexibility, attitudes towards dementia and life satisfaction in a sample of healthcare workers who work with people affected by dementia. METHODS A sample of 105 healthcare workers from the Ricard Fortuny Social Hospital was recruited (day hospital, hospitalization unit, and nursing home), and psychological flexibility (AAQII), burnout levels (MBI), life satisfaction (SWL), anxiety (STAI-R), and attitudes towards dementia (EAD) were assessed. RESULTS Psychological inflexiblility showed a positive relationship with 2 dimensions of burnout (emotional exhaustion [r=.342, P<.01]; depersonalization [r=.328, P<.01]), and with anxiety (r=.723, P<.01), and also showed a negative relation with life satisfaction (r=-.485, P<.01) and affect attitude (r=-.209); p<.05). It was also found a negative relation between rejection attitude with emotional exhaustion (r=-.328, P<.01) and with depersonalization (r=-.328; P<.01). CONCLUSIONS Those participants with greater psychological flexibility, in addition to feel more satisfaction with life, were found to be less likely to feel emotionally exhausted, to depersonalize patients with dementia, and felt more affection for them. On the other hand, no relationship was found between Burnout levels and the cognitive dimension of Attitudes towards dementia (the worker's knowledge of dementia). The results have significant implications regarding the type of training that is given to healthcare workers who work with people affected by dementia. Psychoeducational interventions promoting the psychological flexibility could help to reduce the risk of burnout in healthcare workers who work with dementia.
Collapse
Affiliation(s)
- Xavier Montaner
- Departament de Psicologia Bàsica, Evolutiva i de l'Educació, Facultat de Psicologia, Universitat Autònoma de Barcelona, Campus de Bellaterra, Cerdanyola del Vallés, España; Consorci Sociosanitari Ricard Fortuny, Vilafranca del Penedès, España.
| | - Salomé Tárrega
- Facultat de ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya, Manresa. España; Estudis de Psicologia i Ciències de l'Educació, Universitat Oberta de Catalunya, Barcelona, España
| | - Jenny Moix
- Departament de Psicologia Bàsica, Evolutiva i de l'Educació, Facultat de Psicologia, Universitat Autònoma de Barcelona, Campus de Bellaterra, Cerdanyola del Vallés, España
| |
Collapse
|
27
|
Ho P, Cheong RCY, Ong SP, Fusek C, Wee SL, Yap PLK. Person-Centred Care Transformation in a Nursing Home for Residents with Dementia. Dement Geriatr Cogn Dis Extra 2021; 11:1-9. [PMID: 33790933 PMCID: PMC7989831 DOI: 10.1159/000513069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 11/29/2022] Open
Abstract
Background Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient. Objectives To describe the model of PCC adopted by a nursing home, Apex Harmony Lodge (AHL), with a logic model and evaluate outcomes on residents' well-being, care quality, and staff attrition by comparing pre-PCC initiation (2015) to post-implementation (2016). Methods Male residents in a 30-bed assisted living facility for persons with dementia in AHL were assessed using Dementia Care Mapping. Residents' well-being and staff attrition were measured before and after PCC implementation. Results There were statistically significant improvements in resident well-being (Δ = 0.44, p = 0.029), Positive Engagement Potential (Δ = 0.17, p = 0.002), and Occupational Diversity (Δ = 0.12, p = 0.014) in 2016. Withdrawal and Passive Engagement in the residents were reduced significantly as were Care Detractors. There was also a 55% reduction in staff attrition rates post-PCC. Conclusions Post-PCC implementation, the outcomes indicate a superior quality of care, enhanced resident well-being, and better staff retention. The AHL PCC model could serve as a roadmap for other nursing homes aspiring to raise the quality of care and influence long-term care standards and regulations for policy makers and legislators.
Collapse
Affiliation(s)
- Peiyan Ho
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | | | - Siew Pei Ong
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Carol Fusek
- Alzheimer's Disease Association, Singapore, Singapore
| | - Shiou Liang Wee
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Philip Lin Kiat Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| |
Collapse
|
28
|
Implementation of the National Early Warning Score in UK care homes: a qualitative evaluation. Br J Gen Pract 2020; 70:e793-e800. [PMID: 33020168 DOI: 10.3399/bjgp20x713069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The National Early Warning Score (NEWS) is a tool for identifying and responding to acute illness. When used in care homes, staff measure residents' vital signs and record them on a tablet computer, which calculates a NEWS to share with health services. This article outlines an evaluation of NEWS implementation in care homes across one clinical commissioning group area in northern England. AIM To identify challenges to implementation of NEWS in care homes. DESIGN AND SETTING Qualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee. METHOD Interviews were intended to capture people's attitudes and experiences of using the intervention. Following an inductive thematic analysis, data were considered deductively against normalisation process theory constructs to identify the challenges and successes of implementing NEWS in care homes. RESULTS Care home staff and other stakeholders acknowledged that NEWS could enhance the response to acute illness, improve communication with the NHS, and increase the confidence of care home staff. However, the implementation did not account for the complexity of either the intervention or the care home setting. Challenges to engagement included competing priorities, insufficient training, and shortcomings in communication. CONCLUSION This evaluation highlights the need to involve care home staff and the primary care services that support them when developing and implementing interventions in care homes. The appropriateness and value of NEWS in non-acute settings requires ongoing monitoring.
Collapse
|
29
|
Visscher A, Battjes-Fries MCE, van de Rest O, Patijn ON, van der Lee M, Wijma-Idsinga N, Pot GK, Voshol P. Fingerfoods: a feasibility study to enhance fruit and vegetable consumption in Dutch patients with dementia in a nursing home. BMC Geriatr 2020; 20:423. [PMID: 33096998 PMCID: PMC7584066 DOI: 10.1186/s12877-020-01792-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 09/27/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Eating problems are highly prevalent in older patients with dementia and as a consequence, these patients are at greater risk of becoming malnourished. Fingerfoods, snacks that can be picked with thumb and forefinger, could be used to counteract malnutrition in patients with dementia. The aim of this feasibility study was to evaluate whether providing fruit and vegetable rich fingerfoods in the form of recognizable and familiar snacks on top of the normal intake was feasible for both patients with dementia and caregivers as a means to increase patients' nutritional status. METHODS Institutionalised patients with dementia (N = 15, 93% female, mean age = 85 years) were included in this feasibility study in the Netherlands. The residents received their regular diet supplemented with fingerfoods, comprising quiches and cakes rich in fruit or vegetables, for 6 weeks. Daily fingerfood consumption together with compensation behaviour at dinner of residents was administered with a checklist and food diaries at the start and end of the intervention as dose delivered. Furthermore, caregivers were asked to fill out a feedback form at the end of the intervention to measure fidelity and appreciation of the intervention. RESULTS Patients consumed on average 1.4 pieces (70 g) of fingerfoods daily, containing 41 g of fruit and/or vegetables. Fruit and vegetable consumption increased during the provision of the fingerfoods and the residents seemed not to compensate this intake during the rest of the day. The intervention was generally positively received by the majority of caregivers, depending on the type of fingerfood and state of the resident. CONCLUSION This feasibility study showed that providing recognizable fruit and vegetable rich fingerfoods to patients with dementia seems feasible for both patients and caregivers and could provide a pragmatic approach to enhance fruit and vegetable consumption and total food intake in institutionalized elderly. In an up-scaled study, effects of fingerfoods on nutritional status and quality of life should be investigated.
Collapse
Affiliation(s)
- Annemijn Visscher
- Department of Nutrition and Health, Louis Bolk Instituut, Bunnik, The Netherlands
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | | | - Ondine van de Rest
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Olga N. Patijn
- Department of Nutrition and Health, Louis Bolk Instituut, Bunnik, The Netherlands
| | | | | | - Gerda K. Pot
- Department of Nutrition and Health, Louis Bolk Instituut, Bunnik, The Netherlands
- Department of Nutritional Sciences, King’s College London, London, UK
| | - Peter Voshol
- Department of Nutrition and Health, Louis Bolk Instituut, Bunnik, The Netherlands
| |
Collapse
|
30
|
Lee L, Weston WW, Hillier L, Archibald D, Lee J. Improving family medicine resident training in dementia care: An experiential learning opportunity in Primary Care Collaborative Memory Clinics. GERONTOLOGY & GERIATRICS EDUCATION 2020; 41:447-462. [PMID: 29927720 DOI: 10.1080/02701960.2018.1484737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Family physicians often find themselves inadequately prepared to manage dementia. This article describes the curriculum for a resident training intervention in Primary Care Collaborative Memory Clinics (PCCMC), outlines its underlying educational principles, and examines its impact on residents' ability to provide dementia care. PCCMCs are family physician-led interprofessional clinic teams that provide evidence-informed comprehensive assessment and management of memory concerns. Within PCCMCs residents learn to apply a structured approach to assessment, diagnosis, and management; training consists of a tutorial covering various topics related to dementia followed by work-based learning within the clinic. Significantly more residents who trained in PCCMCs (sample = 98), as compared to those in usual training programs (sample = 35), reported positive changes in knowledge, ability, and confidence in ability to assess and manage memory problems. The PCCMC training intervention for family medicine residents provides a significant opportunity for residents to learn about best clinical practices and interprofessional care needed for optimal dementia care integrated within primary care practice.
Collapse
Affiliation(s)
- Linda Lee
- The Centre for Family Medicine Family Health Team, Kitchener, Canada
- Department of Family Medicine, McMaster University , Hamilton, Canada
| | - W Wayne Weston
- Schulich School of Medicine & Dentistry, Western University , London, Canada
| | - Loretta Hillier
- Geriatric Education and Research in Aging Sciences (GERAS) Centre, Hamilton Health Sciences Centre , Hamilton, Canada
| | - Douglas Archibald
- Department of Family Medicine, University of Ottawa, Bruyère Research Institute , Ottawa, Canada
| | - Joseph Lee
- Department of Family Medicine, McMaster University , Hamilton, Canada
| |
Collapse
|
31
|
Keogh B, Ting To W, Daly L, Hynes G, Kennelly S, Lawlor B, Timmons S, O'Reilly S, Bracken-Scally M, Ciblis A, Cole N, Drury A, Pittalis C, Kennelly B, McCarron M, Brady AM. Acute hospital staff's attitudes towards dementia and perceived dementia knowledge: a cross-sectional survey in Ireland. BMC Geriatr 2020; 20:376. [PMID: 32998718 PMCID: PMC7526250 DOI: 10.1186/s12877-020-01783-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/21/2020] [Indexed: 11/13/2022] Open
Abstract
Background Little is known about staff’s attitudes in Irish acute hospital settings towards people living with dementia and their perceived dementia knowledge. The aim of this study was to understand the general level of dementia knowledge and attitudes towards dementia in different types of hospital staff, as well as to explore the potential influence of previous dementia training and experience (having a family member with dementia) and the potential moderating effects of personal characteristics. This data was required to plan and deliver general and targeted educational interventions to raise awareness of dementia throughout the acute services. Methods A cross-sectional survey was carried out among a diverse range of hospital staff (n = 1795) in three urban acute general hospitals in Ireland, including doctors, nurses, healthcare attendants, allied professionals, and general support staff. Participants’ perceived dementia knowledge and attitudes were assessed as well as their previous dementia training and experience. To measure participant’s attitude towards dementia, the validated Approaches to Dementia Questionnaire (ADQ) was used. Results Hospital staff demonstrated positive attitudes towards people living with dementia, and believed they had a fair to moderate understanding of dementia. Both ‘having previous dementia training’ and ‘having a relative living with dementia’ predicted attitude towards dementia and perceived dementia knowledge. Interestingly, certain personal staff characteristics did impact dementia training in predicting attitude towards dementia and perceived dementia knowledge. Conclusion This study provides a baseline of data regarding the attitudes towards dementia and perceived dementia knowledge for hospital staff in Irish acute hospitals. The results can inform educational initiatives that target different hospital staff, in order to increase awareness and knowledge to improve quality of dementia care in Irish hospitals.
Collapse
Affiliation(s)
- Brian Keogh
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland.
| | - Wing Ting To
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Louise Daly
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Geralyn Hynes
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Siobhan Kennelly
- Medicine for the Elderly, Connolly Hospital, Blanchardstown and National Clinical Integrated Care Programme, Health Services Executive, Dublin, Ireland
| | - Brian Lawlor
- Director Mercer's Memory Clinic, St James's Hospital, Dublin 8, School of Medicine and Global Brain Institute, Trinity College Dublin, Dublin, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork and Mercy University Hospital, Cork, Ireland
| | - Susan O'Reilly
- Medicine for the Elderly, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | | | - Aurelia Ciblis
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Natalie Cole
- National Research and Development Office, Health Service Executive, Dublin, Ireland
| | - Amanda Drury
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Chiara Pittalis
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Brendan Kennelly
- School of Business and Economics, National University of Ireland Galway, Galway, Ireland
| | - Mary McCarron
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| | - Anne-Marie Brady
- School of Nursing and Midwifery, The University of Dublin, Trinity College, 24 D'Olier Street, Dublin, D02, Ireland
| |
Collapse
|
32
|
Briones-Peralta MÁ, Pardo-García I, Escribano-Sotos F. Effects of a practical training programme on burnout among professional caregivers in a care home for older adults with dementia: a pilot study. Psychogeriatrics 2020; 20:391-397. [PMID: 32034853 DOI: 10.1111/psyg.12523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/10/2019] [Accepted: 01/14/2020] [Indexed: 11/30/2022]
Abstract
AIM As the number of persons with dementia has increased so has the need for both specialized care and long-term care centres. Professional caregivers working in these centres encounter specific problems, including stress, burnout, and feelings of dissatisfaction, each which can affect the quality of care. Due to the nature of their work, they are more likely to experience stress, which may lead to burnout syndrome. Therefore, the aim of this work was to assess the results of a practical training programme with regard to burnout among direct care professionals in a nursing home for people with dementia. METHODS A practical training programme was conducted for caregivers at the Sagrado Corazón de Jesús Nursing Home in Cuenca, Spain. The programme used a dynamic, interactive methodology to provide training related to concepts and strategies for dementia care. Weekly 2-h sessions were held over 9 months, from April 2016 to January 2017, with the post-test administered in February. Pretest and post-test measures were taken for a sample of 36 caregivers. An anova was used to analyze the differences in means before and after training. An ancova was also performed to determine the effects of the intervention. RESULTS The results revealed a significant difference between pre- and post-intervention emotional exhaustion and depersonalization scores. Personal accomplishment scores improved, but the changes were not significant. CONCLUSION A practical training programme for direct care professionals working with dementia patients can decrease burnout levels.
Collapse
Affiliation(s)
| | - Isabel Pardo-García
- School of Economics and Business Administration, Sociosanitary Research Center, Castilla-La Mancha University (UCLM), Albacete, Spain
| | - Francisco Escribano-Sotos
- School of Economics and Business Administration, Sociosanitary Research Center, Castilla-La Mancha University (UCLM), Albacete, Spain
| |
Collapse
|
33
|
Jain B, Syed S, Hafford-Letchfield T, O'Farrell-Pearce S. Dog-assisted interventions and outcomes for older adults in residential long-term care facilities: A systematic review and meta-analysis. Int J Older People Nurs 2020; 15:e12320. [PMID: 32394594 DOI: 10.1111/opn.12320] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 03/26/2020] [Accepted: 04/03/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To comprehensively review studies on dog-assisted interventions (DAIs) among older people in residential long-term care facilities (RLTCFs) and to provide an overview of their interventions, outcomes and methodological quality. METHOD We searched 18 electronic databases to identify English articles (published January 2000-December 2019) reporting on well-defined DAIs targeting older adults (≥65 years) in RLTCF. Data were extracted by two independent reviewers. Descriptive statistics were produced for quantitative studies, with key themes identified among qualitative studies. Where possible, estimates were pooled from randomised controlled trials using random effects meta-analyses. RESULTS Forty-three relevant studies (39 quantitative; 4 qualitative) were identified. The majority of quantitative studies were assessed as low-quality according to the MMAT criteria (n = 26, 67%). Almost half of the quantitative studies (n = 18, 46%) found no significant changes over time or between groups across outcomes measured. The most salient intervention effects included improved social functioning (n = 10), reduced depressive symptoms (n = 6) and loneliness (n = 5). A random-effects meta-analysis revealed a medium effect in favour of DAT on reducing depressive or loneliness symptoms (pooled SMD: 0.66, 95%CI 0.21-1.11; I2 = 50.5; five trials), relative to treatment as usual. However, compared to treatment as usual, no overall effect of DAI on activities of daily living was detected (p = .737). Key themes from qualitative studies included (a) animals as effective transitional objects, (b) the therapeutic value of pets and (c) the significance of the care environment and stakeholders in facilitating DAI. IMPLICATIONS FOR PRACTICE The findings of this review indicate that while DAI has value for older people in RLTCF, challenges remain in accurately measuring its impact to provide a stronger evidence-base. Standardisation of DAI service design, delivery and evaluation is required for future research and practice in providing holistic care for older adults.
Collapse
Affiliation(s)
- Briony Jain
- Department of Mental Health and Social Work, Middlesex University, London, UK
| | - Shabeer Syed
- Department of Mental Health and Social Work, Middlesex University, London, UK
| | - Trish Hafford-Letchfield
- Department of Mental Health and Social Work, Middlesex University, London, UK.,School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
| | | |
Collapse
|
34
|
Measuring Self-Efficacy and Attitudes for Providing Mouth Care in Nursing Homes. J Am Med Dir Assoc 2020; 21:1316-1321. [PMID: 32273219 DOI: 10.1016/j.jamda.2020.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/04/2020] [Accepted: 02/09/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Mouth care is increasingly recognized as an important component of care in nursing homes (NHs), yet is known to be deficient. To promote quality improvement and inform research efforts, it is necessary to have valid measures of staff self-efficacy and attitudes to provide mouth care. DESIGN A self-administered questionnaire completed by NH staff, information about the NH obtained from the administrator, and oral hygiene assessments of NH residents. SETTING AND PARTICIPANTS A total of 434 staff in 14 NHs in North Carolina who were participating in a cluster randomized pragmatic trial of Mouth Care Without a Battle (MCWB). METHODS Staff in MCWB homes completed the questionnaire at baseline; staff in control homes completed it at 2-year follow-up. The 35-item questionnaire used new items and those from previous measures, many of which were modified for the NH setting. Factorial, construct, and criterion validity were assessed. RESULTS Exploratory factor analysis identified a 3-factor 11-item self-efficacy scale (promoting oral hygiene, providing mouth care, obtaining cooperation) named "Self-Efficacy for Providing Mouth Care" (SE-PMC), and a 2-factor 11-item attitudes scale (care of residents' teeth, care of own teeth), named Attitudes for Providing Mouth Care (A-PMC). Scores varied significantly across NHs and differentiated them based on profit status, age, and, for the A-PMC, NH size. Scores also differentiated among staff based on age and, for the SE-PMC, years of experience. In NHs where staff scored more highly, residents featured better oral hygiene (P < .001). CONCLUSIONS AND IMPLICATIONS The SE-PMC and A-PMC are valid, parsimonious, and useful measures for quality improvement and research to improve mouth care in NHs that can be used jointly or individually. Preliminary evidence suggests that these scales may be associated with resident-level plaque and gingival hygiene, making them useful tools to assess promotion of mouth care.
Collapse
|
35
|
Yelland E, Stanfield MH. Public perspectives toward long-term care staff's interventions in the sexual relationships of residents with dementia. DEMENTIA 2020; 19:285-300. [DOI: 10.1177/1471301218772915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and objectives Sexual expression is an essential component of older adults’ quality of life, including those with lower cognitive functioning. Issues have been raised with long-term care facility policies related to aspects of staff intervention, permissibility of degree of intimacy, and how involved partners of residents with cognitive decline may be in decision-making processes. Research design and methods: This study used a multiple segment factorial vignette to explore the attitudes of the public toward a dementia-caused non-spousal sexual relationship in a long-term care facility. Specific elements examined included the degree of intimacy, obligation of long-term care staff to intervene in the relationship, and the healthy spouse’s disposition. Respondents ( N = 318) were contacted using a list-assisted random-digit dialing method and read a version of the vignette with the independent variables randomly generated. Two logistic regression models and one ordinal regression model were used to analyze the main effects of the independent design variables and respondent characteristics. Results The majority of respondents report the need for long-term care staff to intervene in sexual relationships and an obligation to inform the healthy spouse of a resident’s sexual relationship. Results suggest differences of opinion exist based on respondent characteristics of education and religiosity. Discussion and implications: Public opinion is in favor of long-term care facilities incorporating spousal involvement into decisions regarding a cognitively impaired resident’s ability to engage in an intimate relationship. Implications for long-term care policy focusing on staff training about sexual expression and intervention in addition to incorporating the spouse into decision-making processes are discussed.
Collapse
|
36
|
Gill D, Almutairi S, Donyai P. "The Lesser of Two Evils" Versus "Medicines not Smarties": Constructing Antipsychotics in Dementia. THE GERONTOLOGIST 2020; 59:570-579. [PMID: 29177512 DOI: 10.1093/geront/gnx178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/20/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Because antipsychotics are associated with an increased risk of morbidity and mortality, they should only be prescribed in dementia in limited circumstances. But antipsychotics are prescribed to a large proportion of residents in formal care settings despite guidance and warnings to the contrary, justifying a study into how professionals define and in turn create realities about antipsychotic usage in dementia. RESEARCH DESIGN AND METHODS Twenty-eight professionals with a role in the care and management of patients with dementia in care homes were recruited and interviewed in this qualitative study. A gap in the literature about the social construction of antipsychotics in dementia prompted the use of critical discourse analysis methodology. RESULTS Antipsychotics were portrayed in 2 distinct ways; as "the lesser of two evils' they were conceptualized as the less harmful or unpleasant of 2 bad choices and as "medicines not Smarties" (a brand of sweets/candy) they were conceptualized as prescribed too frequently and indiscriminately. The first resource could be used to defend the prescribing of antipsychotics and uphold the prescribers' privilege to do so whereas the second enabled the speaker to reject their own wilful involvement in overprescribing. DISCUSSION AND IMPLICATIONS When prescribers draw on "the lesser of two evils" paradigm to sanction the overprescribing of antipsychotics, implicit assumptions about these medications as being the best of bad choices should be recognized and challenged. Future studies should target specific normative beliefs about antipsychotic prescribing consequences, to change the lexicon of common knowledge which perpetuates bad practice.
Collapse
Affiliation(s)
- Dilbagh Gill
- Department of Pharmacy, University of Reading, UK
| | | | | |
Collapse
|
37
|
Iuglio S, Chaudhury H, Lengyel C, Morrison J, Boscart V, Carrier N, Keller H. Construct Validation of the Mealtime Relational Care Checklist for Individual Resident Use in Long-Term Care. J Nurs Meas 2019; 27:493-507. [DOI: 10.1891/1061-3749.27.3.493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and PurposeTo determine the construct validity of the Mealtime Relational Care Checklist (M-RCC) when used with individual residents.MethodsData was collected from 639 residents from 32 long-term care homes; M-RCC was completed at three meals for each resident and averaged. Bivariate analyses determined associations between the M-RCC and other resident level and dining room level measures.ResultsResident M-RCC was positively and significantly (p < .05) associated with three of five summary scales from Dining Environment Audit Protocol and Meal Time Scan as well as resident malnutrition risk (rs = 0.23). M-RCC was negatively associated with protein intake (gram per kilogram body weight; rs = -0.13) and Cognitive Performance Score (t-value = 4.48).ConclusionsThe resident level M-RCC was significantly associated with other measures in expected directions demonstrating construct validity.
Collapse
|
38
|
Mastel-Smith B, Kimzey M, Garner J, Shoair OA, Stocks E, Wallace T. Dementia care boot camp: interprofessional education for healthcare students. J Interprof Care 2019; 34:799-811. [PMID: 31835917 DOI: 10.1080/13561820.2019.1696287] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Dementia prevalence is increasing exponentially and has a profound effect on individuals diagnosed as well as their family caregivers. Dementia care should be patient focused, not task or medically oriented. Patient-centered dementia care requires more staff time, is complex, and, as a result, financially threatens the healthcare system. Therefore, professionals must be prepared to meet the needs of this growing population. The aims of this mixed methods study were to examine the effect of a 16-h interprofessional program on healthcare students' dementia knowledge, attitudes toward people with dementia, confidence for dementia care and empathy, and to understand the relationships among the listed variables. Nursing, occupational therapy assistant, pharmacy, and psychology students participated in a 16-h team-based learning Dementia Care Bootcamp. Students reported significant improvements in dementia attitudes and knowledge, confidence for dementia care and empathy immediately after Bootcamp and 3 months later. Significant relationships among listed variables were noted. Qualitative data complemented the quantitative findings. In addition, the concept of dementia care competency emerged. Students recognized the benefits of learning about, with and from others from diverse professions. Interprofessional education has great potential to improve students' ability to care for people with dementia.
Collapse
Affiliation(s)
| | - Michelle Kimzey
- Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, TX, USA
| | - Jennifer Garner
- Department of Occupational Therapy, Tyler Junior College, Tyler, TX, USA
| | - Osama A Shoair
- Ben and Maytee Fisch College of Pharmacy, The University of Texas at Tyler, Tyler, TX, USA
| | - Eric Stocks
- Psychology & Counseling, The University of Texas at Tyler, Tyler, TX, USA
| | - Takova Wallace
- Ben and Maytee Fisch College of Pharmacy, The University of Texas at Tyler, Tyler, TX, USA
| |
Collapse
|
39
|
Psychometric Evaluation of the Korean Version of the Personhood in Dementia Questionnaire Using Rasch Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234834. [PMID: 31805697 PMCID: PMC6926703 DOI: 10.3390/ijerph16234834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/13/2019] [Accepted: 11/28/2019] [Indexed: 11/21/2022]
Abstract
There is an increasing awareness of the need to promote behaviors consistent with the understanding that individuals with dementia deserve adequate respect. Person-centered attitudes on the part of a care facility’s staff can affect care practices and relationships with residents. This study examined the psychometric properties of the Korean version of the Personhood in Dementia Questionnaire (KPDQ), which measures staff’s person-centered attitudes toward individuals with dementia. The KPDQ was translated and adapted based on commonly used guidelines from the World Health Organization. For psychometric testing, the data obtained from a total of 269 participants in 13 long-term care facilities were analyzed. Factor analysis, item fit, convergent validity, and known-group validity were examined. Reliability and differential item functioning (DIF) based on Rasch analysis were also assessed. The KPDQ consists of 20 items with three subscales (“agency”, “respect for personhood” and “psychosocial engagement”). Item fit statistics indicated that each item fits well with the underlying construct. The KPDQ demonstrated satisfactory convergent validity, known-group validity and internal consistency reliability. There was no DIF by subgroup according to age or educational status. Results indicated that the KPDQ is a reliable and valid tool for measuring long-term care staff’s beliefs about personhood.
Collapse
|
40
|
Gerritsen DL, van Beek APA, Woods RT. Relationship of care staff attitudes with social well-being and challenging behavior of nursing home residents with dementia: a cross sectional study. Aging Ment Health 2019; 23:1517-1523. [PMID: 30409022 DOI: 10.1080/13607863.2018.1506737] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: This study investigates the relationship between attitudes of care staff and social well-being and challenging behavior of residents in long-term dementia care. Methods: The study was based on a cross-sectional design using questionnaires. Care staff members (N = 291) of 15 long-term care facilities in the Netherlands completed the Approaches to Dementia Questionnaire. Additionally, the primary professional caregiver of each participating resident (N = 239) completed an observational questionnaire regarding that resident's behavior, which contained the scale for Social Wellbeing Of Nursing home residents and the Cohen-Mansfield Agitation Inventory. Data were analyzed using multilevel analyses, taking characteristics of residents into account. Results: Attitudes of care staff towards residents with dementia differed between facilities. Further, residents experienced more social well-being and displayed less challenging behavior in facilities where care staff had more hopeful attitudes. Conclusion: This study demonstrates a relationship between attitudes of care staff and resident well-being. The results indicate that it is important to address attitudes towards residents with dementia in the education of (future) care staff. Care processes may also be improved by focusing on the attitudes of care staff. In this way, the well-being of residents with dementia can potentially be improved as well.
Collapse
Affiliation(s)
- D L Gerritsen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboudumc Alzheimer Centre, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - A P A van Beek
- NIVEL, Netherlands Institute for Health Services Research , Utrecht , the Netherlands
| | - R T Woods
- Dementia Services Development Centre Wales, Bangor University , Bangor , UK
| |
Collapse
|
41
|
Scerri A, Innes A, Scerri C. Person-centered dementia care in acute hospital wards-The influence of staff knowledge and attitudes. Geriatr Nurs 2019; 41:215-221. [PMID: 31630871 DOI: 10.1016/j.gerinurse.2019.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 10/25/2022]
Abstract
Person-centered dementia care practices in acute hospital wards are suboptimal and not commonly measured. Although previous research has indicated that the work environment of staff influences their perceptions of person-centeredness, few studies have examined how their personal attributes, such as their level of dementia knowledge and attitudes, influence their person-centered dementia care practices. A questionnaire was distributed to test the relationship between staff perceptions of person-centered dementia care and their dementia knowledge and attitudes in general medical wards. The results showed that staff with better dementia knowledge were significantly more critical about the extent they were using evidence-based guidelines and external expertise. Staff with better attitudes perceived themselves as using more individualized care practices. The findings demonstrate that to enhance person-centered dementia care in acute hospitals, staff training programs should develop both their intellectual and interpersonal skills to improve their knowledge and attitudes.
Collapse
Affiliation(s)
- Anthony Scerri
- Department of Nursing, Faculty of Health Sciences, University of Malta, Msida MSD 2090, Malta.
| | - Anthea Innes
- Faculty of Social Sciences, University of Stirling, Salford Institute for Dementia, University of Salford, Manchester, United Kingdom.
| | - Charles Scerri
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida MSD 2080, Malta.
| |
Collapse
|
42
|
Rivett E, Hammond L, West J. What influences self-perceived competence and confidence in dementia care home staff? A systematic review. Psychogeriatrics 2019; 19:440-456. [PMID: 30809893 DOI: 10.1111/psyg.12422] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 06/10/2018] [Accepted: 01/01/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dementia care staff working in long-term care settings are often exposed to a variety of complex situations that can be emotionally challenging, and a lack of adequate support and limited training opportunities may contribute to high levels of staff turnover in this area. Good-quality training may be beneficial for improving the quality of care provided, and in improving staff confidence and morale. This systematic review aimed to establish how dementia care home staff perceived their own competence and confidence in relation to the care they deliver, whether there are any specific interventions that improve these feelings, and whether feeling more competent and confident impacts on care delivery. METHOD A search of the literature focusing on staff perceptions of competence and confidence identified 14 873 studies. Following the removal of duplicates and papers that did not meet the inclusion criteria, 19 studies were included in the review and subject to quality assessment. RESULTS Studies varied in terms of quality and design, and were categorised as either intervention or non-intervention studies. Four studies found a significant increase in feelings of competence and confidence following intervention, although many studies did not statistically analyze their data. The most successful interventions seemed to be those that involved practical support alongside education, and non-intervention studies highlighted the importance of specific dementia and palliative care training with regard to feelings of competence and confidence. CONCLUSION Teaching alone may not be an adequate method of training dementia care staff, and the most successful interventions were those where practical support was also provided. Most studies suggested that improvements in competence and confidence also had benefits for care delivery and staff wellbeing. More research needs to be done using validated outcome measures and with competence and confidence as the primary aim.
Collapse
Affiliation(s)
- Emma Rivett
- Research Development, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Laura Hammond
- Research Development, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Juniper West
- Research Development, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| |
Collapse
|
43
|
Haeusermann T. Forced continuity: Explorations of biographical narratives in dementia care. J Aging Stud 2019; 49:1-8. [PMID: 31229213 DOI: 10.1016/j.jaging.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 02/10/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Tobias Haeusermann
- Memory and Aging Center, UCSF, 1500 Owens St #320, San Francisco, CA 94158, USA; University of Cambridge, PPSIS Faculty, Department of Sociology, Free School Lane, Cambridge CB2 3, UK.
| |
Collapse
|
44
|
Moyle W, Bramble M, Jones CJ, Murfield JE. "She Had a Smile on Her Face as Wide as the Great Australian Bite": A Qualitative Examination of Family Perceptions of a Therapeutic Robot and a Plush Toy. THE GERONTOLOGIST 2019; 59:177-185. [PMID: 29165558 DOI: 10.1093/geront/gnx180] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 10/21/2017] [Indexed: 12/18/2022] Open
Abstract
Background and Objectives Recent years have seen social robotic pets introduced as a means of treating behavioral and psychological symptoms of dementia, and many show promising potential. In this study, we sought to explore family members' perceptions of the Japanese-developed baby harp seal, Paro (version 9), and a look-alike, nonrobotic Plush Toy, when used by their relative with dementia for 15 min, 3 afternoons per week for 10 weeks. Research Design and Method The study employed a descriptive qualitative approach, which was nested within a larger cluster randomized controlled trial. A convenience sample of 20 family members (n = 10 each from the Paro and Plush Toy conditions) with relatives in 9 long-term care facilities in Queensland, Australia, completed individual semi-structured interviews (telephone or face-to-face). Inductive, data-driven thematic analysis of the data was undertaken with the assistance of the qualitative management software, ATLAS.ti®. Results Family members of long-term care residents with dementia expressed positive perceptions of the Paro, perceiving that it improved mood, reduced agitation, and provided opportunity for communication for their relative. Negative perceptions of the Plush Toy were given by family members, primarily because of its lack of movement and engagement. Conclusion Family members were keen for their older relative with dementia to use a social robot that moved and engaged with them, and Plush Toys that were static and unresponsive were perceived as being unimportant in improving quality of life. However, the current cost of Paro was identified by family members as a major limitation to use.
Collapse
Affiliation(s)
- Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia.,School of Nursing and Midwifery, Griffith University, Nathan, Australia
| | - Marguerite Bramble
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Bathurst, Australia
| | - Cindy J Jones
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia.,School of Nursing and Midwifery, Griffith University, Nathan, Australia
| | - Jenny E Murfield
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
| |
Collapse
|
45
|
Danaci E, Koç Z. The association of job satisfaction and burnout with individualized care perceptions in nurses. Nurs Ethics 2019; 27:301-315. [DOI: 10.1177/0969733019836151] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Individualized care is closely related to the fulfillment of nurses’ ethical responsibilities regarding the provision of healthcare as well as having a strong foundation in the philosophy of nursing. Objective: This study aimed to determine the association of job satisfaction and burnout with individualized care perceptions in nurses working at a university hospital located in the Central Black Sea region of northern Turkey. Research design: A cross-sectional correlational survey design. Participants and research context: The study was conducted between 15 February 2017 and 15 August 2017 with 419 nurses working at a public university hospital located in Samsun. Data were collected using an information form, the Individualized Care Scale-Nurse Version, the Minnesota Job Satisfaction Scale, and the Maslach Burnout Inventory. The Mann–Whitney U test, Kruskal–Wallis test and Spearman Correlation were used. Ethical considerations: Ethical approval for the study was obtained from the Ondokuz Mayıs University Clinical Studies Board of Ethics. Oral informed consent was taken from the participants. Findings: There was a significant positive relationship between the total Individualized Care Scale-A Nurse Version score and the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale (r = 0.121, p < 0.05). The total Individualized Care Scale-A Nurse Version score increased as the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale increased. There was a significant negative relationship between the total Individualized Care Scale-B Nurse Version score and the Desensitization (r = –0.143, p < 0.01) and Personal Achievement subscale scores of the Maslach Burnout Inventory (r = –0.182, p < 0.01). The Desensitization and Personal Achievement subscale scores of the Maslach Burnout Inventory increased as the total Individualized Care Scale-B Nurse Version score decreased. Discussion: Factors associated with the individualized care perceptions of nurses, such as job satisfaction and burnout levels and factors related to personal life and worklife should be taken into consideration. Also in order to increase job satisfaction and motivation in nurses, personal preferences regarding the service they want to work at should be taken into account. Conclusion: Nurses with lower burnout and higher job satisfaction were found to have higher individualized care perceptions and to support the individuality of patients in care applications. It is important to consider work-related factors associated with individualized care perceptions, job satisfaction, and burnout in nurses.
Collapse
|
46
|
Figueiredo M, Teixeira L, Paúl C. StressadaMente: Mental health promotion program for direct care workers of older people. SAGE Open Med 2019; 7:2050312119834116. [PMID: 30828453 PMCID: PMC6390218 DOI: 10.1177/2050312119834116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/01/2019] [Indexed: 11/17/2022] Open
Abstract
Background: In the current context, associated with the increase in longevity, there is a
greater need for institutionalization of old people in search of formal
support. The direct care workers of institutionalized older people, who work
at day care centers and residential homes, are at risk of being victims of
occupational psychosocial risks. There are several psychological complaints
of these workers, highlighting the need to develop a mental health promotion
program aiming at job satisfaction of direct care workers, improving their
provision of care at work and quality of life. Aim: The StressadaMente program is a mental health promotion program for direct
care workers of institutionalized older people in day care centers and
residential homes. This article aims to describe the StressadaMente program
and to evaluate the level of satisfaction of the direct care workers with
the program. Methods: The program was implemented in two day centers/residential homes, enrolling
25 participants, and comprised one session per week, with 90 min per
session, during 7 weeks. Sociodemographic information of direct care workers
was collected. The assessment protocol comprised a satisfaction
questionnaire of the program. Results: In general, the program was evaluated as “very good” and “excellent” by 9.5%
and 90.5% of the participants, respectively. These results may indicate that
mental health promotion intervention seems to encourage new skills and
changes to a better practice, prevent adverse effects of caregiving by
improving the mental health of professionals.
Collapse
Affiliation(s)
- Margarida Figueiredo
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Laetitia Teixeira
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,CINTESIS, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,CINTESIS, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| |
Collapse
|
47
|
Moyle W, Jones C, Murfield J, Thalib L, Beattie E, Shum D, Draper B. Using a therapeutic companion robot for dementia symptoms in long-term care: reflections from a cluster-RCT. Aging Ment Health 2019; 23:329-336. [PMID: 29282989 DOI: 10.1080/13607863.2017.1421617] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES We undertook a cluster-randomised controlled trial exploring the effect of a therapeutic companion robot (PARO) compared to a look-alike plush toy and usual care on dementia symptoms of long-term care residents. Complementing the reported quantitative outcomes , this paper provides critical reflection and commentary on individual participant responses to PARO, observed through video recordings , with a view to informing clinical practice and research. METHOD A descriptive, qualitative design with five participants selected from the PARO intervention arm of the trial. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). RESULTS The five participants and their responses to PARO are presented in terms of three issues: i.) Different pre-intervention clinical presentations and different responses; ii.) Same individual, different response - the need for continual assessment and review; and iii.) The ethics of giving and retrieving PARO. Implications for clinical practice and future research are discussed in relation to each issue. CONCLUSION The findings suggest that one approach does not fit all, and that there is considerable variation in responses to PARO. A number of recommendations are discussed to aid the delivery of psychosocial interventions with PARO in practice, as well as to guide future research.
Collapse
Affiliation(s)
- Wendy Moyle
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,b School of Nursing and Midwifery, Nathan Campus, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Cindy Jones
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,b School of Nursing and Midwifery, Nathan Campus, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Jenny Murfield
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Lukman Thalib
- c Department of Public Health, College of Health Sciences , Qatar University , Qatar
| | - Elizabeth Beattie
- d School of Nursing , Queensland University of Technology , Kelvin Grove, Brisbane , Queensland , Australia
| | - David Shum
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,e School of Applied Psychology, Mt Gravatt Campus, Griffith University , Brisbane , Queensland , Australia.,f Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China
| | - Brian Draper
- g School of Psychiatry, University of New South Wales , Sydney , Australia
| |
Collapse
|
48
|
Callwood A, Groothuizen JE, Allan HT. The “values journey” of nursing and midwifery students selected using multiple mini interviews; year two findings. J Adv Nurs 2019; 75:1074-1084. [DOI: 10.1111/jan.13941] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Alison Callwood
- School of Health Sciences University of Surrey Guildford Surrey GU2 7XHUK
| | | | - Helen Therese Allan
- Centre for Critical Research in Nursing and Midwifery School of Health and Education Middlesex University London UK
| |
Collapse
|
49
|
Abstract
AbstractThe average expected lifespan in Canadian long-term care (LTC) homes is now less than two years post-admission, making LTC a palliative care setting. As little is known about the readiness of LTC staff in Canada to embrace a palliative care mandate, the main objective of this study was to assess qualities relevant to palliative care, including personal emotional wellbeing, palliative care self-efficacy and person-centred practices (e.g. knowing the person, comfort care). A convenience sample of 228 professional and non-professional staff (e.g. nurses and nursing assistants) across four Canadian LTC homes participated in a survey. Burnout, secondary traumatic stress and poor job satisfaction were well below accepted thresholds, e.g. burnout: mean = 20.49 (standard deviation (SD) = 5.39) for professionals; mean = 22.09 (SD = 4.98) for non-professionals; cut score = 42. Furthermore, only 0–1 per cent of each group showed a score above cut-off for any of these variables. Reported self-efficacy was moderate, e.g. efficacy in delivery: mean = 18.63 (SD = 6.29) for professionals; mean = 15.33 (SD = 7.52) for non-professionals; maximum = 32. The same was true of self-reported person-centred care, e.g. knowing the person; mean = 22.05 (SD = 6.55) for professionals; mean = 22.91 (SD = 6.16) for non-professionals; maximum = 35. t-Tests showed that non-professional staff reported relatively higher levels of burnout, while professional staff reported greater job satisfaction and self-efficacy (p < 0.05). There was no difference in secondary traumatic stress or person-centred care (p > 0.05). Overall, these results suggest that the emotional wellbeing of the Canadian LTC workforce is unlikely to impede effective palliative care. However, palliative care self-efficacy and person-centred care can be further cultivated in this context.
Collapse
|
50
|
Blaser R, Berset J. Setting matters: Associations of nurses' attitudes towards people with dementia. Nurs Open 2019; 6:155-161. [PMID: 30534405 PMCID: PMC6279720 DOI: 10.1002/nop2.198] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 06/29/2018] [Accepted: 08/06/2018] [Indexed: 11/23/2022] Open
Abstract
AIM Identify associations between attitudes of nurses towards people with dementia and their socio-demographic (age and gender) and work-related characteristics (employment, work experience, nursing degree, care setting). DESIGN The study was designed in a cross-sectional way, collecting self-reported questionnaire data. METHODS Nurses (N = 417) completed the 20-item Dementia Attitude Scale questionnaire, including socio-demographic and work characteristics. Data were analysed using descriptive statistics, group mean comparison, correlation and regression analysis. RESULTS The attitudes of nurses towards people with dementia were only related to the care setting. Attitudes of nurses working in dementia-specialized long-term care institutions were significantly more positive compared with those working in mixed long-term care institutions and in the homecare setting. The other variables, such as age, gender, employment, nursing degree and work experience, were not associated with the attitudes.
Collapse
Affiliation(s)
- Regula Blaser
- Institute on AgeingUniversity of Applied SciencesBernSwitzerland
| | - Jeanne Berset
- Institute on AgeingUniversity of Applied SciencesBernSwitzerland
| |
Collapse
|