Organizational climate and self-efficacy as predictors of staff strain in caring for dementia residents: A mediation model

Being used for the greater good while fighting on the frontline: care staff's experiences of working with older people during the COVID-19 pandemic in Sweden

BAKGROUND

Worldwide, older people were more severely affected during the COVID-19 pandemic than others. In Sweden, those living in residential care facilities had the highest mortality rate, followed by those receiving home care services. The Swedish and international literature on the working environment for assistant nurses and care aides during the pandemic shows an increase in stress, anxiety, depression and post-traumatic stress syndromes. Care organisations were badly prepared to prevent the virus from spreading and to protect the staff from stress. In order to be better prepared for possible future pandemics, the health and well-being of the staff, the care of older people and the experiences of the staff both during and after a pandemic are important aspects to take into account. Therefore, this study aims to describe the experiences of assistant nurses and care aides working in the care of older people during the COVID-19 pandemic in Sweden, their working conditions and the impact all this had on their lives.

METHODOLOGY

The study has a qualitative, descriptive design. The data was collected in four focus group interviews with 21 participants and analysed using qualitative content analysis.

RESULTS

The results revealed the theme, Being used for the greater good while fighting on the frontline, which was then divided into three categories: portrayed as a risk for older people, not being valued and being burnt out. The worsening working conditions that the pandemic contributed to resulted in a high degree of stress and risk of burnout, with staff members both wanting to and actually leaving their employment. After the pandemic they felt forgotten again and left to cope in an even worse situation than before.

CONCLUSIONS

The pandemic had a major effect on assistant nurses and care aides in terms of their working environment and their private lives. To be better prepared for future pandemics or disasters, organisations with responsibility for the care of older people will need to ensure that their staff have the necessary competencies and that there is adequate staffing in place. This also means that adequate government funding and multiple interventions will be needed.

Clarity and adaptability of instructions preventing the spread of the COVID-19 virus and its association with individual and organisational factors regarding the psychosocial work environment: a cross-sectional study

BACKGROUND

In Sweden, older people in residential care had the highest mortality rates, followed by those who received home care, during the coronavirus disease 2019 (COVID-19) pandemic. Staff working in the care of older people assumed responsibility for preventing the spread of the virus despite lacking the prerequisites and training. This study aimed to investigate the psychosocial work environment during the COVID-19 pandemic among staff in the care of older people and examine the factors associated with staff's perceptions of the clarity of instructions and the ability to follow them.

METHODS

A cross-sectional study design was employed using a web survey. The staff's perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff's ability to follow them, were assessed using multivariate (ordinal) regression analysis.

RESULTS

The main findings show that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on role clarity, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear. Regarding adaptability, high scores for demands on learning and psychological demands were correlated with lower adaptability, while high scores for role clarity, encouraging leadership and social support, were associated with higher adaptability.

CONCLUSIONS

High job demands and individual learning demands were demonstrated to decrease the staff's understanding and adoption of instructions. These findings are significant on an organisational level since the work environment must be prepared for potential future pandemics to promote quality improvement and generally increase patient safety and staff health.

Emotional Stress Experience of Care Professionals for Older Adults with Dementia: A Qualitative Interpretive Meta-synthesis

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.

Psychosocial safety climate and self-efficacy: Moderating role of job-related expectations in Pakistani private-sector employees during the COVID-19 pandemic

The labor force in Pakistan comprises 59.8 million individuals. The employees have faced major changes in work dynamics and psychosocial safety climate during the COVID-19 pandemic. The purpose of the current study is to find the relationship between psychosocial safety climate, self-efficacy, and job-related expectations. It explores the moderating role of job-related expectations on the relationship between psychosocial safety climate and self-efficacy. It was hypothesized that there is likely to be a significant relationship between psychosocial safety climate, self-efficacy, and job-related expectations, job-related expectations are likely to moderate the relationship between psychosocial safety climate and self-efficacy, and there are likely to be differences between married and unmarried employees; men and women; satisfied and unsatisfied employees with respect to psychosocial safety, self-efficacy, and job-related expectations. A correlational research design and a convenience sampling strategy were used. A total of 281 employees (M = 30.74 years, SD = 10.99) of the private-sector (including educational, industrial, and IT) organizations during the COVID-19 pandemic were part of the study. Results show that psychosocial safety climate had a positive significant relationship with job-related expectations and self-efficacy. Job expectations also significantly correlated with self-efficacy. There were significant differences in measures of study variables with respect to gender, marital status, and employee satisfaction. This research has implications for administration, managers, policymakers, and organizational psychologists.

Relationship Between Dementia Knowledge and Occupational Strain Among Staff of Residential Facilities for Older Adults: A Cross-sectional Survey

Working with people living with dementia in residential facilities for older adults can be challenging, and this is exacerbated when staff have a limited understanding of dementia. However, the relationship between knowledge of dementia and strain in caring for people with dementia among residential facility staff is unclear. This cross-sectional study investigated the relationship between dementia knowledge and strain in caring for people with dementia. A questionnaire containing the Dementia Knowledge Assessment and Strain in Dementia Care Scales was administered in 2017 and 2019 to 141 staff in three southern Australian residential facilities for older adults. Bivariate and hierarchical regression analysis examined inter-scale relationships and the power of dementia strain to explain knowledge variance. It was found that staff had substantial gaps in dementia knowledge (mean score 32/50) and low strain in dementia care (mean score 4/16). A positive relationship was found between higher dementia knowledge and greater strain in dementia care (rs = 0.319, p < .001), particularly with feeling that residents are not receiving appropriate care from colleagues (Factor 1 Frustrated Empathy; rs = 0.392, p < .001). Frustrated Empathy explained a significant amount of variance in dementia knowledge beyond demographic variables. The findings suggest that more comprehensive dementia knowledge is associated with higher strain in care of people with dementia, particularly in the context of perceived lapses in the quality of care provided by colleagues. Arguably, organisational-wide dementia education to address identified gaps should be supported by facilitating staff enaction of their knowledge to improve care.

Indicators of job quality in the Australian aged care workforce: A scoping review

OBJECTIVE

As governments grapple with ageing populations, there is a need to understand more about the aged care workforce and how it is managed.

METHODS

We undertook a scoping review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Scopus and PubMed were used to identify papers published between 2010 and 2020. We mapped the breadth and scale of the evidence base according to the QuInnE indicators of job quality.

RESULTS

Out of 642 titles and abstracts that were screened, 122 were selected. Outcomes were measured across a range of domains, including wages, employment quality, education and training, working conditions, work/life balance and consultative participation and collective representation. These were distributed unevenly, revealing evidence gaps.

CONCLUSIONS

We identified significant knowledge gaps regarding Australia's aged care workforce at a time when the sector is coming under fresh scrutiny and projections indicate that it will face critical labour shortfalls going forward.

Caring self-efficacy of direct care workers in residential aged care settings: A mixed methods scoping review

The caring self-efficacy of direct care workers in residential aged care has been explored in the literature mostly as a predictor rather than the focus of interest. This scoping review aimed to provide an overview of the existing literature on aged care workers' caring self-efficacy and factors that influence it. A systematic search was performed in six electronic databases. All primary studies were included. A total of 41 studies met the inclusion criteria. Caring self-efficacy was most often described by aged care workers as their capacity to deal with difficult situations. The self-efficacy scores of direct care workers were high across studies. Self-efficacy was positively influenced by access to resources, relationships with residents and their families, the support of supervisors and co-workers, job satisfaction, and training opportunities, and negatively affected by work pressure and burnout. Findings indicate possible avenues for intervention to improve direct care workers' self-efficacy in aged care.

Factors affecting the quality of dementia care at acute care hospitals: A cross-sectional study

AIM AND OBJECTIVES

The purpose of this study was to investigate which factors are associated with the quality of dementia care in acute care hospitals.

BACKGROUND

The number of people with dementia who are admitted to acute care hospitals is increasing. Improving the quality of dementia care in acute care hospitals is an important issue. Prior studies have demonstrated that not only knowledge and nursing experience, but also psychological factors and the nursing practice environment are related to high-quality care on general wards.

DESIGN

Cross-sectional hypothesis-testing design.

METHODS

Participants were nurses providing care to people with dementia at acute care hospitals. Questionnaires were distributed to 300 acute care hospitals in Japan, 10 copies each and 773 valid responses were received. Based on the hypothesis model, variables were tested using multiple regression analysis. The model described the relationship between quality of care, personal attributes and the nursing practice environment. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used.

RESULTS

Almost 90% of the study sample was female, the mean age was 37.4 ± 9.3 years, and the mean nursing experience was 14.0 ± 8.7 years. The results showed that nursing foundations for quality of care, staffing and resource adequacy, specialist consultation, promoting systematic recreation and exchange, knowledge, and feelings towards people with dementia were associated with the quality of dementia care in acute care hospitals. The adjusted coefficient of determination was 0.367.

CONCLUSION

This study identified factors associated with the quality of dementia care in acute care hospitals. Knowledge and feelings towards people with dementia are important, and the nursing practice environment plays an important role in improving the quality of dementia care.

RELEVANCE TO CLINICAL PRACTICE

Not only improving nurse's practical ability but also a supportive nursing practice environment enhances the quality of dementia care in acute care hospitals.

Quality of care in Hunan Province nursing homes: relationship to staffing and organizational climate

Our objective was to examine the quality of care perceived by nursing staff and its relationship with the staffing and organizational climate in nursing homes. The participants in this cross-sectional study included 358 nursing staff from 26 nursing homes in Hunan Province, China. This study found that the interaction effect between nursing staff to resident ratio and physician to resident ratio exerted a significant effect on quality of care (p < 0.05). Higher scores on the relationships and communication scale (OR = 4.771, p = 0.002) and lower scores on the work stress scale (OR = 0.980, p = 0.050) were also associated with better quality of care. More work experience was related to lower quality of care (OR = 0.944, p = 0.048), and work experience was associated with relationships and communication (Beta = 0.172, p = 0.002) and work stress (Beta= = 0.259, p = 0.000). Staffing level, work experience, work stress, relationships and communication are key factors in providing higher quality of care in nursing homes.