Reliability and Validity Assessment of the Job Attitude Scale

Function-Focused Care for Cognitive Impairment Training Among Formal Caregivers in Long-Term Care Facilities in Taiwan: A Cluster Randomized Controlled Trial

PURPOSE

To examine behavior changes among formal caregivers in Taiwanese long-term care facilities (LTCFs) after receiving training in function-focused care for cognitive impairment (FFC-CI).

METHOD

The current study was a clustered randomized controlled trial. Formal caregivers (i.e., RNs and nursing assistants) (N = 98) from four LTCFs were randomly assigned to experimental or control groups. Training was based on four components of FFC-CI. Data were collected four times within 9 months using five observational outcome measurements: Self-Efficacy for Restorative Care (SERCS), Outcome Expectations for Restorative Care Scale (OERCS), Restorative Care Knowledge Scale (RCKS), Restorative Care Behavior Checklist (RCBC), and Job Attitude Scale (JAS).

RESULTS

Statistically significant changes were noted in each activity of restorative care behavior among the four observational measurements. Results also indicated that job satisfaction was a statistically significant main effect for the experimental group; however, SERCS, OERCS, and RCKS scores were not statistically significant.

CONCLUSION

To eliminate gaps between translating research outcomes to clinical practice, this study applied a theory-based caring model for caregivers to improve knowledge and skills in caring for older adults with dementia. Caregivers who received training in FFC-CI not only had higher job satisfaction but could also provide specific FFC activities for residents during their daily care. [Journal of Gerontological Nursing, 50(7), 42-50.].

Factors Influencing Long-Term Care Workers' Self-Efficacy for Encouraging Residents to Engage in Physical Activity

We aimed to assess work-related factors and their association with long-term care workers' self-efficacy for encouraging and engaging residents in physical activity. Baseline data from a worksite wellness study with 98 workers were used. We used a linear regression model, to assess if job satisfaction, work ability, and social support for staff health behaviors from coworkers and supervisors were associated with staffs' self-efficacy for Function-Focused Care (FFC) and Staffs' Outcome Expectations for FFC. Staffs' social support for healthy behaviors from coworkers was the only factor that was significantly associated with Staffs' Outcome Expectations for FFC and staffs' self-efficacy-FFC, respectively explaining 19% and 14% of the variance. Our findings show that staffs' social support from coworkers is associated with higher self-efficacy for encouraging and engaging residents in physical activity suggests future worksite wellness studies with long-term care workers may wish to consider assessing program impacts on residents' physical activity levels.

Factors Influencing Job Satisfaction Among Long-Term Care Staff

OBJECTIVE

We assessed the intrapersonal, interpersonal, and organizational factors that predicted job satisfaction among long-term care employees.

METHODS

Baseline data were used to describe characteristics that influence job satisfaction. Using a forced linear regression model, while controlling for age and job title, we assessed if higher physical activity levels, fewer symptoms of depression, stress, and/or anxiety (ie, decreased mood), less back pain, stronger social support, and reports of low work demands were associated with higher job satisfaction.

RESULTS

Mood (β = -0.412, P = 0.003) explained 17% of the variance in job satisfaction.

CONCLUSION

This information can be used to guide facility wide programs and interventions aimed at increasing job satisfaction among all long-term care staff.

Rasch analysis of Stamps's Index of Work Satisfaction in nursing population

AIM

One of the most commonly used tools for measuring job satisfaction in nursing is the Stamps Index of Work Satisfaction. Several studies have reported on the reliability of the Stamps' tool based on traditional statistical model. The aim of this study was to apply the Rasch model to examine the adequacy of Stamps's Index of Work Satisfaction for measuring nurses' job satisfaction cross-culturally and to determine the validity and reliability of the instrument using the Rasch criteria.

DESIGN

A secondary data analysis was conducted on a sample of 556 registered nurses from two countries.

METHODS

The RUMM 2030 software was used to analyse the psychometric properties of the Index of Work Satisfaction.

RESULTS

The persons mean location of -0.018 approximated the items mean of 0.00, suggesting a good alignment of the measure and the traits being measured. However, at the items level, some items were misfiting to the Rasch model.

Function Focused Care for Assisted Living Residents With Dementia

PURPOSE OF THE STUDY

Assisted living (AL) residents with dementia require assistance with activities of daily living, encounter limited opportunities to engage in physical activity, and often exhibit challenging behavioral symptoms. The Function Focused Care Intervention for the Cognitively Impaired (FFC-CI) teaches and motivates direct care workers (DCWs) to engage residents with dementia in activities that optimize function and activity while minimizing behavioral symptoms. The purpose of this study was to test the impact of FFC-CI on function, physical activity, behavior, and falls.

DESIGN AND METHODS

A cluster-randomized trial included 96 residents with dementia and 76 DCWs from 4 ALs. Generalized estimating equations were used to evaluate outcomes at 3 and 6 months.

RESULTS

There were no treatment by time differences with regard to resident behavior, mood, counts of physical activity based on actigraphy, falls, and function. There were significant increases in physical activity based on kilocalories burned (p = .001), time spent in physical activity based on survey results (p = .001), and time spent in repetitive behaviors, such as wandering (p = .01) among the control group over time. There were no treatment by time differences with regard to DCW beliefs, knowledge, or performance of FFC, except for less decline in job satisfaction among the treatment group (p = .002). Treatment fidelity with regard to delivery and receipt were poor due to high staff attrition in the treatment group (46% vs. 16%) and limited site support.

IMPLICATIONS

The findings from this study can be used to adapt future FFC intervention studies to improve treatment fidelity and optimize intervention efficacy.

Optimizing function and physical activity among nursing home residents with dementia: testing the impact of function-focused care

PURPOSE OF THE STUDY

The purpose of this study was to test the impact of Function-Focused Care for the Cognitively Impaired Intervention on nursing home residents with dementia and the nursing assistants who care for them.

DESIGN AND METHODS

This was a cluster-randomized controlled trial using repeated measures. A total of 103 cognitively impaired residents and 77 nursing assistants were recruited from four nursing homes. For residents, outcome measures included function, physical activity (survey and actigraphy), mood, behavior, and adverse events (falls and hospitalization). Main outcome measures for nursing assistants included knowledge, beliefs, and performance of function focused care.

RESULTS

There were significant improvements in the amount and intensity of physical activity (by survey and actigraphy) and physical function in the treatment group. In addition, there was a significant decrease in the number of residents who fell during the treatment period with those in the treatment sites having fewer falls (28% vs. 50% in the control group). Nursing assistants were also observed to be providing a greater percentage of function focused care during resident care interactions in the treatment group at 6 months following the completion of baseline measures.

IMPLICATIONS

This study provides some evidence that nursing home residents with severe cognitive impairment can safely and successfully be engaged in physical and functional activities.