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Fokuo JK, Hutman PJ, Gruber VA, Masson CL, Lum PJ, Bush DM, Naugle JA, Sorensen JL. Substance use Attitudes, Beliefs, Experience, and Knowledge Among Nursing and Nursing Assistant Students. J Psychoactive Drugs 2024:1-11. [PMID: 38646910 DOI: 10.1080/02791072.2024.2343402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 03/14/2024] [Indexed: 04/23/2024]
Abstract
Stigma is a public health concern. Stigmatizing attitudes toward persons with substance use disorders (SUDs) can adversely impact clinical care and outcomes. Beliefs about SUD, prior experience and familiarity to persons with SUD, and educational curricula drive attitudes among health-care workers. In 2019, nursing and nursing assistant students were recruited through an online survey platform. Participants completed an SUD knowledge test and a survey assessing education, beliefs, personal experience, and confidence in recognizing the signs and symptoms of SUD. One hundred and ten health-care students (nursing students, n = 67 and nursing assistant students, n = 43) completed the survey. Among nursing assistant students, endorsing a disease model of addiction (F(2, 40) = 5.83, p < .001, R2 = .23), and personal familiarity with SUD (F(2, 40) = 4.46, p < .001, R2 = .18), were significantly positively predictive of positive regard toward working with persons with SUD. For nursing students, endorsing a disease model of addiction, educational curricula involving persons with SUD, and personal familiarity were significantly positively predictive of positive regard toward working with persons with SUDs (F(2, 61) = 11.52, p < .001, R2 = .36). Interventions to mitigate drug-related stigma among health-care students should center students with personal familiarity, promote the disease concept of addiction, and incorporate contact-based training.
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Affiliation(s)
- J Konadu Fokuo
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Paul J Hutman
- Veterans Administration, Northern California Health Care System, Redding, CA, USA
| | - Valerie A Gruber
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Carmen L Masson
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Paula J Lum
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Dylan M Bush
- Division of Biology and Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jessica A Naugle
- San Francisco Department of Public Health, Street Medicine and Shelter Health, San Francisco, CA, USA
| | - James L Sorensen
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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Mateos-González L, Rodríguez-Suárez J, Llosa JA, Agulló-Tomás E. [Spanish version of the Nordic Musculoskeletal Questionnaire: cross-cultural adaptation and validation in nursing aides]. An Sist Sanit Navar 2024; 47:e1066. [PMID: 38488106 PMCID: PMC11016339 DOI: 10.23938/assn.1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/22/2023] [Accepted: 01/18/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND The aim of this study is to translate, culturally adapt, and validate a Spanish version of the Nordic Musculoskeletal Questionnaire for a sample of nursing assistant aides. METHODS The questionnaire was translated and culturally adapted. Next, it was included in a battery of tests that was completed by 526 nursing assistants working in residential care homes in the Principality of Asturias (Spain). To assess its validity, the Exploratory Factor Analysis and the Confirmatory Factor Analysis were used. The internal consistency was estimated with McDonald's Omega coefficient (?), complemented by the test-retest reliability analysis through the intraclass correlation coefficient. The validity of the criteria was established by the correlation between total score on the test and quality of life measures, job insecurity and psychological demand, and social support at work. RESULTS The Exploratory Factor Analysis and Confirmatory Factor Analysis adjustment indices confirmed it is a unidimensional test. The internal consistency values indicated very high reliability (? = 0.81). Similarly, the intraclass correlation coefficient showed statistically significant values and an excellent correlation coefficient (r = 0.95). The validity of the criteria showed a statistically significant correlation with all the constructs studied, particularly with quality of life. CONCLUSIONS This Spanish version of the Nordic Musculoskeletal Questionnaire has good psychometric qualities for a population of nursing aides and therefore may be a valid and reliable tool for assessing musculoskeletal disorders.
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Kung PJ, Fang CJ, Cheng YY, Chen CM. Health and care workers in long-term care facilities and their role in preventing emerging infectious diseases: A scoping review. J Nurs Scholarsh 2024; 56:260-281. [PMID: 37853997 DOI: 10.1111/jnu.12936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/07/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The COVID-19 pandemic has had a tremendous impact on healthcare systems worldwide. In particular, long-term care facilities have proved more susceptible to infection as they care for vulnerable populations at high risk of chronic illness. How this impacts the role and core competencies of health and care workers in these facilities remains less understood. AIM Describe how health and care workers contribute to the prevention of emerging infectious diseases in long-term care facilities. DESIGN A scoping review. METHODS A systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long-term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross-checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings. RESULTS A total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: "The roles of health and care workers evolve with the times", "The core competencies of health and care workers are essential for preventing emerging infectious diseases in long-term care facilities" and "The key to successful prevention of emerging infectious diseases in long-term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels". Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management models were found to have significantly improved infection prevention and control outcomes. CONCLUSIONS The roles of health and care workers are evolving, and effective infection prevention within long-term care facilities depends on their ability to perform core competencies with skill and confidence. Moreover, a systematic, comprehensive framework, for which this paper proposes three guidelines, is urgently needed to ensure consistent policy implementation within the facility as well as support and access to resources for health and care workers. CLINICAL RELEVANCE Infection prevention efforts within long-term care facilities must take into account the evolving roles of health and care workers, with a focus on guaranteeing access to resources, training and support that will help them gain the core competencies necessary for juggling those roles. In addition, there is an urgent need for research instruments that will help assess those competencies and identify areas of improvement.
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Affiliation(s)
- Po-Jen Kung
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Ching-Ju Fang
- Medical Library, National Cheng Kung University, Tainan, Taiwan, ROC
- Department of Secretariat, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Yi-Yuan Cheng
- National Miaoli Senior High School, Miaoli, Taiwan, ROC
| | - Ching-Min Chen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
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Song Y, Keefe JM, Squires J, deGraves B, Duan Y, Cummings G, Doupe MB, Hoben M, Duynisveld A, Norton P, Poss J, Estabrooks CA. Changes in Health and Well-Being of Care Aides in Nursing Homes From a Pre-Pandemic Baseline in February 2020 to December 2021. J Appl Gerontol 2024; 43:3-12. [PMID: 37647610 DOI: 10.1177/07334648231197074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Nursing homes were profoundly affected by the COVID-19 pandemic, influencing work outcomes of care aides who provide the most direct care. We compared care aides' quality of work life by conducting a repeated cross-sectional analysis of data collected in February 2020 and December 2021 from a stratified random sample of urban nursing homes in two Canadian provinces. We used two-level random-intercept repeated-measures regression models, adjusting for demographics and nursing home characteristics. 2348 and 1116 care aides completed the survey in February 2020 and December 2021, respectively. The 2021 sample had higher odds of reporting worked short-staffed daily to weekly in the previous month than the 2020 sample. The 2021 sample also had a small but significant drop in professional efficacy and mental health. Despite the worsening changes, our findings suggest that this workforce may have withstood the pandemic better than might be expected.
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Affiliation(s)
- Yuting Song
- School of Nursing, Qingdao University, Qingdao, China
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Janice M Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Canada
| | - Janet Squires
- School of Nursing, University of Ottawa, Ottawa, Canada
| | | | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Greta Cummings
- College of Health Sciences, University of Alberta, Edmonton, Canada
| | - Malcolm B Doupe
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Canada
- Faculty of Health, York University, Toronto, Canada
| | - Amber Duynisveld
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Canada
| | - Peter Norton
- Department of Family Medicine, University of Calgary, Calgary, Canada
| | - Jeffrey Poss
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Song Y, Bolt S, Thorne T, Norton P, Poss J, Fu F, Squires J, Cummings G, Estabrooks CA. Nursing assistants' use of best practices and pain in older adults living in nursing homes. J Am Geriatr Soc 2023; 71:3413-3423. [PMID: 37565426 DOI: 10.1111/jgs.18527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 06/15/2023] [Accepted: 07/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Inadequate pain management persists in nursing homes. Nursing assistants provide the most direct care in nursing homes, and significantly improving the quality of care requires their adoption of best care practices informed by the best available evidence. We assessed the association between nursing assistants' use of best practices and residents' pain levels. METHODS We performed a cross-sectional analysis of data collected between September 2019 and February 2020 from a stratified random sample of 87 urban nursing homes in western Canada. We linked administrative data (the Resident Assessment Instrument-Minimum Data Set [RAI-MDS], 2.0) for 10,093 residents and survey data for 3547 nursing assistants (response rate: 74.2%) at the care unit level. Outcome of interest was residents' pain level, measured by the pain scale derived from RAI-MDS, 2.0. The exposure variable was nursing assistants' use of best practices, measured with validated self-report scales and aggregated to the unit level. Two-level random-intercept multinomial logistic regression accounted for the clustering effect of residents within care units. Covariates included resident demographics and clinical characteristics and characteristics of nursing assistants, unit, and nursing home. RESULTS Of the residents, 3305 (30.3%) were identified as having pain. On resident care units with higher levels of best practice use among nursing assistants, residents had 32% higher odds of having mild pain (odds ratio, 1.32; 95% confidence interval, 1.01-1.71; p = 0.040), compared with residents on care units with lower levels of best practice use among nursing assistants. The care units did not differ in reported moderate or severe pain among residents. CONCLUSIONS We observed that higher unit-level best practice use among nursing assistants was associated with mild resident pain. This association warrants further research to identify key individual and organizational factors that promote effective pain assessment and management.
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Affiliation(s)
- Yuting Song
- School of Nursing, Qingdao University, Qingdao, China
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Sascha Bolt
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Trina Thorne
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Peter Norton
- Department of Family Medicine, University of Calgary, Calgary, Canada
| | - Jeff Poss
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Fangfang Fu
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Janet Squires
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - Greta Cummings
- College of Health Sciences, University of Alberta, Edmonton, Canada
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Dijxhoorn AFQ, Heijnen Y, van der Linden YM, Leget C, Raijmakers NJH, Brom L. Nursing assistants' perceptions and experiences with the emotional impact of providing palliative care: A qualitative interview study in nursing homes. J Adv Nurs 2023; 79:3876-3887. [PMID: 37308976 DOI: 10.1111/jan.15733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
AIM To gain insight into the perceived emotional impact of providing palliative care among nursing assistants in Dutch nursing homes, their strategies in coping with this impact and associated needs. DESIGN Exploratory qualitative study. METHODS In 2022, 17 semistructured interviews with nursing assistants working in Dutch nursing homes were conducted. Participants were recruited via personal networks and social media. Interviews were open-coded by three independent researchers following the thematic analysis approach. RESULTS Three themes emerged regarding the elements that contribute to the emotional impact of providing palliative care in nursing homes: impactful situations (e.g. witnessing suffering and sudden deaths), interactions (e.g. close relationship and receiving gratitude) and reflection on provided care (e.g. feeling fulfilment or feeling inadequate in caring). Nursing assistants used different strategies to cope, including emotional processing activities, their attitude towards death and work and gaining experience. Participants experienced a need for more education in palliative care and organized peer group meetings. CONCLUSION Elements that play a role in how the emotional impact of providing palliative care is perceived by nursing assistants can have a positive or negative impact. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Nursing assistants should be better supported in coping with the emotional impact of providing palliative care. IMPACT In nursing homes, nursing assistants are most involved in providing daily care to residents and have a signalling role in recognizing the deteriorating conditions of residents. Despite their prominent role, little is known about the emotional impact of providing palliative care among these professionals. This study shows that although nursing assistants already undertake various activities to reduce the emotional impact, employers should be aware of the unmet needs in this area and the responsibility they have in this regard. REPORTING METHOD The QOREQ checklist was used for reporting. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Anne-Floor Q Dijxhoorn
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
- Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - Yanouk Heijnen
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Yvette M van der Linden
- Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - Carlo Leget
- University of Humanistic Studies, Utrecht, The Netherlands
| | - Natasja J H Raijmakers
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Linda Brom
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
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Golay D, Cajander Å, Salminen-Karlsson M. Information technology use and tasks left undone by nursing staff: A qualitative analysis. Health Informatics J 2023; 29:14604582231207743. [PMID: 37882139 DOI: 10.1177/14604582231207743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Nursing staff perceive information technology (IT) as time-consuming and impinging on direct patient care time. Despite this, researchers have directed little attention toward the interplay between IT use and tasks left undone by nursing staff. In this paper, we analyze interview and focus group data on hospital nursing staff's experience working with IT to identify ways IT use interacts with tasks left undone. We found that tasks left undone by nursing staff can have IT-related antecedents and that IT-related tasks are also sometimes left undone. This analysis adds to the body of knowledge by showing that tasks related to the work environment and IT can be left undone and that nursing staff avoid certain IT-supported tasks because they do not know how to do them or why they ought to be done. These findings form the basis for our call for further research on the topic.
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Affiliation(s)
- Diane Golay
- Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Åsa Cajander
- Department of Information Technology, Uppsala University, Uppsala, Sweden
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Shrestha S, Wells Y, While C, Rahman MA. Psychometric properties of the Caring Efficacy Scale among personal care attendants working in residential aged care settings. Australas J Ageing 2023; 42:491-498. [PMID: 37151125 DOI: 10.1111/ajag.13211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/01/2023] [Accepted: 04/18/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE This study assessed the psychometric properties of the Caring Efficacy Scale (CES) among personal care attendants providing care to older residents in residential aged care settings. METHODS This cross-sectional study was completed in Australia in 2020-2021. Confirmatory factor analysis (CFA) of the 30-item original CES (Model 1) and 28-item CES validated in registered nurses (Model 2) was conducted to assess the goodness of fit of these models in our study population. Due to unsatisfactory fit indices for both models, exploratory factor analysis (EFA) was conducted to examine the dimensionality and underlying structure of the original CES among personal care attendants. Internal consistency of the final scale and subscales identified was examined using item-total correlations and Cronbach's alpha coefficients. RESULTS Two hundred and eighty personal care attendants participated in the study. The model fit indices such as Comparative Fit Index and Tucker Lewis Index of both models were less than 0.90, while the Standardised Root Mean Square Residual and Root Mean Square of Approximation values were greater than or equal to 0.08 and 0.06, respectively. The EFA identified a two-factor structure, and 22 items of the 30 in the original scale were retained. Item-total correlations amongst items retained in the scale and subscales were greater than 0.3. Cronbach's alpha for the abbreviated scale was 0.85, with 0.83 and 0.79, respectively, for the two subscales. CONCLUSIONS The modified CES can be used as a robust tool to assess the self-efficacy of personal care attendants in providing care to older residents in residential aged care settings.
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Affiliation(s)
- Sumina Shrestha
- Australian Institute for Primary Care and Ageing, La Trobe University, Victoria, Australia
| | - Yvonne Wells
- Australian Institute for Primary Care and Ageing, La Trobe University, Victoria, Australia
| | - Christine While
- Australian Institute for Primary Care and Ageing, La Trobe University, Victoria, Australia
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
- Department of Non-communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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García-Tudela Á, Simonelli-Muñoz AJ, Gallego-Gómez JI, Rivera-Caravaca JM. Impact of the COVID-19 pandemic on stress and sleep in emergency room professionals. J Clin Nurs 2023. [PMID: 37132445 DOI: 10.1111/jocn.16738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/04/2023] [Accepted: 04/12/2023] [Indexed: 05/04/2023]
Abstract
AIMS AND OBJECTIVES To analyze stress levels, sleep quality, sleepiness and chronotypes on emergency room (ER) professionals before and during the COVID-19. BACKGROUND ER healthcare professionals are exposed to high stress levels, and they often present with poor sleep quality. DESIGN Observational study conducted into two different phases (before the COVID-19 and during the first wave of the COVID-19). METHOD Physicians, nurses and nursing assistants working in the ER were included. Stress, sleep quality, daytime sleepiness and chronotypes were assessed by the Stress Factors and Manifestations Scale (SFMS), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Horne and Österberg Morningness-Eveningness questionnaire, respectively. The first phase of the study was performed between December 2019 and February 2020, and the second between April and June 2020. The STROBE checklist was used to report the present study. RESULTS In total, 189 ER professionals in the pre-COVID-19 phase and 171 (of the initial 189) during COVID-19 were included. The proportion of workers with a morning circadian rhythm increased during the COVID-19, and stress levels were significantly higher during COVID-19 compared to the previous phase (38.34 ± 10.74 vs. 49.97 ± 15.81). ER professionals with poor sleep quality presented higher stress in the pre-COVID-19 phase (40.60 ± 10.71 vs. 32.22 ± 8.19) and during COVID-19 (55.27 ± 15.75 vs. 39.66 ± 9.75). Similarly, workers with excessive sleepiness had higher stress in the pre-COVID-19 phase (42.06 ± 10.95 vs. 36.64 ± 10.24) and during COVID-19 (54.67 ± 18.10 vs. 48.44 ± 14.75). Positive associations were also found between the SFMS and the PSQI, as well as with the ESS in both phases of the study. CONCLUSIONS Emergency room professionals had increased stress levels during the COVID-19 pandemic. Stress was particularly higher in those with poor sleep quality or with excessive daytime sleepiness. RELEVANCE TO CLINICAL PRACTICE These results should aim to impulse the implementation of measures to improve the working conditions of ER professionals.
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Affiliation(s)
- Ángel García-Tudela
- Emergency Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Catholic University of Murcia, Murcia, Spain
| | | | | | - José Miguel Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
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Gustafsson T, Maurin Söderholm H, Sundler AJ, Karlsson P, Lindberg E. 'Sometimes you need an eye-opener': A qualitative study on nursing assistants' experiences of developing communication skills through an educational intervention on person-centred communication. Nurs Open 2023. [PMID: 36882996 DOI: 10.1002/nop2.1702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 12/12/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
AIM To explore nursing assistants' (NAs') experiences of developing communication skills while participating in an educational intervention on person-centred communication. DESIGN A descriptive qualitative study was conducted. METHODS Data were collected from interviews and written assignments before, during and after an educational intervention on person-centred communication targeting NAs in home care services. The data were analysed using a phenomenological approach. A total of 25 NAs participated in the study. RESULTS The findings describe NAs' experiences concerning the communication skills needed for building relationships with older persons and handling emotionally challenging situations. The educational intervention increased their knowledge and awareness of the importance of communication skills and how such skills are developed and refined.
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Affiliation(s)
- Tanja Gustafsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Hanna Maurin Söderholm
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,PreHospen Centre for Prehospital Research, University of Borås, Borås, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Pernilla Karlsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Närhälsan Fristad Primary Health Care Center, Borås, Sweden
| | - Elisabeth Lindberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Saiki M, Takemura Y, Kunie K. Relationship between Unit-Level Nurses' Expectations from Nursing Assistant Roles and Individual Nursing Assistants' Information-Sharing Behaviors: A Multilevel Mediation Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:1-7. [PMID: 36481418 DOI: 10.1016/j.anr.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE This study aimed to investigate the relationship between the expectations of unit-level nurses from nursing assistants (NAs), frequency of individual NAs' information-sharing behaviors with nurses, and the effect of NAs' self-perceived roles on this relationship. NAs provide patient care along with nurses, and their information-sharing behaviors with nurses may be influenced by the expectations of the nurses. METHODS Nurses and NAs from 104 integrated community care (sub- and postacute) units were included in this Japanese cross-sectional study conducted from July to September 2018. Nurses' expectations from NAs and the NAs' self-perceived roles and information-sharing frequency were measured. Multilevel mediation analysis was performed for NAs' information-sharing behaviors, such as expressing, asking, providing linguistic responses, and providing feedback. RESULTS Unit-level nurses' expectations from NAs were associated with the frequency of NAs' asking and responding behaviors with nurses (p < .05), mediated by the NAs' self-perceived roles. The frequency of NAs' expressing behaviors and feedback were also associated with their self-perceived roles (p < .001). CONCLUSIONS High expectations of unit-level nurses from NAs led to better perception by NAs of their roles and led to better information-sharing behaviors. Educating nurses on NAs' roles may improve information-sharing between nurses and NAs that leads to safe and appropriate care to patients.
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Affiliation(s)
- Masatoshi Saiki
- Department of Advanced Clinical Nursing, Frontier Clinical Nursing, Graduate School of Nursing, Chiba University, Japan; Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan.
| | - Yukie Takemura
- Nursing Department, The University of Tokyo Hospital, Japan
| | - Keiko Kunie
- Department of Nursing Administration, School of Nursing, Tokyo Women's Medical University, Japan; Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan
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Sinvani L, Strunk A, Ardito S, Gordon S, Liu Y, Schantz E, Arroon A, Ilyas A, Gromova V, Polokowski A, Levin J, Makhnevich A, D’Angelo S, Boltz M. Reducing Behavioral and Psychological Symptoms of Dementia in Acutely Ill Patients via Patient Engagement Specialists: A Pilot Feasibility Study. Gerontol Geriatr Med 2023; 9:23337214231192162. [PMID: 37601321 PMCID: PMC10439723 DOI: 10.1177/23337214231192162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Behavioral and psychological symptoms of dementia (BPSD) are common in hospitalized persons living with dementia (PLWD). This pilot aimed to test the feasibility of an innovative model of care, PES-4-BPSD (a dementia unit staffed with Patient Engagement Specialists, PES). Non-randomized pilot feasibility trial was conducted, enrolling N = 158 patients to the intervention unit (n = 79, a 10-bed dementia unit, staffed with nursing assistants, NAs, with mental health backgrounds, PES) and an enhanced control unit (n = 79, 40-bed medicine unit, staffed with NAs). All NAs/PES (N = 63) received dementia training, with completion rate of 82.5%. Overall, patients had ~1 NPI-Q (Neuropsychiatric Inventory Questionnaire) assessment/48 hr. 97% (n = 153) of PLWD exhibited at least one behavior. Average NPI-Q scores did not differ across intervention (5.36) and control (3.87) units (p = .23). Patients on the intervention unit had 88% (p = .002) shorter duration of constant observation. A dementia care unit staffed by PES is an innovative model requiring further research.
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Affiliation(s)
- Liron Sinvani
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Andrew Strunk
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, USA
| | - Suzanne Ardito
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Samantha Gordon
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Yan Liu
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Emily Schantz
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, USA
| | - Asma Arroon
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, USA
| | - Anum Ilyas
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Valeria Gromova
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Ashley Polokowski
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, USA
| | - Jessy Levin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alex Makhnevich
- Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Manhasset, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Stefani D’Angelo
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Marie Boltz
- The Pennsylvania State University, University Park, USA
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13
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Bergqvist M, Bastholm‐Rahmner P, Gustafsson LL, Holmgren K, Veg A, Wachtler C, Schmidt‐Mende K. How much are we worth? Experiences of nursing assistants in Swedish nursing homes during the first wave of COVID-19. Int J Older People Nurs 2022; 18:e12498. [PMID: 35978489 PMCID: PMC9539304 DOI: 10.1111/opn.12498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND NHs have been severely exposed during the COVID-19 pandemic. Little is known about how staff who provide practical daily care of older residents experienced work during the pandemic. The aim of this study was to understand how nursing assistants (NAs) experienced their work at nursing homes (NHs) for older people during the first wave of the COVID-19 pandemic. METHODS We conducted a qualitative study of focus group discussions with in total 20 participants from four NHs in Stockholm, Sweden. Discussions were held in November 2020. Transcripts were analyzed using inductive thematic analysis. RESULTS We identified three major themes: 1) We felt abandoned, scared and disrespected, 2) We made sure we made it through, and 3) We can do good work with appropriate resources. NAs felt disregarded as they were often left alone without adequate support from managers, registered nurses and the municipalities. NAs felt distressed and guilty and developed their own strategies to cope and manage their work. CONCLUSION AND IMPLICATION FOR PRACTICE During the first wave of the COVID-19 pandemic NAs felt abandoned and burdened due to lack of leadership. Organizational improvements are required to protect the wellbeing of NAs and to ensure sustainability of patient safety. NAs are crucial in the care for vulnerable older people and their experiences should constitute a keystone for development of future policy and practice in NHs.
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Affiliation(s)
- Monica Bergqvist
- Division of Nursing, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
| | - Pia Bastholm‐Rahmner
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska InstitutetKarolinska University HospitalStockholmSweden,Academic Primary Care CenterStockholmSweden
| | - Lars L Gustafsson
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska InstitutetKarolinska University HospitalStockholmSweden
| | | | - Anikó Veg
- Health Care AdministrationStockholmSweden
| | - Caroline Wachtler
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
| | - Katharina Schmidt‐Mende
- Academic Primary Care CenterStockholmSweden,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
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14
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Gago-Valiente FJ, Moreno-Sánchez E, Vélez-Moreno E, Merino-Godoy MDLÁ, Sáez-Padilla J, de Paula Rodríguez-Miranda F, da Costa EIMT, Saenz-de-la-Torre LC, Segura-Camacho A, Mendoza-Sierra MI. The Upshot of the SARS-CoV-2 Pandemic on Nursing Assistants: Evaluating Mental Health Indicators in Huelva. J Clin Med 2022; 11:2586. [PMID: 35566711 PMCID: PMC9105936 DOI: 10.3390/jcm11092586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare professionals who work in front-line situations are among those under the highest risk of presenting negative mental health indicators. We sought to assess the prevalence of low personal realization, emotional exhaustion, and depersonalization as well as probable non-psychotic psychiatric pathologies during the pandemic in nursing assistants in the city of Huelva (Spain), and to study the association between these mental health indicators and sociodemographic and professional variables. A cross-sectional descriptive investigation with a quantitative approach was used. A representative sample of these professionals, consisting of 29 men and 284 women, completed the GHQ-12 questionnaire, including sociodemographic data and the MBI-HSS questionnaire, collecting information on situations of contact with SARS-CoV-2. Data analysis was conducted, and correlations were established. We found that emotional exhaustion, depersonalization and probable non-psychotic, psychiatric pathologies were related to contact with SARS-CoV-2. Moreover, personal realization, depersonalization and emotional exhaustion were related to just gender. We conclude that nursing assistants from public hospitals in the city of Huelva who had contact with patients with SARS-CoV-2 in the workplace, showed poor mental health indicators than those who did not come into contact with infected individuals.
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Affiliation(s)
| | - Emilia Moreno-Sánchez
- Department of Pedagogy, Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21007 Huelva, Spain
| | - Emilia Vélez-Moreno
- Medicine Department, Faculty of Medicine, University of Malaga, 29071 Malaga, Spain
| | | | - Jesús Sáez-Padilla
- Integrated Didactics Department, Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21071 Huelva, Spain
| | | | - Emília Isabel Martins Teixeira da Costa
- Nursing Department, Health School, University of Algarve, 8000 Faro, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3000 Coimbra, Portugal
| | - Luis-Carlos Saenz-de-la-Torre
- Department of Social, Development and Educational Psychology, Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21007 Huelva, Spain
| | - Adrián Segura-Camacho
- Department of Social, Development and Educational Psychology, Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21007 Huelva, Spain
| | - María-Isabel Mendoza-Sierra
- Department of Social, Development and Educational Psychology, Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21007 Huelva, Spain
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15
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Artime-Ríos E, Suárez-Sánchez A, Sánchez-Lasheras F, Seguí-Crespo M. Computer vision syndrome in healthcare workers using video display terminals: an exploration of the risk factors. J Adv Nurs 2022; 78:2095-2110. [PMID: 35112736 DOI: 10.1111/jan.15140] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/18/2021] [Accepted: 12/09/2021] [Indexed: 02/03/2023]
Abstract
AIMS To estimate the prevalence of computer vision syndrome (CVS) in healthcare workers and its relationship to video display terminal (VDT) exposure, sociodemographic, optical correction and work characteristics, and to analyse whether there are differences among occupational groups. DESIGN Cross-sectional study. METHODS A sample of 1179 physicians and surgeons, nurses, and nursing assistants from two hospitals in Spain between January 2017 and February 2018 were invited to participate in this study. Of these, 622 workers from both hospitals were finally included. CVS was measured using a questionnaire, the CVS-Q© . Logistic regression was used to identify the factors associated with CVS. All the results were stratified by occupational group. RESULTS The prevalence of CVS was 56.75% with nurses being the most affected occupational group (61.75%). It was associated significantly with female sex (aOR = 2.57; 95% CI 1.36-4.88) and morning shifts plus on-call (aOR = 2.33; 95% CI 1.11-4.88) in the physicians and surgeons group. Among the nurses, it was associated with female sex (aOR = 2.35; 95% CI 1.03-5.37), seniority between 10 and 20 years (aOR = 2.17; 95% CI 1.03-4.59), VDT exposure at work of 2-4 h/day (aOR = 6.14; 95% CI 1.08-35.02), VDT exposure at work >4 h/day (aOR = 7.14; 95% CI 1.29-39.62) and self-perception that using the software application was not easy (aOR = 2.49; 95% CI 1.23-5.01). CONCLUSIONS A high prevalence of CVS among healthcare workers was observed. The risk factors that increased the likelihood of suffering from this syndrome depended on the occupation. IMPACT The findings may be used as a reference for occupational health services to implement specific preventive measures to reduce CVS for each occupational group. Such measures should consider both individual factors and the working conditions.
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Affiliation(s)
- Eva Artime-Ríos
- Occupational Health Service, Healthcare Area IV, Public Health Service of the Principality of Asturias (SESPA), Oviedo, Spain.,Doctoral Programme in Health Sciences, University of Alicante, Alicante, Spain
| | - Ana Suárez-Sánchez
- Department of Business Administration, University of Oviedo, Oviedo, Spain
| | | | - Mar Seguí-Crespo
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Public Health Research Group, University of Alicante, Alicante, Spain
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16
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Romero-Sánchez JM, Porcel-Gálvez AM, Paloma-Castro O, García-Jiménez J, González-Domínguez ME, Palomar-Aumatell X, Fernández-García E. Worldwide prevalence of inadequate work ability among hospital nursing personnel: A systematic review and meta-analysis. J Nurs Scholarsh 2021; 54:513-528. [PMID: 34918863 DOI: 10.1111/jnu.12749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/07/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE To estimate the worldwide pooled prevalence of inadequate work ability among hospital nursing personnel using the Work Ability Index (WAI). DESIGN Systematic review and meta-analysis. METHODS A systematic search was conducted on Medline/PubMed, Scopus, Web of Science, Scielo, PsychInfo, CINAHL, Nursing and Allied Health, LILACS, and Google Scholar from inception to July 2021 to identify observational studies on work ability among hospital nursing personnel using the WAI. Two researchers independently completed the study selection, quality assessments, and data extraction on the prevalence of inadequate work ability that was pooled using the random effects model. Finally, subgroup analyses were performed to explore sources of heterogeneity. FINDINGS A total of 42 studies were included, consisting of 24,728 subjects worldwide from 14 countries. Of these, 35 studies were included in the meta-analytical analyses. The worldwide pooled prevalence of inadequate work ability among hospital nursing personnel was 24.7% (95% CI = 20.2%-29.4%). High levels of heterogeneity were detected in all studies. Prevalence was higher in studies where samples were composed of nurses and nursing assistive personnel (26.8%; 95% CI = 22.4%-31.5%) than in those of nurses alone (22.2%; 95% CI = 13.1%-32.9%) and in studies where the sample was over 40 (28.1%; 95% CI = 19.5%-37.5%) than in those with a sample under that age (22.4%; 95% CI = 15.8%-29.7%). CONCLUSIONS Almost one in four members of hospital nursing staff in the world has inadequate work ability and therefore are at risk of several negative outcomes during their working life. These prevalence data correspond to the pre-pandemic period, so new studies should also be especially useful in quantifying the impact of the COVID-19 pandemic on work ability in the hospital nursing workforce. CLINICAL RELEVANCE The above findings justify the launch of initiatives that include annual assessment for the early identification of inadequate work ability, offering the possibility of anticipated corrective measures. Nursing workforce older than 40 years and those belonging to the professional category of nursing assistive personnel should be priority target groups for screening and intervention to improve work ability.
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Affiliation(s)
- José Manuel Romero-Sánchez
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, Spain.,Research Group under the Andalusian Research, Development, and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain
| | - Ana María Porcel-Gálvez
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, Spain.,Research Group under the Andalusian Research, Development, and Innovation Scheme CTS-1050 "Complex Care, Chronic and Health Outcomes", Universidad de Sevilla, Sevilla, Spain
| | - Olga Paloma-Castro
- Research Group under the Andalusian Research, Development, and Innovation Scheme CTS-1019 MELES "Nursing methods and Standardized Languages", Universidad de Cádiz, Cádiz, Spain.,Nursing and Physiotherapy Department, Faculty of Nursing, Universidad de Cádiz, Algeciras, Cádiz, Spain
| | | | | | - Xavier Palomar-Aumatell
- Methodology, Models, Methods and Outcomes of Health and Social Sciences (M3O), Centre for Health and Social Care Research (CESS), Universitat de Vic - Universitat Central de Catalunya, Vic, Barcelona, Spain
| | - Elena Fernández-García
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, Spain.,Research Group under the Andalusian Research, Development, and Innovation Scheme CTS-1050 "Complex Care, Chronic and Health Outcomes", Universidad de Sevilla, Sevilla, Spain
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17
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Jumabhoy S, Jung HY, Yu J. Characterizing the direct care health workforce in the United States, 2010-2019. J Am Geriatr Soc 2021; 70:512-521. [PMID: 34687042 DOI: 10.1111/jgs.17519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND To describe the growth and characteristics of the direct care health workforce, encompassing home health aides, personal care aides, nursing assistants, and orderlies and psychiatric aides from 2010 to 2019 in the United States. METHODS Using nationally representative data from the 2010 to 2019 American Community Survey, we described the growth in the direct care health workforce overall and by type of direct care health worker. In addition, we examined the distribution of direct care workers by geographic region of the country, age categories, citizenship, world area of birth, income, health insurance status, and other characteristics. RESULTS From 2010 to 2019, the number of direct care health workers in the United States per 10,000 individuals decreased slightly from 135.81 in 2010 to 133.78 in 2019. Personal care aides made up 42.1% of the direct care health workforce in 2019, followed by nursing assistants (39.5%) and home health aides (16.3%). In 2019, the number of direct care health workers who were not U.S. citizens accounted for roughly 10% of all workers in each year. The relative percentage of direct care health workers that were not a citizen of the United States was highest among home health aides (16.3%). Among workers born outside of the United States, the majority were from Latin America, followed by Asia. CONCLUSION From 2010 to 2019, there was little growth in the direct care health workforce despite growing demand for direct care health workers. In the midst of the current and projected shortage of direct care health workers-particularly during the COVID-19 pandemic, longer-term solutions to improve retention of direct care health workers and increase the supply of direct care health workers may be needed.
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Affiliation(s)
- Sara Jumabhoy
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Hye-Young Jung
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Jiani Yu
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
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18
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Roche MA, Glover S, Luo X, Joyce M, Rossiter C. Extending the role of nursing assistants in mental health inpatient settings: A multi-method study. Int J Ment Health Nurs 2021; 30:1070-1079. [PMID: 33742529 DOI: 10.1111/inm.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
With continued growth in the demand for nursing care, many organizations have incorporated nursing assistants into the acute care workforce. However, role descriptions are often generic and do not provide clarity in specialist areas such as mental health inpatient settings. Issues have been noted regarding the role of assistants, delegation, and their integration with the nursing team. This study extended an existing set of care activities and explored the perceptions of nursing assistants and registered nurses regarding these activities. A modified Delphi approach added 14 new care activities for nursing assistants. A follow-up survey found significant differences between nursing assistants and registered nurses regarding utilization of the activities, delegation, teamwork, and role clarity. Future research must incorporate the perspectives of those with lived experience of mental health issues, and develop an understanding of the interactions between nursing assistant care activities and other factors such as local supports, skillmix, and the practice environment, as these may impact how an organization can introduce nursing assistants to specialty areas while maintaining consumer and staff safety.
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Affiliation(s)
- Michael A Roche
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia.,School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Suzanne Glover
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Xiaoou Luo
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Mark Joyce
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Chris Rossiter
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
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19
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Kamalraj P, Savundranayagam MY, Orange JB, Kloseck M. Communication in home care: Understanding the lived experiences of formal caregivers communicating with persons living with dementia. Int J Older People Nurs 2021; 16:e12401. [PMID: 34337872 DOI: 10.1111/opn.12401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/05/2021] [Accepted: 06/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about formal caregivers' lived experiences communicating with persons living with dementia (PLWD) who live in their own homes. Most information comes from research conducted in long-term care settings or home care settings involving family care partners. Yet, there are expected needs and rising demands for formal caregivers to provide support within clients' homes. OBJECTIVES Accordingly, this study aimed to understand the lived experiences of personal support workers (PSWs) regarding their communication with PLWD who live in their own homes. METHODS The study was grounded in a hermeneutic phenomenological research approach. Data were collected as part of the Be EPIC project, an evidence-informed, person-centred communication intervention for PSWs caring for PLWD. One, in-depth semi-structured interview was conducted with each of the PSWs (N = 15). Thematic analysis was completed on the interviews. RESULTS Three major themes emerged: (1) Challenged by dementia-related impairments; (2) Valuing communication in care; and (3) Home is a personal space. Findings revealed that PSWs experience difficulties communicating with PLWD because of dementia-related impairments, despite PSWs recognizing the importance of communication when they provide optimal care in the homes of PLWD. This suggests that PSWs view communication as a crucial component of quality care but do not possess the skills necessary to ensure effective interactions. Findings also demonstrated the importance, uniqueness and impact of the personal home space on PSWs' experiences with communication. CONCLUSION Overall, findings indicate that PSWs acknowledge the importance of communication as an integral element of providing optimal care, but dementia-related impairments and the intimate, personal home-based care context can hinder successful communication between PSWs and PLWD. The implications of the findings are that additional and targeted education and training are required for PSWs, especially on how dementia-related impairments impact communication within the context of home care based services for PLWD.
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Affiliation(s)
- Pabiththa Kamalraj
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | | | - J B Orange
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Marita Kloseck
- School of Health Studies, Western University, London, Ontario, Canada
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20
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Passos L, Tavares J, Figueiredo D. Assessing Caregivers' Skills in Assisting People with Dementia during Mealtime: Portuguese Cultural Adaptation of the Feeding Skills Checklist. Int J Environ Res Public Health 2021; 18:6467. [PMID: 34203784 DOI: 10.3390/ijerph18126467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022]
Abstract
In advanced dementia, individuals usually develop feeding difficulties. The Feeding Skills Checklist (FSC) is an instrument to assess caregivers’ skills when assisting people with dementia (PwD) at mealtimes. This study aimed to adapt and culturally validate a European Portuguese version of the FSC (FSC-PT) and test its reliability. Initially, translation and cultural validation of the FSC, with estimation of the content validity index (CVI), was conducted. Then, the FSC was applied to 23 female nursing assistants (mean age 44.73 ± 10.42 years) while offering lunch (n = 41 meals) to institutionalized PwD. Inter-rater reliability was determining using Cohen’s Kappa. FSC-PT showed excellent content validity, with item-content validity index ranging from 0.85 to 1, scale level average CVI = 0.94 and universal agreement CVI = 0.54. It also showed very satisfactory inter-observer reliability, with Cohen’s Kappa = 0.844. Of the 41 meals analyzed, only 37.7% of the actions/good practices in feeding PwD were observed. A positive and moderate correlation was found between the length of time working as nursing assistance and the FSC environment dimension (rs = 0.435; p = 0.038). The results supported the content validity of the FSC-PT, which shows considerable potential to be an instrument for verifying caregivers’ skills when helping PWD to eat and should be increasingly studied.
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21
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Chang YC, Yeh TF, Lai IJ, Yang CC. Job Competency and Intention to Stay among Nursing Assistants: The Mediating Effects of Intrinsic and Extrinsic Job Satisfaction. Int J Environ Res Public Health 2021; 18:6436. [PMID: 34198623 DOI: 10.3390/ijerph18126436] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/28/2021] [Accepted: 06/11/2021] [Indexed: 12/27/2022]
Abstract
This study investigated the influences of nursing assistants' job competency on their intrinsic and extrinsic satisfaction and intention to stay in the profession of long-term care institutions. Understanding the relationship between job competency and job satisfaction, both intrinsic and extrinsic, would enable institutions to strengthen service workers' intention to stay and to retain essential personnel. This study was a cross-sectional study in which nursing assistants from 26 nursing homes and 15 elderly welfare institutions in Taiwan. The relationship between job competency and intention to stay was discovered to be significantly mediated by intrinsic and extrinsic job satisfaction. Given the staff shortages and difficulty retaining staff in long-term care environments, organizations must be able to strengthen employees' intention to stay; one suggestion is to improve the employees' competency, because higher competency results in higher quality of care and greater extrinsic job satisfaction. Furthermore, greater job competency is more likely to result in affirmation and accomplishment, both of which increase intrinsic job satisfaction and thus positively influence intention to stay.
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22
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Peršolja M. General nurses' and nursing technicians' complexity of activities: Cross-sectional study. J Nurs Manag 2021; 29:2175-2182. [PMID: 33963630 DOI: 10.1111/jonm.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/18/2021] [Accepted: 04/30/2021] [Indexed: 12/01/2022]
Abstract
AIMS This study aimed at describing the job content of general nurses and comparing it to the work of nursing technicians, arranging it for orientation and level of work with things, data or people. BACKGROUND There is limited evidence on the content of the general nurses' and nursing technicians' job in post-transitional countries. METHOD A quantitative analysis was conducted. The study was performed in a Slovenian medical hospital and in primary health centre. The variables were collected observing nursing activities at 10-min intervals. RESULTS Forty-three hospital and seven primary health centres' nursing staff participated in this study. A total of 14,584 nursing activities were recorded. The focus of general nurses was on working with data, and the focus of nursing technicians was on working with people (t = 18.328; df = 34,041; p < .001). CONCLUSIONS General nurses' and health care technicians' duties differ in content. General nurses work mostly with data, but health care technicians with people. The job content of both profiles differs related to the setting. IMPLICATIONS FOR NURSING MANAGEMENT It is recommended to return the focus of registered nurses from data to people. There is a need to do job analysis to enhance current practices in nursing management and professional development initiatives.
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Affiliation(s)
- Melita Peršolja
- Faculty of Health Sciences, University of Primorska, Nova Gorica, Slovenia
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Campbell A, Layne D, Scott E. Relational Quality of Registered Nurses and Nursing Assistants: Influence on Patient Safety Culture. Healthcare (Basel) 2021; 9:189. [PMID: 33572352 PMCID: PMC7916158 DOI: 10.3390/healthcare9020189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022] Open
Abstract
Registered nurses (RNs) working within acute care hospitals have an incredible responsibility to provide safe care in a complex environment which requires trust, teamwork, and communication. Nursing assistants (NAs) play a critical role in working with RNs to meet these growing demands of inpatient care. Minimal evidence exists exploring the relational quality between RNs and NAs within hospitals. The aim of this study is to explore RN and NA behaviors and experiences that promote patient safety and teamwork and enhance communication between RNs and NAs within the hospital environment. Qualitative analysis was used, with two focus groups which included six participants within each group (three RNs and three NAs) from two separate inpatient units. Transcripts were reviewed and coded for themes. Collaborative teamwork and two-way communication were commonly reported as behaviors that promote patient safety. Trust between RNs and NAs was identified as a key component of positive relationships between RNs and NAs. Participants identified four common behaviors that build trust, which were accountability, effective conflict resolution, collaborative teamwork, and prioritizing patient needs. Finally, teamwork was identified as a common strategy to increase communication effectiveness between RNs and NAs. High relational quality (RQ) between the RN and NA is an important component of teamwork and patient safety culture.
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Affiliation(s)
- Amy Campbell
- College of Nursing, East Carolina University, Greenville, NC 27858, USA;
| | - Diana Layne
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Elaine Scott
- College of Nursing, East Carolina University, Greenville, NC 27858, USA;
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Saiki M, Takemura Y, Kunie K. Nursing assistants' desired roles, perceptions of nurses' expectations and effect on team participation: A cross-sectional study. J Nurs Manag 2021; 29:1046-1053. [PMID: 33393152 DOI: 10.1111/jonm.13242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/08/2020] [Accepted: 12/30/2020] [Indexed: 01/05/2023]
Abstract
AIMS To examine the gap between nursing assistants' desired roles and their perceptions of nurses' expectations, and the relationship between these perceptions and nursing assistants' nursing team participation. BACKGROUND Nursing assistants' role perceptions may be related to their participation in nursing teams. METHODS We performed a secondary analysis of questionnaire data from 1,316 nursing assistants in Japan. RESULTS Participants rated their desired roles higher than their perceptions of nurses' expectations of them. Where perceptions of nurses' expectations were higher, higher desired role scores were associated with greater nursing team participation. Where perceptions of nurses' expectations were lower, the desired role score was not associated with team participation. CONCLUSIONS Nursing assistants perceive their roles as higher and inclusive of more duties than what nurses have expected of them. When perceptions of nurse expectations were high, they performed at a higher level. When perceptions of nurse expectations were low, they performed at a lower level, despite their desire to do more. IMPLICATIONS FOR NURSING MANAGEMENT It may be useful for nurses and nursing assistants to jointly reflect on and promote awareness of nursing assistants' functional roles in the ward. This would promote nursing assistant team participation and optimize their scope of practice.
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Affiliation(s)
- Masatoshi Saiki
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukie Takemura
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiko Kunie
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Nursing Administration, School of Nursing, Tokyo Women's Medical University, Tokyo, Japan
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McGilton KS, Stewart S, Bethell J, Chu CH, Mateos JT, Pastells-Peiró R, Blanco-Blanco J, Rodriguez-Monforte M, Escrig-Pinol A, Gea-Sánchez M. Factors Influencing Nurse Assistants' Job Satisfaction in Nursing Homes in Canada and Spain: A Comparison of Two Cross-Sectional Observational Studies. J Appl Gerontol 2020; 41:235-244. [PMID: 33353479 DOI: 10.1177/0733464820980567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To access associations between job satisfaction and supervisory support as moderated by stress. METHODS For this cross-sectional study, data collected from 591 nursing assistants in 42 nursing homes in Canada and Spain were analyzed with mixed-effects regression. RESULTS In both countries, stress related to residents' behaviors was negatively associated with job satisfaction, and, in Canada, it moderated the positive association between supervisory support and job satisfaction. Stress related to family conflict issues moderated the positive association of supervisory support and job satisfaction differently in each location: in Canada, greater stress was associated with a weaker association between supervisory support and job satisfaction; in Spain, this was also observed but only when supervisory support was sufficiently weak. DISCUSSION Stress was associated with lower job satisfaction and moderated the association of supervisory support and job satisfaction, reinforcing the importance of supervisors supporting nursing assistants, especially during the COVID-19 pandemic.
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Affiliation(s)
- Katherine S McGilton
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada
| | - Steven Stewart
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Jennifer Bethell
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Charlene H Chu
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada
| | - Jose T Mateos
- Department of Nursing and Physiotherapy, University of Lleida, Spain.,Research Group of Health Care (GRECS), Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain
| | - Roland Pastells-Peiró
- Department of Nursing and Physiotherapy, University of Lleida, Spain.,Research Group of Health Care (GRECS), Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain
| | - Joan Blanco-Blanco
- Department of Nursing and Physiotherapy, University of Lleida, Spain.,Research Group of Health Care (GRECS), Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain
| | - Miriam Rodriguez-Monforte
- GRoW Research Group; Facultat de Ciències de la Salut Blanquerna; Universitat Ramon Llull, Barcelona, Spain
| | - Astrid Escrig-Pinol
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, University of Lleida, Spain.,Research Group of Health Care (GRECS), Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain.,Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
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26
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Cheng TJ, Hsu YM, Tsai TH, Chen MY, Tsay SF, Shieh SH. Factors Affecting the Competence of Nursing Assistants in Taiwan Long-Term Care Institutions. Int J Environ Res Public Health 2020; 17:ijerph17249413. [PMID: 33334015 PMCID: PMC7765356 DOI: 10.3390/ijerph17249413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022]
Abstract
With the increasing number of people with disabilities caused by an aging global population, the need for long-term care is gradually increasing. Nursing assistants (NAs) are the primary providers of direct care services to older adults with disabilities, whose knowledge, skills, and beliefs affect the quality of care provided. This study aimed to investigate the influential factors affecting NAs’ current competences. A total of 255 NAs’ valid questionnaires were collected from 20 long-term care institutions in Taiwan through convenience sampling. The questionnaire comprised dimensions of demographics and care competence. The study results indicated that NAs had the greatest care competence in the domain of recognition of patient rights (4.64 ± 0.54 points). The multiple regression indicated that age, religion, job category, disability care experience, the receiving of performance bonuses, and the receiving of year-end bonuses significantly affected the level of care competence (p < 0.05). With the aforementioned findings, the results of this study serve as references for the government in employing long-term care NAs and developing management policies. Training programs for NAs should be developed to improve the quality of care provided to older adults with disabilities.
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Affiliation(s)
- Tsai-Jung Cheng
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
| | - Yi-Min Hsu
- Department of Public Health, China Medical University, Taichung 40402, Taiwan;
- Department of Nursing, China Medical University Hospital, Taichung 40402, Taiwan
| | - Tung-Han Tsai
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
| | - Ming-Yu Chen
- Taichung Hospital attached Nursing Home, Head Nurse Ministry of Health and Welfare, Taichung 40343, Taiwan;
| | - Shwu-Feng Tsay
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
- Department of Nursing and Health Care, Ministry of Health and Welfare, Taipei 11558, Taiwan
| | - Shwn-Huey Shieh
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (T.-J.C.); (T.-H.T.); (S.-F.T.)
- Department of Nursing, China Medical University Hospital, Taichung 40402, Taiwan
- Department of Nursing, Asia University, Taichung 41354, Taiwan
- Correspondence:
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Rodríguez-Monforte M, Bethell J, Stewart S, Chu CH, Escrig-Pinol A, Gea-Sánchez M, McGilton KS. The influence of supervisory support, work effectiveness, work empowerment and stress secondary to residents' responsive behaviours on job satisfaction of nursing staff: A multisite cross-sectional study. J Nurs Manag 2020; 29:497-507. [PMID: 33030771 DOI: 10.1111/jonm.13173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/18/2020] [Accepted: 09/30/2020] [Indexed: 11/27/2022]
Abstract
AIM To examine the association between stress secondary to residents' responsive behaviours and job satisfaction of nurses and nursing assistants working in nursing homes. To test whether supervisory support, work effectiveness and work empowerment confound this relationship. BACKGROUND Understanding how the stress secondary to residents' responsive behaviours influences job satisfaction for staff and determining the factors influencing this relationship are important for retention of staff in nursing homes. The term 'responsive behaviours' refers to the subset of behavioural and psychological symptoms of dementia. METHODS Survey responses from 191 nursing assistants and 81 nurses in five nursing homes in Ontario were analysed. RESULTS Staff's stress attributed to residents' responsive behaviours was negatively associated with job satisfaction. This direct effect was weakened by more than a third through the confounding net effects of supervisory support, work effectiveness and work empowerment. CONCLUSION The work environment created by leaders in nursing homes can lessen the influence of stress secondary to residents' responsive behaviours on staffs' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT Supervisors need training and education to support and mentor their staff effectively, and to guide their use of evidence-based practices that integrate the patient-centred care approach in order to effectively respond and minimize responsive behaviours.
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Affiliation(s)
- Míriam Rodríguez-Monforte
- Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain.,Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain
| | - Jennifer Bethell
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Steven Stewart
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Charlene H Chu
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Astrid Escrig-Pinol
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Mar Nursing School (ESIMar), Pompeu Fabra University, Barcelona, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Group of Health Care Research (GRECS), IRB Lleida, Lleida, Spain
| | - Katherine S McGilton
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Patel J, Gimeno Ruiz de Porras D, Mitchell LE, Patel RR, De Los Reyes J, Delclos GL. Work-Related Asthma Among Certified Nurse Aides in Texas. Workplace Health Saf 2020; 68:491-500. [PMID: 32364022 PMCID: PMC8851373 DOI: 10.1177/2165079920914322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: Although nurses are well described as being at risk of work-related asthma, certified nurse aides (CNAs) are understudied. Using a statewide registry in Texas, we measured prevalence and risk factors for work-related asthma and bronchial hyperresponsiveness (BHR) symptoms among CNAs. Methods: For this cross-sectional study, a questionnaire was mailed to a random sample of CNAs (n = 2,114) identified through the Texas Department of Aging and Disability Services registry, working in health care during 2016-2017, to collect data on job history, asthma symptoms, and sociodemographics. Two outcomes were defined: (a) new-onset asthma (NOA) after entry into the health care field and (b) BHR-related symptoms. Job exposures to cleaning compounds and tasks were assigned using an externally coded CNA-specific job-exposure matrix. Logistic regression modeling was used to measure associations between cleaning exposures and the two asthma outcomes. Findings: The final sample consisted of 413 CNAs (response rate 21.6%). The prevalence of NOA and BHR symptoms were 3.6% and 26.9%, respectively. In adjusted models, elevated odds for BHR symptoms were observed for patient care cleaning (odds ratio [OR] = 1.71, 95% confidence interval [CI] = [0.45, 6.51]), instrument cleaning (OR = 1.33, 95% CI = [0.66, 2.68]), building-surface cleaning (OR = 1.39, 95% CI = [0.35, 5.60]), exposure to glutaraldehyde/orthophthalaldehyde (OR = 1.33, 95% CI = [0.66, 2.68]), and latex glove use during 1992-2000 (OR = 1.62, 95% CI = [0.84, 3.12]). There were too few NOA cases to warrant meaningful regression analysis. Conclusion/Application to Practice: Although not statistically significant, we observed elevated odds of BHR symptoms among nurse aides, associated with cleaning exposures, suggesting this is an at-risk group of health care professionals for work-related respiratory disease, meriting further study.
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Affiliation(s)
- Jenil Patel
- Department of Epidemiology, University of Arkansas for Medical Sciences,,Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth)
| | - David Gimeno Ruiz de Porras
- Southwest Center for Occupational and Environmental Health (SWCOEH), Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health in San Antonio, The University of Texas Health Science Center at Houston (UTHealth)
| | - Laura E. Mitchell
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth)
| | - Riddhi R. Patel
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth)
| | - Joy De Los Reyes
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth)
| | - George L. Delclos
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth)
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Kwong EWY, Chen LY, Kwan RYC, Lee PH. The effectiveness of a pressure injury prevention program for nursing assistants in private for-profit nursing homes: A cluster randomized controlled trial. J Adv Nurs 2020; 76:1780-1793. [PMID: 32285486 DOI: 10.1111/jan.14391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 03/18/2020] [Accepted: 03/30/2020] [Indexed: 02/04/2023]
Abstract
AIM To examine the effectiveness of a pressure injury prevention program for private for-profit nursing homes. DESIGN This study was a two-arm cluster randomized controlled trial. Ten private for-profit nursing homes made up the clusters. METHODS The participants were nursing home residents who aged 60 or above regardless of whether or not having pre-existing pressure injuries and also three types of nursing home assistants who provided direct care to the residents from 10 private for-profit nursing homes. These 10 nursing homes were randomly assigned to either the experimental or the control group. There were 477 and 536 resident participants and 51 and 62 nursing assistant participants in the experimental and control groups, respectively. The residents were the study participants and the nursing assistant participants were the interveners. The experimental group had the pressure injury prevention program implemented while the control group received the usual care. The primary study outcome which was the pressure injury incidence was analysed by GEE. Significance was set at a p-value of ≤.05. The data were collected between September 2017-March 2018. RESULT There were significant interactive effects of time and group on the incidence of pressure injuries (p = .0015) and on the skill performance of the nursing assistant participants (p < .0001). CONCLUSIONS An evidence-based pressure injury prevention program reduced the development of the pressure injuries and improved the skill performance of the nursing assistant participants. It is highly recommended that private for-profit nursing homes with high proportion of non-professional nursing assistants and insufficient nurses adopt this program for improving the prevention care of pressure injuries. IMPACT This research has an impact on prevention care of pressure injury in private for-profit nursing homes with high proportion non-professional nursing assistants which have the similar characteristics as the nursing homes studied in various regions and countries. TRIAL REGISTRATION The Controlled Trial registration ID is NCT02270385.
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Affiliation(s)
- Enid W-Y Kwong
- School of Nursing, Putian University, Putian, Fujian Province, China.,School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Liang Y Chen
- School of Nursing, Putian University, Putian, Fujian Province, China
| | - Rick Y-C Kwan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Paul H Lee
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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30
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Henriques M, Sacadura-Leite EM, Serranheira F. Low back pain among hospital nursing assistants. Rev Bras Med Trab 2020; 17:370-377. [PMID: 32368671 DOI: 10.5327/z1679443520190365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 08/28/2019] [Indexed: 11/05/2022] Open
Abstract
Background Occupational low back pain (LBP) is a relevant condition among hospital nursing assistants (NA). Objective To characterize the context of LBP among NA who sought medical care for this reason. Methods We conducted structured interviews to characterize the participants' sociodemographic profile, state of health and most relevant LBP episode. Next we subjected the participants to brief objective physical examination and reviewed their occupational health records. Results We interviewed 30 NA, most of whom were middle-aged women with excess weight and sedentary lifestyle. The most relevant LBP episodes were characterized by severe pain (93.3%) and resulted in functional restrictions for 63.3% of the sample. Job tasks most frequently associated with LBP were patient transfer (23.3%) and lifting/carrying loads >12 kg (20%). Although all the participants had sought medical care, 80% still complained of pain at the time of the interviews. On physical examination, the Lasègue and Bragard signs were found in 11 participants. We found significant association (p<0.05) between clinical signs, ongoing pain and incapacity for work. Conclusions According to most participants, LBP episodes occurred while performing tasks involving high physical demands, such as patient transfer and lifting/carrying loads >12 kg. The influence of individual factors notwithstanding, prevention and treatment of LBP among NA requires integrated occupational health interventions to minimize its impact on health and absenteeism.
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Affiliation(s)
- Moisés Henriques
- Naval Research Center, Portuguese Navy - Almada, Setúbal, Portugal
| | | | - Florentino Serranheira
- Occupational and Environmental Health Department, Public Health Research Center, National Public Health School, Universidade Nova de Lisboa - Lisbon, Portugal
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Lepetit-Vitou V, Gély-Nargeot MC, Mimoun N, Million E, Gayral A, Bayard S. [Pain assessment of nursing home's residents by certified nursing assistants: a real-world study]. ACTA ACUST UNITED AC 2019; 17:423-8. [PMID: 31570331 DOI: 10.1684/pnv.2019.0826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In French care facilities for dependent aged people (NHDAP), prevalence of pain among residents with dementia is high, and source of behavior disturbances and quality of life impairment. However, in spite of many international expert statements, pain remains under-assessed and under-managed in these patients. Certified nursing assistants (CNA) are on the front-line in NHDAP to detect the presence of pain in residents with communication difficulties, while they received little training for pain management and directives for specific care. Moreover, no studies were presently devoted to the impact of demographic and socio-professional determinants of CNA on pain assessment. In our study, we assessed the presence and intensity of pain in cognitively impaired residents in NHDAP, by CNA performing as a pair for the morning care. 42 pairs were recruited and independently completed a standardized behavioral assessment for pain (Doloplus scale) as well as a numeric rating scale. CNA personal characteristics were investigated to analyse the determinants of potential assessment discrepancies between each of the pairs. Presence of pain was detected in 51.1 to 91.1% of the patients depending on the tool and analysis criteria. In 28.9% important discrepancies were observed in the pain assessment between the CNA pairs, which could be related to professional status and prior use of the observational assessment. These inter-rater discrepancies should be reduced providing clear pain assessment guidelines for CNA in NHDAP, and further studies should be completed to figure out the role of CNA personal determinants in the patients' pain assessment.
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Walton AL, Kneipp S, Linnan L, Asafu-Adjei J, Douglas C, Leff M, Rogers B. Nursing Assistants' Use of Personal Protective Equipment Regarding Contact With Excreta Contaminated With Antineoplastic Drugs. Oncol Nurs Forum 2019; 46:689-700. [PMID: 31626622 DOI: 10.1188/19.onf.689-700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the feasibility of observing and interviewing nursing assistants about handling of antineoplastic drugs contaminated with excreta, acceptability of a measure of personal protective equipment (PPE) use with nursing assistants, and predictors of PPE use. PARTICIPANTS & SETTING 27 nursing assistants in an inpatient hematology-oncology unit at an academic medical center in the southeastern United States. METHODOLOGIC APPROACH This was an exploratory, multimethod study using observation, verbally administered questionnaires, and interviews. Research variables included recruitment rates, acceptability of observation, and understandability of a safe-handling instrument. FINDINGS Observed use of double gloves, chemotherapy gowns, and face shields was low; use of plastic-backed pads when flushing excreta was high. IMPLICATIONS FOR NURSING Nursing assistants are willing to participate in research. Standardized training and education about PPE use are needed.
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Lundgren D, Ernsth Bravell M, Börjesson U, Kåreholt I. The Impact of Leadership and Psychosocial Work Environment on Recipient Satisfaction in Nursing Homes and Home Care. Gerontol Geriatr Med 2019; 5:2333721419841245. [PMID: 31037251 PMCID: PMC6475839 DOI: 10.1177/2333721419841245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/27/2019] [Accepted: 03/07/2019] [Indexed: 12/03/2022] Open
Abstract
This study examines the association between nursing assistants’ assessment of leadership, their psychosocial work environment, and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted with nursing assistants (n = 1,132) and people receiving care (n = 1,535) in 45 nursing homes and 21 home care units. Direct leadership was associated with the psychosocial work environment in nursing homes and home care. Furthermore, better leadership was related to higher satisfaction among nursing assistants and older people in nursing homes. Thus, indirect leadership had no effect on recipients’ satisfaction in either nursing homes or home care. The path analysis showed an indirect effect between leadership factors and recipient satisfaction. The findings suggest that the psychosocial work environment of nursing assistants and recipient satisfaction in nursing homes can be increased by improving leadership.
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Affiliation(s)
- Dan Lundgren
- Jönköping University, Sweden.,Division of Social Services, Municipality of Jönköping, Sweden
| | | | | | - Ingemar Kåreholt
- Jönköping University, Sweden.,Karolinska Institutet, Stockholm, Sweden.,Stockholm University, Sweden
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34
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Lundgren D, Ernsth Bravell M, Börjesson U, Kåreholt I. The Association Between Psychosocial Work Environment and Satisfaction With Old Age Care Among Care Recipients. J Appl Gerontol 2018; 39:785-794. [PMID: 29900808 DOI: 10.1177/0733464818782153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examines the association between nursing assistants' perceptions of their psychosocial work environment and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted among people receiving care (N = 1,535) and nursing assistants (N = 1,132) in 45 nursing homes and 21 home care units within municipal old-age care. Better psychosocial work environment was related to higher satisfaction in old-age care among the recipients. Significant and stronger associations were more common in nursing homes than in home care. Perception of mastery and positive challenges at work were associated with higher recipient satisfaction both in home care and in nursing homes: social climate, perception of group work, perception of mastery, and positive challenges at work only in nursing homes. Findings suggest that recipient satisfaction may be increased by improving the psychosocial work environment for nursing assistants, both in nursing homes and in home care.
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Affiliation(s)
- Dan Lundgren
- Jönköping University, Sweden.,Municipality of Jönköping, Sweden
| | | | | | - Ingemar Kåreholt
- Jönköping University, Sweden.,Karolinska Institute, Stockholm, Sweden.,Stockholm University, Sweden
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35
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Kudo Y, Kono K, Kume R, Matsuhashi A, Tsutsumi A. Feelings about Nursing Assistants that Enhance the Work Motivation of Japanese Registered Nurses and Licensed Practical Nurses. J UOEH 2017; 39:259-69. [PMID: 29249739 DOI: 10.7888/juoeh.39.259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.
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Molinari V, Hobday JV, Roker R, Kunik ME, Kane R, Kaas MJ, Mehrotra C, Williams CL, Robbins JC, Dobbs D. Impact of serious mental illness online training for certified nursing assistants in long term care. Gerontol Geriatr Educ 2017; 38:359-374. [PMID: 28632071 PMCID: PMC6192676 DOI: 10.1080/02701960.2016.1188811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Certified nurse assistants (CNAs) spend the most staff time with nursing home residents, yet they receive little training in addressing the mental health needs of residents with serious mental illness (SMI). Forty CNAs from four long-term-care facilities took the online interactive CARES-® Serious Mental Illness™ training consisting of two modules guided by the Recovery Movement philosophy of care. Responses from pre-post testing, Likert-type items, and open-ended questions indicated that CNAs gained information, changed their perspectives, and had more confidence in dealing with SMI. Although there were minor concerns regarding length, clarity of content, and technical issues, CNAs found the online format acceptable and easy to use, and many said they would recommend the training. CARES Serious Mental Illness online training appears to be a viable way of helping CNAs address the mental health needs of long term care residents. Additional testing on CARES Serious Mental Illness is planned.
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Affiliation(s)
- Victor Molinari
- a University of South Florida , School of Aging Studies , Tampa , Florida USA
| | - John V Hobday
- b HealthCare Interactive, Inc. , Minneapolis , Minnesota USA
| | - Rosalyn Roker
- a University of South Florida , School of Aging Studies , Tampa , Florida USA
| | - Mark E Kunik
- c Michael E. DeBakey VA Medical Center, Houston, Texas USA and Baylor College of Medicine , Houston , Texas USA
| | - Rosalie Kane
- d University of Minnesota , Center on Aging , Minneapolis , Minnesota USA
| | - Merrie J Kaas
- e University of Minnesota , School of Nursing , Minneapolis , Minnesota USA
| | | | | | - Joyce C Robbins
- h HealthCare Interactive, Inc. , Minneapolis , Minnesota USA
| | - Debra Dobbs
- i University of South Florida , Tampa , Florida USA
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Boscart VM, Heckman GA, Huson K, Brohman L, Harkness KI, Hirdes J, McKelvie RS, Stolee P. Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care. J Interprof Care 2017; 31:583-592. [PMID: 28876202 DOI: 10.1080/13561820.2017.1340875] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Heart failure affects up to 20% of nursing home residents and is associated with high morbidity, mortality, and transfers to acute care. A major barrier to heart failure management in nursing home settings is limited interprofessional communication. Guideline-based heart failure management programs in nursing homes can reduce hospitalisation rates, though sustainability is limited when interprofessional communication is not addressed. A pilot intervention, 'Enhancing Knowledge and Interprofessional Care for Heart Failure', was implemented on two units in two conveniently selected nursing homes to optimise interprofessional care processes amongst the care team. A core heart team was established, and participants received tailored education focused on heart failure management principles and communication processes, as well as weekly mentoring. Our previous work provided evidence for this intervention's acceptability and implementation fidelity. This paper focuses on the preliminary impact of the intervention on staff heart failure knowledge, communication, and interprofessional collaboration. To determine the initial impact of the intervention on selected staff outcomes, we employed a qualitative design, using a social constructivist interpretive framework. Findings indicated a perceived increase in team engagement, interprofessional collaboration, communication, knowledge about heart failure, and improved clinical outcomes. Individual interviews with staff revealed innovative ways to enhance communication, supporting one another with knowledge and engagement in collaborative practices with residents and families. Engaging teams, through the establishment of core heart teams, was successful to develop interprofessional communication processes for heart failure management. Further steps to be undertaken include assessing the sustainability and effectiveness of this approach with a larger sample.
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Affiliation(s)
- Veronique M Boscart
- a Conestoga College Institute of Technology and Advanced Learning , Kitchener , Ontario , Canada
| | - George A Heckman
- b Research Institute for Aging and School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada
| | - Kelsey Huson
- c Colleges in Seniors Care, Conestoga College Institute of Technology and Advanced Learning , School of Health & Life Sciences and Community Services , Kitchener , Ontario , Canada
| | - Lisa Brohman
- d Sunnyside Home Seniors' Services , Kitchener , Ontario , Canada
| | - Karen I Harkness
- e McMaster University , Clinical Lead, Heart Failure and Cardiovascular Chronic Disease Management, Cardiac Care Network, Hamilton Health Sciences , Hamilton , Ontario , Canada
| | - John Hirdes
- f School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada
| | | | - Paul Stolee
- h School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada
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Abstract
CONTEXT Direct care workers in long-term care can develop close relationships with their patients and subsequently experience significant grief after patient death. Consequences of this experience for employment outcomes have received little attention. OBJECTIVES To investigate staff, institutional, patient, and grief factors as predictors of burnout dimensions among direct care workers who had experienced recent patient death; determine which specific aspects of these factors are of particular importance; and establish grief as an independent predictor of burnout dimensions. METHODS Participants were 140 certified nursing assistants and 80 homecare workers who recently experienced patient death. Data collection involved comprehensive semistructured in-person interviews. Standardized assessments and structured questions addressed staff, patient, and institutional characteristics, grief symptoms and grief avoidance, as well as burnout dimensions (depersonalization, emotional exhaustion, and personal accomplishment). RESULTS Hierarchical regressions revealed that grief factors accounted for unique variance in depersonalization, over and above staff, patient, and institutional factors. Supervisor support and caregiving benefits were consistently associated with higher levels on burnout dimensions. In contrast, coworker support was associated with a higher likelihood of depersonalization and emotional exhaustion. CONCLUSION Findings suggest that grief over patient death plays an overlooked role in direct care worker burnout. High supervisor support and caregiving benefits may have protective effects with respect to burnout, whereas high coworker support may constitute a reflection of burnout.
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Affiliation(s)
- Kathrin Boerner
- Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, Massachusetts, USA.
| | - Hayley Gleason
- Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Daniela S Jopp
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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Fahlström G, Kamwendo K, Forsberg J, Bodin L. Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial. Scand J Caring Sci 2017; 32:575-585. [PMID: 28851132 DOI: 10.1111/scs.12481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 04/23/2017] [Indexed: 11/28/2022]
Abstract
Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention.
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Affiliation(s)
| | - Kitty Kamwendo
- College of Medicine, University of Malawi, Malawi, Malawi
| | | | - Lennart Bodin
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research in Worker Health, Karolinska Institutet, Stockholm, Sweden
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Stowers BA, Giblin L, Laspina L, Perry K. Perceptions of Program Directors and Educators Regarding the Adequacy of Oral Health Education in Nursing Assistant Curricula. J Dent Hyg 2017; 91:21-28. [PMID: 29118080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/02/2017] [Indexed: 06/07/2023]
Abstract
Purpose: National data indicate that the oral health status of the aging population in long term care facilities (LTCF) is poor in the majority of cases. Nursing assistants are considered to be the primary caregivers of oral health care to elders residing in LTCF's. The aim of this research was to explore the perspectives among nursing educators and program directors on the adequacy of oral health education in nursing assistant curricula.Methods: This exploratory, cross-sectional study utilized a web-based questionnaire adapted, with permission, from a prior study conducted in 2009. The 17- question survey regarding the adequacy of oral health education, was e-mailed to 253 nursing educators and program directors in 71 locations in the New England area with an explanation of the study and a link to SurveyMonkey®.Results: Of the 253 surveys e-mailed, 100 surveys (n=100) were returned giving an overall response rate of 40%. Fourteen respondents (n=14) indicated that their program did not include oral health education in their curriculum and were excluded from the study. The remaining 86 participants (program directors n=26 and educators n=60) indicated that oral health education was included in their nursing assistant curricula. Respondents who reported spending more time on both didactic (P<0.001) and clinical instruction in oral health (P<0.001) were more likely to agree that the oral health care education provided in their program was adequate (P<0.001).Conclusion: The results indicate that the perception of nursing educators and program directors is that the level of oral health education within the nursing assistant curricula is adequate in preparing students with the skills and knowledge needed to provide oral health care to patients.
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Abstract
Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p < .01). More work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.
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Walton AL, Rogers B. Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review. Int J Environ Res Public Health 2017; 14:E544. [PMID: 28534859 DOI: 10.3390/ijerph14050544] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/08/2017] [Accepted: 05/16/2017] [Indexed: 11/16/2022]
Abstract
Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.
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Netherwood M, Skittrall R, Alexis O. Opinion piece: Regulation of nursing assistants: A critical international issue? Contemp Nurse 2017; 48:197-8. [PMID: 25549713 DOI: 10.5172/conu.2014.48.2.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract Health care or nursing assistants are valuable members of health care teams who undertake a wide range of tasks, contribute to meeting the increasingly complex healthcare needs of patients and have various levels of training. However, they are not subject to regulation in many countries. If training and regulation are pre-requisites for ensuring the standards of care delivered by registered nurses, then this must also apply to nursing assistants. Regulation ensures the need for on-going education and development which is critical to maintaining and refreshing the values underpinning compassionate care for both nursing assistants and registered nurses.
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Boscart VM, d'Avernas J, Brown P, Raasok M. Changing the Impact of Nursing Assistants' Education in Seniors' Care: the Living Classroom in Long-Term Care. Can Geriatr J 2017; 20:15-21. [PMID: 28396705 PMCID: PMC5383402 DOI: 10.5770/cgj.20.238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Evidence-informed care to support seniors is based on strong knowledge and skills of nursing assistants (NAs). Currently, there are insufficient NAs in the workforce, and new graduates are not always attracted to nursing home (NH) sectors because of limited exposure and lack of confidence. Innovative collaborative approaches are required to prepare NAs to care for seniors. METHODS A 2009 collaboration between a NH group and a community college resulted in the Living Classroom (LC), a collaborative approach to integrated learning where NA students, college faculty, NH teams, residents, and families engage in a culture of learning. This approach situates the learner within the NH where knowledge, team dynamics, relationships, behaviours, and inter-professional (IP) practice are modelled. RESULTS As of today, over 300 NA students have successfully completed this program. NA students indicate high satisfaction with the LC and have an increased intention to seek employment in NHs. Faculty, NH teams, residents, and families have increased positive beliefs towards educating students in a NH. CONCLUSION The LC is an effective learning approach with a positive and high impact learning experience for all. The LC is instrumental in contributing to a capable workforce caring for seniors.
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Affiliation(s)
- Veronique M Boscart
- Conestoga College Institute of Technology & Advanced Learning, Kitchener, ON; Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON; Schlegel Villages, Kitchener, ON
| | - Josie d'Avernas
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON
| | | | - Marlene Raasok
- Conestoga College Institute of Technology & Advanced Learning, Kitchener, ON
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Maurits EEM, de Veer AJE, Groenewegen PP, Francke AL. Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey. J Adv Nurs 2017; 73:2430-2440. [PMID: 28299824 DOI: 10.1111/jan.13298] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 11/28/2022]
Abstract
AIMS The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction. BACKGROUND Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff. DESIGN A cross-sectional study based on two questionnaire surveys in 2014 and 2015. METHODS The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings. RESULTS Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree. CONCLUSIONS This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care.
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Affiliation(s)
- Erica E M Maurits
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Anke J E de Veer
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Peter P Groenewegen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of Sociology and Department of Human Geography, Utrecht University, Utrecht, The Netherlands
| | - Anneke L Francke
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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O'Neill BJ, Dwyer T, Reid-Searl K, Parkinson L. Managing the deteriorating nursing home resident after the introduction of a hospital avoidance programme: a nursing perspective. Scand J Caring Sci 2016; 31:312-322. [PMID: 27327142 DOI: 10.1111/scs.12349] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/29/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hospital avoidance programmes aim to reduce the number of emergency transfers from nursing homes to hospitals and facilitate early discharge for hospitalised residents. Nursing staff are at the forefront of these efforts, yet little is known about how the programmes affect them and their management of the deteriorating resident. This information is needed to inform hospital avoidance programmes and better understand their work. AIM To examine nursing home nursing staff perceptions regarding their management of the deteriorating resident after the introduction of a hospital avoidance programme. METHODS A thematic analysis was conducted of focus group data collected from nursing staff 14 to 15 months after the introduction of a pilot hospital avoidance programme at an Australian nursing home. FINDINGS The programme was well received and filled a gap in nursing staff management of residents with deteriorating health by providing structure and support. Staff were more confident and focused on this area of their work. Nursing assistants felt more integrated into the system and were supported and learning from nurses. Workload remained heavy and there was a shift in how time was allocated, but nursing staff preferred to keep residents at the facility. CONCLUSION Nursing staff welcomed the programme and benefitted from its implementation. However, strategies must be explored to accommodate the staffing needs associated with providing emergency and subacute care in the nursing home setting.
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Affiliation(s)
- Barbara J O'Neill
- School of Nursing and Midwifery, Central Queensland University (CQU), Rockhampton, Qld, Australia
| | - Trudy Dwyer
- School of Nursing and Midwifery, Central Queensland University (CQU), Rockhampton, Qld, Australia
| | - Kerry Reid-Searl
- School of Nursing and Midwifery, Central Queensland University (CQU), Rockhampton, Qld, Australia
| | - Lynne Parkinson
- School of Human Health & Social Sciences, Central Queensland University (CQU), Rockhampton, Qld, Australia
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Allemann H, Sund-Levander M. Nurses' actions in response to nursing assistants' observations of signs and symptoms of infections among nursing home residents. Nurs Open 2015; 2:97-104. [PMID: 27642516 PMCID: PMC5006863 DOI: 10.1002/nop2.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 06/07/2015] [Indexed: 11/25/2022] Open
Abstract
Aims To describe what nurses do during episodes of suspected infection in elderly nursing home residents and if these actions are linked to who is initiating an episode and whether the episode is considered an infection or not. Design Prospective descriptive study. Data were collected in 2008–2010. Methods Summarized and categorized documentation by nursing assistants and nurses was used for summative content analysis. Results Nurses' actions seem to be related to who initiated the episode and if the episodes are categorized as ‘non‐infection’, ‘possible infection’ or ‘infection’. Actions could be ‘observation’, ‘screenings’, ‘engaged in waiting’, ‘follow‐ups’, ‘nurse‐prescribed actions’, ‘diagnosing’, ‘contacting the physician’, ‘carrying out an action prescribed by the physician’, ‘contacting an ambulance or arranging an emergency visit to the hospital’ and ‘prescribing screening’. As NAs often initiate episodes of suspected infection by observing changed conditions, it seems important to include the NA in the decision‐making process as these observations could detect possible early signs and symptoms of infections.
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Affiliation(s)
- Hanna Allemann
- Faculty of Health Sciences Department of Medical and Health Sciences Linköping University Linköping Sweden
| | - Märta Sund-Levander
- Faculty of Health Sciences Department of Medical and Health Sciences Linköping University Linköping Sweden
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Lundgren D, Ernsth-Bravell M, Kåreholt I. Leadership and the psychosocial work environment in old age care. Int J Older People Nurs 2015; 11:44-54. [PMID: 26073426 PMCID: PMC5033033 DOI: 10.1111/opn.12088] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 01/22/2015] [Indexed: 11/29/2022]
Abstract
Aims and objectives To study leadership factors and their associations with psychosocial work environmental among nursing assistants who are engaged in old age care and to analyse (i) differences in the assessment of leadership factors and the assessment of psychosocial work environmental in nursing homes and home help services and (ii) the association between the psychosocial work environment and factors that are related to leadership in nursing homes and home help services. Background Leadership factors are an important element of the psychosocial work environment in old age care. The physical distance between leaders and nursing assistants is larger in home help services than in nursing homes. Therefore, it is important to study leadership separately in nursing homes and home help services. Design Assessments from 844 nursing assistants in nursing homes and 288 in home help services (45 nursing homes and 21 home help service units) were analysed. Methods The data were analysed using linear regression. Age, gender, number of staff at the unit, number of years at the current working unit and educational level were controlled in Model 1. Summarised indexes that were based on all independent variables except the main independent variable were additionally controlled in Model 2. Results Psychosocial work environment was related to leadership factors, but stronger associations occurred more frequently in nursing homes than in home help services. Empowering leadership, support from superiors, the primacy of human resources and control over decisions were associated with higher assessments on all the variables that were related to the psychosocial work environment in both the nursing homes and home help services. Conclusions Organisational differences in conducting leadership in old age care must be considered. Some leadership characteristics are better prerequisites for creating and maintaining a positive psychosocial work environment for nursing assistants in nursing homes and home help services. Implications for practice Due to the differences in organisational settings, it is important to consider the differences in prerequisites in conducting leadership. To influence nursing assistants' performance and to increase quality in old age care in the long term, appropriate leadership is necessary.
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Affiliation(s)
- Dan Lundgren
- Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden.,Department of Analysis and Strategy, Division of Social Services, Municipality of Jönköping, Jönköping, Sweden
| | - Marie Ernsth-Bravell
- Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Ingemar Kåreholt
- Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden.,Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden
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Boerner K, Burack OR, Jopp DS, Mock SE. Grief after patient death: direct care staff in nursing homes and homecare. J Pain Symptom Manage 2015; 49:214-22. [PMID: 24996033 PMCID: PMC4300283 DOI: 10.1016/j.jpainsymman.2014.05.023] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/12/2014] [Accepted: 05/28/2014] [Indexed: 11/25/2022]
Abstract
CONTEXT Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. OBJECTIVES To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared the staff members were for the death of their patients, and 3) identify characteristics associated with their grief. METHODS This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression. RESULTS Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being "not at all prepared" for the death and struggling with "acceptance of death" were prevalent among the staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death. CONCLUSION Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare.
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Affiliation(s)
- Kathrin Boerner
- Jewish Home Lifecare, Research Institute on Aging, New York, New York, USA; Brookdale Department of Geriatrics & Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| | - Orah R Burack
- Jewish Home Lifecare, Research Institute on Aging, New York, New York, USA
| | - Daniela S Jopp
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Steven E Mock
- RBC Retirement Research Centre, University of Waterloo, Waterloo, Ontario, Canada
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Liu JYW. Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study. J Adv Nurs 2013; 70:1065-77. [PMID: 24102751 DOI: 10.1111/jan.12259] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2013] [Indexed: 12/01/2022]
Abstract
AIM To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. BACKGROUND Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. DESIGN This is a descriptive, exploratory qualitative study. METHODS Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. RESULTS Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. CONCLUSIONS This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation.
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Affiliation(s)
- Justina Y W Liu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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