Building capacity and resilience in the dementia care workforce: a systematic review of interventions targeting worker and organizational outcomes

Elliott, Kate-Ellen; Scott, Jenn; Stirling, CM; Martin, Angela; Robinson, Andrew

doi:10.1017/s1041610211002651

Cited by 54 publications

(105 citation statements)

References 52 publications

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“…Our review builds on the evidence base from a number of systematic reviews that have addressed discrete areas of improving dementia care [55–59]. Whilst mostly concerned with effectiveness of interventions [55, 56, 59], these reviews have addressed some elements of dissemination and implementation. Elliot [56] and Reis [58] highlight the lack of detail reported on implementation in their reviews of training interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Whilst mostly concerned with effectiveness of interventions [55, 56, 59], these reviews have addressed some elements of dissemination and implementation. Elliot [56] and Reis [58] highlight the lack of detail reported on implementation in their reviews of training interventions. Reis [58] and Spector [59] emphasise the limited accessibility and lack of reporting on training manuals which impact the ability to reproduce interventions.…”

Section: Discussionmentioning

confidence: 99%

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Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

et al. 2017

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BackgroundThe need to better understand implementing evidence-informed dementia care has been recognised in multiple priority-setting partnerships. The aim of this scoping review was to give an overview of the state of the evidence on implementation and dissemination of dementia care, and create a systematic evidence map.MethodsWe sought studies that addressed dissemination and implementation strategies or described barriers and facilitators to implementation across dementia stages and care settings. Twelve databases were searched from inception to October 2015 followed by forward citation and grey literature searches. Quantitative studies with a comparative research design and qualitative studies with recognised methods of data collection were included. Titles, abstracts and full texts were screened independently by two reviewers with discrepancies resolved by a third where necessary. Data extraction was performed by one reviewer and checked by a second. Strategies were mapped according to the ERIC compilation.ResultsEighty-eight studies were included (30 quantitative, 34 qualitative and 24 mixed-methods studies). Approximately 60% of studies reported implementation strategies to improve practice: training and education of professionals (94%), promotion of stakeholder interrelationships (69%) and evaluative strategies (46%) were common; financial strategies were rare (15%). Nearly 70% of studies reported barriers or facilitators of care practices primarily within residential care settings. Organisational factors, including time constraints and increased workload, were recurrent barriers, whereas leadership and managerial support were often reported to promote implementation. Less is known about implementation activities in primary care and hospital settings, or the views and experiences of people with dementia and their family caregivers.ConclusionThis scoping review and mapping of the evidence reveals a paucity of robust evidence to inform the successful dissemination and implementation of evidence-based dementia care. Further exploration of the most appropriate methods to evaluate and report initiatives to bring about change and of the effectiveness of implementation strategies is necessary if we are to make changes in practice that improve dementia care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0528-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

et al. 2017

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“…Diet As the population ages and the prevalence of dementia increases, in both LMICs and HICs, an adequately skilled and sufficiently large dementia care workforce is essential to meet long-term care needs (World Health Organisation and Alzheimer's Disease International, 2012;Coogle et al, 2007; Bruckner et al, 2011;Elliott et al, 2012;Elliott et al, 2013). As with informal caregivers, the majority of formal paid health and social care for people with dementia is provided by women, who make up over 85 per cent of this workforce (Alzheimer's Association, 2014;Cummings et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

The impact of dementia on women internationally: An integrative review

Erol

Brooker

Peel

2016

Health Care for Women International

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Women are disproportionately affected by dementia, both in terms of developing dementia and becoming caregivers. We conducted an integrative review of English language literature of the issues affecting women in relation to dementia from an international perspective. The majority of relevant studies were conducted in high income countries, and none were from low-income countries. The effects of caregiving on health, wellbeing and finances are greater for women; issues facing women, particularly in low and middle-income countries need to be better understood.Research should focus on building resilience to help people adjust and cope long term.Dementia is a global public health issue that disproportionately affects women, either through developing the condition themselves, or as a carer for someone with dementia. The effects on women of living with or caring for someone with dementia from an international perspective needs to be more fully understood. In our review of the published literature, we explore the impact of dementia on changing roles, identity, wellbeing and finances for women in both high-income and low-and middle income countries. An improved understanding of these factors can support research, and policy developments, that address the issues specifically relevant to women.As age is the greatest risk factor for dementia, and women have a greater life expectancy worldwide than men, a larger number of people with dementia are women (Alzheimer's Association, 2014).There are also clinical differences between genders in disease risk and severity, especially in relation to dementia and cognition (Carter et al., 2012). There is a significant association between age, gender, and dementia in many areas of the world, with women showing a higher prevalence rate for dementia than men (Bamford, 2011;Takeda et al., 2011; Alzheimer's Disease International, 2015) expectation that women will assume caregiving roles (Godfrey & Warshaw, 2009;Lantz, 2009;Gibbons et al., 2014). In many studies of dementia caregivers, all or most participants are women, reflecting the disproportionate extent to which women are relied upon as carers, although few reports focus on gender specifically (Robinson et al., 2014). Therefore the assumption that women provide informal care to people with dementia is embedded (often implicitly) in much of the existing research.The financial impact of providing dementia care on family caregivers is substantial; caregivers in the United States reported that they were reluctant to take time off work to provide care, or took on additional work to cover caregiving costs, which had increased because of the recent economic downturn (Evercare, 2009). Women may also have the responsibility of caring for young children alongside caring for a parent with dementia -referred to as the 'sandwich generation' (Solberg et 3 al., 2014). Despite this (often dual) caring responsibility, families often prefer , for a variety of cultural, obligational and practical reasons to continue to provide care at ho...

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“…Aged care workers also make up a significant proportion of the nursing workforce, with a recent report indicating that approximately 14% of the nursing workforce is employed in aged care facilities . Current shortages and the rapidly increasing need for more aged care staff make research on factors that impact the retention and performance of this workforce vital . Specific issues that have been shown to influence these outcomes include workplace aggression .…”

Section: Introductionmentioning

confidence: 99%

Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants

Rodwell

Demir

Gulyas

2015

Int J of Nursing Practice

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Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers.

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Building capacity and resilience in the dementia care workforce: a systematic review of interventions targeting worker and organizational outcomes

Cited by 54 publications

References 52 publications

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map

The impact of dementia on women internationally: An integrative review

Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants

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