Mental health knowledge and training needs among direct care workers: a mixed methods study

Abstract

Data from this study suggest important areas for DCW development. However, system issues that affect DCWs such as workload, resources, mental health stigma, and diverse client populations should be addressed concurrently.

Perceptions and practice behaviors regarding late-life depression among private duty home care workers: a mixed-methods study

“…The knowledge gaps among PCAs identified in the present study are largely congruent with reports from previous studies, which have consistently reported that direct care workers lacked a comprehensive understanding of the symptoms of depression and tended to view depression as dispositional problems (Ayalon et al, 2008;Davison et al, 2009;Gleason & Coyle, 2016;Konnert et al, 2018;McCabe et al, 2008). Compared with other LTSS staff such as social workers, nurses, and case managers, direct care workers tended to hold less accurate beliefs about symptoms of depression and were less familiar with the effectiveness of depression treatments (Ayalon et al, 2008), possibly due to a lower level of education.…”

“…PCAs' relevant work experiences averaged 6.3 years in our study sample which could explain their enhanced performance on the knowledge quiz in comparison to community adults. Interestingly, 72% of PCAs in our study disagreed or strongly disagreed with the statement that depression is a natural part of being old whereas normalization of depression in later life was a prevalent misconception among direct care workers from previous studies (Ayalon et al, 2008;Davison et al, 2009;Konnert et al, 2018).…”

“…These direct care workers are the eyes and ears of the home care system and important gatekeepers for identifying depressive symptoms in care recipients (Institute of Medicine and National Research Council, 2015). However, research has shown that direct care workers across settings of long-term services and supports (LTSS) often do not receive training in depression and have perceptions inconsistent with the current scientific knowledge (Ayalon, Arean, & Bornfeld, 2008;Davison et al, 2009;Gleason & Coyle, 2016;Grundberg, Hansson, Religa, & Hilleras, 2016;Konnert, Huang, & Pesut, 2018;McCabe, Davison, Mellor, & George, 2008;McCrae et al, 2005). Given that improved knowledge on depression may lead to improved referral and care (McAiney et al, 2007;Mellor et al, 2010), identifying knowledge deficits among home care workers is an important first step in developing effective training programs.…”

“…Previous studies often involved multiple occupations across the LTSS settings such as nurses, social workers, physical therapists, and direct care workers (Ayalon et al, 2008;Davison et al, 2009;Delaney, Barrere, Grimes, & Apostolidis, 2016;McCabe et al, 2008;McCrae et al, 2005). The limited literature on home care workers did not specify occupation titles and broadly examined perceptions of mental and behavioral health problems (Gleason & Coyle, 2016;Grundberg et al, 2016;Konnert et al, 2018). PCAs are direct care workers who tend to have the lowest level of education and training compared to other LTSS providers.…”

“…Many studies relied on either qualitative interview (Gleason & Coyle, 2016;Grundberg et al, 2016;McCabe et al, 2008;McCrae et al, 2005) or survey (Ayalon et al, 2008;Davison et al, 2009). A study involving mixed-methods used single item or one-dimensional measures (Konnert et al, 2018). Previous studies therefore did not provide a comprehensive account of workers' knowledge regarding the multidimensional aspects of depression etiology, symptoms, and treatments (Karantzas, Davison, McCabe, Mellor, & Beaton, 2012).…”