Self-efficacy in dementia care staff: Experiences from the care home context

Abstract

Perceived self-efficacy is proposed to impact on the psychological health of dementia care staff. The current study adopted a qualitative methodology to increase understanding of the experiences of self-efficacious care assistants. Purposive sampling identified eight care assistants with high levels of self-efficacy. Data from semi-structured interviews were analysed using interpretative phenomenological analysis. Four themes captured experiences of 'feeling torn' between competing demands when providing care; a sense of 'togetherness and connection', included sub-themes of support, closeness and the value of engaging; 'emotional attunement' to resident's needs, including reciprocity of emotion, personal perspective-taking and empathy as guides to care. The final theme, 'caring as a part of life', described interest, motivation and accepting attitudes as well as caring being part of carers' identity. The themes highlight how staff might manage the dilemmas they face and emphasize important areas for care staff training as well as further research.

Conceptualizing attunement in dementia care: a meta-ethnographic review

“…In order to understand the person with dementia, the caregivers must be aware of the history, wishes and relations of the individual. Coates and Fossey (2016), Jost et al (2010), and Palmer (2013) described how caregivers attune to personhood in order to fulfil the person's needs: "The caregivers were attuned to the needs, desires, moods and concerns of their family members with dementia; thus, they were attuned to personhood" (Palmer, 2013, p. 224). Working with personhood involved acknowledging the needs and life story of the individual.…”

“…According to Coates and Fossey (2016), Palmer (2013), and R. Ward et al (2008), attunement requires the caregivers' emotional involvement when they interact with the person. Care work was described as deeply emotional work, and to understand and attune to the person, emotional openness and awareness was central (Coates & Fossey, 2016). "Seemingly valuing the emotional content in the relation with the residents as a prerequisite for understanding them" (Häggström et al, 1998, p. 254).…”

“…"In this gendered field of employment, the emotional dimension of dementia care is typically overlooked, and receives little in the way of formal support, but the emotional work of care staff is crucial to what they do, not least because it enhances and supports communication" (R. Ward et al, 2008, p. 647). If the emotional dimension to care work is not acknowledged and articulated, it may become difficult for the caregivers to involve themselves emotionally, and attuned interactions where the person with dementia experiences meaningful contact and is able to express themselves might not take place (Coates & Fossey, 2016;R. Ward et al, 2008).…”

Health and burnout of home health care assistants: impact of a training intervention

“…All of these problems mentioned above are important because they decrease workers' health and retention, their job satisfaction and the quality of care (Ravenswood, Douglas, & Haar, 2018;George, Hale, & Angelo, 2017;Zhang, Punnett, & Nannini, 2017;Estabrooks et al, 2015). For these reasons, it is necessary to create educational programs and interventions on reducing dysfunctional coping strategies, learning healthy sleep practices, increasing self-efficacy (Coates & Fossey, 2019) and improving communication (George et al, 2017). Islam, Baker, Huxley, Russell, & Dennis (2017) highlight the importance of dementia training in care homes, in order to reduce stress in professionals, especially in nursing and larger care homes.…”

Self-Efficacy of Direct Care Workers Providing Care to Older People in Residential Aged Care Settings: A Scoping Review Protocol

“…A qualitative study by Coates found increased dilemma among care workers in the process of caregiving due to the lack of con dence in their role [10]. A study in Canadian long-term care home found a high level of perceived self-e cacy to provide palliative care among the care workers though there was a knowledge gap on palliative care [11].…”