Swedish assistant nurses’ experiences of job satisfaction when caring for persons suffering from dementia and behavioural disturbances. An interview study

Abstract

Job satisfaction is complex and is an important component in facilitating high quality nursing care. Behavioural and psychological symptoms of dementia (BPSD) can be clustered into one of five syndromes: psychosis, aggression, psychomotor agitation, depression and apathy, and comprise signs and symptoms of disturbed perception, thought content, mood or behaviour that frequently occur in patients with dementia. BPSD can cause tremendous distress both for the patients and for their caregivers and they have been seen as the most stressful aspect of care giving. Two registered nurses, 16 assistant nurses and two nursing assistants in Sweden talked about their job satisfaction when caring for residents suffering from dementia and BPSD. Thematic content analysis was conducted. The nurses' narrations indicate exposure, insufficiency, not being valued and doubt, as well as respect and importance and devotion towards the residents. One core theme was formulated: ''Job satisfaction as a process moving between breaking down and occasionally building up the working person''. A positive relationship with colleagues was the primary reason for nurses continuing to work at the group dwellings. The organization and resident behaviours were seen as very negative. Some nurses described insecurity in terms of how long they could continue to take rudeness, being spat at, being scratched or physically hit by residents, without ''hitting back''. In order to increase the well-being of the nurses, the pressure on them needs to be relieved. The development of leadership, education, supervision and reflection might be one possible way of reducing the prevalence of BPSD-related violence, enhancing job satisfaction and handling moral stress.

A Meta-Ethnography of Paid Dementia Care Workers’ Perspectives on Their Jobs

“…(33) A group of nurse assistants reported that the administration in their facility made them feel like an extra cost, in contrast with their co-workers by whom they felt valued. (49) …”

“…(34,49) A lack of education and training impacted nurses and nurse trainees whose reactions to symptoms or behaviours might range from sadness to fear of the patients. (35,40) …”

Non-Pharmalogical Interventions towards Behavioural and Psychological Symptoms of Dementia—An Integrated Literature Review

“…Kristiansen et al [4] consider that one possible way to reduce the prevalence of BPSD-related violence is to develop education, leadership, supervision and reflection. This could also be a way to increase the well-being of the nurses and increase their job satisfaction.…”

“…BPSD includes many different symptoms such as screaming, restlessness, wandering, anxiety, apathy, depression, hallucinations, sleep disturbance and agitation [2] [3]. The frequency and severity of the BPSD symptoms are highly associated with caregiver burden and reducing quality of life for both the person with dementia and their caregivers [2] [4].…”

Paradoxical and powerful: Volunteers’ experiences of befriending people with dementia

“…Understanding workers' experiences can help to identify appropriate support, which in turn can positively influence their satisfaction and wellbeing (e.g. Kristiansen, Hellzén, & Asplund, 2006;Stockwell-Smith, Jones, & Moyle, 2011). 7 Existing research with dementia volunteers has identified issues relating to a) volunteers' role, particularly regarding the need for role clarity, b) emotional experiences, including emotional reward, acceptance of their own experiences, fear of rejection and difficulties ending the relationship, c) personal development, such as increased empathy and appreciation of clients, and d) professional support in terms of the need for specific training (Chung, 2008;Greenwood et al, 2013;Guerra, Demain, Figueiredo & De Sousa, 2012;Pillemer, Landreneau, & Suitor, 1996;Tanner & Brett, 2014).…”