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Associations between the working characteristics of nursing staff and the prevalence of behavioral symptoms in people with dementia in residential care

Published online by Cambridge University Press:  01 August 2008

David Edvardsson*
Affiliation:
Department of Nursing, Umeå University, Sweden Australian Centre for Evidence-Based Aged Care, La Trobe University, Australia
P. O. Sandman
Affiliation:
Department of Nursing, Umeå University, Sweden
Rhonda Nay
Affiliation:
Australian Centre for Evidence-Based Aged Care, La Trobe University, Australia
Stig Karlsson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Sweden
*
Correspondence should be addressed to: David Edvardsson, La Trobe University/Bundoora Extended Care Centre, 1231 Plenty Rd, Bundoora, Victoria 3083, Australia. Phone: +61 03 9495 3330; Fax: +61 03 9495 3154. Email: [email protected].

Abstract

Background: Clinical experience suggests that the work characteristics of staff in residential care may influence the well-being of residents with dementia. However, few studies have explored those anecdotal experiences. The aim of this study was to investigate associations between work characteristics of nursing staff and prevalence of behavioral symptoms among people with dementia in residential care settings.

Methods: The self-report job strain assessment scale was used to measure staff perceptions of their working environment, and the Multi Dimensional Dementia Assessment Scale to measure the occurrence of behavioral symptoms among residents in 40 residential care units for people with dementia.

Results: The findings show that in settings where staff reported high job strain, the prevalence of behavioral symptoms was significantly higher compared to settings where staff reported low job strain. Furthermore, settings characterized by staff having a more positive caring climate had significantly less prevalence of escape, restless and wandering behaviors compared to settings having a less positive caring climate. There was no statistically significant association between staff members' self-reported knowledge in caring for people with dementia and prevalence of behavioral symptoms.

Conclusions: This study provides evidence for the oft-cited clinical experience that the well-being of nursing staff is associated with the well-being of people with dementia in residential care settings.

Type
Research Article
Copyright
© International Psychogeriatric Association 2008

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References

Berg, A., Welander-Hansson, U. and Hallberg, I. R. (1994). Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care: comparisons between a ward for severely demented patients and a similar control ward. Journal of Advanced Nursing, 20, 742749.CrossRefGoogle Scholar
Berg, A., Hallberg, I. R. and Norberg, A. (1998). Nurses' reflections about dementia care: the patients, the care and themselves in their daily care giving. International Journal of Nursing Studies, 35, 271282.CrossRefGoogle Scholar
Brodaty, H., Draper, B. and Low, L. F. (2002). What environmental and staffing characteristics predict behavioural and psychological symptoms of dementia in nursing home residents. Psychogeriatrics, 2, 4753.CrossRefGoogle Scholar
Brodaty, H., Draper, B. and Low, L. F. (2003). Nursing home staff attitudes towards residents with dementia: strain and satisfaction with work. Journal of Advanced Nursing, 44, 583590.Google Scholar
Desai, A. K. and Grossberg, G. T. (2001). Recognition and management of behavioural disturbances in dementia. Journal of Clinical Psychiatry, 3, 93109.Google Scholar
Edvardsson, D., Sandman, P. O. and Rasmussen, B. (2005). Sensing an atmosphere of ease a tentative theory of supportive care settings. Scandinavian Journal of Caring Sciences, 19, 344353.CrossRefGoogle ScholarPubMed
Finkel, S. I., Costa e Silva, J., Cohen, G., Miller, S. and Sartorius, N. (1996). Behavioral and psychological signs and symptoms of dementia: a consensus statement on current knowledge and implications for research and treatment. International Psychogeriatrics, 8, 497500.CrossRefGoogle ScholarPubMed
Graneheim, U. H. (2005). The meaning of interaction between persons with dementia and disturbing behavior and their care providers. Umeå University Medical Dissertations, New Series no. 906, Umeå, Sweden (in Swedish).Google Scholar
Grossberg, G. T. and Desai, A. K. (2003). Management of Alzheimer's disease. Journals of Gerontology, Series A, Biological Sciences and Medical Sciences, 58, 331353.CrossRefGoogle ScholarPubMed
Hallberg, I. R. and Norberg, A. (1995). Nurses' experiences of strain and their reactions in the care of severely demented patients. International Journal of Geriatric Psychiatry, 10, 757766.CrossRefGoogle Scholar
Hallberg, I. R., Welander-Hansson, U. and Axelsson, K. (1994). Satisfaction with nursing care and work during a year of clinical supervision and individualized care. Comparison between two wards for care of severely demented patients. Journal of Nursing Management, 1, 297307.Google Scholar
Karasek, R. and Theorell, T. (1990). Healthy Work. Stress, Productivity, and the Reconstruction of Working Life. New York: Basic Books.Google Scholar
Karlsson, S., Bucht, G., Eriksson, S. and Sandman, P. O. (2001). Factors relating to the use of physical restraints in geriatric care settings. Journal of the American Geriatrics Society, 49, 17221728.CrossRefGoogle Scholar
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Buckingham: Open University Press.Google Scholar
Kivimäki, M., Leino-Arjas, P., Luukkonen, R., Riihimäki, H., Vahtera, K. and Kirjonen, J. (2002). Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ, 325, 857860.CrossRefGoogle ScholarPubMed
Kuper, H. and Marmot, M. (2003). Job strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study. Journal of Epidemiology and Community Health, 57, 147153.Google Scholar
Lawton, M. P. (1986). Environment and Aging. Albany: Center for the Study of Aging.Google Scholar
Lintern, T., Woods, B. and Phair, L. (2000). Training is not enough to change care practice. Journal of Dementia Care, 8, 1517.Google Scholar
Lövheim, H., Sandman, P. O., Kallin, K., Karlsson, S. and Gustafson, Y. (2006). Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. International Psychogeriatrics, 18, 713726.Google Scholar
MacDonald, A. J. D. and Woods, R. T. (2005). Attitudes to dementia and dementia care held by nursing staff in U.K. “non-EMI” care homes: what difference do they make? International Psychogeriatrics, 17, 19.CrossRefGoogle Scholar
Miller, B. L., Darby, A., Benson, D. F., Cummings, J. L. and Miller, M. H. (1997). Aggressive, socially disruptive and antisocial behavior associated with fronto-temporal dementia. British Journal of Psychiatry, 170, 150155.CrossRefGoogle ScholarPubMed
Nasman, B., Bucht, G. and Eriksson, S. (1993). Behavioural symptoms in the institutionalized elderly – relationship to dementia. International Journal of Geriatric Psychiatry, 8, 843849.CrossRefGoogle Scholar
Norberg, K. G., Hellzén, O., Sandman, P. O. and Asplund, K. (2002). The relationship between organizational climate and the content of daily life for people with dementia living in a group-dwelling. Journal of Clinical Nursing, 11, 237–146.CrossRefGoogle Scholar
Pekkarinen, L., Elovainio, M., Sinervo, T., Finne-Soveri, H. and Noro, A. (2006). Nursing working conditions in relation to restraint practices in long-term care units. Medical Care, 44, 11141120.Google Scholar
Purundare, N., Allen, N. P. H. and Burns, A. (2000). Behavioral and psychological symptoms of dementia. Reviews in Clinical Gerontology, 10, 245260.CrossRefGoogle Scholar
Sandman, P. O., Adolfsson, R., Norberg, A., Nystrom, L. and Winblad, B. (1988). Long-term care of the elderly: a descriptive study of 3600 institutionalized patients in the county of Våsterbotten, Sweden. Comprehensive Gerontology, 2, 120132.Google ScholarPubMed
Sandman, P. O., Edvardsson, D. and Winblad, B. (2006). Care of patients in the severe stage of dementia. In Gauthier, S. (ed.), Clinical Diagnosis and Management of Alzheimer's Disease, 3rd edn (pp. 233246). London: Taylor & Francis.Google Scholar
Santavirta, N., Solovieva, S. and Theorell, T. (2007). The association between job strain and emotional exhaustion in a cohort of 1,028 Finnish teachers. British Journal of Educational Psychology, 77, 213228.CrossRefGoogle Scholar
Zimmerman, S. et al. (2005). Attitudes, stress, and satisfaction of staff who care for residents with dementia. The Gerontologist, 45, 96105.CrossRefGoogle ScholarPubMed