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Applying a palliative care approach in residential care: Effects on nurse assistants' work situation

Published online by Cambridge University Press:  21 October 2013

Ingela Beck ,
Ulf Jakobsson  and
Anna-Karin Edberg
Ingela Beck*
Affiliation:
The Swedish Institute for Health Sciences, Lund University, Lund, Sweden Department of Health and Society, Kristianstad University, Kristianstad, Sweden
Ulf Jakobsson
Affiliation:
Center for Primary Health Care Research, Lund University, Lund, Sweden
Anna-Karin Edberg
Affiliation:
The Swedish Institute for Health Sciences, Lund University, Lund, Sweden Department of Health and Society, Kristianstad University, Kristianstad, Sweden
*
Address correspondence and reprint requests to: Ingela Beck, Department of Health and Society, Kristianstad University, SE-291 88 Kristianstad, Sweden. E-mail: ingela.beck@hkr.se
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Abstract

Objectives:

The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.

Method:

A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).

Results:

Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.

Significance of results:

The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.

Keywords

Palliative care approach interventionLong-term careJob satisfactionStrainLeadership
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 3 , June 2015 , pp. 543 - 553
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Australian Palliative Residential Aged Care (APRAC) (2006). Guidelines for a palliative approach in residential aged care. Canberra: Australian National Health and Medical Research Council. Available online from http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/pc29.pdf.Google Scholar
Arnö, S. & Tuvning, K. (2002). Arbetstillfredställelse och sjukfrånvaro [Job satisfaction and sick leave]. Stockholms universitet: Psykologiska institutionen.Google Scholar
Augustsson, H., Törnquist, A. & Hasson, H. (2013) Challenges in transferring individual learning to organizational learning in residential care of older people. Journal of Health Organization and Management, 27, 390–408.Google Scholar
Beck, I., Törnquist, A., Broström, L., et al. (2012 a). Having to focus on doing rather than being: Nurse assistants' experience of palliative care in municipal residential care settings. International Journal of Nursing Studies, 49, 455–464.Google Scholar
Beck, I., Törnquist, A. & Edberg, A.K. (2012 b). Nurse assistants' experience of an intervention focused on a palliative care approach for older people in residential care. International Journal of Older People Nursing, doi:10.1111/j.1748-3743.2012.00343.x.Google Scholar
Beck, I., Jakobsson, U. & Edberg, A.K. (2013). Applying a palliative care approach in residential care: Effects on care provision and caring climate. Manuscript submitted for publication.Google Scholar
Bolmsjö, I. (2008). End-of-life care for old people: A review of the literature. American Journal of Hospice & Palliative Care, 25, 328–338.Google Scholar
Brodaty, H., Draper, B. & Low, L.F. (2003). Nursing home staff attitudes towards residents with dementia: Strain and satisfaction with work. Journal of Advanced Nursing, 44, 583–590.Google Scholar
Castle, N.G., Degenholtz, H. & Rosen, J. (2006). Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania. BMC Health Service Research, 6, 60. doi: 10.1186/1472-6963-1186-1160.Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: L. Erlbaum Associates.Google Scholar
Edberg, A.-K., Anderson, K., Orrung Wallin, A., et al. (2009). Strain in nursing care of people with dementia: Identifying aspects of importance as a first step towards preventive means. International Psychogeriatrics, 21(Suppl. 2), S161–S162.Google Scholar
Edberg, A.-K., Anderson, K., Orrung Wallin, A., et al. (2013). Development of the Strain in Dementia Care scale. Manuscript submitted for publication.Google Scholar
Edvardsson, D., Sandman, P.O., Nay, R., et al. (2009). Predictors of job strain in residential dementia care nursing staff. Journal of Nursing Management, 17, 59–65.Google Scholar
Ekvall, G. (2001). Manual—formulär C: Arbetstillfredställelse [Manual—formulary C: Job satisfaction]. Stockholm: Ekvall Organisationspsykologi.Google Scholar
Ekvall, G. & Arvonen, J. (1994). Leadership profiles, situation and effectiveness. Creativity and Innovation Management, 3, 139–161.Google Scholar
Ekvall, G., Waldenström-Lindblad, I. & Arvonen, J. (1983). Creative organizational climate: Construction and validation of a measuring instrument. In Report 2: Swedish Council for Management and Organizational Behaviour, 0281-7942; 1983:2. Stockholm: FA-Rådet.Google Scholar
Engström, M., Ljunggren, B., Lindqvist, R., et al. (2005). Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care. Journal of Telemedicine and Telecare, 11, 304–309.Google Scholar
Engström, M., Ljunggren, B., Lindqvist, R. & Carlsson, M. (2006). Staff satisfaction with work, perceived quality of care and stress in elderly care: Psychometric assessments and associations. Journal of Nursing Management, 14, 318–328.Google Scholar
Ernsth Bravell, M., Westerlind, B., Midlov, P., et al. (2011). How to assess frailty and the need for care? Report from the Study of Health and Drugs in the Elderly (SHADES) in community dwellings in Sweden. Archives of Gerontology and Geriatrics, 53, 40–45.Google Scholar
Glasberg, A.L., Eriksson, S., Dahlqvist, V., et al. (2006). Development and initial validation of the Stress of Conscience Questionnaire. Nursing Ethics, 13, 633–648.Google Scholar
Glasberg, A.L., Eriksson, S. & Norberg, A. (2008). Factors associated with “stress of conscience” in healthcare. Scandinavian Journal of Caring Sciences, 22, 249–258.Google Scholar
Josefsson, K. & Hansson, M. (2011). To lead and to be led in municipal elderly care in Sweden as perceived by registered nurses. Journal of Nursing Management, 19, 498–506.Google Scholar
Lawton, M.P. & Simon, B. (1968). The ecology of social relationships in housing for the elderly. The Gerontologist, 8, 108–115.Google Scholar
National Board of Health and Welfare (2010). Lägesrapport 2010: Folkhälsa, hälso- och sjukvård, individ- och familjeomsorg, stöd och service till personer med funktionsnedsättningar, vård och omsorg om āldre [Report 2010: Public health, health- and care, individual- and family care, support and service to persons with function disabilities, care and services for elderly]. Stockholm: National Board of Health and Welfare.Google Scholar
National Board of Health and Welfare (2012). Äldreguiden statistikuppgifter [The older guide], 2012. Stockholm: National Board of Health and Welfare.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2007). How to change practice: Understand, identify and overcome barriers to change. London: NICE.Google Scholar
Orrung Wallin, A., Edberg, A.-K. & Jakobsson, U. (2012). Job satisfaction and associated variables among nurse assistants working in residential care. International Psychogeriatrics, 24, 1904–1918.Google Scholar
Phillips, J.L., Davidson, P.M., Jackson, D., et al. (2008). Multifaceted palliative care intervention: Aged care nurses' and care assistants' perceptions and experiences. Journal of Advanced Nursing, 62, 216–227.Google Scholar
Polit, D.F. & Beck, C.T. (2004). Nursing research: Principles and methods. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Swedish Association of Local Authorities and Regions (SALAR) (2009). Öppna jämförelser 2009: Vård och omsorg om āldre [Open comparisons 2009: Care and service of older people]. Stockholm: SALAR.Google Scholar
Sellgren, S., Ekvall, G. & Tomson, G. (2007). Nursing staff turnover: Does leadership matter? Leadership in Health Services, 20, 169–183.Google Scholar
SOU (2008:51). Värdigt liv i äldreomsorgen: Betänkande [A life with dignity in old care: Report]. In Statens offentliga utredningar (SOU) [Government Official Reports]. Stockholm: Fritzes offentliga publikationer.Google Scholar
Stillman, D., Strumpf, N., Capezuti, E., et al. (2005). Staff perceptions concerning barriers and facilitators to end-of-life care in the nursing home. Geriatric Nursing, 26, 259–264.Google Scholar
van den Pol-Grevelink, A., Jukema, J.S. & Smits, C.H. (2012). Person-centred care and job satisfaction of caregivers in nursing homes: A systematic review of the impact of different forms of person-centred care on various dimensions of job satisfaction. International Journal of Geriatric Psychiatry, 27, 219–229.Google Scholar
Westergren, A., Axelsson, C., Lilja-Andersson, P., et al. (2009). Study circles improve the precision in nutritional care in special accommodations. Food & Nutrition Research, 53. doi:10.3402/fnr.v3453i3400.1950.Google Scholar
World Health Organization (WHO) (2002). National cancer control programs: Policies and managerial guidelines. Geneva: WHO.Google Scholar
World Health Organization (WHO) (2011). Palliative care for older people: Better practices. Copenhagen: WHO, Regional Office for Europe.Google Scholar
World Medical Association (WMA) (2008). WMA Declaration of Helsinki: Ethical principles for medical research involving human subjects. Seoul: 59th WMA General Assembly.Google Scholar