A systematic review and meta-analysis of the prevalence and associations of stress and burnout among staff in long-term care facilities for people with dementia

Abstract

Background:Care home staff stress and burnout may be related to high turnover and associated with poorer quality care. We systematically reviewed and meta-analyzed studies reporting stress and burnout and associated factors in staff for people living with dementia in long-term care.Methods:We searched MEDLINE, PsycINFO, Web of Science databases, and CINAHL database from January 2009 to August 2017. Two raters independently rated study validity using standardized criteria. We meta-analyzed burnout scores across comparable studies using a random effects model.Results:17/2854 identified studies met inclusion criteria. Eight of the nine studies reporting mean Maslach Burnout Inventory (MBI) scores found low or moderate burnout levels. Meta-analysis of four studies using the 22-item MBI (n = 598) found moderate emotional exhaustion levels (mean 18.34, 95% Confidence Intervals 14.59–22.10), low depersonalization (6.29, 2.39–10.19), and moderate personal accomplishment (33.29, 20.13–46.46). All three studies examining mental health-related quality of life reported lower levels in carer age and sex matched populations. Staff factors associated with higher burnout and stress included: lower job satisfaction, lower perceived adequacy of staffing levels, poor care home environment, feeling unsupported, rating home leadership as poor and caring for residents exhibiting agitated behavior. There was preliminary evidence that speaking English as a first language and working shifts were associated with lower burnout levels.Conclusions:Most care staff for long-term care residents with dementia experience low or moderate burnout levels. Prospective studies of care staff burnout and stress are required to clarify its relationship to staff turnover and potentially modifiable risk factors.

Registered Nurse Burnout, Job Dissatisfaction, and Missed Care in Nursing Homes

“…Research on nursing home staff burnout has also mostly come from abroad without particular focus on licensed nurses . While one expects that similar factors contribute to burnout and missed care for nursing assistants, licensed practical nurses (LPNs), and RNs in nursing homes, the latter have unique clinical leadership roles that warrant examining them separately.…”

Clinical and cost-effectiveness of the Managing Agitation and Raising Quality of Life (MARQUE) intervention for agitation in people with dementia in care homes: a single-blind, cluster-randomised controlled trial

“…Similarly, although all staff attended training, the staff recruited to the study reported high levels of selfassessed competence at baseline and had higher personal accomplishment and lower depersonalisation scores on the burnout scale than did care home staff in general. 42 We planned to analyse cost-effectiveness, which is important in the UK because it informs the National Institute for Health and Care Excellence (NICE) guidelines. The fact that the cost of MARQUE was not found to be significantly less than TAU might be explained by the fact that cost data has higher variance than effect data and the study was powered for the primary outcome.…”

Effects of a practical training programme on burnout among professional caregivers in a care home for older adults with dementia: a pilot study

“…31 However, another study that measured the association between age and burnout found no significant association. 45 Therefore, more research is needed to identify the relationship between these variables and burnout in professional caregivers of persons with dementia.…”