Coming to grips with challenging behaviour: A cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units

Abstract

Please cite this article as: Zwijsen, S.A., Gerritsen, D.L., Eefsting, J.A., Smalbrugge, M., Hertogh, C.M.P.M., Pot, A.M.,Coming to grips with challenging behaviour: a cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units., International Journal of Nursing Studies (2014), http://dx.doi.org/10. 1016/j.ijnurstu.2014.10.003 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A c c e p t e d M a n u s c r i p tWhat is already known?-Caring for people with dementia is a demanding job -Job satisfaction of care staff is, amongst other things, influenced by challenging behaviour of residents What this paper adds:-The introduction of a care programme that provides the multidisciplinary team with education and tools to structure the process of detecting, analysing, treatment and evaluation of treatment of challenging behaviour. -By using the care programme, job satisfaction of care staff can be improved without increasing job demands Objectives: To determine the effects of a care programme for the challenging behaviour of nursing home residents with dementia on the burnout, job satisfaction and job demands of care staff. Design:The care programme was implemented according to a stepped wedge design in which care units were randomly divided over five groups with different time points of starting with implementation.Setting: 17 Dutch dementia special care units. Participants:Care staff members of the 17 units. Intervention:The care programme consists of an education package and of various structured assessment tools that guide professionals through the multidisciplinary detection, analysis, treatment and evaluation of treatment of challenging behaviour. Results: Of the 1441 questionnaires, 645 were returned (response 45%, 318 control measurements, 327 intervention measurements) by 380 unique care staff members.Significant effects were found on job satisfaction (0.93, 95% CI 0.48 to 1.38). On the other outcomes, no significant changes in the scores were found. Conclusion:Positive effects of using the Grip on Challenging behaviour care programme were found on job satisfaction, without an increase in job demands.

Behavioural Changes in Dementia and their Impact on Professional Caregivers: A Grounded Theory Approach

“…Previous literature has identified a similar pattern in family caregivers who often report similar feelings and frustration (Zwijsen et al, 2014). Such extreme negative changes were mostly identified as temporary but some professionals reported more permanent feelings.…”

“…Burnout has a negative impact on staff behaviour which might lead to lower levels of empathy and less willingness to help (Brooker & Latham, 2015). Challenging behaviour plays a key part in burnout and job satisfaction of individuals who are caring for dementia (Zwijsen et al, 2014) changing the nature of relationships between residents and professional caregivers. This may be a temporary or permanent change which may in turn affect their care.…”

The enduring self: personhood, autonomy and compassion in the context of community-based dementia daycare centers

“…The literature shows that in nursing homes, some evidence-based studies indicate that person-centered care including autonomy, can be taught (e.g. [49][50][51][52]). However, only a few evidencebased practical guidelines for daycare staff on how to deal with death and grieving issues were published [53,54] despite the studies describing that PwD may exhibit autonomy and emotional capacity even in advance stages [19,55].…”

Evaluation of occupational health interventions using a randomized controlled trial: challenges and alternative research designs

“…For the evaluation of a care program for staff members in dementia special care units, a stepped-wedge design was used (27). The care program consisted of tools and procedures to guide staff members through the detection, analysis, treatment and evaluation of residents' challenging behavior.…”