Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services

Sandberg, Linda; Borell, Lena; Edvardsson, David; Rosenberg, Lena; Boström, Anne‐Marie

doi:10.2147/jmdh.s155467

Cited by 21 publications

(30 citation statements)

References 35 publications

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“…Other research showed perceived job strain among staff because of their inability to deliver good enough care. 41 Our study also found that older persons receiving HCS (both PwDs and controls) reported being treated with decreasing levels of dignity and respect over the years from 2016 to 2018. This was especially true for PwDs with poor self-rated health, those who had answered the survey by proxy, and those who were granted more HCS hours.…”

Section: Discussionsupporting

confidence: 66%

Being Treated With Respect and Dignity?—Perceptions of Home Care Service Among Persons With Dementia

Hammar

Alam

Olsen

et al. 2021

Journal of the American Medical Directors Association

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Objective: Studies on the quality of home care services (HCS) offered to persons with dementia (PwDs) reveal the prevalence of unmet needs and dissatisfaction related to encounters and a lack of relationships with staff. The objective of this study was to enhance knowledge of the perceptions of PwDs regarding their treatment with dignity and respect in HCS over time. Design: A mixed longitudinal cohort study was designed to study trends in the period between 2016 and 2018 and compare the results between PwDs (cases) and persons without dementia (controls) living at home with HCS. Setting and Participants: Persons aged 65 years and older with HCS in Sweden. Methods: Data from an existing yearly HCS survey by the Swedish National Board of Health and Welfare (NBHW) was used. The focus was on questions concerning dignity and respect. NBHW data sets on diagnoses, medications, HCS hours, and demographic information were also used. We applied GEE logistic and cumulative logit regression models to estimate effects and trends of interest after controlling for the effects of age, gender, self-rated health, and number of HCS hours. Results: Over the study period, 271,915 (PwDs ¼ 8.1%) respondents completed the survey. The results showed that PwDs were significantly less likely (3%-10% lower odds and cumulative odds) than controls to indicate that they were satisfied in response to questions related to dignity and respect. Both groups experienced a decrease in satisfaction from 2016 to 2018. Females, individuals with poor self-rated health, and individuals granted more HCS hours were found to be more dissatisfied. Conclusions and Implications: The HCS organization needs to shift from a task-oriented system to a person-centered approach, where dignity and respect are of the utmost importance. The HCS organizations need to be developed to focus on competence in person-centered care, and leadership to support staff.

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Section: Discussionsupporting

confidence: 66%

Being Treated With Respect and Dignity?—Perceptions of Home Care Service Among Persons With Dementia

Hammar

Alam

Olsen

et al. 2021

Journal of the American Medical Directors Association

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“…In a previous study, Sandberg, Borell, Edvardsson, Rosenberg, and Boström () found that home care staff, who more frequently served clients with dementia and increased needs, reported higher job strain than other home care staff. While this study reports that clients with cognitive impairment were granted a higher numbers of services and more hours per month, there is no evidence if this greater number of hours per month is equal to the time needed.…”

Section: Discussionmentioning

confidence: 96%

Home care services for older clients with and without cognitive impairment in Sweden

Sandberg

Nilsson

Rosenberg

et al. 2018

Health Soc Care Community

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Little is known about the types of home care services granted to older clients in Sweden. The objectives of this study were to: (a) identify and describe the range of granted home care services and service hours; (b) compare services granted for clients with and without documented cognitive impairment; and (c) examine associations between the range of granted home care services and factors related to cognitive impairment and demographical characteristics. The study design was descriptive and cross-sectional. The data, included records of granted home care services for clients age 65+ with (n = 43) and without (n = 88) cognitive impairment documented by the local municipality assessors, collected from one agency in Sweden during a 2-month period in 2015. Data analyses resulted in an overview of the range of home care services divided into two categories: personal care and service. In the personal care category, the median was 3 for types of services (range 0-12), and shower (n = 69; 52.7%) was the most common service. In the service category, the median was 5 for types of services (range 0-10), and cleaning the household (n = 103; 78.6%) was the most common service. The median for service hours was 27 hr per month (range 2.5-127.5). Logistic regression models revealed that cognitive impairment was associated with a higher number of services in the personal care category and a higher number of hours per month. Living alone was associated with a higher number of services in the service category. In conclusion, a wide range of home care services were provided for clients who have complex needs in daily life. Home care services were granted to clients with cognitive impairment and to a greater extent with clients who were living alone.

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“…One possible reason for their highly rated job strain could be that dementia care specialists rather than other staff worked more extensively with persons with dementia and those with special needs. 12 The dementia care specialists reported higher mean scores on job strain in the study by Sandberg et al 12 compared to nursing home staff from a previous study. 14 It is important to examine job strain reported by staff as previous studies have shown that wellbeing among staff is correlated with the quality of their work and the services provided.…”

Section: Introductionmentioning

confidence: 78%

“…10 Moreover, home care staff often work alone in the older person's home, requiring them to be independent and flexible to accomplish tasks. 11 In a previous study by the research group, 12 dementia care specialists, referring to the nurse aides/ assistants who received dementia care education by taking a web-based course focusing on the guidelines for persons with dementia 13 in the context of home care service, rated job strain significantly higher than other home care staff. One possible reason for their highly rated job strain could be that dementia care specialists rather than other staff worked more extensively with persons with dementia and those with special needs.…”

Section: Introductionmentioning

confidence: 89%

<p>Dementia Care Education Targeting Job Strain and Organizational Climate Among Dementia Care Specialists in Swedish Home Care Services</p>

Fallahpour

Borell

Sandberg

et al. 2020

JMDH

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Introduction: An increasing number of older persons live at home with various limitations, such as dementia, requiring well-educated and trained home care staff to meet their complex care needs. Dementia care specialists working in home care service have reported high levels of job strain in comparison with home care staff in general. Aim: This pilot study aims to evaluate the effects of a dementia care education model targeting self-reported job strain and organizational climate, among dementia care specialists in home care service. Methods: A quasi-experimental, one-group pretest-posttest design was applied, with 12 months' follow-up. Participants were dementia care specialists who worked in home care service (n=34 baseline; n=30 follow-up). The data were collected using the Strain in Dementia Care Scale and Creative Climate Questionnaires, administered pre-and postintervention. The intervention applied an educational model based on previous research in dementia care and a person-centered approach. Results: The educational model was implemented in the context of home care services. Of 34 participants at baseline, only 21 responded to the questionnaires, due to a drop off of 13 participants and recruitment of 9 new participants (follow-up=30). A significantly reduced perceived job strain among the participants was detected, indicating perceiving less difficulty in "Balancing competing needs" when caring for the older persons. No significant difference was found in the self-reported creative organizational climate between the two occasions. Conclusion: The educational model could be integrated into dementia home care and it seemed to reduce job strain among dementia care specialists. Future studies are needed to evaluate the effects of the intervention using a stronger study design and a larger sample.

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Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services

Cited by 21 publications

References 35 publications

Being Treated With Respect and Dignity?—Perceptions of Home Care Service Among Persons With Dementia

Being Treated With Respect and Dignity?—Perceptions of Home Care Service Among Persons With Dementia

Home care services for older clients with and without cognitive impairment in Sweden

<p>Dementia Care Education Targeting Job Strain and Organizational Climate Among Dementia Care Specialists in Swedish Home Care Services</p>

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