The nature, characteristics and associations of care home staff stress and wellbeing: a national survey

Abstract

BackgroundThe majority of residents in care homes in the United Kingdom are living with dementia or significant memory problems. Caring in this setting can be difficult and stressful for care staff who work long hours, have little opportunity for training, are poorly paid and yet subject to high expectation. This may affect their mental and physical wellbeing, cause high rates of staff turnover and absenteeism, and affect the quality of care they provide. The main objective of this survey was to explore the nature, characteristics and associations of stress in care home staff.MethodsStaff working in a stratified random sample of care homes within Wales completed measures covering: general health and wellbeing (SF-12); stress (Work Stress Inventory); job content (Karasek Job Content); approach to, and experience of, working with people living with dementia (Approaches to Dementia Questionnaire; and Experience of Working with Dementia Patients); and Productivity and Health Status (SPS-6). Multiple linear regressions explored the effects of home and staff characteristics on carers.Results212 staff from 72 care homes completed questionnaires. Staff from nursing homes experienced more work stress than those from residential homes (difference 0.30; 95% confidence interval (CI) from 0.10 to 0.51; P < 0.01), and were more likely to report that their health reduced their ability to work (difference -4.77; CI -7.80 to -1.73; P < 0.01). Psychological demands on nurses were higher than on other staff (difference = 1.57; CI 0.03 to 3.10; P < 0.05). A positive approach to dementia was more evident in those trained in dementia care (difference 8.54; CI 2.31 to 14.76; P < 0.01), and in staff working in local authority homes than in the private sector (difference 7.75; CI 2.56 to 12.94; P < 0.01).ConclusionsOur study highlights the importance of dementia training in care homes, with a particular need in the private sector. An effective intervention to reduce stress in health and social care staff is required, especially in nursing and larger care homes, and for nursing staff.Trial registrationISRCTN registry: ISRCTN80487202. Registered 24 July 2013

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

“…The two largest studies to measure the association between age and burnout (n=1194) (Chamberlain et al 2017), or age and stress (n=344) (Edvardsson et al 2009), found no significant association. This was consistent with a study of 212 UK care staff which reported no association between length of time working in the care sector (which has a relationship to age) and mental health related quality of life (Islam, Baker et al 2017). However, 3/6 smaller studies found that younger age was associated with higher emotional exhaustion (Duffy et al 2009), higher depersonalisation (Furumura 2014) and higher stress (Lucchetti et al 2014).…”

“…Three studies used versions of the Short Form-36 (SF-36), to measure mental health-related quality of life score in staff working in care homes in Australia, Brazil and the United Kingdom respectively Lucchetti et al 2014;Islam et al 2017). All found lower mental health quality of life scores than the equivalent age and sex matched normative populations.…”

“…Two studies assessed whether stress and burnout levels varied with staff role (Juthberg et al 2010;Islam et al 2017). No significant difference in burnout levels was found between 50 nurses and 96 nurse aides working in care homes in Sweden (Juthberg et al2010).…”

Health and burnout of home health care assistants: impact of a training intervention

“…For these reasons, it is necessary to create educational programs and interventions on reducing dysfunctional coping strategies, learning healthy sleep practices, increasing self-efficacy (Coates & Fossey, 2019) and improving communication (George et al, 2017). Islam, Baker, Huxley, Russell, & Dennis (2017) highlight the importance of dementia training in care homes, in order to reduce stress in professionals, especially in nursing and larger care homes.…”

The relationship between workplace characteristics and work ability in residential aged care: What is the role of work–life interaction?

“…Residential aged care work has been recognized as physically and emotionally demanding, leading to high levels of stress and poor health (Edvardsson, Sandman, Nay, & Karlsson, 2009;Islam, Baker, Huxley, Russell, & Dennis, 2017;Testad, Mikkelsen, Ballard, & Aarsland, 2010). Psychosocial work hazards, including low managerial support, insufficient training, high workload, and shift scheduling have been identified as more important predictors of employee stress than resident care factors (e.g., extent of dementia in residents; Islam et al, 2017;Testad et al, 2010).…”