What influences self‐perceived competence and confidence in dementia care home staff? A systematic review

Abstract

Background Dementia care staff working in long‐term care settings are often exposed to a variety of complex situations that can be emotionally challenging, and a lack of adequate support and limited training opportunities may contribute to high levels of staff turnover in this area. Good‐quality training may be beneficial for improving the quality of care provided, and in improving staff confidence and morale. This systematic review aimed to establish how dementia care home staff perceived their own competence and confidence in relation to the care they deliver, whether there are any specific interventions that improve these feelings, and whether feeling more competent and confident impacts on care delivery. Method A search of the literature focusing on staff perceptions of competence and confidence identified 14 873 studies. Following the removal of duplicates and papers that did not meet the inclusion criteria, 19 studies were included in the review and subject to quality assessment. Results Studies varied in terms of quality and design, and were categorised as either intervention or non‐intervention studies. Four studies found a significant increase in feelings of competence and confidence following intervention, although many studies did not statistically analyze their data. The most successful interventions seemed to be those that involved practical support alongside education, and non‐intervention studies highlighted the importance of specific dementia and palliative care training with regard to feelings of competence and confidence. Conclusion Teaching alone may not be an adequate method of training dementia care staff, and the most successful interventions were those where practical support was also provided. Most studies suggested that improvements in competence and confidence also had benefits for care delivery and staff wellbeing. More research needs to be done using validated outcome measures and with competence and confidence as the primary aim.

How about an Educational Framework for Nursing Staff in Long-Term Care Facilities to Improve the Care of Behavioral and Psychological Symptoms of Dementia?

“…Little attention being given to nursing staff and their BPSD care competence has resulted in the insufficient and inconsistent content of relevant education, undermining the quality of BPSD care [ 17 , 18 ]. Continuing BPSD education that has a clear basis on competencies and specifically targets nursing staff would generate consistent positive outcomes for practice and residents in LTCFs [ 19 , 20 ]. Therefore, it is imperative to establish an educational direction suitable for BPSD care in LTCFs that aims to improve the nursing staff’s competence in providing direct care.…”

Developing effective workforce training to support the long‐term care of older adults: A review of reviews

“…LGBT+ community (Jurček et al, 2020). Additional outcomes included improved comfort (Higgins et al, 2019), confidence, competence (Higgins et al, 2019;Rivett et al, 2019;Surr et al, 2017) and self-ef ficacy in delivering care (Pleasant et al, 2020;Surr et al, 2017). For informal carers, caregiver burden was also assessed (Pleasant et al, 2020).…”

“…Specific skills included supporting activities of daily living though improved management of behavioural symptoms (Bauer et al, 2018), understanding the nature of dementia (Rivett et al, 2019;Spector et al, 2013), behaviour management skills (Kuske et al, 2007) and communication skills (Eggenberger et al, 2013;Nguyen et al, 2019).…”

Admiral Nurse Case Management within Enhanced Health in Care Homes

“…Care home staff often provide care for residents with complex needs as a result of a variety of conditions, including dementia. The nature of dementia care can be demanding of their knowledge and skills and also emotionally challenging [90]. Rivett and colleagues [90] also identified that a lack of adequate support and limited training opportunities for care home staff may contribute to high levels of staff turnover in this area.…”

“…The nature of dementia care can be demanding of their knowledge and skills and also emotionally challenging [90]. Rivett and colleagues [90] also identified that a lack of adequate support and limited training opportunities for care home staff may contribute to high levels of staff turnover in this area. However, Goodman et al [89] identified that when a care home resident is approaching their end-of-life there is often uncertainty about the roles and responsibilities of the care home staff, the families and primary care professionals.…”