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Objectives: This study compared the caring self-efficacy between personal care attendants (PCAs) from English-speaking and non-English-speaking countries, controlling for potential sociodemographic and work-related covariates. PCAs' perceptions of their caring self-efficacy were further explored. Methods: An independent samples t -test was used to determine the mean difference in the caring self-efficacy score between the two groups. A multivariate analysis was conducted to adjust for covariates. Thematic analysis was conducted on open-ended responses. Results: The results showed that caring self-efficacy was significantly influenced by whether participants primarily spoke English at home rather than where they were born. Younger age and everyday discrimination experiences were negatively associated with caring self-efficacy. Both groups perceived that inadequate resources and experiencing bullying and discrimination reduced their caring self-efficacy. Discussion: Access to organisational resources and training opportunities and addressing workplace bullying and discrimination against PCAs, particularly younger PCAs and those from non-English-speaking backgrounds, could improve their caring self-efficacy. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the psychometric properties of the Caring Efficacy Scale (CES) among personal care attendants providing care to older residents in residential aged care settings. Methods: This cross‐sectional study was completed in Australia in 2020–2021. Confirmatory factor analysis (CFA) of the 30‐item original CES (Model 1) and 28‐item CES validated in registered nurses (Model 2) was conducted to assess the goodness of fit of these models in our study population. Due to unsatisfactory fit indices for both models, exploratory factor analysis (EFA) was conducted to examine the dimensionality and underlying structure of the original CES among personal care attendants. Internal consistency of the final scale and subscales identified was examined using item‐total correlations and Cronbach's alpha coefficients. Results: Two hundred and eighty personal care attendants participated in the study. The model fit indices such as Comparative Fit Index and Tucker Lewis Index of both models were less than 0.90, while the Standardised Root Mean Square Residual and Root Mean Square of Approximation values were greater than or equal to 0.08 and 0.06, respectively. The EFA identified a two‐factor structure, and 22 items of the 30 in the original scale were retained. Item‐total correlations amongst items retained in the scale and subscales were greater than 0.3. Cronbach's alpha for the abbreviated scale was 0.85, with 0.83 and 0.79, respectively, for the two subscales. Conclusions: The modified CES can be used as a robust tool to assess the self‐efficacy of personal care attendants in providing care to older residents in residential aged care settings. [ABSTRACT FROM AUTHOR]

Objectives. This study explored whether consumer experience report (CER) data from residential aged care services (RACSs) could be combined into a general factor and determined whether poor experience in RACSs could be predicted by known resident or home characteristics or sampling procedures. Methods. CER data collected by structured interviews in 2018 and early 2019 were analysed using structural equation modelling and linear regression analysis. Results. Data were available from 17 194 interviews undertaken at 1159 RACSs. The 10 CER items loaded onto two independent factors. Bifactorial modelling indicated that items could be combined into a general factor. Controlling for state or territory, consumer experience was best predicted by home size: those in large facilities reported poorer experience than those in smaller facilities. Other significant negative predictors with small effect sizes included not being independently mobile, being male and not being randomly selected. Dementia did not predict total CER score. Conclusions. The results of this study support the inclusion of people with dementia and exclusion of volunteer participants from published CERs. Further research is needed to explore why a relatively poor consumer experience is reported by people in larger homes, men and those with mobility issues. [ABSTRACT FROM AUTHOR]

Background: Self-efficacy is developed through a person's interaction with his/her physical and social environment. Self-efficacy in caring is an essential attribute of care workers to develop a positive attitude towards their clients, improve work performance, and enhance job satisfaction. Care workers' self-efficacy may vary according to the context in which the care is being provided. Aged care is a multidimensional and challenging setting, and characteristics of aged care services are different from those of acute care services. The objective of this review is to give an overview of the self-efficacy of residential aged care workers in caring for older people and factors influencing their self-efficacy. Methods: The protocol for this review is based on the Joanna Briggs Institute Reviewer's Manual for Scoping Review. A systematic search of the literature on electronic databases MEDLINE, PsycINFO, CINAHL, AgeLine, SCOPUS, and ProQuest Dissertations and Theses Global will be carried out using predefined search terms to identify relevant studies. This review will include studies that examined the self-efficacy of direct care workers in caring for older people living in residential aged care facilities. All primary studies irrespective of the study design will be included. Studies conducted to develop measures or studies with informal care workers or students as study participants will not be considered. Two reviewers will independently conduct title and abstract screening, full-text screening, and data charting. A third reviewer will resolve discrepancies, while the final decision for conflicting studies will be made by consensus within the review team. Descriptive statistics will be utilized to analyze the quantitative findings, and the result will be presented in narrative form accompanied by tables and charts. Content analysis will be carried to analyze the qualitative findings and will be presented in narrative form supported by illustrative quotations. Discussion: This study will be an important source of knowledge to policymakers and aged care providers to understand the self-efficacy of aged care workers to support and enhance their self-efficacy and thereby improve their caring behaviors towards their clients. Scoping review registration: Joanna Briggs Institute Systematic Review Register with the title "A scoping review of factors influencing caring efficacy of direct care workers providing care to older people". [ABSTRACT FROM AUTHOR]

Cognitive behavioral therapy (CBT) for depression and anxiety for older adults living in residential aged care facilities (RACFs) needs to accommodate the care needs of residents and the circumstances of RACFs. This systematic review examines the delivery and content characteristics of these interventions, in relation to participant satisfaction, staff appraisal, uptake rate, attrition rate, and treatment effectiveness. Such a review could provide important information for the development of future CBT-based interventions. Studies that examined the application of CBT for depression or anxiety in RACFs were identified by systematically searching a number of relevant databases. Reference lists of all included studies were examined, and citation searches on the Web of Science were conducted. Two independent reviewers were involved in screening articles and in extracting data and assessing methodological quality of the selected studies. Across the 18 studies included in this review, the most common therapeutic strategy was pleasant activities scheduling. Studies varied on treatment duration (2–24 weeks), number of sessions (6–24), and length of sessions (10–120 min). Residents and staff members were satisfied with the CBT interventions. The average uptake rate was 72.9%. The average attrition rate was 19.9%. Statistically significant results were reported in 8 of the 12 randomized controlled trials (RCTs). In these eight RCTs, CBT was characterized by psychoeducation, behavioral activation, and problem-solving techniques; further, the therapists in six of these studies had training in psychology. CBT interventions for depression and anxiety are acceptable to RACF residents and judged positively by staff members. Effective studies differed from non-effective studies on content and training characteristics, but not on other delivery features. [ABSTRACT FROM AUTHOR]

Objective: To develop and pilot a short interview tool to be implemented by the Australian Aged Care Quality Agency (AACQA) in residential aged care, to inform prospective consumers about the quality of care and services received—the consumer experience report (CER). Methods: Twenty‐four questions addressing the four Aged Care Quality Standards were piloted with 140 residents and 48 representatives (including 27 resident‐representative pairs). A method for approximating random selection was also trialled. Fifty‐two residents were interviewed twice, one week apart, and each question's usability was rated by 11 surveyors and two interpreters. Selection criteria for questions included consumer preference, test‐retest reliability, resident‐representative agreement, usability and low missing data. Results: Nineteen questions performed well on missing data, 16 on test‐retest, 17 on resident‐representative agreement and 12 on usability. Ten quantitative and two open‐ended questions were selected. Conclusions: The CER questions proved suitable to collect data systematically on consumer experience in residential aged care. AACQA (now the Aged Care Quality and Safety Commission) uses the CER interview to support their audit process, and aggregated results are published online. [ABSTRACT FROM AUTHOR]

Objective: To assess the quality of life of older Australians living in rural and urban communities over time. Design: Panel survey conducted in 2012‐2013 and 2014‐2015. Setting: Participants lived in metropolitan Melbourne (urban sample, N = 279), rural Victoria (N = 98) or Tasmania (N = 47). Participants: All participants (N = 424) were clients of aged care providers or residents in retirement housing or residential care. Main outcome measures: Quality of life. Result: A repeated‐measures analysis of variance showed a decrease in quality of life over time. There was no difference in change in quality of life over time by location of participants (urban vs rural). Multiple regression analysis showed that resilience predicted baseline quality of life in all three locations. Conclusion: These findings generally did not support significant differences between geographic locations in trajectories of older adults' quality of life over time. Instead, individuals' resilience appears to be the strongest predictor of quality of life. [ABSTRACT FROM AUTHOR]

Aims: To examine whether the work–life interface (through work–family conflict and overall work–life balance) moderates the relationship between work ability and workplace demands and resources. Design: This study used a cross‐sectional survey design to collect data from 426 employees working in residential aged care. Methods: A paper‐based questionnaire was distributed to all permanent and casual employees at eight aged care facilities in Melbourne, Australia, between June ‐ September 2013. Moderation analyses were conducted using PROCESS v. 2.13 in SPSS v. 22. Results/Findings: As expected, workplace demands and resources directly influenced workers' work ability. In addition, moderate‐to‐high levels of work–family conflict and low‐to‐moderate levels of satisfaction with work–life balance combined interactively with particular workplace demands and resources (relationships with management, physical demands, and safety climate) to reduce work ability. Conclusions: This study advances understanding of how work–life balance and work–life conflict can influence work ability levels and shows that addressing the work–life interface may be a legitimate means to improve work ability, potentially leading to continued workforce participation. Impact: Staff retention in the residential aged care sector needs to be addressed. One possible means of achieving this is through improving work ability. This study expanded knowledge of how the work–life interface may influence work ability. The research demonstrated that relationships between work ability and particular workplace demands and resources were moderated by the work–life interface. This finding has implications for how human resources managers of residential aged care facilities may improve workforce retention—through facilitating employees to manage the work–life interface better. [ABSTRACT FROM AUTHOR]

Objectives: The project aimed to evaluate a pain management program (PMP) using non-pharmacological approaches at five residential aged care facilities (RACFs) in Australia. Methods: The PMP involved a physiotherapist implementing four sessions per week of treatments (massage therapy, TENS, exercises and stretching, or combinations of these). Ninety-five participants were recruited (average age, 83 years; SD = 7.6; 38% men, 62% women; 56% with dementia). Sessions lasted approximately 10 minutes, and residents' levels of pain were recorded using a 5-point scale before and after each treatment. The intervention period for each participant was the first consecutive 8 weeks in which they received the intervention. Results: Data analyses showed: (1) a small but statistically significant decrease in the number of as required (PRN) medications; and (2) a decrease in average pain ratings from pre-session to post-session from 2.4 (some to moderate pain) to 1.1 (a little pain). Notably, residents with dementia received lower pain ratings than those without. Conclusions: Non-pharmacological approaches to pain in residential care settings are effective, especially when two or more are combined. Staff working in residential care settings should rely on best practice to recognise pain in residents with dementia. Clinical Implications: Non-pharmacological interventions may be effective in reducing pain and reliance on PRN medications in residential care settings, especially when two or more are used. Staff working in residential aged care settings should be provided with training in pain assessment and management, with particular attention to residents with dementia. [ABSTRACT FROM AUTHOR]

Objective: To review studies published in the Australasian Journal on Ageing (AJA) about the aged care workforce, and to identify influences on quality of care and potential policy directions. Methods: Articles in the AJA on the aged care workforce published from 2009 to 2018 were identified, grouped into themes and rated for quality. Results: Twenty‐eight articles were identified. Articles fell into four themes: (i) staff knowledge, skills and attitudes; (ii) staff well‐being and workforce stability; (iii) environmental factors that influence staff capacity; and (iv) interventions to improve staff capacity. Studies reinforced the importance of staff–consumer, staff–relatives and staff–staff relationships and a supportive workplace culture for staff work ability and capacity to provide high quality care. Conclusions: It is possible to improve practice in community and residential aged care, given: (i) enough staff; (ii) better training in person‐centred practice; and (iii) a supportive staff culture that encourages staff to put their training into practice. [ABSTRACT FROM AUTHOR]

Objective Rates of depression and anxiety are high among older adults in residential aged care facilities (RACFs). This study examined the extent to which psychological services are made available to facility residents in Australia, and investigated barriers to accessing such services. Method The sample consisted of 90 senior staff from a random sample of RACFs. Participants completed self-report questionnaires regarding their perspectives on the availability of psychological services and potential barriers to access psychological services. Results Access to psychological services was poor. Psychologists were employed at a rate only one third that of other providers of mental health services. Residents were rarely referred to psychologists or to psychological treatments. The most important barriers to access, as perceived by participants, were the low availability of psychologists specialising in treating older adults, lack of government funding for such access, and limited staff training in detecting depression and anxiety. Conclusion Access to psychologists and psychological services remains poor in Australian residential aged care settings. Such access may be improved by developing a workforce of clinical geropsychologists, improving funding mechanisms for residents to access psychological services, and addressing staff knowledge about depression and anxiety. [ABSTRACT FROM AUTHOR]

Concussions are a type of traumatic injury caused by a jolting of the brain that disrupts normal brain function, and multiple concussions can lead to serious long-term health consequences. In this article, we examine the relationship between college students' understanding of concussions and their willingness to continue playing despite the possibility of sustaining multiple head injuries. We use a mixed-methods approach that includes participant observation, cultural domain analysis, and structured interviews. Our research finds that students hold a robust cognitive understanding of concussion yet discursively frame concussions as skeletomuscular injuries. More importantly, students affirm the importance of playing sports for themselves and others, so their decisions to risk multiple concussions must be understood within cultural and biocultural contexts of meaningful social play. We suggest that peoples' decision to risk multiple head injuries should be understood as a desire for meaningful social play rather than an uninformed health risk. [ABSTRACT FROM AUTHOR]

Objective. The aims of the present study were to describe the views of senior clinical and executive staff employed in public sector residential aged care services (RACS) about the benefits and limitations of using quality indicators (QIs) for improving care, and to identify any barriers or enablers to implementing the QI program. Methods. Across-sectional qualitative study using semistructured interviews and direct observation of key informants involved in the QI program was performed across 20 public sector RACS in Victoria, Australia. Participants included senior clinical, executive and front-line staff at the RACS. The main outcome measures were perceived benefits and the enablers or barriers to the implementation of a QI program. Results. Most senior clinical and executive staff respondents reported substantive benefits to using the QIs and the QI program. A limited number of staff believed that the QI program failed to improve the quality of care and that the resource requirements outweighed the benefits of the program, resulting in disaffected staff. Conclusions. The QIs and QI program acted as a foundation for improving standards of care when used at the front line or point of care. Senior executive engagement in the QI program was vital to successful implementation. [ABSTRACT FROM AUTHOR]

This qualitative study investigated the ageing and aged care experiences in Australia of two cohorts of older survivors of genocide: Jewish Holocaust survivors and older Cambodian genocide survivors. It was carried out in response to an identified need to better train aged care workers who are in contact with these groups. In-depth interviews were conducted with 21 community-dwelling survivors aged 65 and over. Credibility was ensured by methodological triangulation and peer debriefing. The study highlighted the importance of understanding older survivors’ ageing and aged care experiences in the context of their entire lifecourse and in terms of both vulnerability and resilience. It showed that trauma history can heighten older survivors’ sensitivity to many aspects of the social and physical environments in residential, community and home-based aged care settings. The study also uncovered the potential for aged care services to help older survivors cope with the psycho-social and emotional effects of resurfacing post-traumatic stress symptoms. The implications of the study findings for care practice include the importance of recognising older survivors of genocide as a distinct group of clients and the need to distinguish staff training for caring for this client group from general cultural awareness training. [ABSTRACT FROM PUBLISHER]