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Thirty-six family child care providers were divided into matched pairs, then randomly assigned to two treatment groups; catalyst and self-study. The purpose was to investigate how training affects quality of child care and to determine what provider characteristics interact with self-paced learning methods to change quality of care. The Family Day Care Rating Scale (Harms & Clifford, 1989) was used to rate quality of care. Three pretest and three posttest ratings were collected for each provider before and after a three-month treatment period. Ratings were collected from trained validators, from the providers as a self-rating, and from parents with children in care. An additional score was collected from providers regarding their perception of training method using a ten-item rating scale. There was a 38% attrition rate in the original sample resulting in a final sample size 8 Pp of 22. Results from this study suggest that at least two key criteria affect quality of care in family child care; (a) provider training in child-related areas and, (b) provider affiliation with family day care organizations. Providers not previously affiliated with a family day care association had a greater initial margin for improving their quality (E=9.21 p<.007) than affiliated providers. All providers improved their quality of care scores during the three month period. When asked to evaluate the training, all providers perceived their assigned training method as flexible and convenient. Providers in the catalyst training group rated two items significantly higher than self-study; the value of new information (E=11.30 p<.003), and the degree of personal growth experienced (F=9.28, p<.007). Parents differed from both validators and providers in their evaluation of the provider’s child care environment. This suggests that parents are not fully aware of either the components of quality child care or the daily operations in the home of their own family child care provider. / Ph. D.

Yes / This study assessed the effects of a person-centred care based psycho-educational intervention on direct care workers' communicative behaviours with people with dementia living in aged care facilities. An experimental study with a pre-posttest control group design was conducted in four aged care facilities. Two experimental facilities received an eight-weekly psycho-educational intervention aiming to develop workers’ knowledge about dementia, person-centred care competences and tools for stress management; control facilities received an education-only, with no support to deal with stress. A total of 332 morning care sessions, involving fifty-six direct care workers (female, mean age 44.72±9.02), were video-recorded before and two weeks after the intervention The frequency and duration of a list of verbal and non-verbal communicative behaviours were analysed. Within the experimental group there was a positive change from pre to post-test on the frequency of all workers’ communicative behaviours. Significant treatment effects in favour of the experimental group were obtained for the frequency of inform (p<0.01, ƞ2partial=0.09) and laugh (p<0.01, ƞ2 partial=0.18). Differences between groups emerged mainly in relation to non-verbal communicative behaviours. The findings suggest that a person-centred care based psycho-educational intervention can positively affect the direct care workers’ communicative behaviours with residents with dementia. Further research is required to determine the extent of the benefits of this approach. / Foundation for Science and Technology

Yes / This study aimed to assess the effects of a psycho-educational intervention, designed to improve direct care workers’ stress, burnout and job satisfaction and person-centered communicative behavior with people with dementia. A pretest-posttest control group design was conducted in four aged-care facilities. Two experimental facilities received a psycho-educational intervention; two control facilities received an education-only. Data were gathered from fifty three care workers at baseline, immediately and six months after the intervention, through self-administrated instruments and video-recorded morning care sessions. The experimental group showed a significant decrease in care workers’ burnout and a significant improvement in several communicative behaviors (e.g., involvement). Stress levels deteriorated at six months and no intervention effects were found for job satisfaction. The findings highlight the importance of providing care workers with both technical competences and tools for stress management as this might be associated with a reduction of their levels of exhaustion and improved communicative behaviors. / Foundation for Science and Technology

Yes / Challenges in the recruitment and retention of care workers is a long-standing issue [1]. However, these challenges have worsened during the Covid-19 pandemic. In October 2021, there was an average staff vacancy rate of 17% [2], and in November 2021, care homes feared they would lose around 8% of their care home staff as a direct result of the policy of vaccination being a condition of deployment in care homes [3]. This has profound impacts, not only on those in care homes and receiving care at home, but on the health service as a whole, with 33% of social care providers limiting or stopping admissions from hospital [2]. Therefore, this review was undertaken to identify learning about how to support recruitment and retention of care workers during the pandemic. Methods: To identify strategies that are currently being used to support recruitment and retention of care workers, a Google search was undertaken, combining termsthat referred to the setting or role (“social care”, “care worker”) and the topics of interest (recruitment, retention), and for some searches adding in terms that referred to the type of literature being sought (“case study”). Through this, we identified that research on recruitment and retention of care workers since the pandemic was already being published and so a search was also undertaken on Google Scholar for research published since 2020. This was supplemented by a review of websites recommended by an expert working in the area: Care England, National Care Forum, Care Forum, Care Choices, Care Workers Charity, National Association of Care & Support Workers, and Skills for Care. We also reviewed the websites of NHS Confederation, NHS Employers, and the Local Government Association. Inclusion criteria were reports that included recommendations and/or examples of strategies to recruit and retain the social care workforce. While we focused on reports published since the start of the pandemic, given that recruitment and retention of care workers is a long-standing challenge, we also included some significant reports that were published before then. A number of the documents included did not provide a publication date. While many of the reports identified discussed the problems that have led to the social care workforce crisis, we limit our discussion of these in this report, instead focusing on possible solutions. Findings: From the Google and Google Scholar searches, 190 records were screened and 22 potentially relevant documents were reviewed in detail for possible inclusion. Alongside this, seven potentially relevant documents from the websites listed above were reviewed in detail for possible inclusion. From this, 21 relevant documents were identified and included in this review. These included seven documents reporting case studies, one Government report, one report based on a survey of employers, four reports based on surveys of care workers, two reports based on interviews with stakeholders, one report based on interviews and focus groups with care workers, managers, and commissioners, and one based on interviews with care workers. It quickly became apparent that potential strategies for improving recruitment of care workers were closely interlinked with strategies for improving retention of care workers. Below we consider those strategies relevant to both, before moving on to consider specific recruitment strategies and strategies focused specifically on increasing retention.

Yes / Health Care Workers (HCWs) are at higher risk of COVID-19 infection with their efforts while protecting the greater community and also exposed to hazards, such as psychological distress, fatigue, and stigma. This study aimed to explore the perception of frontline HCWs on barriers of managing COVID-19 in Fiji. Methods: A qualitative study method was approached to conduct this study among the HCWs who worked on the frontline during the COVID-19 pandemic based at ten purposively selected health facilities in the Suva subdivision in the Central Division of Fiji. The Colonial War Memorial Hospital (CWMH), the Fiji Centre for Communicable Diseases (Fiji CDC), Twomey hospital laboratory, and CWMH laboratory did the main control and most of the operations of other divisions were monitored from these settings. A semi-structured open-ended questionnaire was used to collect data using in-depth interviews. The participants' responses were audio-recorded and were later transcribed and analyzed using thematic analysis. Results: A total of twenty-nine HCWs took part in the in-depth interview and the responses were grouped into four themes, which include: workload, poor communication, lack of resources, and hindrance to education. It was also found through this study that some of the HCWs felt tired, frustrated, got rude to patients, and found it difficult to handle situations, which affected them mentally and physically stressed. Conclusion: Managing the COVID-19 cases has been attributed to the presence of many barriers, such as workload, tiredness, frustration, and sometimes difficult-to-handle situations, and the HCWs were indeed affected mentally and physically. Regular training for HCWs and more awareness programs would help the general public to follow the preventive measures, which reduces the cases and would help the HCWs manage COVID-19 well. / Research Development Fund Publication Prize Award winner, Aug 2022.

Yes / Objectives: Dementia progressively affects cognitive functioning, including the ability to communicate. Those who struggle to communicate are often considered unable to relate to other people. Frontline care workers are in a position to connect with residents. However, we know little about their perspectives. The aim of this study was to understand how and when nursing home staff meaningfully engaged with residents with advanced dementia. Methods: Semi-structured interviews, supplemented by informal conversations, were conducted with 21 staff from seven nursing homes. Inductive thematic analysis identified themes in the accounts. Results: Four themes related to how staff engaged with residents with advanced dementia (initiating meaningful engagement, recognising subtle reactions, practising caring behaviours, patience and perseverance). Two themes related to when meaningful engagement occurred (lacking time to connect, making the most of time during personal care). Conclusion: A key barrier to implementing formal interventions to improve care is lack of staff time. Staff overcome this by using personal care time for meaningful engagement with residents. Their approach, developed through experience, is consonant with person-centred dementia care. Building on this, future research should use participatory approaches building on practice wisdom to further develop and evaluate meaningful engagement with residents with advanced dementia. / The work reported in this article contributed to a PhD by the first author, with funding awarded to the Centre for Applied Dementia Studies at the University of Bradford by BUPA.

This study sought to explore the views of healthcare workers regarding paediatric anti-retroviral therapy (ART) adherence in Nigeria. An exploratory descriptive qualitative research design was used to identify and describe healthcare workers’ views in Kano and Lagos, Nigeria. Three focus group discussions were held. The transcribed data was analysed using the framework approach of data analysis. Healthcare providers perceived poverty, illiteracy, stigma and discrimination, inappropriate care approaches, and parental dynamics as factors influencing ART adherence. Recommendations for enhancing paediatric ART adherence levels in Nigeria included: mainstreaming adherence counselling in paediatric ART and adopting a comprehensive family centred care approach were identified as measures for improving paediatric ART adherence. Other measures included free ART services, quality improvement in paediatric ART services, parental empowerment and stigma and discrimination reduction programmes. / Health Studies / M.A. (Public Health)

Health care associated infections cause major challenges to the provision of health care. This isdue to the burden placed on individuals, their families, and health services. Hand hygiene actions are cost effective measures towards reducing the spread of health care associated infections and have proven very effective in preventing microbial transmission during patient care. It has beenproven that health care workers hands are the main routes of transmission of health care associated infections. Despite this, hand hygiene is still frequently overlooked by health careworkers especially in settings with limited resources. This paper therefore explores hand hygieneknowledge and behaviours of public and private health care workers in The Gambia with focuson the health belief model. The required information has been gathered from 4 public and 2 private health care facilities through the use of a questionnaire based on the WHO evaluation toolkit. Hand hygiene knowledge of health care workers corresponded with their hand hygiene behaviour. Inadequate hand hygiene performance was noted in many health care workers as wellas limited availability of hand hygiene resources from health care facilities. Private health care facilities provided better hand hygiene opportunities for their health care workers yet neither private nor public health care facilities offered adequate hand hygiene training and feedback on hand hygiene performances to their health care workers.

Made available in DSpace on 2016-03-22T17:26:05Z (GMT). No. of bitstreams: 1 Luciene_Smiths_Primo.pdf: 231428 bytes, checksum: b56724f430de805565c8a99a26321e9e (MD5) Previous issue date: 2008-04-30 / This study investigated the occurrence of accidents with biological material among health care workers at the university hospitals in the city of Pelotas. A survey was carried out among 406 doctors, nurses, technicians or nurses assistants. After signing a document stating their consent, they answered a questionnaire. The prevalence of accidents last year was 18%. Forty percent of these cases were not reported. Doctors presented 76% more risks of having accidents when compared to technicians or nurses assistants (p=0.045). The risk in hospital B was twice higher than hospital A (PR=2,06 CI95% 1,30-3,27; p=0,002). The majority of accidents occurred with percutaneous exposure (60%), fingers being the body part most injured (47%), and the Surgical Center was the place where more accidents were reported (24%). This finding is in accordance with the fact that among the surgeous the prevalence of accidents was 48%. The prevalence of accidents during the professional lifetime was 64%. Thirty six percent of these cases were not reported. The factors related to accidents in the last year were young age, to work in hospital B and to be a medical doctor or nurse. The higher time in the function, not mattering age and hospital, was associated to accidents during the professional experience / Investigou-se a ocorrência de acidentes com material biológico entre profissionais dos Hospitais Universitários de Pelotas. A amostra incluiu 406 médicos, enfermeiros e técnicos e auxiliares de enfermagem que, após consentimento assinado, responderam um questionário aplicado por entrevistador. A prevalência de acidentes no último ano foi de 18%, dos quais 40% não foram notificados. Os médicos apresentaram risco 76% maior de acidentes quando comparados a técnicos e auxiliares de enfermagem (p=0,045). O hospital B apresentou risco duas vezes maior do que o hospital A (RP=2,06 IC95% 1,30-3,27; p=0,002). A maioria dos acidentes ocorreu com materiais pérfuro-cortantes (60%), os dedos foram a parte do corpo mais atingida (47%), o local mais freqüente foi o Centro Cirúrgico (24%), achado consistente com a proporção de acidentes entre cirurgiões (48%). A prevalência de acidentes durante a vida profissional foi de 64%, dos quais 36% não foram notificados. Os fatores associados a acidentes no último ano foram a menor idade, trabalhar no hospital B e ser médico ou enfermeiro, e, para acidentes na vida, o maior tempo de função, independente da idade e do hospital