Dementia Care Education Targeting Job Strain and Organizational Climate Among Dementia Care Specialists in Swedish Home Care Services

Figures & data

Table 1 Conceptual Phases, Aim, and Content of the Intervention

Conceptual Phase	Aim	Content
Knowledge translation	To provide a shared understanding of national guidelines and the content to the home care staff	• Educational seminar presenting and discussing the Swedish national guidelines for care of persons with dementia (4h) • Workshop seminar to present and discuss their working place’s strengths, weaknesses, opportunities and threats in association with the national guidelines; and to present a topic for their home based knowledge generation process (4h).
Knowledge generation	To develop, implement, and evaluate a practice improvement	• Ten home-based improvement seminars. Seminars guided the staff by support and supervision from a team of researchers through the process of Identifying problem area Finding evidence Planning intervention Collecting data Conducting intervention Evaluating
Knowledge dissemination	To share experiences, knowledge and skills	• One facility-wide day including reflective seminars to orally present the projects • One facility wide poster session where projects were presented in poster format

Table 2 Demographic Characteristics of the Dementia Care Specialists at Baseline (n=34), Follow-Up (n=30) and Completers (n=21)

Variable	Intervention Group
	Baseline (Pre- Intervention, 2014)	Follow-Up (Post- Intervention, 2015)	Completers Those who Responded at the Baseline and the Follow-Up
Sample, n	34	30	21
Age (years)
Mean (SD)	47.9 (9.9)	49.8 (10.5)	49.8 (8.9)
N	32	27	20
Duration of working as home care service (years)
Mean (SD)	14.8 (10.3)	16.7 (11.8)	16.9 (11.1)
Range	3–39	5–40	4–39
N	34	29	21
Duration of working in dementia care unit (years)
Mean (SD)	14.8 (10.7)	16.2 (10.8)	16.2 (11.7)
Range	2–39	5–40	2–39
N	31	26	19
Gender, n (%)
Female	29 (85.3)	24 (80.0)	16 (76.2)
Male	5 (14.7)	6 (20.0)	5 (23.8)
Education (Yes/no), n (%)
Primary and intermediate (grade 1–9)	32/1 (94.1/2.9)^a	28/2 (93.3/6.7)	21/0 (100/0)
High school (grade 10–12)	29/4 (85.3/11.8)^a	22/8 (73.3/26.7)	18/2 (85.7/9.5)^a
Course on University level	11/22 (32.4/64.7)^a	7/23 (23.3/76.7)	5/15 (23.8/71.4)^a
Dementia education (web-based or comparable)	27/7 (79.4/20.6)	20/10 (66.7/33.3)	18/3 (85.7/14.3)
Swedish as their first language (yes/no), n (%)	17/17 (50/50)	18/11 (60/36.7)^a	12/9 (57.1/42.9)
Employment status, n (%)
Permanent	32 (94.1)	30 (100)	21 (100)
Timely paid	2 (5.9)	0 (0)	0 (0)
Working hours, n (%)
Day time/weekdays	15 (44.1)	15 (50)	10 (47.6)
Day time/week days and weekends	9 (26.5)	10 (33.3)	5 (23.8)
Evening time	10 (29.4)	6 (28.6)	6 (28.6)

Note: ^aMissing data.

Figure 1 Study sample over the study phases.

Table 3 Presentation of the Baseline and Follow-Up Scores Among the Samples at Baseline (n=34) and Follow-Up (n=30) on Perceived Job Strain and Creative Organizational Climate

Questionnaire	Baseline (Pre-Intervention, 2014) (n=34)	Follow-Up (Post-Intervention, 2015) (n=30)
	Mean (SD), n	Mean (SD), n
SDCS assessing 5 factors, range 1–16, higher value indicates higher job strain
Frustrated empathy	6.15 (2.63), n=32	5.39 (2.20), n=28
Difficulties understanding and interpreting	4.76 (2.30), n= 33	3.98 (1.81), n=28
Balancing competing needs	6.85 (3.46), n=31	5.46 (2.41), n=28
Balancing emotional involvement	5.68 (2.79), n=30	4.96 (1.84), n=29
Lack of recognition	6.59 (2.59), n=32	5.90 (3.12), n=29
Total strain SDCS	5.70 (2.17), n=29	4.95 (4.95), n=26
CCQ assessing 10 dimensions, range 0–3, higher value indicates more creative climate except Conflicts
Challenge	1.94 (0.51), n=30	1.83 (0.53), n=30
Freedom	1.71 (0.49), n=29	1.51 (0.47), n=30
Idea support	1.63 (0.62), n=30	1.49 (0.52), n=30
Trust/Openness	1.72 (0.45), n=29	1.48 (0.47), n=29
Dynamism/Liveliness	1.58 (0.51), n=29	1.66 (0.53), n=28
Playfulness/Humor	1.75 (0.54), n=31	1.79 (0.61), n=29
Debate	1.48 (0.53), n=29	1.50 (0.48), n=29
Conflicts	2.01(0.79), n=30	2.04 (0.68), n=28
Risk-taking	1.36 (0.54), n=30	1.33 (0.46), n=29
Ideas time	0.97 (0.60), n=29	1.07 (0.45), n=29
Total CCQ	1.63 (0.39), n=28	1.57 (0.40), n=28

Abbreviations: n, number of participants who answered the question; SD, Standard Deviation; SDCS, Strain in Dementia Care Scale; CCQ, Creative Climate Questionnaire.

Table 4 Presentation of the Baseline and Follow-Up Scores Among the Completers (n=21) on Perceived Job Strain and Creative Organizational Climate

Questionnaire	n	Baseline (Pre-Intervention, 2014)	Follow Up (Post Intervention, 2015)	p-Value
		Mean (SD)	Mean (SD)
SDCS assessing 5 factors, range 1–16, higher value indicates higher job strain
Frustrated empathy	18	6.10 (2.30)	5.42 (2.32)	0.200
Difficulties understanding and interpreting	19	4.64 (1.82)	4.12 (1.88)	0.346
Balancing competing needs	18	7.03 (3.55)	5.77 (2.65)	0.033
Balancing emotional involvement	17	5.76 (2.04)	4.96 (2.05)	0.162
Lack of recognition	18	6.61 (2.60)	6.04 (3.32)	0.454
Total strain SDCS	16	5.68 (1.84)	5.13 (2.02)	0.210
CCQ assessing 10 dimensions, range 0–3, higher value indicates more creative climate except Conflicts
Challenge	18	1.86 (0.51)	1.76 (0.54)	0.592
Freedom	17	1.66 (0.43)	1.48 (0.35)	0.195
Idea support	18	1.66 (0.67)	1.44 (0.53)	0.298
Trust/Openness	17	1.61 (0.38)	1.49 (0.45)	0.424
Dynamism/Liveliness	18	1.53 (0.51)	1.53 (0.51)	1.000
Playfulness/Humor	18	1.61 (0.47)	1.60 (0.62)	0.891
Debate	18	1.49 (0.52)	1.41 (0.47)	0.671
Conflicts	18	1.96 (0.86)	2.06 (0.65)	0.739
Risk-taking	18	1.39 (0.53)	1.28 (0.45)	0.427
Ideas time	18	1.01 (0.61)	1.09 (0.52)	0.692
Total CCQ	17	1.59 (0.37)	1.52 (0.43)	0.641

Note: Significant values are shown in bold (level of significance p ≤0.05).

Abbreviations: n, number of participants who answered the question; SD, Standard Deviation; SDCS, Strain in Dementia Care Scale; CCQ, Creative Climate Questionnaire.

Table 5 Presentation of the Baseline and Follow-Up Scores Among the Completers (n=21) on Factor 3 SDCS, “Balancing Competing Needs”

SDCS	n	Baseline (Pre-Intervention, 2014)	Follow-Up (Post- Intervention, 2015)	p-Value
		Mean (SD)	Mean (SD)
Factor 3 – Balancing competing needs	18	7.03 (3.55)	5.77 (2.65)	0.033
I have to balance the needs of the older person against the needs of his or her family	18	7.22 (4.43)	5.44 (3.05)	0.038
I have to balance the needs of the older person against the needs of other older persons	18	8.00 (4.79)	6.00 (4.59)	0.029
I have to prioritize on the basis of urgency rather than fairness or the needs of older persons	18	7.44 (3.90)	6.22 (3.47)	0.167
Older persons resist the care I want to provide	18	6.50 (3.55)	6.17 (3.49)	0.607
I have to balance the safety of older persons against their quality of life	19	5.89 (3.93)	5.05 (2.01)	0.281

Notes: Significant values are shown in bold (level of significance p ≤0.05).

Abbreviations: n, number of participants who answered the question; SD, standard deviation.