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• The quality of staff care has pervasive effects on resident quality of life • Increasing relevance and applicability of staff training and qualifications is key • Staff upskilling is required in empathic care, communication and restraint reduction • Mealtime assistance and increased recreational activities improve QOL • Experienced nurse managers and rotating staff shifts improve QOC : Despite the integral role residential care staff play in the lives of residents with dementia, the mechanisms for supporting staff to bring about good quality of care (QOC) and quality of life (QOL) are poorly understood. This study focused on establishing the key mechanisms to improve QOC and in turn QOL of residents with dementia. : Over a 10-month period we followed: 247 older adults with dementia from 12 not-for-profit residential care facilities, their families/care partners (n=225), managers (n=12) and staff (n=232). Facilities ranged in size from 10 to 137 beds, located across remote, rural and metropolitan areas of NSW/ACT. Measures included: staff surveys, family member and resident interviews, resident file audits, live resident and staff observations and organisational audits. Multilevel Modelling or Generalised Estimating Equations analyses were conducted for each of the 12 QOC variables, with 22 staff and control variables as the predictors, and for each of the 11 QOL variables, with 20 QOC and control variables as predictors. : Analyses established significant associations between a large number of staff and QOC variables and between QOC and QOL variables. : The quality of the care provided to residents has strong, widespread influences on the QOL of residents. The most promising areas for intervening with staff were: increasing the relevance and applicability of staff training and qualifications, upskilling staff in empathic care provision, communication, and restraint reduction, using a mixture of permanent and rotating shifts, prioritising recreational activity provision by all staff and increasing assistance with meals. [Display omitted] [ABSTRACT FROM AUTHOR]

Mental health practices are not working for older people with anxiety in residential care, as there is a persistent lack of recognition and treatment. This suggests that alternative ways of reaching and meeting the needs of this population need to be explored. One possibility involves enabling older adults themselves to seek help. The current work explored various factors impacting on help-seeking behaviours. In total, 105 participants from independent living units in a residential care setting completed a questionnaire focusing on attitudes and stigma towards anxiety, likelihood to seek help, help-seeking barriers and literacy around the symptoms of anxiety. Participants in the main did not hold negative attitudes towards other people with anxiety, despite concerns that other people could view them negatively if they were experiencing anxiety. Barriers to help-seeking included: difficulties recognising physical anxiety symptoms as being indicative of anxiety; the effectiveness of treatments; costs; misdiagnosis; privacy; medication usage and the associated side-effects; and, uneasiness about the skills and knowledge of health professionals. Although concerns were not held by all participants, the fact remains that anxiety is largely undiagnosed and untreated for this population and these stoppages to appropriate care must be addressed.

Background: Medical school is a challenging environment that requires students to deal effectively with stress borne out of the medical education environment, as well as their personal lives. Previous research has not systemically distinguished between academic and personal sources of stress, and in particular has not explored the independent contribution that academic stressors make to medical student depression., Purposes: This study aimed to investigate whether academic stressors make a unique contribution to the level of depressive symptoms in medical students, over and above the contribution made by personal stressors alone., Methods: Sixty-seven medical students completed an online questionnaire designed to measure the total number of recent life events (personal and academic), and their perceived impact, using a modified version of the Psychiatric Epidemiology Research Interview Life Events Scale. Depressive symptoms were measured using the Centre for Epidemiological Studies Depression Scale., Results: Both the total number of personal stressors, r(67) = .363, p = .003, and their perceived impact, r(67) = .412, p = .001, were found to be positively related to depressive symptoms. A positive relationship was also observed between depressive symptoms and the total number of academic stressors, r(67) = .321, p = .008, and their perceived impact, r(67) = .489, p < .001. In addition, it was found that the perceived impact of academic stressors was able to explain higher levels of depressive symptoms in medical students over and above the effect afforded by personal stressors alone., Conclusion: The findings of this study suggest that stress borne out of the medical school environment contributes to depressive symptoms in medical students over and above the contribution made by personal stressors alone. This indicates that although it is important to help students cope with stress borne out of their personal lives, interventions by medical schools aimed at reducing the impact of academic stressors on medical student depression may also be of great importance.