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Background: Research on workforce development for high‐quality dementia care more often focuses on enhancing employee knowledge and skill and less on managing employee stress and coping at work. Objective: To review employee stress and coping in response to high job demands in community‐based dementia care organizations in Tasmania, Australia. Methods: Stress and coping in response to job roles of 25 community‐based dementia care workers were reviewed using self‐report questionnaire data. Data were analysed for descriptive results and at an individual case level. Individual participant scores were reviewed for clinically significant stress and coping factors to create worker profiles of adjustment. Results: Two adjustment profiles were found. The ‘global resilience’ profile, where workers showed positive adjustment and resilience indicating they found their jobs highly rewarding, were very confident in their abilities at work and had a strong match between their personal and organizational values. The second ‘isolated distress’ profile was only found in a minority and included poor opportunities for job advancement, a missmatch in personal and work values or clinically high levels of psychological distress. Conclusion: Aged care workplaces that advocate employee well‐being and support employees to cope with their work roles may be more likely to retain motivated and committed staff. Future research should consider employee stress and coping at the workforce level, and how this can influence high‐quality care delivery by applying the measures identified for this study. Comparative research across different care settings using meta‐analytic studies may then be possible. [ABSTRACT FROM AUTHOR]

Background: International evidence suggests that dementia is under-diagnosed in the community and that General Practitioners (GPs) are often reluctant to engage to their fullest capability with patients who exhibit cognitive symptoms. This is potentially reflected by a lack of GP knowledge about the syndrome. However, it is also recognised that attitudes and confidence are important in relation to how and to what extent a GP approaches a person with dementia. This research sought to develop a reliable and valid measure of GPs attitudes and confidence towards dementia. Methods: The General Practitioner Attitudes and Confidence Scale for Dementia (GPACS-D) was developed via a four stage process, including initial content development, pretesting, pilot testing and psychometric evaluation, including Principal Component Analysis (PCA). Participants were recruited for pre-testing (n = 12), test-retest (n = 55), and dementia workshop pre-and post-education evaluation (n = 215). Results: The process of scale development and psychometric evaluation resulted in a 20-item measure of GP attitudes and confidence towards dementia, with 4 items removed due to poor reliability, low sensitivity, or lack of model fit. Among 55 respondents who completed the scale on two occasions with no intervening education, Kappa coefficient scores per item ranged from fair (n = 2, candidates for removal), moderate (n = 5), substantial (n = 15), and almost perfect (n = 2). A test of the sensitivity of item scores to change following dementia education among 215 GPs indicated that, with the exception of one item, all scale responses exhibited significant differences between pre-and post-workshop scores, indicating acceptable sensitivity. With one further item removed due to a low communality score, the final PCA undertaken with the remaining 20 items supports a four-component solution, which accounted for 51.9 % of the total variance. Conclusion: The GPACS-D provides a reliable and preliminarily valid measure of GP attitudes and confidence towards dementia. The scales provide useful information for medical educators and researchers who are interested in evaluating and intervening in GP perceptions of the syndrome and their capacity to provide effective care. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to examine the opinions of aged care residents with mild cognitive decline and their families about interdisciplinary student placements in the residential aged care facilities (RACF) in Tasmania. The study used a mixed methods design and participants have completed a questionnaire on the quality of life of residents. Results showed that different benefits of students provided care in RACFs had experienced by residents and their families.

OBJECTIVES: To develop a reliable and valid dementia knowledge scale to address limitations of existing measures, support knowledge evaluation in diverse populations, and inform educational intervention development. DESIGN: A five-stage, systematic scale development process was employed to construct and assess the psychometric properties of the Dementia Knowledge Assessment Scale (DKAS). SETTING: Data for the study were generated in an online environment and during clinical dementia care placements from Australian (n = 1,321) and international respondents (n = 446). PARTICIPANTS: Volunteers from a dementia-related massive open online course (n = 1,651), medical students on clinical placement in a residential aged care facility (n = 40), and members of the Australian health workforce (n = 76). MEASUREMENTS: Psychometric properties of the DKAS were established using a literature review to assess the veracity of scale items, respondent feedback during pilot testing, a Delphi study with dementia experts, construction and review by an expert panel, evaluation of item difficulty, item-total and interitem correlations. Principal components analysis (PCA) was also performed along with measures of test-retest reliability, internal consistency, construct validity, and concurrent validity. RESULTS: The pilot DKAS was reduced from 40 to 27 items during analysis. PCA identified four distinct and interpretable factors. The revised DKAS displays high levels of test-retest reliability; internal consistency; and preliminary construct, concurrent, and factorial validity. CONCLUSION: The 27-item DKAS is reliable and shows preliminary validity for the assessment of knowledge deficiencies and change in those who provide care and treatment for people with dementia. [ABSTRACT FROM AUTHOR]

Background: Typically, dementia involves progressive cognitive and functional deterioration, leading to death. A palliative approach recognizes the inevitable health decline, focusing on quality of life. The approach is holistic, proactive, supports the client and the family, and can be provided by the client's usual care team. In the last months of life, distressing symptoms, support needs, and care transitions may escalate. This project trialed a strategy intended to support a consistent, high quality, palliative approach for people with dementia drawing close to death. The strategy was to implement two communities of practice, drawn primarily from service provider organizations across care sectors, supporting them to address practice change. Communities comprised practitioners and other health professionals with a passionate commitment to dementia palliative care and the capacity to drive practice enhancement within partnering organizations. Project aims were to document: (i) changes driven by the communities of practice; (ii) changes in staff/practitioner characteristics during the study (knowledge of a palliative approach and dementia; confidence delivering palliative care; views on death and dying, palliative care, and a palliative approach for dementia); (iii) outcomes from perspectives of family carers, care providers, and community of practice members; (iv) the extent to which changes enhanced practice and care continuity; and (v) barriers to and facilitators of successful community of practice implementation. Methods/design: This action research project was implemented over 14 months in 2010/11 in metropolitan Perth, Western Australia and regional Launceston, Tasmania. Each state based community of practice worked with the researchers to scope existing practice and its outcomes. The research team compiled a report of existing practice recommendations and resources. Findings of these two steps informed community of practice action plans and development of additional resources. Change implementation was recorded and explored in interviews, comparisons being made with practice recommendations. Changes in staff/practitioner characteristics were evaluated using survey data. Findings from semi structured interviews and survey administration established outcomes from perspectives of family carers, care providers, and community of practice members. Consideration of processes and outcomes, across the two state based settings, informed identification of barriers and facilitators. Community of practice reflections also informed study recommendations [ABSTRACT FROM AUTHOR]