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Little attention has been given to the perceptions of formal care providers on the nature and quality of home- and community-based dementia care. The purpose of this descriptive interpretive research was to explore formal care providers' perceptions of their experiences with Canadian home- and community-based dementia care. Participants within three personal interviews and six focus groups (n = 41) included nurses, social workers, therapists, home care aides, and Alzheimer Society personnel (front line/management) in rural and urban areas of Saskatchewan (n = 16), Manitoba (n = 20), and Ontario (n = 8). Two overarching thematic categories, Service Availability and Service Acceptability, emerged from the data analysis. Subthemes of availability were identified as: (a) challenges of service availability, including service wait lists, lack of home care provider training, lack of community-based dementia care infrastructure, and sociocultural and geographic barriers to accessing dementia services; and (b) essential facilitators of availability, including service infrastructure, service bridging, and agency partnerships to form coordinated care systems. Subthemes of acceptability were revealed as: (a) essential components of dementia care, including provision of comprehensive personal care and the use of dementia care professional practice knowledge within a home care setting; and (b) service challenges, including inadequate service time for the physical care and socioemotional support of the client and family caregiver, caregiver and formal provider difficulty with navigation of a fragmented care system, lack of system coordination, and financial costs of services. Essential, integrated dementia care could be established by listening to the "voices of formal care providers," thereby decreasing dementia care costs and increasing the quality of life for those with dementia, and their family caregivers.

Purpose: The purpose of this descriptive study was to explore the influence of efficacy-enhancing experiences on breast-feeding self-efficacy., Methods: Using the Breastfeeding Self-Efficacy Scale-Short Form, the influences of enactive mastery and various forms of experiences (vicarious, verbal persuasory, and physiological) on breast-feeding self-efficacy were assessed at 48 hours and 4 weeks postpartum among a convenience sample of 63 mothers., Results: Those women who observed breast-feeding role models through videotapes or received praise from their partners or their own mothers had significantly higher levels of breast-feeding self-efficacy than mothers who did not. In addition, mothers who experienced physical pain or received professional assistance with breast-feeding difficulties had significantly lower levels of breast-feeding self-efficacy than those who did not., Conclusion: This study provides preliminary evidence that specific efficacy-enhancing strategies may significantly influence breast-feeding self-efficacy. Further research is warranted.