Improving Outcomes for Support Workers in Aged Care
Czuba, Karol Jan
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The population of people requiring long-term care is growing, the workforce is ageing, and the demand, shortages and challenges are widespread and likely to increase. Support workers are central to providing care to our ageing populations. They provide the majority of direct care to residential aged care recipients and are dealing with increasingly challenging work conditions. It is therefore imperative to find effective strategies to support this key workforce group. This Mixed Research project, informed by the Medical Research Council framework for developing complex interventions, aimed to develop a peer-mentoring intervention to improve outcomes for aged care support workers in NZ. It consisted of three phases: Phase 1: To establish the conceptual and theoretical basis to define the peer-mentoring intervention protocol (Study 1A and 1B) Phase 2: To define the intervention and develop the protocol (Study 2) Phase 3: To investigate the feasibility and acceptability of the proposed intervention, and provide data required to plan a future randomised controlled (Study 3) The aim of Study 1A was to review the evidence on the effectiveness of strategies that could be incorporated into a peer-mentoring intervention improving psychosocial and turnover-related outcomes for support workers in aged care. The study found low certainty evidence for some of the previously proposed interventions. However, none of the proposed approaches stood out as particularly effective and none of them had been developed for the NZ context. Study 1B aimed to explore NZ aged care stakeholder perspectives on interventions improving outcomes for support workers. The study found there were increasing demands to support this workforce in NZ, focus on their psychosocial outcomes (job and life satisfaction, stress, and other), and use flexible approaches that can be tailored to the individual needs and preferences of support workers. However, the reported inability of the aged care organisations to invest further resources in support workers was identified as a major barrier to implementing any workplace-based intervention and necessitated a modification of the originally proposed mentoring approach. This resulted in proposing an online-based peer-mentoring (e-mentoring) intervention as a strategy to improve outcomes for support workers. The aim of Study 2 was to provide insight into usability of the proposed e-mentoring intervention, its acceptability, and perceived barriers, facilitators and benefits. Participants identified a few areas for refinement. Their stories highlighted the importance of the quality of the mentor-mentee match and a preference for like-minded people to be matched. These insights were used to inform final refinements of the WeCare Mentoring Programme before testing it in Study 3. The final study in this project, Study 3, aimed to investigate the feasibility and acceptability of the proposed intervention, and to provide data required to plan a future randomised controlled trial. The study found that the proposed intervention was feasible and acceptable. Participants proposed some areas which could improve the experience further but were overwhelmingly in support of the programme. They would recommend, or already had recommended, this programme to other support workers. This thesis describes a rigorous and structured approach to development of an evidence-based e-mentoring intervention for NZ aged care support workers. The proposed programme is an acceptable and safe intervention to improve health and well-being outcomes for this workforce. Its users reported improvements in a range of areas of their professional and personal lives. A range of refinements are proposed to further enhance the programme’s feasibility. The next step is to test the intervention’s effectiveness in a definitive randomised controlled trial. If effective, this programme will offer a much-needed support to people who have been historically undervalued and are experiencing increasingly difficult working conditions. Better support for these workers is likely to lead to better health outcomes for them and the people they care for.