Caring Self-Efficacy and Behaviours of Culturally and Diverse Personal Care Attendants in Residential Aged Care Settings

Submitted in total fulfillment of the requirements for the degree of Doctor of Philosophy to the School of Nursing and Midwifery, La Trobe University, Victoria, Australia.</p

Caring behaviours of culturally diverse personal care attendants from the perspective of older people living in residential aged care settings

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Use of Internet Technology among Older Adults in Residential Aged Care Facilities: Protocol for a Systematic Review and Meta-Analysis

Internet usage may help promote the physical and mental health of older adults living in Residential Aged Care Facilities (RACF). There is little evidence of how these older citizens use internet services. This systematic review aims to explore the trends and factors contributing to internet use among aged care residents. A systematic search will be conducted on nine online databases—MEDLINE, EMBASE, PsycInfo, CINAHL, AgeLine, ProQuest, Web of Science, Scopus, and the Cochrane Library. Two reviewers will independently conduct title and abstract screening, full-text reading, critical appraisal, and data extraction. Any discrepancies will be resolved by consensus. Methodological risk of bias will be assessed using the Effective Public Health Practice Project measure and Joanna Briggs Institute checklist. We will report a narrative synthesis of the evidence. Information on factors contributing to internet use and their strength of association will be reported. If feasible, we will undertake a meta-analysis and meta-synthesis. Our review will provide information on the factors predicting internet use among older adults in residential aged care facilities. The evidence from this review will help to formulate further research objectives and, potentially, to design an intervention to trial internet access for these groups. (Protocol Registration: PROSPERO-CRD 42020161227)

Psychometric properties of the Caring Efficacy Scale among personal care attendants working in residential aged care settings

Objective: This study assessed the psychometric properties of the Caring Efficacy Scale (CES) among personal care attendants providing care to older residents in residential aged care settings. Methods: This cross-sectional study was completed in Australia in 2020–2021. Confirmatory factor analysis (CFA) of the 30-item original CES (Model 1) and 28-item CES validated in registered nurses (Model 2) was conducted to assess the goodness of fit of these models in our study population. Due to unsatisfactory fit indices for both models, exploratory factor analysis (EFA) was conducted to examine the dimensionality and underlying structure of the original CES among personal care attendants. Internal consistency of the final scale and subscales identified was examined using item-total correlations and Cronbach's alpha coefficients. Results: Two hundred and eighty personal care attendants participated in the study. The model fit indices such as Comparative Fit Index and Tucker Lewis Index of both models were less than 0.90, while the Standardised Root Mean Square Residual and Root Mean Square of Approximation values were greater than or equal to 0.08 and 0.06, respectively. The EFA identified a two-factor structure, and 22 items of the 30 in the original scale were retained. Item-total correlations amongst items retained in the scale and subscales were greater than 0.3. Cronbach's alpha for the abbreviated scale was 0.85, with 0.83 and 0.79, respectively, for the two subscales. Conclusions: The modified CES can be used as a robust tool to assess the self-efficacy of personal care attendants in providing care to older residents in residential aged care settings.</p

Caring Self-Efficacy of Personal Care Attendants From English-Speaking and Non-English-Speaking Countries Working in Australian Residential Aged Care Settings

Objectives: This study compared the caring self-efficacy between personal care attendants (PCAs) from English-speaking and non-English-speaking countries, controlling for potential sociodemographic and work-related covariates. PCAs’ perceptions of their caring self-efficacy were further explored. Methods: An independent samples t-test was used to determine the mean difference in the caring self-efficacy score between the two groups. A multivariate analysis was conducted to adjust for covariates. Thematic analysis was conducted on open-ended responses. Results: The results showed that caring self-efficacy was significantly influenced by whether participants primarily spoke English at home rather than where they were born. Younger age and everyday discrimination experiences were negatively associated with caring self-efficacy. Both groups perceived that inadequate resources and experiencing bullying and discrimination reduced their caring self-efficacy. Discussion: Access to organisational resources and training opportunities and addressing workplace bullying and discrimination against PCAs, particularly younger PCAs and those from non-English-speaking backgrounds, could improve their caring self-efficacy.</p

Effectiveness of trauma care systems at different stages of development in reducing mortality: a systematic review and meta-analysis protocol

IntroductionThe introduction of trauma systems that began in the 1970s resulted in improved trauma care and a decreased rate of morbidity and mortality of trauma patients. Worldwide, little is known about the effectiveness of trauma care system at different stages of development, from establishing a trauma centre, to implementing a trauma system and as trauma systems mature. The objective of this study is to extract and analyse data from research that evaluates mortality rates according to different stages of trauma system development globally.Methods and analysisThe proposed review will comply with the checklist of the ‘Preferred reporting items for systematic review and meta-analysis’. In this review, only peer-reviewed articles written in English, human-related studies and published between January 2000 and December 2020 will be included. Articles will be retrieved from MEDLINE, EMBASE and CINAHL. Additional articles will be identified from other sources such as references of included articles and author lists. Two independent authors will assess the eligibility of studies as well as critically appraise and assess the methodological quality of all included studies using the Cochrane Risk of Bias for Non-randomised Studies of Interventions tool. Two independent authors will extract the data to minimise errors and bias during the process of data extraction using an extraction tool developed by the authors. For analysis calculation, effect sizes will be expressed as risk ratios or ORs for dichotomous data or weighted (or standardised) mean differences and 95% CIs for continuous data in this systematic review. PROSPERO registration numberCRD42019142842.</div

Effectiveness of trauma care systems at different stages of development in reducing mortality: a systematic review and meta-analysis protocol

IntroductionThe introduction of trauma systems that began in the 1970s resulted in improved trauma care and a decreased rate of morbidity and mortality of trauma patients. Worldwide, little is known about the effectiveness of trauma care system at different stages of development, from establishing a trauma centre, to implementing a trauma system and as trauma systems mature. The objective of this study is to extract and analyse data from research that evaluates mortality rates according to different stages of trauma system development globally.Methods and analysisThe proposed review will comply with the checklist of the ‘Preferred reporting items for systematic review and meta-analysis’. In this review, only peer-reviewed articles written in English, human-related studies and published between January 2000 and December 2020 will be included. Articles will be retrieved from MEDLINE, EMBASE and CINAHL. Additional articles will be identified from other sources such as references of included articles and author lists. Two independent authors will assess the eligibility of studies as well as critically appraise and assess the methodological quality of all included studies using the Cochrane Risk of Bias for Non-randomised Studies of Interventions tool. Two independent authors will extract the data to minimise errors and bias during the process of data extraction using an extraction tool developed by the authors. For analysis calculation, effect sizes will be expressed as risk ratios or ORs for dichotomous data or weighted (or standardised) mean differences and 95% CIs for continuous data in this systematic review. PROSPERO registration numberCRD42019142842.</div

Caring self-efficacy of direct care workers in residential aged care settings: A mixed methods scoping review

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