A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings

Background:&nbsp;The high occurrence and under-treatment of clinical depression and behavioral and psychological symptoms of dementia (BPSD) within aged care settings is concerning, yet training programs aimed at improving the detection and management of these problems have generally been ineffective. This article presents a study protocol to evaluate a training intervention for facility managers/registered nurses working in aged care facilities that focuses on organisational processes and culture as well as knowledge, skills and self-efficacy. Methods. A Randomised Control Trial (RCT) will be implemented across 18 aged care facilities (divided into three conditions). Participants will be senior registered nurses and personal care attendants employed in the aged care facility. The first condition will receive the training program (Staff as Change Agents - Enhancing and Sustaining Mental Health in Aged Care), the second condition will receive the training program and clinical support, and the third condition will receive no intervention. Results: Pre-, post-, 6-month and 12-month follow-up measures of staff and residents will be used to demonstrate how upskilling clinical leaders using our transformational training approach, as well as the use of a structured screening, referral and monitoring protocol, can address the mental health needs of older people in residential care. Conclusions: The expected outcome of this study is the validation of an evidence-based training program to improve the management of depression and BPSD among older people in residential care settings by establishing routine practices related to mental health. This relatively brief but highly focussed training package will be readily rolled out to a larger number of residential care facilities at a relatively low cost.</div

Improving training outcomes: the significance of motivation when learning about new shipboard technology

This paper reports on some of the findings from a study of new technology and training in shipping. It identifies the key significance of motivation in the learning process and identifies potential factors that motivate or demotivate seafarers when undertaking training about new equipment. It shows that seafarers’ motivation is likely to be impacted by confidence that training is good for the job as well as for promotion. It demonstrates that companies can facilitate and encourage individuals to initiate learning activities but that they may equally adopt strategies which discourage learning. Enabling factors include: establishing a positive learning environment; adopting clear policies; allowing seafarers to identify their own training needs and allowing seafarers to request support for specific courses. Conversely, companies may demotivate some seafarers in relation to training by shifting the burden of training ‘costs’, such as time and money, onto them

Depression in multicultural Australia: Policies, research and services

BACKGROUND: Depression is one of the leading causes of disability in Australia. The cultural and linguistic diversity of the Australian population poses a significant challenge to health policy development, service provision, professional education, and research. The purpose of this study is to explore the extent to which the fact of cultural and linguistic diversity has influenced the formulation of mental health policy, the conduct of mental health research and the development of mental health services for people with depression from ethnic minority communities. METHODS: The methods used for the different components of the study included surveys and document-based content and thematic analyses. RESULTS: Policy is comprehensive but its translation into programs is inadequate. Across Australia, there were few specific programs on depression in ethnic minority communities and they are confronted with a variety of implementation difficulties. The scope and scale of research on depression in Ethnic minority communities is extremely limited. CONCLUSION: A key problem is that the research that is necessary to provide evidence for policy and service delivery is lacking. If depression in Ethnic minority communities is to be addressed effectively the gaps between policy intentions and policy implementation, and between information needs for policies and practice and the actual research that is being done, have to be narrowed

Managing teams for integrated design solutions and working practices

Design integration in the architecture, engineering and construction sector requires a multiplicity of skills, knowledge and experience. Design practice requires management tools and skills besides the design skills and the domain knowledge. Teams and design teams have been extensively studied, and it is widely accepted that the team management practices are contingent on the nature of collaboration. This research specifically investigates the critical success factors for managing teams for integrated design and delivery solutions (IDDS), which aims to involve virtual collaborative environments and various stakeholders and supply chain players such as architects, consultants, contractors, and suppliers across the project lifecycle. Since IDDS is a recent development, the associated teamwork factors and challenges are not currently well understood, especially for the design development phases. Therefore, there is an immediate need to investigate the teamwork requirements and challenges for successfully meeting the IDDS objectives. This paper reports the preliminary findings from an ongoing research that investigates this gap. This investigation builds on the rich literature on teamwork and organizational studies, design management and construction supply chain integration to identify the critical success factors necessary for an IDDS team. For teams to be efficient, team members need to have well developed mental models of each other, as well as the mental models for the task, process, context, and competence of the team. In particular, our question is what are the critical task, process, context and competence factors specific to the IDDS teams that involve multiple players representing the construction supply chain

Real World Challenges in Delivering Consumer Directed Care to Enhance Nursing Home Residents’ Well Being

Objectives: The aim of this study was to use the ADKAR model of organizational change to gain an understanding of why a training program designed to equip staff with the skills to provide a Consumer Directed Care (CDC) model in nursing homes produced little change in the outcome variables, including resident quality of life. Methods: We collected and analyzed various forms of site-specific data including CDC implementation plans developed by staff trained in 21 facilities, and their training facilitators’ records. Results: Staff trained in the principles of CDC produced well-developed, facility-specific plans to introduce a CDC model of care, yet they faced many barriers to the implementation of these plans. These barriers were spread across multiple stages of the ADKAR model and included staff turnover (including managers), lack of engagement by management, lack of or inconsistent availability of a CDC champion, and disruptions to the training program. Conclusions: We identified several organizational factors contributing to the failure of the training program to produce anticipated changes. Clinical Implications: Without organizational commitment and full management support, attempts to implement CDC training programs are likely to fail, leading to negative consequences for residents’ autonomy and control over how they are cared for

An evaluation of a community-based psychoeducation program for successful ageing

Background: The increasing numbers and proportion of the ageing population make it essential to develop and evaluate programs to meet the needs of older adults to empower them to age actively, healthily and successfully. Consequently, positive ageing programs have been developed and the need to evaluate their outcomes is essential. This study used mixed methods to evaluate cognitive and behavioural changes and to monitor psychological health and active ageing in participants of a longstanding positive ageing psychoeducation program, Successful Ageing for Growth & Enjoyment (SAGE) conducted in Australia, and to evaluate participant satisfaction with the program. Methods: Two approaches were utilised. The first involved a survey of demographic variables, measures of psychological health (depression, anxiety and stress, self-esteem and resilience) active ageing, including measures of subjective learning and behavioural change after the seminar series, sent to program participants prior to the annual program commencement, and again at the end of the ten-seminar program. The second approach was for participants to complete a Likert-rated and short answer survey assessing session satisfaction of participants after each of the ten seminars in the program. Results: The analyses revealed that of those who attended SAGE, almost half reported specific positive changes to their cognitions or behaviours, with most of these identified changes being maintained at the end of the year-long program. Participant feedback from those attending SAGE seminars was overwhelmingly positive. No clinically significant differences were seen between those who did and did not attend SAGE in psychological health or active ageing before or after attending. Conclusions: Participants who engaged with SAGE often reported positive behavioural and cognitive changes. Qualitative feedback suggested that SAGE is certainly appreciated and valued by those attending

An evaluation of a consumer directed care training program for nursing home staff

Objectives: This study evaluated a training program to support the delivery of consumer directed care (CDC). It was hypothesized that both interventions, compared to the control condition, would demonstrate increased levels of CDC in nursing homes, increased staff practice of CDC, and improved resident QoL. The training plus support group was expected to show greater gains, compared to the training only group. Materials and methods: In a cluster RCT design, 33 nursing homes were randomly allocated to one of three conditions: training plus support, training only, and care as usual. Outcome measures included level of CDC within each home, staff practice of CDC, and resident QoL. Results and discussion: Hypotheses for this study were partially supported. Nursing homes became more CDC-oriented but with minimal changes in staff practice of CDC. Resident QoL also demonstrated limited change. The findings are discussed in terms of organizational barriers to change within nursing homes