Explaining reasons for stress, burnout and self-efficacy in direct care staff in supported aged care accommodation services

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The workplace environment can be a source of stress for many direct care staff who work in supported aged care accommodation services. Depression, fatigue, burnout, and heart disease are a few of the many health consequences of chronic work-related stress for these staff. This study aimed to better understand the stress phenomenon occurring in a sample of direct care staff working in the Australian supported aged care accommodation service sector. The relationship between direct care staff stress, burnout and self-efficacy for aged care work was investigated. The study was undertaken between 2007 and 2012 and conducted in 20 purposefully selected supported aged care accommodation services located in a Sydney Metropolitan regional area. Each supported service had comparable management structures, staff numbers, staff mix, older people demographics and held current Government accreditation status. A sample of 162 consenting direct care staff (registered nurses, assistant nurses, personal carers and recreational staff) completed a demographic questionnaire; the Expanded Nurse Stress Scale (ENSS); the Maslach Burnout Inventory (MBI); and General Self-efficacy Scale (GSE). Qualitative data (written narratives) were obtained from a single open-ended survey item inviting respondents to write about stressful experiences they may have encountered when interacting with the families of older people. Descriptive statistics examined the frequency of data distributions, means, standard deviations and confidence intervals for normally distributed data and median and inter quartile ranges for skewed data. Parametric tests (t-tests) were used for normally distributed variables and non-parametric tests (Spearman Rho and Kruskal Wallis) were used for non-normally distributed variables. Correlational statistics (Pearson’s correlation and Spearman’s correlation) were used to determine possible relationships between the variables of the ENSS, MBI and GSE and variables of direct care staff demographics. Thematic analyses were conducted for the written narrative responses to the single open-ended survey item on stress associated with the families of older people living in supported aged care accommodation services. The study findings confirmed high levels of stress of direct care staff was correlated with their work and with their interactions with families of older people. Strong associations were found between stress, burnout and self-efficacy for work, which were confirmed in the open-ended survey item responses. Having higher self-efficacy and valuing one’s work were identified as buffers for stress and burnout. Given the study findings, it behoves all stakeholders to enter into collaborative discussions that support and provide a healthy and satisfying work environment for all direct care staff.
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