Research Article
Volume 4 Issue 7 - 2022
Workplace Stress for Health Care Assistants in a UK National Health Service Dementia Hospital After 10 Years of Financial Austerity: A Qualitative Study
Christopher Chigozie Udushirinwa*, Andrew Mcvicar and Julie Teatheredge
Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, Essex, UK
*Corresponding Author: Christopher Chigozie Udushirinwa, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, Essex, UK.
Received: August 12, 2021; Published: June 14, 2022




Abstract

Health care support workers have patient-facing roles within care teams but little autonomy; work is allocated. This study reports work stress experiences of Health Care Assistants (HCAs; UK support workers) in a dementia unit in 2018 towards the end of national austerity, a period of significant staff reduction in the UK National Health Service. HCAs (15; 40% of total) were individually interviewed, and in a focus group (6). Analysis revealed high job demands but low job resources. HCAs were altruistic regarding stressful dementia care but tension from the work environment was high. Difficulties directly or indirectly related to staff shortage: workload, inadequate staffing, and reliance on inexperienced temporary staff who required supervision, poor team skill mix, and poor shift patterns. Serious relationship issues for HCAs were exposed so post-hoc interviews with nurses (n = 10) from the same unit were undertaken for further insight. HCAs considered nurses unsupportive, poor leaders and disrespectful of their experience. Nurses considered HCAs obstructive, compounded by failure to recognise nurses’ professional responsibilities. Coping by HCAs was mainly through short, time-out breaks but these were constrained by lack of staff cover. Tensions had been left to fester. Better awareness of managers is required that staffing impacts extend beyond workload.

Keywords: Workplace Stress; Job Stress; Job Strain; Health Care Assistants; Healthcare Support Worker; HCA; Dementia

References

  1. Smythe A., et al. “The experiences of staff in a specialist mental health service in relation to development of skills for the provision of person centred care for people with dementia”. Dementia2 (2015): 184-198.
  2. Sarre S., et al. “The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals”. International Journal of Nursing Studies 79 (2018): 145-153.
  3. Anderson JE., et al. “Nursing teamwork in the care of older people: A mixed methods study”. Applied Ergonomics 80 (2019): 119-129.
  4. McPherson S., et al. “Distress in working on dementia wards-A threat to compassionate care: A grounded theory study”. International Journal of Nursing Studies 53 (2016): 95-104.
  5. Afzal A., et al. “The role of unregulated care providers in Canada-A scoping review”. International Journal of Older People Nursing 3 (2018): e12190.
  6. Lloyd V., et al. “In group identity as an obstacle to effective multi professional abd inter professional teamwork: findings from an ethnographic study of healthcare assistants in dementia care”. Journal of Interprofessional Care 5 (2011): 345-351.
  7. Yan GJ., et al. “Association between patients with dementia and high caregiving burden for caregivers from a medical center in Taiwan”. Psychology Research and Behavior Management 12 (2019): 55-65.
  8. Small GW. “Treating dementia and agitation”. Journal of the American Medical Association 7 (2014): 677-678.
  9. Hopkinson MD., et al. “Cognitive behavioral therapy for depression, anxiety, and stress in caregivers of dementia patients: A systematic review and meta-analysis”. The Gerontologist4 (2018): 343-362.
  10. Brien R., et al. “When people living with dementia say no Negotiating refusal in the acute hospital setting”. Social Science and Medicine 263 (2020): 113188.
  11. https://kar.kent.ac.uk/76514/1/challenging%20care.pdf
  12. https://www.rcn.org.uk/professional-development/publications/pub-007927
  13. Rimmer A. “Staff stress levels reflect rising pressure on the NHS, says NHS leaders”. British Medical Journal 360 (2018): k1074.
  14. Buchan J., et al. “A critical moment: NHS staffing trends, retention and attrition”. The Health Foundation.
  15. https://www.nao.org.uk/wp-content/uploads/2020/03/The-NHS-nursing-workforce-Summary.pdf
  16. Cheloni S and Tinker A. “Working with older people with dementia: motivations and demotivations among health carers”. Working with Older People 23 (2019): 117-126.
  17. Demerouti E., et al. “The job demands resources model of burnout”. Journal of Applied Psychology 3 (2007): 499-512.
  18. Braun V and Clarke V. “Using thematic analysis in psychology”. Qualitative Research in Psychology 2 (2006): 77-101.
  19. Guba EG and Lincoln YS. “Competing Paradigms in Qualitative Research”. Handbook of Qualitative Research. Sage Publications Inc (1994): 105-117.
  20. nuffieldtrust.org.uk/resource/the-nhs-workforce-in-numbers
  21. Bailey S., et al. “The emotional labour of health-care assistants in inpatient dementia care”. Ageing and Society2 (2015): 246-269.
  22. Cousins R., et al. “Management Standards work-related stress in the UK: practical development”. Work and Stress 2 (2004): 113-136.
  23. Bakker AB and Demerouti E. “The Job Demands-Resources model: State of the art”. Journal of Managerial Psychology 3 (2007): 309-328.
  24. Vogel B., et al. “Dementia care worker stress associations with unit type, resident, and work environment characteristics: a cross-sectional secondary data analysis of the Swiss Nursing Homes Human Resources Project (SHURP)”. International Psychogeriatrics 3 (2017): 441-454.
  25. Goldberg SE., et al. “Medical Crises in Older People Study Group. The prevalence of mental health problems among older adults admitted as an emergency to a general hospital”. Age and Ageing1 (2011): 80-86.
  26. George MS. “Stress in NHS staff triggers defensive inward-focussing and an associated loss of connection with colleagues: this is reversed by Schwartz Rounds”. Journal of Compassionate Health Care 3 (2016): 9.
  27. McVicar A. “Scoping the common antecedents of job stress and job satisfaction for nurses (2000-2013) using the job demands-resources model of stress”. Journal of Nursing Management 2 (2016): 112-136.
  28. Mc Vicar A. “Workplace stress in nursing: A literature review”. Journal of Advanced Nursing 6 (2003): 633-642.
  29. Jansen BDW., et al. “Exploring healthcare assistants’ role and experience in pain assessment and management for people with advanced dementia towards the end of life: a qualitative study”. BMC Palliative Care 1 (2017): 6.
  30. Joshua-Amadi M. “Recruitment and retention in the NHS: a study in motivation”. Nursing Management9 (2003): 14-19.
  31. Chenoweth L., et al. “Attracting and retaining qualified nurses in aged and dementia care: outcomes from an Australian study”. Journal of Nursing Management 2 (2014): 234-247.
  32. Cowdell F. “Care of older people with dementia in an acute hospital setting”. Nursing Standard 23 (2010): 42-48.
  33. https://www.hse.gov.uk/statistics
  34. Houdmont J., et al. “Psychosocial risk assessment in organizations: Concurrent validity of the brief version of the Management Standards Indicator Tool”. Work and Stress 4 (2013): 403-412.
  35. Moonga J and Likupe G. “A systematic literature review on nurses’ and health care support workers’ experiences of caring for people with dementia on orthopaedic wards”. Journal of Clinical Nursing 13-14 (2016): 1789-1804.
  36. Newman K., et al. “The nurse satisfaction, service quality and nurse retention chain: implications for management of recruitment and retention”. Journal of Management in Medicine 4-5 (2002): 271-291.
Citation: Christopher Chigozie Udushirinwa., et al. “Workplace Stress for Health Care Assistants in a UK National Health Service Dementia Hospital After 10 Years of Financial Austerity: A Qualitative Study”. EC Nursing and Healthcare 4.7 (2022): 01-16.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


July Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the July issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before July 19, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.