title: Staff outcomes from the caring for aged dementia care resident study (CADRES): a cluster randomised trial.
abstract: BACKGROUND
  Dementia care mapping and person centred care are well-accepted as processes for improving care and well-being for persons with dementia living in the residential setting. However, the impact of dementia care mapping and person centred care on staff has not been well researched.
  
  
  OBJECTIVE
  The impact of person centred care and dementia care mapping compared to each other and to usual dementia care on staff outcomes was examined in terms of staff burnout, general well-being, attitudes and reactions towards resident behavioural disturbances, perceived managerial support, and quality of care interactions.
  
  
  METHODS
  A cluster-randomised, controlled trial.
  
  
  METHODS
  The study was conducted between 2005 and 2007 in 15 residential aged care sites in the Sydney metropolitan area, Australia, with comparable management structures, staffing mix and ratios, and standards of care.
  
  
  METHODS
  194 consenting managers, nurses, therapists and nurse assistants working in the participating sites.
  
  
  METHODS
  Intervention care sites received training and support in either person centred care (n=5) or dementia care mapping (n=5); control sites continued with usual dementia care (n=5). Staff outcomes of those three groups were assessed before, directly after the four month intervention (post) and after a further four months (follow-up). The primary outcome measures were the Maslach Burnout Inventory-Human Services Survey and the 12-item General Health Questionnaire. Analysis involved repeated measures analyses of variance for each of the outcome measures and adjustment for potential confounders to limit bias.
  
  
  RESULTS
  The Maslach Burnout Inventory-Human Services Survey results showed that change over time in emotional exhaustion scores differed between the three groups. Post-hoc analyses for each group separately revealed that the only significant time effect was in the dementia care mapping group (p=0.006), with emotional exhaustion scores declining over time. At baseline, more perceived support from management was associated with less emotional exhaustion (r(s)=0.26, p=0.004, n=122) and less depersonalisation (r(s)=0.21, p=0.023, n=122), but not for any of the other outcome measures.
  
  
  CONCLUSIONS
  This study has shown that person centred approaches of care, in particular with dementia care mapping, may contribute to reducing staff job related burnout. The findings also highlight a potentially important role of managerial support and a whole of system approach.
authors.affiliation: Sydney Nursing School, The University of Sydney, Camperdown, NSW, Australia. yun-hee.jeon@sydney.edu.au
authors.forename: Yun-Hee
authors.initials: YH
authors.lastname: Jeon
authors.forename: Georgina
authors.initials: G
authors.lastname: Luscombe
authors.forename: Lynn
authors.initials: L
authors.lastname: Chenoweth
authors.forename: Jane
authors.initials: J
authors.lastname: Stein-Parbury
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Madeleine
authors.initials: M
authors.lastname: King
authors.forename: Marion
authors.initials: M
authors.lastname: Haas
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D003704:Dementia / Q000451:nursing*; D006801:Humans; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care; D011787:Quality of Health Care