title: Applying a palliative care approach in residential care: effects on nurse assistants' work situation.
abstract: OBJECTIVE
  The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.
  
  
  METHODS
  A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).
  
  
  RESULTS
  Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.
  
  
  CONCLUSIONS
  The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
authors.affiliation: The Swedish Institute for Health Sciences,Lund University,Lund,Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Beck
authors.affiliation: Center for Primary Health Care Research,Lund University,Lund,Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Jakobsson
authors.affiliation: The Swedish Institute for Health Sciences,Lund University,Lund,Sweden.
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Edberg
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D065228:Non-Randomized Controlled Trials as Topic; D009728:Nursing Assistants / Q000193:education* / Q000639:trends; D009732:Nursing Care / Q000379:methods*; D010166:Palliative Care / Q000379:methods* / Q000706:statistics & numerical data; D012112:Residential Facilities / Q000379:methods*; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Job satisfaction; Leadership; Long-term care; Palliative care approach intervention; Strain