title: Coming to grips with challenging behaviour: a cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units.
abstract: BACKGROUND
  Caring for people with dementia in dementia special care units is a demanding job. Challenging behaviour is one of the factors influencing the job satisfaction and burnout of care staff. A care programme for the challenging behaviour of nursing home residents with dementia might, next to diminishing the challenging behaviour of residents, improve job satisfaction and reduce the care staff's feelings of burnout.
  
  
  OBJECTIVE
  To determine the effects of a care programme for the challenging behaviour of nursing home residents with dementia on the burnout, job satisfaction and job demands of care staff.
  
  
  METHODS
  The care programme was implemented according to a stepped wedge design in which care units were randomly divided over five groups with different time points of starting with implementation.
  
  
  METHODS
  17 Dutch dementia special care units.
  
  
  METHODS
  Care staff members of the 17 units.
  
  
  METHODS
  The care programme consists of an education package and of various structured assessment tools that guide professionals through the multidisciplinary detection, analysis, treatment and evaluation of treatment of challenging behaviour.
  
  
  METHODS
  Burnout, job satisfaction and job demands were measured before implementation, halfway through the implementation process and after all the care units had implemented the care programme. Burnout was measured with the Dutch version of the Maslach burnout inventory (UBOS-C, three subscales); job satisfaction and job demands were measured with subscales of the Leiden Quality of Work Questionnaire. Mixed model analyses were used to determine effects. Care staff could not be blinded for the intervention.
  
  
  RESULTS
  Of the 1441 questionnaires, 645 were returned (response 45%, 318 control measurements, 327 intervention measurements) by 380 unique care staff members. Significant effects were found on job satisfaction (0.93, 95% CI 0.48-1.38). On the other outcomes, no significant changes in the scores were found.
  
  
  CONCLUSIONS
  Positive effects of using the Grip on Challenging behaviour care programme were found on job satisfaction, without an increase in job demands.
authors.affiliation: Department of General Practice and Elderly Care Medicine/EMGO+Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands. Electronic address: s.zwijsen@vumc.nl.
authors.forename: S A
authors.initials: SA
authors.lastname: Zwijsen
authors.affiliation: Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Radboud Alzheimer Center, Nijmegen, The Netherlands.
authors.forename: D L
authors.initials: DL
authors.lastname: Gerritsen
authors.affiliation: Zonnehuisgroep IJssel-Vecht, Zwolle, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Eefsting
authors.affiliation: Department of General Practice and Elderly Care Medicine/EMGO+Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands. Electronic address: m.smalbrugge@vumc.nl.
authors.forename: M
authors.initials: M
authors.lastname: Smalbrugge
authors.affiliation: Department of General Practice and Elderly Care Medicine/EMGO+Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands.
authors.forename: C M P M
authors.initials: CM
authors.lastname: Hertogh
authors.affiliation: Department of Clinical Psychology, Faculty of Psychological and Educational Sciences, VU University, Amsterdam, The Netherlands; Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; School of Psychology, University of Queensland, Australia.
authors.forename: A M
authors.initials: AM
authors.lastname: Pot
mesh_terms: D000328:Adult; D002055:Burnout, Professional; D003704:Dementia / Q000451:nursing*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000458:organization & administration*; D009740:Nursing Staff / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Behaviour; Burnout; Dementia; Job satisfaction; Nursing staff