title: E-assessment and an e-training program among elderly care staff lacking formal competence: results of a mixed-methods intervention study.
abstract: BACKGROUND
  Among staff working in elderly care, a considerable proportion lack formal competence for their work. Lack of formal competence, in turn, has been linked to higher staff ratings of stress symptoms, sleep disturbances and workload.
  
  
  OBJECTIVE
  1) To describe the strengths and weaknesses of an e-assessment and subsequent e-training program used among elderly care staff who lack formal competence and 2) to study the effects of an e-training program on staff members' working life (quality of care and psychological and structural empowerment) and well-being (job satisfaction and psychosomatic health). The hypothesis was that staff who had completed the e-assessment and the e-training program would rate greater improvements in working life and well-being than would staff who had only participated in the e-assessments.
  
  
  METHODS
  An intervention study with a mixed-methods approach using quantitative (2010-2011) and qualitative data (2011) was conducted in Swedish elderly care. Participants included a total of 41 staff members. To describe the strengths and weaknesses of the e-assessment and the e-training program, qualitative data were gathered using semi-structured interviews together with a study-specific questionnaire. To study the effects of the intervention, quantitative data were collected using questionnaires on: job satisfaction, psychosomatic health, psychological empowerment, structural empowerment and quality of care in an intervention and a comparison group.
  
  
  RESULTS
  Staff who completed the e-assessments and the e-training program primarily experienced strengths associated with this approach. The results were also in line with our hypotheses: Staff who completed the e-assessment and the e-training program rated improvements in their working life and well-being.
  
  
  CONCLUSIONS
  Use of the e-assessments and e-training program employed in the present study could be one way to support elderly care staff who lack formal education by increasing their competence; increased competence, in turn, could improve their self-confidence, working life, and well-being.
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden. ans@hig.se.|Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden. ans@hig.se.
authors.forename: Annika
authors.initials: A
authors.lastname: Nilsson
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden. mem@hig.se.|Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden. mem@hig.se.
authors.forename: Maria
authors.initials: M
authors.lastname: Engström
mesh_terms: D000328:Adult; D020375:Education, Distance; D005260:Female; D005851:Geriatric Nursing; D006801:Humans; D007318:Inservice Training / Q000592:standards*; D020407:Internet; D007407:Interviews as Topic; D007588:Job Satisfaction; D008297:Male; D008503:Medical Staff / Q000193:education*; D001523:Mental Disorders; D008875:Middle Aged; D011209:Power, Psychological; D011361:Professional Competence; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013548:Sweden