Validation of the Maslach burnout inventory-general survey 9-item short version (MBI-GS9) among care aides in Canadian nursing homes.

Background: The Maslach Burnout Inventory-General Survey (MBI-GS) is the leading measure of burnout for all occupations. The MBI-GS9, the 9-item version of the MBI-GS, was formulated based on the MBI-GS and has been used for several years. However, very few studies have systematically tested its psychometric properties, and none have focused on care aides working in nursing homes who are susceptible to burnout.

Examining factorial validity and internal consistency of Professional Quality of Life (ProQoL-9) among care aides working in Long-term Care (LTC).

Background: The ProQoL (30 items) is a widely used instrument of work-related quality of life for health care workers. Recently, a shorter 9-item version of the ProQoL was developed and validated among palliative care workers. The ProQoL-9 consists of three subscales: compassion satisfaction (CS), burnout (BO), and compassion fatigue (CF).

The implementation of infant pain practice change resource to improve infant procedural pain practices: a hybrid type 1 effectiveness-implementation study.

Implementation of infant pain practice change (ImPaC) is a multifaceted web-based resource to support pain practice change in neonatal intensive care unit (NICU). We evaluated the (1) intervention effectiveness and (2) implementation effectiveness of ImPaC using a hybrid type 1 effectiveness-implementation study (ie, cluster randomized controlled trial and longitudinal descriptive study). Eligible level 2 and 3 Canadian NICUs were randomized to intervention (INT) or waitlisted to usual care (UC) for 6 months.

Changing Trends in Job Satisfaction and Burnout for Care Aides in Long-Term Care Homes: The Role of Work Environment.

Objectives: This study examined the association between care unit work environments in long-term care (LTC) homes and trends in care aides' job satisfaction and burnout (exhaustion, cynicism, reduced professional efficacy) from 2014 to early 2020.

Design: This was a retrospective longitudinal study using data from care aide surveys collected by the Translating Research in Elder Care research program over 3 periods: September 2014-May 2015 (T), May 2017-December 2017 (T), and September 2019-March 2020 (T).

Settings And Participants: The study included 631 care aides from a stratified random sample of 84 LTC homes in 3 Canadian provinces, who participated in data collection at all 3 time points.

Dissociation in Long-Term Care Home Staff During COVID-19: Challenges and Promising Practices.

Objectives: Long-term care (LTC) staff may develop dissociation due to high-stress work environments and trauma exposures. This study aimed to (1) assess the prevalence of pathological dissociation in LTC home staff during the COVID-19 pandemic; (2) examine the associations of pathological dissociation with demographic characteristics, mental health, insomnia, and professional quality of life; and (3) examine whether pathological dissociation was sensitive to change following a coherent breathing intervention.

Design: We analyzed data from a pre-post breathing intervention study conducted between January and September 2022.

Evidence pointing toward invalidity of the SF-8 physical and mental scales: a fusion validity assessment.

Background: The SF-8™ Short Form Health Survey creates physical and mental health scale scores from responses to eight survey questions. These widely used scales demonstrate reasonable reliablity, and some forms of validity but have not been assessed for fusion validity. We assess the fusion validity of the SF-8 physical and mental health scales, and provide comments assisting fusion validity assessment of other scales.

'We listened and supported and depended on each other': a qualitative study of how leadership influences implementation of QI interventions.

Background: There is growing recognition in the literature of the 'Herculean' efforts required to bring about change in healthcare processes and systems. Leadership is recognised as a critical lever for implementation of quality improvement (QI) and other complex team-level interventions; however, the processes by which leaders facilitate change are not well understood. The aim of this study is to examine 'how' leadership influences implementation of QI interventions.

Quality of Work Life and Mental Well-Being for Long-Term Care Staff in Nova Scotia.

This study assesses the quality of work life for Nova Scotian continuing care assistants (CCAs) ( = 266), nurses ( = 144) and managers ( = 45) from 10 long-term care (LTC) homes in late 2021. CCAs scored significantly worse than nurses and managers on measures of mental health and anxiety. All groups reported high levels of cynicism and emotional exhaustion; CCAs' scores were higher than nurses or managers.

Palliative care in small-scale living facilities: a scoping review.

Background: Innovative small-scale facilities for dementia focus on providing quality of life and maintaining the functional abilities of residents while offering residents a home for life. To fulfill the home-for-life principle, palliative care approaches are necessary to maintain quality of life in these facilities. Few studies have reported on how palliative care is provided to residents in small-scale facilities.

Validation of the Maslach Burnout Inventory-General Survey 9-item short version: psychometric properties and measurement invariance across age, gender, and continent.

Background: The Maslach Burnout Inventory-General Survey (MBI-GS) stands as the preeminent tool for assessing burnout across various professions. Although the MBI-GS9 emerged as a derivative of the MBI-GS and has seen extensive use over several years, a comprehensive examination of its psychometric properties has yet to be undertaken.

Methods: This study followed the Standards for Educational and Psychological Testing guidelines to validate the MBI-GS9.

Cumulative sucrose exposure for repeated procedural pain in preterm neonates and neurodevelopment at 18 months of corrected age: a prospective observational longitudinal study.

Introduction: Oral sucrose is repeatedly administered to neonates in the neonatal intensive care unit (NICU) to treat pain from commonly performed procedures; however, there is limited evidence on its long-term cumulative effect on neurodevelopment. We examined the association between total sucrose volumes administered to preterm neonates for pain mitigation in the NICU and their neurodevelopment at 18 months of corrected age (CA).

Methods: A prospective longitudinal single-arm observational study that enrolled hospitalised preterm neonates <32 weeks of gestational age at birth and <10 days of life was conducted in four level III NICUs in Canada.

The development and validation of a conceptual definition of avoidable transitions from long-term care to the emergency department: A mixed methods study.

Background/objectives: Transitions to and from Emergency Departments (EDs) can be detrimental to long-term care (LTC) residents and burden the healthcare system. While reducing avoidable transfers is imperative, various terms are used interchangeably including inappropriate, preventable, or unnecessary transitions. Our study objectives were to develop a conceptual definition of avoidable LTC-ED transitions and to verify the level of stakeholder agreement with this definition.

How context links to best practice use in long-term care homes: a mixed methods study.

Background: Context (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) homes are understudied. This study used an innovative approach to investigate how context elements interrelate and influence best practice use by LTC care aides.

Evaluating Real-World Implementation of INFORM (Improving Nursing Home Care through Feedback on Performance Data): An Improvement Initiative in Canadian Nursing Homes.

Background: INFORM (Improving Nursing Home Care through Feedback on Performance Data) was a research intervention that equipped nursing home managers with skills to conduct local improvement projects and supported them in improving performance through modifiable elements in their units. Prior reports have found positive and sustained outcomes from INFORM intervention. In this article, the authors report findings from a formative service evaluation of INFORM as modified for implementation in real-world settings.

Excess Deaths in Assisted Living and Nursing Homes during the COVID-19 Pandemic in Alberta, Canada.

Objectives: Assisted living (AL) is a significant and growing congregate care option for vulnerable older adults designed to reduce the use of nursing homes (NHs). However, work on excess mortality in congregate care during the COVID-19 pandemic has primarily focused on NHs with only a few US studies examining AL. The objective of this study was to assess excess mortality among AL and NH residents with and without dementia or significant cognitive impairment in Alberta, Canada, during the first 2 years of the COVID-19 pandemic, relative to the 3 years before.

Contextually appropriate nurse staffing models: a realist review protocol.

Introduction: Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from all Registered Nurse workforce to a mix of differentially educated nurses and aides (regulated and unregulated), such as Licensed Practical or Vocational Nurses and Health Care Aides. Systematic reviews have examined relationships between specific nurse staffing models and client, staff and health system outcomes (eg, mortality, adverse events, retention, healthcare costs), with inconclusive or contradictory results.

The Association of Nursing Homes' Organizational Context With Care Aide Empowerment: A Cross-Sectional Study.

Background And Objectives: Organizational context is thought to influence whether care aides feel empowered, but we lack empirical evidence in the nursing home sector. Our objective was to examine the association of features of nursing homes' unit organizational context with care aides' psychological empowerment.

Research Design And Methods: This cross-sectional study analyzed survey data from 3765 care aides in 91 Western Canadian nursing homes.

Organizational Context and Facilitation Interactions on Delirium Risk in Long-Term Care: A Cross-Sectional Study.

Objectives: Organizational context (eg, leadership) and facilitation (eg, coaching behaviors) are thought to interact and influence staff best practices in long-term care (LTC), including the management of delirium. Our objective was to assess if organizational context and facilitation-individually, and their interactions-were associated with delirium in LTC.

Design: Retrospective cross-sectional analysis of secondary data.

Towards equitable representation in long-term residential care: widening the circle to ensure "essential voices" in research teams.

The COVID-19 pandemic exposed long-standing inequities in Canada's long-term residential care (LTRC) sector with life-threatening consequences. People from marginalized groups are overrepresented among those who live in, and work in LTRC facilities, yet their voices are generally silenced in LTRC research. Concerns about these silenced voices have sparked debate around ways to change LTRC policy to better address long-standing inequities and enhance the conditions that foster dignity for those who live and work in LTRC.

A longitudinal observational study on the epidemiology of painful procedures and sucrose administration in hospitalized preterm neonates.

Although sucrose is widely administered to hospitalized infants for single painful procedures, total sucrose volume during the entire neonatal intensive care unit (NICU) stay and associated adverse events are unknown. In a longitudinal observation study, we aimed to quantify and contextualize sucrose administration during the NICU stay. Specifically, we investigated the frequency, nature, and severity of painful procedures; proportion of procedures where neonates received sucrose; total volume of sucrose administered for painful procedures; and incidence and type of adverse events.

Building a communication and support network among quality improvement teams in nursing homes: a longitudinal study of the SCOPE trial.

Background: We applied a longitudinal network analysis approach to assess the formation of knowledge sharing and collaboration networks among care aide-led quality improvement (QI) teams in Canadian nursing homes participating in the Safer Care for Older Persons (in residential) Environments (SCOPE) trial which aimed to support unregulated front-line staff to lead unit-based quality improvement (QI) teams in nursing homes. We hypothesized that SCOPE's communicative and participatory nature would provide opportunities for peer support, knowledge sharing, and collaboration building among teams.

Methods: Fourteen QI teams in Alberta (AB) and seventeen QI teams in British Columbia (BC) participated in the study.

Counting what counts: assessing quality of life and its social determinants among nursing home residents with dementia.

Background: Maximizing quality of life (QoL) is a major goal of care for people with dementia in nursing homes (NHs). Social determinants are critical for residents' QoL. However, similar to the United States and other countries, most Canadian NHs routinely monitor and publicly report quality of care, but not resident QoL and its social determinants.