Exploring the everyday care practices of healthcare support workers when working with people with dementia admitted to National Health Service hospital wards in the United Kingdom: a qualitative systematic review of the literature.

Objectives: This review analyses and thematically structures the literature exploring the everyday care practices of healthcare support workers (HCSWs) based on hospital wards caring for patients with dementia in the National Health Service in the United Kingdom. Understanding the experiences of this staff group can enhance education, research, and practice initiatives, which in turn supports high-quality dementia care.

Method: In February 2024, we searched a range of databases: PsycINFO, EMBASE, Medline, CINAHL, British Nursing Index, AMED and ASSIA, to identify qualitative and mixed methods papers exploring HCSW's care practices. We extracted and tabulated: research focus, methods of data collection and analysis, themes, findings, and all quotes attributed to HCSWs. The CASP tool was used for quality appraisal. We analysed the data following guidance for the thematic synthesis of qualitative research in systematic reviews to generate overarching themes.

Results: We uncovered 19 papers, and our thematic analysis generated four themes: i) roles and responsibilities, ii) training and teamwork, iii) practicing and reflecting, and iv) always being front and centre.

Conclusion: Our themes are consistent with the literature exploring HCSW practice generally, including the challenges, skills and dedication to their craft demonstrated by this staff group. However, the nature of working with patients with dementia with behaviours that challenge is a more prominent issue within this data compared to the generic HCSW literature. This includes the need to recognise the complexity of bodywork and the interactional skills required when supporting activities of daily living in the context of behaviour change.