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Capacity building and resilience for the community-based dementia care workforce


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Elliott, KEJ 2012 , 'Capacity building and resilience for the community-based dementia care workforce', PhD thesis, University of Tasmania.

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Projected increases in dementia prevalence worldwide have focused
attention on the need to build capacity to support the workforce in order to avert
formal care shortages. Dementia care is characterised by a low qualified
workforce with low levels of recruitment and retention. The thesis expands the
view of workforce capacity building, from a focus on knowledge and skills, to
include adjustment to work roles and coping in the face of high job demands. This
approach will inform the design of effective interventions and quality of training
to develop and retain dementia care workers. Understanding aspects of worker
resilience will help define ways to enhance the capacity of workers with low
The series of studies explored different aspects of capacity building,
applying theories from organisational, clinical and social psychology to offer a
multi-disciplinary approach. The job-demands and resources model, self-efficacy
and communion were concepts applied to the experience of community-based
dementia care workers. Study One compared the effectiveness of dementia training
interventions for both workforce and organisational climate variables, in a
systematic review of the most rigorous research. Study Two used a mixed
methods design and described community-based dementia care workers’ resilience
and vocational experiences. Workers’ job roles, training, employer agenda,
organisational support and commitment to work were investigated. While Study
Two examined the workforce, Study Three explored informal dementia carers’
experience of present and future community-based service delivery, and followed
a mixed methods design. The findings informed recommendations for service
providers to improve capacity for workers and organisations.
Collectively, the results identified variables relevant for capacity building
intervention research and health service delivery. There was a consensus between
paid workers and informal carers that improvements in community dementia
awareness, workforce, and organisational systems would reform future dementia
care services. Specifically, dementia knowledge and stress management were
areas consistently identified as ways to improve worker skills and capabilities.
Whereas, organisational factors such as, better employment conditions,
collaboration, and quality supervision were identified to improve worker
commitment and performance. Intrapersonal factors that formed a resilient profile
of adjustment were found to be essential for coping with high job demands at
work. A sense of belonging based in social connectedness at work typified this
experience and was proposed as a core construct, called occupational communion.
A conceptual model was presented where occupational communion mediated the
effects of job demands on capacity building and resilience.
The thesis expanded the view of capacity building to include both
intrapersonal coping and organisational factors to enhance worker development and
resilience. In this way, the findings of the thesis offer a significant contribution to
workforce capacity building for health and dementia care services. Future health
care practice that recognises and aims to enhance occupational communion is
needed, in order to attract and retain workers, and improve care for people with

Item Type: Thesis - PhD
Authors/Creators:Elliott, KEJ
Keywords: capacity building, clinical psychology, dementia care, organisational psychology, resilience, social psychology, work force
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Copyright 2012 the Author

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