An environmental scan of equity-related measures for the certified nursing assistant dementia care workforce

IF 4.9 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2024-11-30 DOI:10.1002/trc2.70012

Jasmine L. Travers, Shivani Shenoy, Julia Tague-LaCrone, Hillary Leger

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Abstract

INTRODUCTION

Certified nursing assistants (CNAs) constitute the largest segment of the nursing home workforce, with over 50% of the dementia care workforce comprised of racial and ethnic minoritized individuals. Despite their critical role in dementia care, CNAs face significant inequities in terms of salary, treatment, and working conditions. To enhance equity and improve working conditions, valid and reliable measures are essential for nursing homes to assess their current environment, track progress, and refine strategies. This paper synthesizes existing measures and tools that assess equity-related constructs among CNAs.

METHODS

We conducted an environmental scan to identify existing measures, tools, and instruments assessing equity-related constructs among CNAs in nursing homes. Our search focused on nine key equity-related constructs: training, job satisfaction, compensation, staffing/workload, burnout, working conditions/environment, role, leadership, and turnover.

RESULTS

Our environmental scan resulted in 15 measures, tools, or instruments relevant to CNA equity. These instruments focused on job satisfaction, retention and turnover, job commitment, leadership experiences, and work environment. Sixty percent of these tools lacked reported validity or reliability data. While the remaining 40% demonstrated strong psychometric properties, overall, the methodological rigor of available measures is inconsistent. A critical gap in the existing literature is the absence of tools measuring burnout or workload, among CNAs.

DISCUSSION

The identified measures/tools offer potential for evaluating the effectiveness of interventions addressing CNA equity. However, it is imperative to establish the validity and reliability of these instruments across diverse populations, particularly among racial and ethnic minoritized groups, and develop or adapt tools that measure burnout and workload for CNAs. Furthermore, a deeper understanding of the underlying mechanisms driving these inequities through qualitative data is crucial for developing targeted and impactful interventions.

Highlights

Measuring equity among CNAs is important to evaluate strategies intended to improve equity.
The identified tools enable assessment of how CNAs feel about important constructs that are related to equity.
We found no tools that comprehensively measured workload or burnout experienced by CNAs.

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环境扫描的权益相关措施的认证护理助理痴呆症护理工作人员

注册护理助理（CNAs）是养老院劳动力中最大的一部分，超过50%的痴呆症护理劳动力由种族和少数民族个人组成。尽管他们在痴呆症护理中发挥着关键作用，但CNAs在工资、待遇和工作条件方面面临着严重的不平等。为了加强公平和改善工作条件，有效和可靠的措施对养老院评估其当前环境、跟踪进展和完善战略至关重要。本文综合了评估cna之间股权相关结构的现有措施和工具。方法：我们进行了一项环境扫描，以确定现有的措施、工具和工具，评估疗养院中cna的股权相关结构。我们的研究集中在九个与股权相关的关键要素上：培训、工作满意度、薪酬、人员配置/工作量、倦怠、工作条件/环境、角色、领导力和人员流失率。结果：我们的环境扫描产生了15种与CNA公平相关的测量、工具或仪器。这些工具主要关注工作满意度、留任和离职率、工作承诺、领导经验和工作环境。这些工具中有60%缺乏报告的有效性或可靠性数据。虽然其余40%表现出强烈的心理测量特性，但总体而言，可用测量方法的严谨性是不一致的。现有文献中的一个关键差距是缺乏测量cna中职业倦怠或工作量的工具。已确定的措施/工具为评估解决CNA公平问题的干预措施的有效性提供了潜力。然而，必须在不同的人群中建立这些工具的有效性和可靠性，特别是在种族和少数民族群体中，并开发或调整测量cna的倦怠和工作量的工具。此外，通过定性数据更深入地了解导致这些不平等的潜在机制，对于制定有针对性和有影响力的干预措施至关重要。衡量cna之间的公平对于评估旨在改善公平的战略非常重要。所确定的工具可以评估cna对与公平相关的重要结构的感受。我们发现没有工具可以全面测量cna的工作量或倦怠。

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来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.