International Psychogeriatrics

Review Article

A systematic review of stress in staff caring for people with dementia living in 24-hour care settings

Catherine Pitfielda1 c1, Khodayar Shahriyarmolkia1 and Gill Livingstona1

a1 Department of Mental Health Sciences, University College London, U.K.

ABSTRACT

Background: Family carers of people with dementia are at risk of psychological morbidity, and it is suggested that this may also be the case in paid carers as caring for people with dementia can be emotionally and physically demanding. Care homes have historically had difficulty recruiting and retaining staff, and job stress has previously been linked to high turnover amongst long-term care staff. We performed a systematic review of studies of the prevalence of psychological stress in staff caring for people with dementia in residential long-term care settings.

Methods: We conducted a comprehensive literature search of MEDLINE, PsychINFO and Web of Science databases up to May 2009, supplemented by a search of the references of all relevant articles. Search terms encompassed nursing staff, residential care and psychological distress. Validity of studies was graded by two authors independently using a standardized checklist.

Results: We identified 601 studies of which five met our inclusion criteria. Two studies reported on prevalence rates of staff distress and found 37% and 5% levels of being “at risk” from burnout, four studies reported mean stress scores and all were low.

Conclusions: All studies were either small or used instruments with unsatisfactory psychometric properties and so our conclusions are limited by the lack of good quality evidence. The preliminary evidence suggests that most staff who remain working in homes do not have a high prevalence of psychological stress or level of symptoms.

(Received January 11 2010)

(Revised February 16 2010)

(Revised March 04 2010)

(Accepted March 09 2010)

(Online publication May 18 2010)

Correspondence:

c1 Correspondence should be addressed to: Catherine Pitfield, Department of Mental Health Sciences, UCL, Holborn Union Building, Archway Campus, Highgate Hill, London N19 5NL, U.K. Phone: +44 020 7288 3552; Fax: +44 020 7288 3411. Email: c.pitfield@ucl.ac.uk.