Cole, Rosalind; (1998) The effect of challenging behaviour, and staff support, on the psychological well-being of staff working with older adults with dementia. Doctoral thesis (D.Clin.Psy.), UCL (University College London).

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Abstract

This study aimed to investigate the range and prevalence of challenging behaviour found in residents with dementia, and to compare them with physically frail residents living in nursing homes. The study also aimed to investigate the relationship between levels of challenging behaviour in residents, the degree of staff support, and the psychological welleing of staff. Seven residential homes took part in the study, four mental health settings and three nursing homes, and 96 staff completed questionnaires. Twenty-eight separate behaviours were measured, and many occurred more frequently in the dementia group than the control group. The most common behaviours recorded in all settings included lack of motivation and lack of occupation. Staff ratings of how frequently a behaviour occurred, and how difficult it was to manage, were highly correlated. Behaviours which had an aggressive component, or were loud and disruptive tended to be cited as most personally distressing by staff, whereas least distressing behaviours usually had a minimal impact upon the surrounding environment. The challenging behaviour of residents elicited a variety of emotions in staff, most commonly feeling upset or angry. Staff in the mental health settings had a higher level of perceived staff support than those working in the nursing home settings. Psychological well-being in staff was found to be highly correlated to the degree of staff support perceived by staff. However psychological well-being was not related to levels of resident challenging behaviour.

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