Using the Theoretical Framework of Acceptability to understand the acceptability of e-training for nurse led prevention of unwanted sexual behaviour in Australia’s residential aged care services

Abstract

Objective: The aim of this study was to evaluate the acceptability of one specific e-training (intervention) for prevention of unwanted sexual behaviour in Australia’s residential aged care services using the Theoretical Framework of Acceptability. Background: Aged care staff are of fundamental importance in unwanted sexual behaviour incident management and prevention. The research team developed and implemented an evidence-informed intervention designed to increase awareness, promote collaborative practice, and improve prevention and management of such incidents in aged care. Current acceptability of training on this topic is yet to be studied despite it being recognised as a key factor for successful implementation and translation into practice. Study design and methods: This is a qualitative, cross-sectional study employing semi-structured telephone interviews with actively working enrolled and registered aged care nurses who had completed the intervention. Acceptability of the intervention was measured with the Theoretical Framework of Acceptability. Of the 36 participants that signed the consent form, 18 completed interviews. One participant was excluded from analysis as they did not complete all modules of the intervention. Results: Analysis revealed favourable evaluation in all seven domains of the Theoretical Framework of Acceptability, finding high acceptability of the intervention amongst all participants. The intervention aligned with participant’s values and the content was perceived to fill a knowledge gap. This is showcased in participants unanimous belief that it would be helpful for all front-line aged care staff to receive the intervention frequently. Although participants showcased high acceptability of the intervention, participants recommended that sexuality content be included before detailing unwanted sexual behaviour, and that this content inclusion may increase awareness and understanding of unwanted sexual behaviour. Conclusion: Participants reported this e-training to be highly acceptable. They believed it has potential to improve attitudes and awareness of incidents in aged care. However, favourable results may reflect a personal interest with the topic, for example, the content aligned with their personal values, experience, and beliefs. More research is needed to understand both the acceptability and the efficacy of the training short and long-term. Implications for research, policy, and practice: This study indicates that larger scale national staff training on this topic is possible and considered necessary by the sample. Future national policy should explore the inclusion of this topic in the curriculum standards. Future research should focus on evaluating the efficacy of the training in changing attitudes, awareness and influencing professional practice. What is already known about the topic? Known prevalence of unwanted sexual behaviour in aged care suggests most nursing staff will be required, at some stage, to provide care to a resident who has been a target, or exhibitor of unwanted sexual behaviour. Previous studies of this pilot intervention indicate that it provides a useful model and curriculum of specific topics to guide development of training on unwanted sexual behaviour initiatives nationally and internationally. Acceptability of healthcare interventions is a critical measure in facilitating their implementation and in this instance, capacity of the aged care workforce to be trained on unwanted sexual behaviour. What this paper adds E-training about prevention of unwanted sexual behaviour is acceptable to aged care nurses. E-training filled an existing program gap in education provision and addressed current staff knowledge deficits that aged care nurses perceived as important for better resident care and reducing work related stress. Lack of prior learning about intimacy and sexuality hampered optimal learning about prevention of unwanted sexual behaviour.