Shortage Of Care Workers Research Articles

Changes in Technology Acceptance of Smart Care Beds Among Long-Term Care Workers in Korea.

This study investigates the changing perceptions of Korean care workers regarding a robotic bed designed to assist with repositioning and prevent pressure ulcers. With the primary aim of assessing the technology acceptance among care workers using the robotic bed to solve the problem of a shortage of care workers in Korea, we sought to examine the possibility of applying care robots in the field. A total of 20 long-term care workers participated in the experiment, and their attitudes were measured before and after using the robot. Frequency analysis and paired t-tests were conducted using Stata 17 to analyze the data. The results show significant changes in the perceived ease of use (PEOU), facilitating conditions (FCs), and gerontology anxiety (GA), with the PEOU increasing by 19.87%, FC increasing by 20.63%, and GA decreasing by 17.2%. However, there was no significant change in the perceived usefulness (PU) and intention to use (IU). The results showing that the perception of technology acceptance changed significantly mean that the use of the care robot means that there is a high possibility of positive perceptions in Korean care settings when care robots are distributed in the field in the future, considering that the experimental environment was limited due to the early stage of development of care robots. This study highlights the need for practical demonstrations and thorough training to improve technology acceptance among care workers before the application of care technology in the long-term care environment in South Korea.

“I Figured It Might Be Because We Are Rural”: A Qualitative Study of Barriers and Opportunities Related to Home-Based Personal Assistance Services

Personal care assistance (PCA) provides vital support so rural disabled people and older adults can live in their communities. Currently, the state of home and community-based services in the United States is dire, with major shortfalls in access and utilization of these services. Moreover, little is known about the experiences of people living in rural areas who need paid, in-home assistance with activities of daily living. Because rural areas are often underserved and under-resourced, this study aimed to understand the experiences of rural users of personal care assistance services to inform the development of a training for rural people. Between February and November of 2021, 38 semi-structured qualitative interviews were conducted with 40 self-identified rural-dwelling people across the United States who use paid PCAs. Interview topics included finding, hiring, and training workers; worker qualities; and how living in a rural place impacted PCA services. Using thematic coding, results highlight how rurality intersected with participants’ daily experiences. Respondents identified 3 barriers to getting PCA services: (1) lack of transportation and travel distance, (2) worker shortages, and (3) fewer local community services; and one facilitator of obtaining PCA services: strong community connection. Additionally, some aspects of rural culture—such as valuing a slower pace of life, independence, and rugged individualism—presented both barriers and opportunities for rural PCA recipients. As the home care worker shortage crisis in the United States is expected to worsen in coming decades, rural people needing PCA services face unique circumstances related to place and culture.

Immigrants are crucial to U.S. Health System Resilience

A polycrisis of climate and non-climate related shocks and stresses are straining U.S. health systems and affecting mental health. In contrast to negative rhetoric surrounding immigrants and immigration, immigrants make contributions that are fundamental to ensuring health system resilience. As in many other countries, in the United States foreign born compensate for health care worker shortages; help subsidize health programs with their labor; and support response, recovery, and rebuilding following disaster. However, immigrants are often trapped in political inflammatory narratives and public’s clashing sentiments. To harness the power of immigrants’ contributions in facilitating health system resilience, policies that help pair the pool of global talent with the needs of America’s public health systems are needed. This may require redressing harmful policies that reduce participation on the labor pool and crafting more humane policies that encourage migration. Doing so may result in a stronger health system better able to weather converging crises.

Engaging Community Health Workers (CHWs) in Africa: Lessons from the Canadian Red Cross supported programs.

Universal Health Coverage (UHC) will not be achieved if health care worker shortages, estimated to increase to 18 million by 2030, are not addressed rapidly. Community-based health systems, which pivot to effective engagement of community health workers (CHW), may have an essential role in linking communities with health care facilities and reducing unmet health services needs caused by these shortages. The Canadian Red Cross (CRC) has partnered with different National Red Cross/Red Crescent Societies and Ministries of Health in Africa in the implementation of programs where CHWs contributed to the provision of various health services. This study reports on key findings (i.e., beneficiaries reached, CHWs engaged, programs implemented, intervention outcomes) and lessons learned from CRC supported CHW programs in Africa over the last 15 years (2007-2022). Qualitative methodology was employed to conduct document analysis on 17 sets of reports from each CRC-supported community health worker project in Africa over the past 15 years. Focus was on identifying challenges, facilitators, and lessons learned. CRC supported projects have trained over 9000 CHWs, benefiting nearly 7.5 million people across Africa. Key success factors include adaptability and agility in programming and project management, and considering contextual factors (political, social, and cultural systems). Investing in essential training for CHWs, staff, and volunteers is crucial, alongside employing an evidence-based approach to inform all aspects of programming and implementation. Additionally, projects prioritizing protection, gender and inclusion (PGI) while leveraging existing community structures and partnerships important for successful implementation. Despite challenges (i.e., weak health systems, lack of political commitment, insufficient funding, inadequate training) CHWs are recognized as crucial in promoting community-based health, improving access to care, addressing disparities, and contributing to achieving (UHC). Their unique position within communities enables them to provide culturally appropriate and localized primary health care- particularly in remote, resource limited and poverty-stricken regions.

VALUING AND SUPPORTING THE INVISIBLE WORKFORCE OF FAMILY CAREGIVERS

Abstract The 2023 update to the Valuing the Invaluable series estimates the economic value of unpaid, family caregiving in America was $600 billion in 2021. This estimate continues a 25-year trend of increasing economic value for family caregiving, which fills an essential role in the fractured LTSS system. This work also details the diversity of family caregivers and their care experiences, the challenges that caregivers face juggling care with work and child care, and the impact of direct care worker shortages on family caregivers. This symposium showcases the national and state estimates of the economic value of caregiving, details who caregivers are today, what challenges they face, and what policies and practices can support and recognize them and the vital care they provide. Presenter 1 shares an overview of the methodology used in this report and the national and state estimates of the economic value of caregiving. Presenter 2 discusses the increasing generational, racial and ethnic, and sexual identity and orientation diversity of family caregivers today and the challenges specific to different communities of caregivers. Presenter 3 highlights promising policies and practices to support caregivers and details recommendations for building on those promising policies and practices. This is a Family Caregiving Interest Group Sponsored Symposium.

Human-robot interactions with an autonomous health screening robot in long-term care settings

Socially assistive robots are increasingly being considered to help address the shortage of care workers in long-term care, which has been further exacerbated by the COVID-19 pandemic. In this paper, we present the first human-robot interaction study with care staff and an autonomous screening socially assistive robot in a long-term care facility. We assessed: (1) overall perceptions, experiences and attitudes of care staff prior to and after interacting with the robot, and (2) perceived workload and usability of the robot by administrators and management staff. Results show staff had overall high ratings of the robot, with a statistically significant increase identified for cognitive attitude towards the robot after interaction. Furthermore, we found that overall, perceived workload was moderately low as defined by the NASA Task Load Index while using the robot screener, and the usability rating of the robot was rated between OK and Good by the System Usability Scale. Personalization of the robot was found to be an important factor for usability. Staff enjoyed using the robot and had high willingness to frequently use it. In general, our robot study motivates the application of autonomous socially assistive robots from the staff perspective for repetitive tasks in long-term care homes.

9.N. Workshop: How to solve shortages and uneven distribution of health workers in Europe?

Abstract Background Europe's health workforce is under extreme pressure. The increasing challenge of an uneven distribution of health workers within countries is amplified by a structural problem of shortages, inappropriate skill mix, inadequate working conditions and ageing of health workers. In this workshop the results from five research projects, ROUTE-HWF, OASES, AHEAD, TASHI and METEOR (joined in the EU Health Workforce project cluster) will be presented. The ROUTE-HWF, OASES and AHEAD projects focus on the uneven distribution of health workers resulting in ‘medical deserts’, while the TASHI project focusses on task shifting and METEOR on the retention of health workers. In this workshop it will become clear which lessons can be learned from the five projects and how they complement each other. How should retention and task shifting policies be implemented locally, and can they mitigate the uneven distributions of health workers? And vice versa, how should retention and task shifting policies by customized in different types of medical deserts? By combining the five projects into one workshop their links and added values will be made clear. While all projects are based on cross-national comparisons and aim to improve health workforce policy by in-depth research, they also differ and complement approaches to overcome the pressing struggles of the current health workforce. Aims and Objectives The aim of this workshop is to present the key findings of the different projects, focusing on the need for different solutions for countries to mitigate structural problems of health workers. Workshop format This will be a regular workshop. During the workshop, all five projects will shortly present their key results and after each there will be room for discussion. At the end of the workshop there will be room to discuss the complementarity of the five projects, and how they jointly provide an overview of policy options to mitigate structural problems related to medical deserts, task shifting and retention of health workers. Key messages • The workshop will give insight into the specific problems of medical deserts and the possible approaches with regard to retention and task shifting policies. • The workshop will give insight into the need for customizing policy solutions to attach the complex problem of health care worker shortages and regional disparities.

Digital interventions for people with dementia and carers: effective, cost-effectiveand equitable?

Digital interventions for people with dementia and carers: effective, cost-effectiveand equitable?

A comparative perspective on long‐term care systems

AbstractThis article investigates the challenges of ageing for long‐term care. The analysis proceeds in three steps. In the first step, we estimate the prospective care demand for 30 developed countries based on projected ageing and disabilities among the elderly. In the second step, we outline challenges for care systems with respect to shortages of care workers, increasing skill requirements for care workers, barriers to universal and equitable access to care, and cost containment subject to adequate care quality. In the third step, we identify solutions for these challenges by comparing the care systems of Germany, Israel, Japan, the Republic of Korea and the Netherlands.

Governance of Assisted Living in Singapore: Lessons for Aging Countries.

A global trend toward aging populations means that the challenge of providing adequate long-term care to older people looms large in many countries. In Singapore, a public discourse revolving around the expansion of assisted living to create age-friendly environments in long-term care has emerged. This study examines Singapore's experience in developing regulations for assisted living by documenting the different levels of regulation in place and by identifying the regulatory gaps remaining to govern assisted living. Anchoring in a conceptual framework on the governance of assisted living, different regulatory components of assisted living at the micro-, meso-, and macro-levels are analyzed. Using a case study method, primary and secondary data examining the experiences of governing and implementing assisted living in Singapore were collected. Analysis was conducted using a thematic analysis approach. Micro- and some macro-level regulations, which include admission assessment, staffing, and infrastructural requirements for assisted living, are maturing and evolving, while meso-level regulations, such as operational management, the monitoring framework, and stipulations for training requirements for staff, remain a work-in-progress in Singapore. The regulations for assisted living are currently primarily guided by soft laws, such as practice guidelines; the government has committed toward enacting permanent regulations for all long-term care facilities with the phased implementation of the Health Care Services Act from 2021 to 2023. We conclude that assisted living, despite the early stage of its development in Singapore, is a viable care model that should be expanded to meet the rising demand for care on the part of a majority of older people, who fall in the middle of the care continuum (that is, they can neither live independently nor need complete institutionalization). We also propose five policy recommendations for all aging countries to strengthen the governance of assisted living in long-term care. These include establishing (i) clear provisions on care quality assessment and the redress of grievance, (ii) minimum standards of care, (iii) differential regulations for assisted living, (iv) routine care assessment, and, (v) applying technology in assisted living facilities to address a shortage of care workers.

Research on an Anomaly Detection Method for Physical Condition Change of Elderly People in Care Facilities

Currently, the shortage of care workers for the elderly has become a big problem, and more streamlined care operations are needed. In care facilities, care workers are required to use their subjective experience to detect anomalies in physical condition of care receivers, including serious or insignificant deterioration or behavioral and psychological symptoms of dementia, which can decrease the work efficiency. Therefore, we aim to create a model using objective data for detecting anomalies in physical condition. In this study, data from 13 subjects in a care facility were collected, and isolation forest models were constructed for each subject. The subject's anomalies in physical condition were documented in a care record by a nurse and used as reference for model evaluation. Recall and specificity were used to evaluate the model, expressed as the percentage of detection success for abnormal or normal conditions. Data collected for 1 to 60 days were used to train the isolation models, and the relationship between the amount of training data and model performance was simulated. Heart rate, respiratory rate, and time of getting out of bed were collected from a sensor placed on the subject's bed and used as the model features. In addition, dietary intake information was collected from the care record. Analysis of the evaluation results showed recall and specificity of 45.6 ± 46.7% and 83.88 ± 6.06%, respectively, for the model constructed using training data of 60 days. For future studies, we will continue to collect data and increase the number of participants to improve the robustness and accuracy of the proposed anomaly detection system.

11 IMPROVING CARE QUALITY IN A NURSING HOME IN JAPAN: ORGANISATIONAL RESILIENCE, ROBOTICS-AIDED CARE AND SYSTEMS APPROACH

Abstract Background As one of the most rapidly ageing economies, Japan is currently faced with a shortage of care workers and relatively low intakes of migrant workers. While there is a shortage of health and social care professionals, the retention of professional staff is paradoxically becoming more difficult. The environment in domiciliary care is often associated with heavy and challenging workload. Robotics-aided care has been proposed in Japan to ameliorate the situation. While some positive effects of such a novel care model have been reported, the mechanism by which the technology-driven system improved care and residents’ quality of life remains unclear. Methods Using a case study approach, this paper examines one of the nursing homes in Japan where robotics-aided care was introduced. The organisational mechanism was analysed through documents and semi-structured staff interviews from the perspective of safety science. The key attributes of organisational resilience are: anticipating; responding; monitoring and learning. The paper details some of the tools that predated the introduction of the socially assistive robots and monitoring system in the care home. The interviews were conducted with 16 health and social care professionals. Results The results of the technological intervention itself demonstrated improved scores for the quality of life among the residents. However, the subsequent interview data highlight the significance of an organisational context in which technologies can be effectively introduced and implemented in nursing homes. The organisation had several well-trained care professionals, including the leaders, who share the mental map of ‘person-centred care’ and the ‘capability approach’. In addition, some tools were used to ‘visualise’ staff practice. Health and social care professionals pointed out some challenges surrounding the human-technology interface. Conclusion In order to understand the effectiveness and potential issues of the ICT robotics solution in care for older people, future research should investigate the human-technology interface and the interconnectedness between work system, care processes and outcomes.

Classification of Care Assistive Technology Based on the Relationship Between Users and Technologies

While an aging population in Japan and other countries is resulting in an increased demand for nursing care services, there is a shortage of care workers due to a decrease in the working population. The use of care assistive technologies such as robots, artificial intelligence, and information technology is expected to compensate for this shortage, and many care assistive technologies such as power assist devices and communication robots have been developed. However, their introduction and widespread use in actual service have not progressed. The aim of this study is to address the problem on less technology introduction in nursing care by surveying the attitudes of potential users to care assistive technologies, clarify the factors affecting the use of such technologies, and propose a new design method for the technologies. We surveyed attitudes to the use of care assistive technology from the perspective of function and information utilization for three groups: active seniors, informal carers, and formal carers. The survey was conducted in Japan and Finland, which have high aging populations. Based on the survey results, we proposed, as a design method, a classification of care assistive technologies according to their interaction with users as well as the nursing care process.

Comparing public funding approaches to the development and commercialization of care robots in the European Union and Japan

Faced with ageing populations, escalating care needs, and growing shortages of care workers, Japanese and EU governments have pursued large, publicly-funded research projects to develop and commercialize care robots. Yet despite their global leadership in this field, Japan and the EU have rarely been compared directly in studies of care robotics. This paper explores similarities in their approaches to the public funding and planning of care robot development, commercialization, and implementation since the late 1990s, and what the differences reveal about their contrasting priorities in science, technology, and innovation policy, as well as differential treatment of care robotics as an industry and as a research domain. I conclude by arguing for the importance of studying such funding mechanisms and institutional actors to better understand their key role in shaping the emergent landscape of care robotics.

Care Worker Shortage and the Regional Characteristics of Foreign Candidate Acceptance for Certified Care Workers in Japan

Care Worker Shortage and the Regional Characteristics of Foreign Candidate Acceptance for Certified Care Workers in Japan

Rural Employment of Health Care Workers: A Longitudinal Cohort Study.

Preserving and increasing the health care workforce in rural areas has become imperative due to the shortage of health care workers serving rural populations. However, limited data are available on long-term patterns of employment in rural settings among health care workers. We analyzed the National Longitudinal Survey of Youth, which enrolled a nationally representative sample of adolescents in 1979 and tracked their career outcomes through 2016. Using the US Census Bureau occupation codes, we identified participants who worked in health care occupations, and we classified their employment in rural versus urban areas. Of the 1,007 respondents (including 109 doctoral health professionals), 70% worked only in urban locations, 13% worked only in rural locations, and 17% worked in both rural and urban locations during their health care career. Rural upbringing, White race, and female gender were associated with rural employment. Among nondoctoral health professionals, lower educational attainment was associated with increased likelihood of working only in rural settings. Our study indicates the rural workforce is split between workers who are only employed in rural settings, and those who are intermittently employed in rural and urban settings. Therefore, retention of health care workers in rural settings and recruitment of workers from urban settings to practice in rural areas are important strategies for addressing the rural health care worker shortage. Rural upbringing, previously described as predictive of physician practice in rural locations, appears the strongest predictor of rural employment for both doctoral health professionals and nondoctoral health professionals.

Professional Doctorate in Clinical Exercise Physiology

Professional Doctorate in Clinical Exercise Physiology

The contribution of the immigrant population to the U.S. long-term care workforce.

The long-term care (LTC) sector will soon face a shortage of care workers. The consequences are potentially dramatic, urging the need to design policies aiming at reducing the turnover rate of LTC workers. Immigrant workers are an important part of the LTC workforce. Pooling data from the Annual Social and Economic (ASEC) supplement to the Current Population Survey (CPS) for years 2003-2019, we compare US-born and immigrant LTC workers' propensity to stay in the LTC workforce over one year. We distinguish two categories of LTC workers: personal care workers and nurses. We show that for both categories, naturalized citizens, legal noncitizen immigrants, and unauthorized immigrants have a higher probability of staying in the LTC workforce compared to US-born citizens. We provide two potential explanations: we show that immigrant personal care workers are more likely to report a better health, and that immigrant nurses have a lower wage variation sensitivity. Our results also suggest that wage increases are likely to be associated with higher retention rates in the profession.

Identifying Barriers to Organizational Identification among Low-Status, Remote Healthcare Workers

ABSTRACT When employees have strong identification with an organization, they are more likely to remain working there and to make decisions that are in the best interest of the organization. This can be important when employees work remotely and have little contact with the organization. Through analyzing interviews with low status, remote-working home health aides and their supervisors, this study identifies barriers to identification that the aides face. Findings suggest that these barriers include the aides’ limited interaction with supervisors and other aides; their close relationship with clients; their lack of status and respect within the organization; and financial incentives to take a second job. Finding ways to increase identification among direct care workers could contribute to finding solutions to the U.S. direct care worker shortage.

Reducing Provider Workload While Preserving Patient Safety: A Randomized Control Trial Using 2-Way Texting for Postoperative Follow-up in Zimbabwe's Voluntary Medical Male Circumcision Program.

Voluntary medical male circumcisions (MCs) are safe: the majority of men heal without complication. However, guidelines require multiple follow-up visits. In Zimbabwe, where there is high mobile phone ownership, severe health care worker shortages, and rapid MC scale up intersect, we tested a 2-way texting (2wT) intervention to reduce provider workload while safeguarding patient safety. Two high-volume facilities providing MC near Harare, Zimbabwe. A prospective, unblinded, noninferiority, randomized control trial of 722 adult MC clients with cell phones randomized 1:1. 2wT clients (n = 362) responded to a daily text with in-person follow-up only if desired or an adverse event (AE) was suspected. The control group (n = 359) received routine in-person visits. All men were asked to return on postoperative day 14 for review. AEs at ≤day 14 visit and the number of in-person visits were compared between the groups. Cumulative AEs were identified in 0.84% [95% confidence interval (CI): 0.28 to 2.43] among routine care men as compared with 1.88% (95% CI: 0.86 to 4.03) of 2wT participants. Noninferiority cannot be ruled out (95% CI: -∞ to +2.72); however, AE rates did not differ between the groups (P = 0.32). 2wT men attended an average of 0.30 visits as compared with 1.69 visits among routine care men, a significant reduction (P < 0.001). Although noninferiority cannot be demonstrated, increased AEs in the 2wT arm likely reflect improved AE ascertainment. 2wT serves as a proxy for active surveillance, improving the quality of MC patient care. 2wT also reduced provider workload. 2wT provides an option for men to heal safely at home, returning to care when desired or if complications arise. 2wT should be further tested to enable widespread scale-up.