Graduation Date

Fall 12-16-2022

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Nursing

First Advisor

Ann M. Berger

Second Advisor

Claudia Chaperon

Abstract

Formal caregivers are the direct care workforce in nursing homes that aid residents. Providing care to residents is hazardous and demanding, as highlighted during the pandemic. Caregiver burden affects formal caregivers; however, is interchanged with caregiver stress and caregiver burnout. The overall purpose of this dissertation was to describe formal caregiver burden among nursing assistants who provide direct care to residents in nursing homes. This was first accomplished by conducting a concept analysis of formal caregiver burden in nursing homes. Next, an integrative review of the literature was performed to assess formal caregiver burden in nursing homes and available psychometric measures. Finally, a cross-sectional, descriptive, convergent mixed methods study was conducted to determine if the attributes of perceived stress, caring for another, dependency of the older adult, responsibility for providing direct care, and the degree of competence were confirmed among nursing assistants. Major findings include the conceptual definition statement of formal caregiver burden as the demands of caring for dependent older adults with a level of competency and responsibility within the context of perceived stress. The integrative review confirmed three attributes in the literature: perceived stress, caring for another, and dependency of the older adult. Responsibility and competence were not confirmed. The literature review exposed gaps in the knowledge of formal caregiver burden. Major findings of the cross-sectional, descriptive, convergent mixed methods study confirmed the presence of these five attributes of formal caregiver burden among the qualitative and quantitative data. This study was the first to identify the presence of the attributes of formal caregiver burden among nursing assistants. Burnout was not present. This dissertation has implications for research, practice, and policy. Understanding formal caregiver burden will advance conceptual model design and testing and creation of a psychometric measure. Results may reframe practice and respond to the challenges experienced by nursing assistants in nursing homes. Advancing knowledge of formal caregiver burden can increase awareness of the value of these professionals, thereby strengthening the direct care workforce in nursing homes. Further investigation of formal caregiver burden among a larger, diverse sample of nursing assistants, nursing homes, and residents is warranted.

Comments

2022 Copyright, the authors

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