a Department of Psychology , University of Calgary , T2N 1N4 , Calgary , Alberta , Canada.
b Department of Psychology , Ryerson University , M5B 2K3 , Toronto , Ontario , Canada.
Aging Ment Health. 2019 Jul;23(7):897-904. doi: 10.1080/13607863.2018.1453483. Epub 2018 Apr 16.
Direct care providers (DCWs) spend the most time with clients in the home, and as such, play an integral role in identifying mental health problems. However, DCWs receive little preparation in mental health and there is little research regarding their role in the mental health care of clients. The purpose of this study was to explore DCWs' knowledge, attitudes, and experiences of caring for clients with mental health problems from the perspectives of DCWs and key administrators (KAs).
Mixed method design. Structured interviews were conducted with DCWs. Focus groups were conducted with KAs.
Twenty-nine DCWs and 12 KAs took part in the study. Loneliness and memory problems in clients were the most prevalent challenges identified by DCWs. DCWs' self-reported mental health knowledge was mid to high across all domains, although they had many misconceptions about mental health and aging. Helpful strategies in working with clients included communication skills, rapport-building, behavioral, cognitive, emotion-regulation, and making use of external resources. KAs noted individual differences in DCWs' mental health knowledge and indicated that mental health issues were often viewed by DCWs as dispositional problems or a normal part of aging. KAs viewed DCWs' greatest challenges as personalizing difficult client behaviors, lack of knowledge about how to manage specific behaviors, and difficulties managing their own emotions towards clients.
Data from this study suggest important areas for DCW development. However, system issues that affect DCWs such as workload, resources, mental health stigma, and diverse client populations should be addressed concurrently.
直接护理人员（DCWs）在家庭中与客户相处的时间最长，因此在识别心理健康问题方面发挥着重要作用。然而，DCWs 在心理健康方面接受的培训很少，关于他们在客户心理健康护理中的作用的研究也很少。本研究的目的是从 DCWs 和关键管理员（KAs）的角度探讨 DCWs 照顾有心理健康问题的客户的知识、态度和经验。
混合方法设计。对 DCWs 进行了结构化访谈。对 KAs 进行了焦点小组讨论。
29 名 DCWs 和 12 名 KAs 参加了这项研究。孤独和记忆问题是 DCWs 最常遇到的挑战。DCWs 自我报告的所有领域的心理健康知识都处于中等至高水平，尽管他们对心理健康和老龄化有很多误解。与客户合作的有用策略包括沟通技巧、建立融洽关系、行为、认知、情绪调节以及利用外部资源。KAs 注意到 DCWs 心理健康知识的个体差异，并指出心理健康问题通常被 DCWs 视为性格问题或正常衰老的一部分。KAs 认为 DCWs 面临的最大挑战是个性化客户的困难行为、缺乏管理特定行为的知识以及难以管理自己对客户的情绪。
这项研究的数据表明 DCW 发展的重要领域。然而，应同时解决影响 DCWs 的系统问题，例如工作量、资源、心理健康污名和不同的客户群体。
