Sarah Maat, BSc1, Frances Carr, MBChB, FRCPC, MSc1, Megan Kennedy, MLIS2, Peggy Chi, PhD3, Whitney Berta, PhD4, Adrian Wagg, MBBS, FRCP(Lond), FRCP(Edin), FCGS, FHEA1
1Department of Medicine, University of Alberta, Edmonton, AB;
2University of Alberta Libraries, University of Alberta, Edmonton, AB;
3Research and Design Consultant, Toronto, ON;
4Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, CanadaDOI: https://doi.org/10.5770/cgj.29.901
ABSTRACT
Background
The motivations and attitudes of caregivers strongly influence the care they provide. Motivation is also a central component in staff retention and care consistency, whereas attitude shapes delivery and degree of person-centeredness in care. Although caregiver attitudes and motivations have been examined separately in dementia care research, these constructs have not been comprehensively mapped together within residential memory care settings or explicitly linked to care quality.
Objective
This review aims to assess literature pertaining to attitudes and motivations of formal caregivers in residential dementia care facilities and to examine how these constructs are associated with care quality. This review seeks to generate practical insights to inform workforce training and recruitment strategies to support high-quality, person-centered dementia care.
Inclusion Criteria
Literature focused on the attitudes and motivations of formally employed caregivers providing care to residents in a residential memory care setting. Studies published of any design, from any year, country, or language will be considered.
Method
This scoping review will follow the Joanna Briggs Institute (JBI) method. A comprehensive search will be conducted across major health, social science, and interdisciplinary databases, along with grey literature sources. Data will be extracted according to a JBI template informed by three theoretical frameworks: the Tripartite Model of Attitudes, the Empathy-Altruism Hypothesis, and Person-Centered Care. Results will be reported in accordance with the PRISMA-ScR guidelines.
Registration
Open Science Framework https://osf.io/8yrge
Key words: dementia, homes for the aged, nursing staff, quality of health care, health attitudes, work motivation, nurse’s practice patterns, geriatrics
In 2019, The World Health Organization estimated that 55.2 million individuals worldwide were living with dementia, with a projected increase to 139 million by 2050, largely as a result of global ageing.(1–4) The socioeconomic burden of dementia is disproportionately high relative to the general population.(5–9) As dementia prevalence rises, health-care systems are under increasing strain, making the need for effective and efficient care more urgent.
People living with dementia (PLWD) have complex and evolving care needs, making them increasingly vulnerable to unmet needs or lapses in care.(10,11) As their cognitive function declines, their ability to independently meet their basic self-care needs diminishes. To support these needs, many individuals reside in specialized memory care communities.(12) Memory care programs—also referred to as special care units, secured units, or memory care facilities, communities, and units—generally provide 24-hour nursing care to residents and assist with activities of daily living.(13) For the purpose of this review, we define memory care as any residential senior living program or unit designed to meet the needs of PLWD regardless of philosophical care model (e.g., Butterfly Model, Eden Alternative).
Compared to general long-term care (nursing home) and assisted living settings, memory care programs place greater emphasis on engagement and meaningful activity,(13) though priorities and level of support may be variable depending on the model of care adopted by each individual facility and the care needs of residents. The enhanced care objectives of memory care programs may lead to increased staffing demands in terms of both volume and responsibility.(14) Formal caregivers, defined here as paid caregivers employed by the facility in which the PLWD resides, play a central role in the day-to-day lives of PLWD, and are vital to ensuring that resident needs are consistently met.(15,16) As such, caregivers’ performance significantly influences residents’ quality of life.(10,16) However, due to the extensive care requirements, caregivers in dementia care settings face a heightened risk of burnout and emotional exhaustion(17,18) which, in turn, affects care quality.(14,19)
The motivations and attitudes of care staff strongly influence the quality of care they provide.(10,17,20) Motivation is often credited as being a central component in staff retention and care consistency among nurses,(21) whereas attitude influences delivery and degree of person-centeredness in care.(10) Intrinsic work motivation, whereby the drive to perform well in one’s job prompts personal satisfaction or positive feelings,(22) is most associated with individuals in health-care professions, whereas extrinsic motivators appear to play only a minor role.(23) Numerous studies have examined strategies to enhance health-care staff motivation in the workplace,(24–25) finding motivation to be a central component in staff retention and professional development,(17) which benefits residents by fostering consistency and interpersonal relationships.(26) There is evidence of altruism being a strong motivator for individuals within the caregiving workforce.(27–29) Intrinsic work motivation leads to increased productivity and decreased staff turnover, both of which positively influence resident care quality.(17,30,31) Intrinsic motivation may also serve as a protective factor against caregiver burnout,(32,33) where burnout can negatively affect quality of care,(34) collectively suggesting a multidimensional effect on quality of care.
On the other hand, attitude has a strong influence on the way in which care is delivered, and is founded on knowledge, experience,(35) beliefs, stigma and biases,(36) and job satisfaction.(37) Caregiver attitude shapes the delivery of care in many ways, but is largely associated with the ability to demonstrate empathy, compassion, and person-centeredness.(38–39) Person-centered care (PCC) is an approach widely accepted as the gold standard of care(40–42) with its foundational principles of interpersonal relationships and personhood.(42–44) Fostering positive caregiver attitudes towards PLWD is essential to the delivery of PCC, as it requires a substantial amount of respect towards the individual and understanding the person as more than their dementia.(38,45,46)
Conversely, when caregivers hold negative perceptions of PLWD, such as viewing them as incapable or beyond help, the sense of purpose and meaning that they feel from their job can diminish both care quality and caregiver well-being.(10,35) Negative caregiver attitudes also increase the risk of caregiver stress and burnout,(37,47–49) contributing to a cycle of diminished care quality and increased emotional exhaustion. Existing evidence suggests that caregiver attitudes and intrinsic motivations influence care quality and resident outcomes through multiple pathways, including person-centered care practices, caregiver well-being, staff retention, and the consistency and quality of daily interactions with residents.
There are several published works investigating the attitudes and motivations of caregivers, although few address residential memory care. Attitudes and motivations are examined in isolation rather than as interrelated constructs. Available literature on the matter rarely integrates theoretical frameworks to organize and ground findings. By adopting a broadened scoping review approach, guided by established theoretical frameworks, this review addresses these gaps and provides a structured mapping of evidence relevant to workforce development, training, and policy.
This review focuses on psychosocial constructs (attitudes and intrinsic motivations), rather than professional obligations or disciplinary frameworks, which are typically examined within organizational or regulatory contexts.
This review will map the existing literature on caregiver attitudes and motivations and associations with care quality (e.g., resident satisfaction, resident behavioral responses, person centered care, resident quality of life) in residential dementia care. The findings may inform stakeholders in the development of training programs, recruitment strategies, and policies that will maximize quality of care by identifying caregiver characteristics that may be associated with care quality.
This review is guided by three theoretical frameworks: the Tripartite Model of Attitudes, the Empathy-Altruism Hypothesis, and Person-Centered Care.
The Tripartite Model of Attitudes, also sometimes referred to as the ABC model, is a widely used framework for understanding attitudes, frequently cited in psychological and health research.(50) Credit for this model is often given to Rosenberg et al.,(51) although others before them have made similar observations.(50,52) The model comprises three distinct components: affect (feelings and emotions), behavior (actions), and cognition (thoughts and beliefs),(50,52) and has been successfully employed in health-care research(53,54) including dementia research.(55,56) The model conceptualizes attitudes as a multidimensional construct built upon the complex interplay of an individual’s feelings, actions, and beliefs.(50,52) The Dementia Attitudes Scale was created based on this model, and has since been demonstrated to be a reliable and valid measure of attitudes towards dementia across different contexts.(55)
The Empathy-Altruism Hypothesis(57) challenges the egoistic (self-serving) assumption of motivation, dominant in Western society,(57–59) by suggesting that empathy or empathetic concern drives altruistic motivation.(57–59) Conversely, altruism in the Empathy-Altruism Hypothesis is motivation driven by an interest in increasing the welfare of others.(57–60) Empathy is described as the core of altruistic motivation.(57–59,61) Numerous studies have investigated this, and the Empathy Altruism Hypothesis is largely supported.(58–60) Available literature suggests that the motivation among health-care workers is significantly more altruistic than egoistic, making this framework most suitable for this study. Moreover, research has been conducted investigating the relevance of the Empathy-Altruism Hypothesis to caregivers and found it to be a valuable model in health-care settings.(60,61)
PCC has been widely accepted as the gold standard of dementia care.(40–42) It is a care philosophy that prioritizes the residents’ autonomy and personhood while highlighting the importance of interpersonal relationships and connections between caregivers and their patients.(42) The degree of PCC in a care environment has been found to be associated with patient satisfaction and quality of life.(62–64) Due to its connection to patient outcomes, PCC is often used to assess satisfaction with care and effectiveness of care practices.(65,66)
Together, these models provide a synergistic framework for this review, with the Tripartite Model of Attitudes addressing the attitude component of this study, the Empathy-Altruism hypothesis addressing the motivation component, and person-centered care providing an estimation of resident outcomes and a measure to assess quality of care. These frameworks will inform each aspect of this review, guiding data extraction and synthesis.
What is known about the attitudes and motivations of caregivers working in residential dementia care facilities?
What caregiver attitudes and motivations are associated with care quality in residential dementia care facilities?
The Joanna Briggs Institute (JBI) scoping review protocol template was used to create this protocol (Joanna Briggs Institute, JBI Scoping Review Network Resources; Adelaide, Australia; https://jbi.global/scoping-review-network), and the JBI method will be followed in conducting the scoping review.(67) This review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and guidelines (PRISMA, 2020; https://www.prisma-statement.org/). No ethical approval was required for this study as it did not involve human or animal subjects.
Literature focused on caregiving staff who engage in daily interaction with residents in residential dementia care facilities will be considered, regardless of job title. Caregiving staff will include care aides (also known as care assistants and personal care workers), licensed practical nurses, registered nurses, recreation aides, occupational therapists, and auxiliary staff (e.g., housekeeping staff, kitchen staff, administrative staff). Only literature pertaining to formally employed caregivers will be considered.
Attitudes, such as personal beliefs, stigma, personality, empathy, feelings and values, and intrinsic motivations such as altruism, desire to help others, job satisfaction, and commitment of caregivers and how they relate to, or affect, the quality of care provided to dementia care residents.
Residential dementia care communities, as well as dementia-specific facilities or units within broader long-term care or nursing home facilities, will be included where data specific to residents with dementia are available. General care facilities without specialized dementia programs will be excluded. In cases where dementia-specific and non-dementia populations are combined, studies will be considered for inclusion if the data are stratified. Studies focused on acute care or day programs will be excluded.
This review will capture studies of any research method and incorporate both published and unpublished sources investigating the attitudes and motivations of formal caregivers in a residential memory care setting. Literature published from any country and in any language will be included to ensure that a variety of cultural settings are included. There will be no limitation placed on publication year. Review papers will be included, and to ensure that all relevant sources are encompassed in this review, reference lists will also be searched, inducing a snowballing effect.(68) The full journal article of any relevant conference abstracts published in a peer-reviewed journal will be included.
To locate studies, a three-step search strategy will be conducted. A preliminary search of Ovid MEDLINE was conducted on 20 August 2025 by a health sciences librarian to retrieve relevant articles (see Table S1 in the supplementary material) and inform development of a full search strategy for Ovid MEDLINE in step two, which will be adapted for each information source. The search strategy was structured around dementia, residential memory care settings, formal caregivers, and caregiver attitudes and motivations. The complete MEDLINE search strategy, including MeSH terms and Boolean operators, is provided in Table S2 in the supplementary material. Once the search strategy is constructed, it will be reviewed by the research team and, if necessary, an additional research librarian. The search will utilize Medline, EMBASE, PsycINFO, CINAHL, HealthSource: Nursing/Academic Edition, SocINDEX, Scopus, Web of Science, and grey literature. To ensure that recently published literature is included, the search strategy will be updated six months following the initial search.
There will be no limitations on literature inclusion based on publishing date or language. For studies published in a language other than English, DeepL Translator and Google Translator (https://www.deepl.com/en/translator and https://translate.google.com/) will be used and compared. Native speakers of the language will be consulted for clarification, as needed.
To ensure that this review encompasses the breath of published literature relevant to our topic, grey literature will be considered. Grey literature will be systematically searched to identify relevant non–peer–reviewed evidence. Sources include Grey Matters (Canada’s Drug Agency. https://greymatters.cda-amc.ca/about ; Canada’s Drug Agency. Grey Matters: A Tool for Searching Health-related Grey Literature (https://greymatters.cda-amc.ca), Government of Canada publications, Health Systems Evidence, and Google Scholar. Searches will be conducted using combinations of terms related to dementia, memory care, caregiving staff, attitudes, and motivation. For Google Scholar, the first 200 results will be screened in accordance with recommended practices for grey literature searching. All records identified through grey literature sources will be screened using the same inclusion criteria applied to peer-reviewed literature. The date of search, source, search terms, number of results retrieved, and number of included studies will be documented to ensure transparency and reproducibility. A reference list search of relevant reviews identified in the search will be conducted, ensuring detailed documentation and screening is conducted with consistent inclusion criteria.
All citations identified in the search will be uploaded into Covidence, a web-based software platform that streamlines the production of systematic and other literature reviews (Covidence. https://www.covidence.org). Duplicates are removed automatically. Two independent reviewers will manually conduct title and abstract screening, followed by full-text screening of results. Screening for study inclusion will be facilitated by Covidence. Disagreements between the reviewers at any stage of the selection procedure will be resolved via discussion or with the input of a third reviewer, as needed. The results process will be reported in full, presented in a PRISMA flow diagram within the final scoping review.
A data extraction chart (Table 1) was created in Microsoft Excel and guided by the JBI data extraction form template (Joanna Briggs Institute. JBI Data Extraction Form for Systematic Reviews and Research Syntheses. https://jbi-global-wiki.refined.site/space/MANUAL/355830547). The chart includes article details pertaining to bibliographic details of the article (e.g., date of publication, authors) as well as key findings relevant to caregiver attitudes, motivations, and indicators of care quality, organized by theoretical framework components. Studies that do not clearly fit any single framework component will be reported descriptively, with additional categories created as needed to capture concepts not adequately represented within the selected frameworks. This will allow the review to maintain systematic organization supported by established theoretical models while ensuring that the study’s comprehensiveness is not compromised. When necessary, study authors will be contacted to obtain missing or additional data.
TABLE 1 Draft data extraction chart
Data extraction will be conducted by two reviewers. The data charting form may be refined iteratively during the review process to capture additional relevant information as needed, consistent with scoping review method. To support consistency across reviewers during data extraction and synthesis, shared definitions and guidance will be used when applying the data charting form, and regular discussions will be held within the review team to resolve uncertainties and align interpretations.
The data obtained in the scoping review will be mapped as a tabular summary or with a qualitative format, as appropriate. Major themes and trends will be outlined. Consistent with scoping review methodology, a formal assessment of study quality will not be conducted. The results of the review will be published in a peer-reviewed open access journal with a focus on open-access publication. The results will be presented at university research days, academic and lay professional conferences, and workshops.
Optima Living, a Canadian memory care provider, was consulted in the design of this protocol, specifically in determining the scope of the staff inclusion criterion. SM gratefully acknowledges the financial support of the 2025 Peter N. McCracken Scholarship.
We have read and understood the Canadian Geriatrics Journal’s policy on disclosing conflicts of interest and declare the following interests: SM has received funding from the Mitacs Accelerate program. AW has received matching funding for the student from Optima Living. MK and PC declare no conflicts of interest.
This review was funded by an unrestricted grant to the principal investigator from Optima Living and a Mitacs Accelerate scholarship. The funders had no role in data collection and analysis, decision to publish, or preparation of the manuscript.
Supplemental material linked to the online version of the paper (https://doi.org/10.5770/cgj.29.901):
1. Prince M, Ali GC, Guerchet M, Prina AM, Albanese E, Wu YT. Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimer’s Res Ther. 2016 Jul 30;8(1):23. doi:10.1186/s13195-016-0188-8. Accessed 23 June 2025.
Crossref
2. World Health Organization. Ageing: Global population. 2025 Feb 21. Available from: https://www.who.int/news-room/questions-and-answers/item/population-ageing
3. World Health Organization. Global status report on the public health response to dementia: executive summary. 2021 Sep 1. Geneva: WHO; 2021. Accessed 22 June 2025.
4. Nichols E, Szoeke CEI, Vollset SE, Abbasi N, Abd-Allah F, Abdela J, et al. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 Jan 1;18(1):88–106. doi:10.1016/s1474-4422(18)30403-4
Crossref
5. Frytak JR, Henk HJ, Zhao Y, Bowman L, Flynn JA, Nelson M. Health service utilization among Alzheimer’s disease patients: evidence from managed care. Alzheimers Dement. 2008 Sep 1;4(5):361–67. doi:10.1016/j.jalz.2008.02.007
Crossref PubMed
6. Han EJ, Lee J, Cho E, Kim H. Socioeconomic costs of dementia based on utilization of health care and long-term-care services: a retrospective cohort study. Int J Environ Res Public Health. 2021 Jan 6;18(2):376. doi:10.3390/ijerph18020376
Crossref PubMed PMC
7. Kane RL, Atherly A. Medicare expenditures associated with Alzheimer disease. Alzheimer Dis Assoc Disord. 2000 Oct 1;14(4):187–95. doi:10.1097/00002093-200010000-00001
Crossref
8. Zhao Y, Kuo T-C, Weir S, Kramer MS, Ash AS. Healthcare costs and utilization for Medicare beneficiaries with Alzheimer’s. BMC Health Serv Res. 2008 May 22;8(1):108. doi:10.1186/1472-6963-8-108
Crossref
9. Aranda MP, Kremer IN, Hinton L, Zissimopoulos J, Whitmer RA, Hummel CH, et al. Impact of dementia: Health disparities, population trends, care interventions, and economic costs. J Am Geriatr Soc. 2021 Jul 10;69(7):1774–83. doi:10.1111/jgs.17345
Crossref PubMed PMC
10. Evripidou M, Charalambous A, Middleton N, Papastavrou E. Nurses’ knowledge and attitudes about dementia care: systematic literature review. Perspect Psychiatr Care. 2018 May 15; 55(1):48–60. doi:10.1111/ppc.12291
Crossref PubMed
11. Bail K, Grealish L. Failure to Maintain’: a theoretical proposition for a new quality indicator of nurse care rationing for complex older people in hospital. Int J Nurs Stud. 2016 Nov 1; 63:146–61. doi:10.1016/j.ijnurstu.2016.08.001
Crossref PubMed
12. Canadian Institute for Health Information. Dementia in home and community care. Available from: https://www.cihi.ca/en/dementia-in-canada/dementia-care-across-the-health-system/dementia-in-home-and-community-care. Accessed 22 June 2025.
13. Calkins MP. Memory care and Alzheimer’s units, Chap. 14. In: Devlin AS, ed. Environmental psychology & human well-being. Amsterdam, The Netherlands: Elsevier; 2018 Aug 24. p. 365–86. doi:10.1016/B978-0-12-811481-0.00014-7
Crossref
14. Barbosa A, Nolan M, Sousa L, Figueiredo D. Supporting direct care workers in dementia care: effects of a psychoeducational intervention. Am J Alzheimers Dis Other Demen. 2015 Mar;30(2):130–38. doi:10.1177/1533317514550331
Crossref
15. Anderson K, Bird M, MacPherson S, Blair A. How do staff influence the quality of long-term dementia care and the lives of residents? A systematic review of the evidence. Int Psychogeriatr. 2016 Apr 15;28(8):1263–81. doi:10.1017/S1041610216000570
Crossref PubMed
16. Chapman DP, Williams SM, Strine TW, Anda RF, Moore MJ. Dementia and its implications for public health. Prev Chronic Dis. 2006 Mar 15;3(2):A34.
PubMed PMC
17. Cheloni S, Tinker A. Working with older people with dementia: motivations and demotivations among health carers. Work Older People. 2019 Sep 17;23(3):117–26. doi:10.1108/wwop-04-2019-0007
Crossref
18. Takai M, Takahashi M, Iwamitsu Y, Ando N, Okazaki S, Nakajima K, et al. The experience of burnout among home caregivers of patients with dementia: relations to depression and quality of life. Arch Gerontol Geriatr. 2009 Jul 1;49(1):e1–e5. doi:10.1016/j.archger.2008.07.002
Crossref
19. Eltaybani S, Yamamoto-Mitani N, Ninomiya A, Igarashi A. The association between nurses’ burnout and objective care quality indicators: a cross-sectional survey in long-term care wards. BMC Nurs. 2021 Feb 23;20(1):34. doi:10.1186/s12912-021-00552-z
Crossref PubMed PMC
20. Kada S, Nygaard HA, Mukesh BN, Geitung JT. Staff attitudes towards institutionalised dementia residents. J Clin Nurs. 2009 Jul 6;18(16):2383–92. doi:10.1111/j.1365-2702.2009.02791.x
Crossref PubMed
21. Tzeng HM. The influence of nurses’ working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan. Int J Nurs. Stud. 2002 Nov 1;39(8):867–78. doi:10.1016/S0020-7489(02)00027-5
Crossref PubMed
22. Warr P, Cook J, Wall T. Scales for the measurement of some work attitudes and aspects of psychological well-being. J Occup Psychol.1979 Jun;52(2):129–48. doi:10.1111/j.2044-8325.1979.tb00448.x
Crossref
23. Smith A. The characteristics and perceptions of goals in Swedish primary health care and their consequences on motivation [Masters thesis in Management, University of Gothenburg]. Sweden: University of Gothenbury; 2011 Jul 21. Available from: https://gupea.ub.gu.se/handle/2077/26345. Accessed 8 Aug 2025.
24. Chenoweth L, Jeon YH, Merlyn T, Brodaty H. A systematic review of what factors attract and retain nurses in aged and dementia care. J Clin Nurs. 2009 Dec 17;19(1–2):156–67. doi:10.1111/j.1365-2702.2009.02955.x
Crossref
25. Toode K, Routasalo P, Suominen T. Work motivation of nurses: a literature review. Int J Nurs Stud. 2011 Feb 1;48(2):246–57. doi:10.1016/j.ijnurstu.2010.09.013
Crossref
26. Wong CM, Como DH, Lekovitch C, Chew F, Leland NE. Nursing home staff perspectives of the benefits and challenges of providing dementia care. J Am Med Dir Assoc. 2025 Feb 1;26(2):105411. doi:10.1016/j.jamda.2024.105411
Crossref
27. De Cooman R, De Gieter S, Pepermans R, Du Bois C, Caers R, Jegers M. Freshmen in nursing: job motives and work values of a new generation. J Nurs Manag. 2008 Jan 16;16(1):56–64. doi:10.1111/j.1365-2934.2007.00800.x
Crossref PubMed
28. Galizzi MM, Godager G, Li J, Linnosmaa I, Tammi T, Wiesen D. Economics of healthcare provider altruism. In: Zimmermann KF, ed. Handbook of labor, human resources and population economics. Cham, Switzerland: Springer; 2023. p. 1–23.
29. Smith R, Lagarde M, Blaauw D, Goodman C, English M, Mullei K, et al. Appealing to altruism: an alternative strategy to address the health workforce crisis in developing countries? J Public Health. 2013 Mar 1;35(1):164–70. doi:10.1093/pubmed/fds066
Crossref
30. McNeese-Smith DK. The relationship between managerial motivation, leadership, nurse outcomes and patient satisfaction. J Organ Behav. 1999 Mar 9;20(2):243–59. doi:10.1002/(SICI)1099-1379(199903)20:2<243::AID-JOB888>3.0.CO;2-2
Crossref
31. Wang E, Hu H, Mao S, Liu H. Intrinsic motivation and turnover intention among geriatric nurses employed in nursing homes: the roles of job burnout and pay satisfaction. Contemp Nurse. 2019 May 4;55(2–3):195–210. doi:10.1080/10376178.2019.1641120
Crossref PubMed
32. Cuadrado E, Tabernero C, Fajardo C, Luque B, Arenas A, Moyano M, et al. Type D personality individuals: Exploring the protective role of intrinsic job motivation in Burnout. J Work Organ Psychol. 2021 Aug;37(2):133–41. doi:10.5093/jwop2021a12
Crossref
33. Papathanasiou I, Fradelos E, Kleisiaris C, Tsaras K, Kalota M, Kourkouta L. Motivation, leadership, empowerment and confidence: their relation with nurses’ burnout. Mater Sociomed. 2014 Dec 14;26(6):405. doi:10.5455/msm.2014.26.405-410
Crossref
34. Harrad R, Sulla F. Factors associated with and impact of burnout in nursing and residential home care workers for the elderly. Acta BioMed. 2018 Dec 7;89(Suppl 7):60–69. doi:10.23750/abm.v89i7-S.7830
PubMed PMC
35. Norbergh K-G, Helin Y, Dahl A, Hellzén O, Asplund K. Nurses’ attitudes towards people with dementia: the semantic differential technique. Nurs Ethics. 2006 May 1;13(3):264–74. doi:10.1191/0969733006ne863oa
Crossref PubMed
36. Hall AJ, Griffin R, Manning F, Goodwin VA. Support workers knowledge, skills and education relating to dementia—a national survey. NIHR Open Res. 2024 Nov 27;4:54. doi:10.3310/nihropenres.13671.2
Crossref
37. Blaser R, Berset J. Setting matters: Associations of nurses’ attitudes towards people with dementia. Nurs Open. 2018 Oct 12;6(1):155–61. doi:10.1002/nop2.198
Crossref PubMed PMC
38. Boumans J, Van Boekel L, Kools N, Scheffelaar A, Baan C, Luijkx K. How staff characteristics influence residential care facility staff’s attitude toward person-centered care and informal care. BMC Nurs. 2021 Nov 1;20(1):217. doi:10.1186/s12912-021-00743-8
Crossref PubMed PMC
39. Sjögren K, Lindkvist M, Sandman PO, Zingmark K, Edvardsson D. To what extent is the work environment of staff related to person-centred care? A cross-sectional study of residential aged care. J Clin Nurs. 2015 May;24(9–10):1310–19. doi:10.1111/jocn.12734
Crossref
40. Edvardsson D, Fetherstonhaugh D, Nay R. Promoting a continuation of self and normality: person-centred care as described by people with dementia, their family members and aged care staff. J Clin Nurs. 2010 Aug 15;19(17–18):2611–18. doi:10.1111/j.1365-2702.2009.03143.x
Crossref PubMed
41. Coulter A, Oldham J. Person-centred care: what is it and how do we get there? Future Hosp J. 2016 Jun 1;3(2):114–46. doi:10.7861/futurehosp.3-2-114
Crossref PubMed PMC
42. Edgman-Levitan S, Schoenbaum SC. Patient-centered care: achieving higher quality by designing care through the patient’s eyes. Israel J Health Policy Res. 2021 Mar 5;10(1):21. doi:10.1186/s13584-021-00459-9
Crossref
43. Fazio S, Pace D, Maslow K, Zimmerman S, Kallmyer B. Alzheimer’s Association Dementia care practice recommendations. Gerontologist. 2018 Jan 18;58(suppl_1):S1–S9. doi:10.1093/geront/gnx182
Crossref PubMed
44. Sharma T, Bamford M, Dodman D. Person-centred care: an overview of reviews. Contemp Nurse. 2015 Nov 2;51(2–3):107–20. doi:10.1080/10376178.2016.1150192
Crossref
45. Entwistle VA, Watt IS. Treating patients as persons: a capabilities approach to support delivery of person-centered care. Am J Bioeth. 2013 Aug 1;13(8):29–39. doi:10.1080/15265161.2013.802060
Crossref PubMed PMC
46. Baillie L, Cox J, Merritt J. Caring for older people with dementia in hospital Part one: challenges. Nurs Older People. 2012 Sep 28; 24(8):33–37. doi:10.7748/nop2012.10.24.8.33.c9312
Crossref PubMed
47. Zawadzki L, Mondon K, Peru N, Hommet C, Constans T, Gaillard P, et al. Attitudes towards Alzheimer’s disease as a risk factor for caregiver burden. Int Psychogeriatr. 2011 May 4;23(9):1451–61. doi:10.1017/s1041610211000640
Crossref PubMed
48. Schou-Juul F, Ferm LM, Boje IR, Rise JE, Skov SS, Ritz C, et al. Development and prima facie validation of the Dementia-Specific Ethical Self-Efficacy scale for professional caregivers. Dementia. 2024 Jun 14;23(6):1036–51. doi:10.1177/14713012241262833
Crossref PubMed
49. Åström S, Nilsson M, Norberg A, Sandman PO, Winblad B. Staff burnout in dementia care—relations to empathy and attitudes. Int J Nurs Stud. 1991 Jan 1;28(1):65–75. doi:10.1016/0020-7489(91)90051-4
Crossref
50. Breckler SJ. Empirical validation of affect, behavior, and cognition as distinct components of attitude. J Person Soc Psychol.1984 Dec;47(6):1191–205. doi:10.1037//0022-3514.47.6.1191
Crossref
51. Rosenberg MJ, Hovland CI, McGuire WJ, Abelson RP, Brehm JW. Attitudes organization and change: an analysis of consistency among attitude components. Yale Studies in Attitude and Communication Vol. II. New Haven, CT: Yale University Press; 1960.
52. Ostrom TM. The relationship between the affective, behavioral, and cognitive components of attitude. J Exp Soc Psychol. 1969 Jan 1;5(1):12–30. doi:10.1016/0022-1031(69)90003-1
Crossref
53. Giménez-Espert MDC, Prado-Gascó VJ. The role of empathy and emotional intelligence in nurses’ communication attitudes using regression models and fuzzy-set qualitative comparative analysis models. J Clin Nurs. 2018 Mar 1;27(13–14):2661–72. doi:10.1111/jocn.14325
Crossref
54. Wong EML, Zhong XB, Sit JWH, Chair SY, Leung DY, Leung C, et al. Attitude toward the out-patient cardiac rehabilitation program and facilitators for maintenance of exercise behavior. Psychol Health Med. 2016 Aug 17;21(6):724–34. doi:10.1080/13548506.2015.1115107
Crossref
55. O’Connor ML, McFadden SH. Development and psychometric validation of the Dementia Attitudes Scale. Int J Alzheimers Dis. 2010 Mar 22;2010(1):454218. doi:10.4061/2010/454218
PMC
56. Teichmann B, Gkioka M, Kruse A, Tsolaki M. Informal caregivers’ attitude toward dementia: the impact of dementia knowledge, confidence in dementia care, and the behavioral and psychological symptoms of the person with dementia. A cross-sectional study. J Alzheimers Dis. 2022 Aug 2;88(3):971–84. doi:10.3233/jad-215731
Crossref PubMed PMC
57. Batson CD, Duncan BD, Ackerman P, Buckley T, Birch K. Is empathic emotion a source of altruistic motivation? J Pers Soc Psychol. 1981 Feb;40(2):290–302. doi:10.1037/0022-3514.40.2.290
Crossref
58. Batson CD, Lishner D, Stocks E. The empathy-altruism hypothesis. In: Schroeder DA, Graziano WG, eds. The Oxford handbook of prosocial behavior. Oxford University Press; 2015 Jan 1. p.259–81. doi:10.1093/oxfordhb/9780195399813.013.023
Crossref
59. Batson CD. The Empathy-Altruism Hypothesis: What and so what? Oxford Handbooks Online. 2017 Nov 20. p. 27–40. doi:10.1093/oxfordhb/9780190464684.013.3
Crossref
60. Burks DJ, Youll LK, Durtschi JP. The Empathy-altruism association and its relevance to health care professions. J Soc Behav Pers. 2012 Apr 1;40(3):395–400. doi:10.2224/sbp.2012.40.3.395
Crossref
61. McCamant KL. Humanistic nursing, interpersonal relations theory, and the empathy-altruism hypothesis. Nurs Sci Q. 2006 Oct;19(4):334–38. doi:10.1177/0894318406292823
Crossref PubMed
62. Wolf DM, Lehman L, Quinlin R, Zullo T, Hoffman L. Effect of patient-centered care on patient satisfaction and quality of care. J Nurs Care Qual. 2008 Oct 1;23(4):316–21. doi:10.1097/01.NCQ.0000336672.02725.a5
Crossref PubMed
63. Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2012 Nov 20;70(4):351–79. doi:10.1177/1077558712465774
Crossref PubMed
64. Bru-Luna LM, Martí-Vilar M, Merino-Soto C, Livia-Segovia J, Garduño-Espinosa J, Toledano-Toledano F. Person-centered care assessment tool with a focus on quality healthcare: a systematic review of psychometric properties. BMC Psychol. 2024 Apr 19;12(1):217. doi:10.1186/s40359-024-01716-7
Crossref PubMed PMC
65. Larson E, Sharma J, Bohren MA, Tunçalp Ö. When the patient is the expert: measuring patient experience and satisfaction with care. Bull World Health Organ. 2019 May 28;97(8):563–69. doi:10.2471/BLT.18.225201
Crossref PubMed PMC
66. Cribb A, Woodcock T. Measuring with quality: the example of person-centred care. J Health Serv Res Policy. 2022 Mar 2; 27(2):151–56. doi:10.1177/13558196211054278
Crossref PubMed PMC
67. Peters M, Godfrey C, McInerney P, Trico A, Khalil H. Chapter 11: Scoping Reviews. In: Aromataris E, Munn Z, eds. JBI Manual for Evidence Synthesis. North Adelaide, Australia: JBI; 2020. p. 407–452. doi:10.46658/JBIMES-20-12
Crossref
68. Sayers A. Tips and tricks in performing a systematic review. Preliminary evidence gathering: snowballing and reverse snowballing. Br J Gen Pract. 2007 Sep 1;57(542):759. doi:10.3399/096016407782604938
Crossref
Correspondence to: Adrian Wagg, MBBS, FRCP(Lond), FRCP (Edin), FCGS, FHEA, Department of Medicine, University of Alberta, 198 Clinical Sciences Building, 11350 - 83 Avenue, Edmonton, AB, Canada T6G 2P4, E-mail: wagg@ualberta.ca
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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited.
Canadian Geriatrics Journal, Vol. 29, No. 2, JUNE 2026