Exploring the association of staff characteristics with staff perceptions of quality of life of individuals with intellectual disabilities and challenging behaviours.
Eke Bruinsma, Barbara J van den Hoofdakker, Pieter J Hoekstra and 2 others
PMID 35689398WHAT IT FOUND
Higher staff education and team self-efficacy linked to better resident well-being and self-determination.
Unexpectedly, higher staff-to-resident ratios associated with lower self-determination and social inclusion. These are correlations from proxy reports, not proof that changing staff traits improves outcomes.
Key findings
01Higher educational level and self-reflection in individual staff members were associated with better emotional well-being of the individuals they cared for.
02In staff teams, a higher percentage of highly educated staff was associated with better self-determination, social inclusion, and total quality of life for the individuals.
03Contrary to expectations, higher staff-individual ratios (more staff per resident) were associated with lower self-determination and less social inclusion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot prove that staff characteristics cause changes in quality of life. Quality of life was assessed by staff proxies rather than by the individuals themselves, risking social desirability bias. Staff characteristics and quality of life outcomes were both reported by staff, which may inflate associations due to shared source variance. Variables like negative staff emotions and hostile behaviour were excluded from analysis because scores were too low or uniform to test. The finding that higher staff ratios linked to lower quality of life may be confounded by resident complexity, such as communication problems or autism, which were not fully controlled for.
Declared interests
Funded by the Dutch Research Council. Authors declared no conflicts of interest.
The easy way to misread this
Do not assume that increasing staff numbers will improve resident quality of life. The study found that higher staff-to-resident ratios were associated with lower self-determination and social inclusion, possibly because these settings care for individuals with more complex needs.