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AIMS Public Health

2025, Volume 12, Issue 2: 600-631. doi: 10.3934/publichealth.2025032
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Supporting the mental wellbeing of aged care workers: A systematic review of factors and interventions

  • 1.
    Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia
  • 2.
    Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney
  • 3.
    NHS-Department of Leadership and Service Innovation, Faculty of Social Sciences, University of Stavanger, Norway
  • 4.
    SHARE ‑ Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Norway
  • 5.
    Centre for Health Services Research, the University of Queensland, Australia
  • 6.
    Faculty of Health and Well-Being, Turku University of Applied Sciences, Finland
  • 7.
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Netherlands
  • 8.
    Faculty of Health, Western Norway University of Applied Sciences, Norway
  • 9.
    Faculty of Medicine and Biological Sciences, Ştefan cel Mare University of Suceava, Romania
  • 10.
    Medical School, University of Cyprus, Nicosia, Cyprus
  • 11.
    Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Spain
  • 12.
    Department of Health and Social Management, University of Eastern Finland, Finland
  • Received: 24 December 2024 Revised: 02 May 2025 Accepted: 20 May 2025 Published: 17 June 2025
  • Background 

    The aged care sector faces significant challenges due to rising demand from aging populations and chronic diseases, in addition to workforce shortages, contributing to staff stress, burnout, and poor mental wellbeing. In this review, we synthesized quantitative studies on factors and interventions to improve the mental wellbeing of the aged care workforce across indicators and system levels.

    Methods 

    Five academic databases (Medline, Embase, Scopus, PsycInfo, and CINAHL) were searched from January 2014 to May 2024, using keywords related to aged care, care workers, and mental wellbeing. Quantitative studies examining factors or outcomes of interventions related to staff wellbeing were included. Identified factors were classified as micro-, meso-, and macro-level using a combined inductive and deductive approach.

    Results 

    Eighty-nine studies were included: 64 (72%) identified significant factors, and 25 (28%) evaluated interventions aiming to improve workers' mental wellbeing. Almost half concentrated on nursing staff (n = 38, 43%), with others addressing direct care workers (n = 25, 28%) or aged care workers more broadly (n = 19, 21%). From the synthesis, a multi-level model of factors affecting aged care worker wellbeing was developed, comprising 11 themes and 39 sub-themes; 3 micro-level themes (1. personal factors, 2. work engagement, and 3. skills and abilities), 6 meso-level themes (4. job demands, 5. professional relations, 6. job control, 7. leadership, 8. professional development, and 9. workplace resources), and 2 macro-level themes (10. policy and regulation and 11. structure and governance). Among the 25 intervention studies, most entailed micro-level changes (n = 24, 96%), including relaxation, emotion regulation, and behavioral management education training.

    Conclusions 

    Understanding system-level factors is a key to designing comprehensive improvement approaches. Our new model can help guide organizations in developing targeted strategies to promote mental wellbeing and strengthen care delivery. While individual-focused interventions have shown benefits, organizational and broader system-level strategies to improve mental wellbeing are pivotal for achieving sustainable change.

    Citation: Louise A Ellis, Tanja Schroeder, Maree Saba, Kate Churruca, Janet C Long, Annie Haver, Kristin Akerjordet, Kristiana Ludlow, Inger Johanne Bergerød, Sini Nevantaus, Jan-Willem Weenink, Zoe Gonzales, Samantha Spanos, Hilda Bø Lyng, Cecilie Haraldseid-Driftland, Daniel Adrian Lungu, Malin Knutsen Glette, Mari Lahti, Florin Tibu, Andreas Chatzittofis, Juana Maria Delgado-Saborit, Eila Kankaanpää, Viviana Wuthrich, Robyn Clay-Williams, Jeffrey Braithwaite, Siri Wiig. Supporting the mental wellbeing of aged care workers: A systematic review of factors and interventions[J]. AIMS Public Health, 2025, 12(2): 600-631. doi: 10.3934/publichealth.2025032

    Related Papers:

  • Background 

    The aged care sector faces significant challenges due to rising demand from aging populations and chronic diseases, in addition to workforce shortages, contributing to staff stress, burnout, and poor mental wellbeing. In this review, we synthesized quantitative studies on factors and interventions to improve the mental wellbeing of the aged care workforce across indicators and system levels.

    Methods 

    Five academic databases (Medline, Embase, Scopus, PsycInfo, and CINAHL) were searched from January 2014 to May 2024, using keywords related to aged care, care workers, and mental wellbeing. Quantitative studies examining factors or outcomes of interventions related to staff wellbeing were included. Identified factors were classified as micro-, meso-, and macro-level using a combined inductive and deductive approach.

    Results 

    Eighty-nine studies were included: 64 (72%) identified significant factors, and 25 (28%) evaluated interventions aiming to improve workers' mental wellbeing. Almost half concentrated on nursing staff (n = 38, 43%), with others addressing direct care workers (n = 25, 28%) or aged care workers more broadly (n = 19, 21%). From the synthesis, a multi-level model of factors affecting aged care worker wellbeing was developed, comprising 11 themes and 39 sub-themes; 3 micro-level themes (1. personal factors, 2. work engagement, and 3. skills and abilities), 6 meso-level themes (4. job demands, 5. professional relations, 6. job control, 7. leadership, 8. professional development, and 9. workplace resources), and 2 macro-level themes (10. policy and regulation and 11. structure and governance). Among the 25 intervention studies, most entailed micro-level changes (n = 24, 96%), including relaxation, emotion regulation, and behavioral management education training.

    Conclusions 

    Understanding system-level factors is a key to designing comprehensive improvement approaches. Our new model can help guide organizations in developing targeted strategies to promote mental wellbeing and strengthen care delivery. While individual-focused interventions have shown benefits, organizational and broader system-level strategies to improve mental wellbeing are pivotal for achieving sustainable change.


    Abbreviations

    DCM

    Dementia Care Mapping

         EMDR

    Eye Movement Desensitization and Reprocessing

         JBI

    Joanna Briggs Institute

         MBI

    Maslach Burnout Inventory

         NA

    Not applicable

         NAM

    National Academy of Medicine

         PFA

    Psychological First Aid

         PPE

    Personal protective equipment

         PRISMA

    Preferred Reporting Items for Systematic Reviews and Meta-Analyses

         RACFs

    Residential aged care facilities

         RCTs

    Randomised Controlled Trials

         WHO

    World Health Organization
    加载中

    Acknowledgments


    This study is part of the Support4Resilience research program. It is funded by the European Union (101136291) and National Health and Medical Research Council (2032788). Views and opinions expressed are however those of the authors only and do not necessarily reflect those of the European Union or European Health, Digital Executive Agency (HADEA), or the National Health and Medical Research Council. Neither the European Union nor the granting authorities can be held responsible for them.

    Authors' contributions


    This study was originally conceived by SW, LAE, RCW, JB and EK. Data extraction and screening was conducted by LAE, KA, TS, SN, JCL, JWW, KC, AH, KL, IJB, MS, and ZG. First draft of the results section was written by LAE, CHD, HBL, DAL, SS, IJB, MS, TS, FT. All authors (LAE, TS, MS, KC, JCL, AH, KA, KL, IJB, SN, JWW, ZG, SS, HBL, CHD, DAL, MKG, ML, FT, AC, JMDS, EK, VW, RCW, JB, SW) provided critical feedback and helped shape the final manuscript.

    Conflicts of interest


    The authors declare that they have no competing interests.

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