Browsing by Author "Duan, Yinfei"

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    Conceptual and relational advances of the PARIHS and i-PARIHS frameworks over the last decade: a critical interpretive synthesis
    (2022-12-07) Duan, Yinfei; Iaconi, Alba; Wang, Jing; Perez, Janelle S.; Song, Yuting; Chamberlain, Stephanie A.; Shrestha, Shovana; Choroschun, Katharina; Hoben, Matthias; Beeber, Anna; Anderson, Ruth A.; Cummings, Greta G.; Lanham, Holly J.; Norton, Peter G.; Estabrooks, Carole A.; Berta, Whitney
    Abstract Background The number of research publications reporting the use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework and the integrated PARIHS (i-PARIHS) framework has grown steadily. We asked how the last decade of implementation research, predicated on the (i-)PARIHS framework (referring to the PARIHS or i-PARIHS framework), has contributed to our understanding of the conceptualizations of, relationships between, and dynamics among the core framework elements/sub-elements. Building on the Helfrich et al. (2010) review of research on the PARIHS framework, we undertook a critical interpretive synthesis to: (1) identify conceptual and relational advances in the (i-)PARIHS framework and (2) identify conceptual and relational aspects of the (i-)PARIHS framework that warrant further work. Methods We performed a systematic search in PubMed/PubMed Central, Ovid MEDLINE, CINAHL, JSTOR, SCOPUS, Web of Science, and PsycInfo. Articles were eligible for synthesis if they (a) were peer-reviewed articles, written in English, and published between January 2009 and December 2021, (b) applied the (i-)PARIHS framework explicitly to guide implementation research, and (c) made conceptual (expanding the conceptualization of core elements) and/or relational contributions (elaborating relationships among elements/sub-elements, or theorizing the relationships using empirical data). We used a critical interpretive synthesis approach to synthesize conceptual-relational advances of the (i-)PARIHS framework. Results Thirty-seven articles were eligible for synthesis. Twenty-four offered conceptual contributions, and 18 offered relational contributions (5 articles contributed in both ways). We found conceptual expansion of all core (i-)PARIHS elements, with most emphasis on context (particularly outer context and leadership), facilitation, and implementation success. Articles also gave insights into the complex relationships and relational dynamism among these elements, characterized as contingent, interactive, multilevel, and temporal effects. Conclusions We observed developmental advances of the (i-)PARIHS framework and proposed several directions to further advance the framework. Conceptualization of (i-)PARIHS elements (particularly evidence/innovation and recipients) need to be further developed by specifying conceptual and operational definitions of underlying sub-elements. Relationships among (i-)PARIHS elements/sub-elements need to be further elaborated through empirical studies that consider situational contingencies and causal complexities. This will require examining necessity and sufficiency of (i-)PARIHS elements/sub-elements in relation to implementation outcomes, interactions among elements, and mechanism-based explanations.
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    Examining factorial validity and internal consistency of Professional Quality of Life (ProQoL-9) among care aides working in Long-term Care (LTC)
    (2025-01-02) Saeidzadeh, Seyedehtanaz; Wang, Anni; Duan, Yinfei; Hipel, Isaiah; Norton, Peter G.; Estabrooks, Carole A.
    Abstract Background The ProQoL (30 items) is a widely used instrument of work-related quality of life for health care workers. Recently, a shorter 9-item version of the ProQoL was developed and validated among palliative care workers. The ProQoL-9 consists of three subscales: compassion satisfaction (CS), burnout (BO), and compassion fatigue (CF). Care aides (personal support workers, nursing assistants) are an understudied population in terms of their professional quality of life. It is critical to use validated instruments to measure their experiences. The purpose of this study was to examine the internal consistency and factorial structure of the ProQoL-9 among care aides working in LTC. Methods We used surveys collected by the Translating Research in Elder Care (TREC), a pan-Canadian program that collects longitudinal surveys from the healthcare workforce in the LTC. We used TREC surveys containing information on demographics, characteristics of LTC homes (e.g., ownership model), and the ProQoL-9. Our sample included all care aides who completed TREC surveys in the province of Alberta, Canada, from 2020–2021. We examined internal consistency via alpha and omega coefficients. To examine the factorial structure, we conducted confirmatory factor analysis (CFA) testing one factor, two factors (CF and BO together & CS), and three factor models (CF, BO, and CS). Results N = 760 care aides completed the surveys in Alberta. The majority were female (90.79%) and worked in general LTC units (55.29%). The Cronbach’s alpha results showed an overall α = 0.56 for the whole scale and adequate reliability of the subscales (α = 0.73 for CS, α = 0.68 for CF, and α = 0.75 for BO). The omega reliability results for all the subscales were ≥ 0.70, reflecting good internal consistency (BO = 0.77, CS = 0.73, and CF = 0.70). The three-factor model had the best goodness of fit values, reflecting an adequate goodness of fit (X2 = 165.82, DF = 24, X2/DF = 6.9, P < .0001, RMSEA = 0.08, CFI = 0.92, TLI = 0.89). Conclusions The ProQoL-9 is a valid and reliable instrument among care aides in LTC. The factorial structure shows that this shorter version of the ProQoL is rigorously designed and can be utilized by health service researchers in LTC.
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    How context links to best practice use in long-term care homes: a mixed methods study
    (2024-06-07) Duan, Yinfei; Wang, Jing; Lanham, Holly J.; Berta, Whitney; Chamberlain, Stephanie A.; Hoben, Matthias; Choroschun, Katharina; Iaconi, Alba; Song, Yuting; Perez, Janelle S.; Shrestha, Shovana; Beeber, Anna; Anderson, Ruth A.; Hayduk, Leslie; Cummings, Greta G.; Norton, Peter G.; Estabrooks, Carole A.
    Abstract Background Context (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) homes are understudied. This study used an innovative approach to investigate how context elements interrelate and influence best practice use by LTC care aides. Methods In this secondary analysis study, we combined coincidence analysis (a configurational comparative method) and qualitative analysis to examine data collected through the Translating Research in Elder Care (TREC) program. Coincidence analysis of clinical microsystem (care unit)-level data aggregated from a survey of 1,506 care aides across 36 Canadian LTC homes identified configurations (paths) of context elements linked consistently to care aides’ best practices use, measured with a scale of conceptual research use (CRU). Qualitative analysis of ethnographic case study data from 3 LTC homes (co-occurring with the survey) further informed interpretation of the configurations. Results Three paths led to very high CRU at the care unit level: very high leadership; frequent use of educational materials; or a combination of very high social capital (teamwork) and frequent communication between care aides and clinical educators or specialists. Conversely, 2 paths led to very low CRU, consisting of 3 context elements related to unfavorable conditions in relationships, resources, and formal learning opportunities. Our qualitative analysis provided insights into how specific context elements served as facilitators or barriers for best practices. This qualitative exploration was especially helpful in understanding 2 of the paths, illustrating the pivotal role of leadership and the function of teamwork in mitigating the negative impact of time constraints. Conclusions Our study deepens understanding of the complex interrelationships between context elements and their impact on the implementation of best practices in LTC homes. The findings underscore that there is no singular, universal bundle of context-related elements that enhance or hinder best practice use in LTC homes.
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    Validation of the Maslach burnout inventory-general survey 9-item short version (MBI-GS9) among care aides in Canadian nursing homes
    (2025-01-16) Wang, Anni; Duan, Yinfei; Saeidzadeh, Seyedehtanaz; Norton, Peter G.; Estabrooks, Carole A.
    Abstract Background The Maslach Burnout Inventory-General Survey (MBI-GS) is the leading measure of burnout for all occupations. The MBI-GS9, the 9-item version of the MBI-GS, was formulated based on the MBI-GS and has been used for several years. However, very few studies have systematically tested its psychometric properties, and none have focused on care aides working in nursing homes who are susceptible to burnout. Methods Following the Standards for Educational and Psychological Testing, this study validated the MBI-GS9 among 3,765 care aides from 91 Canadian nursing homes, using data collected between September 2019 and February 2020 by the Translating Research in Elder Care (TREC) program. Results The Exhaustion subscale had good reliability with coefficients around 0.66–0.74. The Cynicism subscale had medium reliability with coefficients around 0.60–0.66, and the Efficacy subscale also had medium reliability with coefficients around 0.51–0.58. The MBI-GS9 was significantly correlated with various conceptually related constructs, such as health status, working environment, job satisfaction, psychological empowerment, work engagement, and organizational citizenship behaviors. The MBI-GS9 had a three-factor structure in the full sample and showed equivalent factor structure, factor loadings, latent values, factor variance and error variance across different sex and age groups. Care aides with English as their first language showed higher latent values of the Exhaustion subscale compared to those with English as a second language. Conclusion Overall, the MBI-GS9 exhibited acceptable psychometric properties, but medium reliability of cynicism and efficacy subscales, for measuring burnout among care aides in nursing homes, demonstrating equivalence across sex and gender groups. When comparing across different languages or racial or ethnic groups among care aides, it is important to consider inequivalent latent values on Exhaustion before comparing scores on the measure.