Background

Home Care Services for older adults vary widely across countries regarding how they are structured, organised, and funded. Contextual factors such as workload, staffing challenges, and variability in educational backgrounds may influence participation in communication training. Previous evaluations of the ACTION programme (A person-centred CommunicaTION programme for nursing assistants (NAs) in home care for older adults) have shown promising feasibility and acceptability, providing the basis for the current scaled-up evaluation. This study aimed to evaluate the impact of ACTION on NAs in Swedish home care, using a mixed-methods cluster design.

Methods

This study used a convergent mixed-methods cluster quasi-experimental design Data were collected from both intervention and control groups using pre- and post-intervention surveys assessing person-centred care, empathy, job satisfaction, and communication self-efficacy. The intervention group also completed a programme evaluation with open-ended questions upon completing the training modules.

Results

Quantitative results showed no statistically significant differences between groups after cluster-corrected analysis, while qualitative findings indicated increased awareness and reflection regarding communication.

These findings highlight the importance of considering contextual factors and providing ongoing support when implementing person-centred communication interventions in elder care. The evaluation shows both strengths and methodological limitations. While some positive qualitative changes were observed, the findings emphasise the need to include the perspectives of older adults and their relatives in future research.

Conclusions

While quantitative effects were limited, the training programme contributed to meaningful qualitative improvements in communication awareness. Longer follow up and larger samples are needed to determine measurable effects.