Investigating the implementation of education with a focus on person-centered communication in homecare services targeting nursing assistants

INTERVENTION: The ACTION program will be implemented in home care organisations in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited; 150 for the intervention group and 150 for the control group. The researchers will evaluate impact measures and the process. Home care organisations will be contacted in both urban and rural areas with a request to participate. Each participating home care organisation will be randomly assigned to either the control or the intervention group. The control groups will be offered the education after completion of all data collection, to compensate for their effort to gather data as controls. The education in ACTION is mainly web‐based and the course is divided into six learning modules. The ACTION program has a blended learning approach, combining e‐learning and face‐to‐face instructions, and each course is estimated to last for 6‐8 weeks. CONDITION: Competence development by implementing a training intervention in person‐centered communication, aimed at nursing assistants working within in‐home care for older people ; Not Applicable PRIMARY OUTCOME: ; 1. Person‐centred communication measured with audio recordings of communication during home care visits collected at baseline (e.g. before education) and after education (e.g. 8 weeks later), and analysed and coded by sequences of empathic statements and responses to emphatic opportunities, emotional communication and degree of person‐centeredness:; 1.1. Emphatic and emotional communication defined according to empathic opportunities, described by Suchman et al. and their model of emphatic communication; 1.2. Emotional communication coded by the Verona Coding Definitions on Emotional Sequences (VR‐CoDES); 1.3. Degree of person‐centered communication coded by the Roter Interaction of Analysis (RIAS); The coding will be made by two independent coders after training, and interrater reliability will be calculated with Cohen’s kappa coefficient or with Pearson correlation analysis.; INCLUSION CRITERIA: Nursing assistants: 1. Permanent employment 2. Understand and speak Swedish Older persons receiving in‐home care: 1. 65 years or older 2. Understand and speak Swedish 3. No cognitive impairment SECONDARY OUTCOME: ; 1. Communication skills measured with the Self‐efficacy questionnaire (SE‐12) at baseline (e.g. before education) and after education (e.g. 8 weeks later); 2. Person‐centred care measured with the Person‐centered Care Assessment Tool (P‐CAT) at baseline (e.g. before education) and after education (e.g. 8 weeks later); 3. Empathy measured with the Jefferson Scale of empathy (JSE) at baseline (e.g. before education) and after education (e.g 8 weeks later); 4. Job satisfaction measured with the Measure of Job Satisfaction at baseline (e.g. before education) and after education (e.g 8 weeks later); 5. Process evaluation with interviews, field notes and observations during the education with a focus on qualitative aspects and experiences of the implementation, weekly at weeks 1‐6 during the education; 6. Older persons’ perceptions measured with interviews about the meaning of and experiences from nursing assistant’s person‐centred communication at weeks 6 ‐ 8;