Song, Y., Nassur, A. M., Rupasinghe, V., Haq, F., Boström, A. M., Reid, R. C., ... & Weeks, L. E. (2023). Factors Associated With Residents’ Responsive Behaviors Toward Staff in Long-Term Care Homes: A Systematic Review. The Gerontologist, 63(4), 674-689.

Background and Objectives When staff experience responsive behaviors fromresidents, this can lead to decreased quality of work life and lower qualityof care in long-term care homes. We synthesized research on factorsassociated with resident responsive behaviors directed toward care staff andcharacteristics of interventions to reduce the behaviors. Research Design andMethods We conducted a mixed-methods systematic review with quantitative andqualitative research. We searched 12 bibliographic databases and “gray”literature, using 2 keywords (long-term care, responsive behaviors) and theirsynonyms. Pairs of reviewers independently completed screening, dataextraction, and risk of bias assessment. We developed a coding scheme usingthe ecological model as an organizing structure and prepared narrativesummaries for each factor. Results From 86 included studies (57 quantitative,28 qualitative, 1 mixed methods), multiple factors emerged, such as stafftraining background (individual level), staff approaches to care(interpersonal level), leadership and staffing resources (institutionallevel), and racism and patriarchy (societal level). Quantitative andqualitative results each provided key insights, such as qualitative resultspertaining to leadership responses to reports of behaviors, and quantitativefindings on the impact of staff approaches to care on behaviors. Effects ofinterventions (n  = 14) to reduce the behaviors were inconclusive. Discussionand Implications We identified the need for an enhanced understanding of theinterrelationships among factors associated with resident responsivebehaviors toward staff and processes leading to the behaviors. To addressthese gaps and to inform theory-based effective interventions for preventingor mitigating responsive behaviors, we suggest intervention studies withsystematic process evaluations.