Table 3.

General description of sources included in this review, including author names, year, study design, sample characteristics, measures, and the main findings.

#	References	Study design	Sample characteristics	Measure(s)	Main finding(s)
1	Adra et al., 2015	Qualitative: Qualitative description	Residents of nursing homes (n = 20), nurses (n = 11), and family caregivers (n = 8) in Lebanon.	Interviews.	Four themes were identified: 1) Maintaining family connectedness, 2) engaging in worthwhile activities, 3) maintaining and developing significant relationships, and 4) holding and practicing spiritual beliefs.
2	Arnetz and Hasson, 2007	Quantitative: Non-randomized controlled Intervention: Educational toolbox intervention	Nursing staff from two municipalities in western Sweden. Intervention group: n = 213–270. Reference group: n = 606–647.	Quality-work-competence (QWC). Pyramid quality of care questionnaire. Relative questionnaire.	The intervention group showed a larger significant improvement for some aspects of self-rated knowledge and psychosocial work environment than the reference group.
3	Bing-Jonsson et al., 2014	Mixed method: Sequential exploratory Quantitative: Descriptive study Qualitative: Qualitative description	Experts (about older people care) from Norway. N = 42.	Interviews. Nursing Older People—Competence Evaluation Tool (NOP-CET).	Various important aspects of competences were identified, such as health promotion, disease prevention, treatment, palliative care, ethics and regulation, assessment and taking action, covering basic needs, communication and documentation, responsibility and activeness, cooperation, and attitudes toward older people.
4	Bing-Jonsson et al., 2016	Quantitative: Descriptive study	Nursing staff in Norway. N = 1016.	Nursing Older People—Competence Evaluation Tool (NOP-CET).	The participants expressed competence in all variables measured. However, the degree to which this was the case varied.
5	Blomberg et al., 2013	Qualitative: Qualitative description	Healthcare professionals in Sweden. N = 13.	Interviews.	The meaning of work has changed over time from a focus on obstacles to one of opportunities.
6	Burger et al., 2009	Qualitative: Descriptive study	Expert panel in the USA. N = 31.	Focus group interview.	There's a shift to resident-focused care. Nurses should be involved in decision making and be empowered. Various themes for the new roles of registered nurses were identified, including: Autonomy, dignity, respect, flexibility, leadership, professional development, and considerate behavior. Nurses currently experience high work pressure and are not adequately prepared for this new work role.
7	Cairns et al., 2013	Quantitative: Descriptive study	Health and social care professionals across four NHS Trusts in England. N = 192.	Dignity questionnaire.	Dignified care was described with terms such as: “respect,” “being treated as an individual,” “being involved in decision making,” and “privacy.” The most important aspects were “being treated as an individual” and “maintaining privacy.” Relational components were more important for dignified care than physical caring tasks.
8	DeHart et al., 2009	Qualitative: Descriptive study	Nursing home staff, policy makers, and related professionals in the USA. N > 20.	Interviews.	Assistants often lack the ability to deal with conflicts. Suggested competences include: Communication with a focus on improving relations, self-reflection, realizing the dependence of residents, client-oriented care, individualized care, sharing of values, teamwork.
9	Duffy et al., 2009	Quantitative: Descriptive study	Staff working in Continuing Care homes for older people with dementia in the UK. N = 61.	Maslach Burnout Inventory (MBI). Jeffcott Reciprocity Questionnaire. Inventory of Geriatric Nursing Self-Efficacy. Occupational Commitment Questionnaire (OCQ).	Burnout was most strongly predicted by (a lack of) self-efficacy. Other factors include reciprocity, occupational commitment, and demographic factors.
10	Ellis and Rawson, 2015	Qualitative: Qualitative description	Registered nurses, nurses in training, and assistants in Australia. N = 20.	Interviews.	Two themes were identified: “What it's like for them”: awareness of the consequences of relocation, staffing and nursing care; additional services and the environment, “We can make it better”: suggestions for improving relocation, e.g., socializing with new residents, and the importance of person-centered care.
11	Engström et al., 2011	Quantitative: Cross-sectional analytic	Caregivers in elderly care in Sweden. Formal competence: n = 447. No formal competence: n = 125.	Satisfaction with Work Questionnaire (SWQ). Conditions of Work Effectiveness Questionnaire II (CWEQ II).	Those without formal competence experienced a relatively higher workload, more communication obstacles, less competence, poorer sleep and more stress than those with formal competence.
12	Engström et al., 2010	Quantitative: Non-randomized controlled Intervention: Training program consisting of 8 group sessions during 9 months.	Female caregivers in Sweden. Intervention: n = 14. Control: n = 32.	Spreitzer's Empowerment scale. Psychosocial aspects of job satisfaction.	Over time, the amount of “criticism” significantly increased for the intervention group, whereas the control group remained the same. Empowerment showed a positive correlation with most aspects job satisfaction.
13	From et al., 2013	Quantitative: Cross-sectional analytic	Staff from 14 communities in Sweden. Nursing assistants: n = 70. Enrolled nurses: n = 163. Registered nurses: n = 198.	Quality of care from the Patients' Perspective (QPP). The Creative Climate Questionnaire (CCQ). Stress of conscience questionnaire (SCQ). Questionnaire on education and competence development. Health Index (HI).	Work-related competences were better developed than social competences. The most important competence was deemed to be work-related in nature. The culture was creative in some regards, but stagnant in others. Well-being of nurses was generally good, but registered nurses scored worse compared to the other types of nurses. Education is often utilized to make one feel “safe” at work, and is more often (voluntarily) applied in practice by registered nurses than the other nurses.
14	Ha et al., 2014	Quantitative: Descriptive study	Care workers in 14 nursing homes in Korea. N = 504.	5-point Likert scales measuring various variables defined by other studies.	High-performance partially mediated turnover intention through organizational support and commitment. Turnover intention was influenced the most by organizational commitment.
15	Hasson et al., 2008	Qualtitative: Descriptive study	Link nurses from 10 nursing homes in Northern Ireland. N = 14.	3 focus group interviews.	Although link nurses have the potential to improve palliative care they experienced a number of difficulties, such as lack of managerial support, a transient workforce and a lack of adequate preparation. Favorable conditions included external support, monthly meetings, access to resource files and peer support.
16	Hasson and Arnetz, 2008	Quantitative: Cross-sectional analytic	Nursing staff in two older people care organizations in Sweden. Home care: n = 298. Nursing homes: n = 565.	Quality-work-competence (QWC). Single-item work satisfaction rating.	Home care staff had insufficient knowledge, but experienced less strain compared to nursing homes' staff. Both care settings were equal in terms of exhaustion, mental energy and work satisfaction. Exhaustion was the strongest negative predictor of work satisfaction.
17	Huizenga et al., 2016	Qualitative: Qualitative description	Registered nurses in geriatrics and gerontology in The Netherlands, both working in nursing homes as well as in home care, general healthcare, hospitals, etc. N = 67.	7 focus group interviews.	Although nurses often fulfill all of the “CanMEDS” roles, they rarely possess all the required competences. Having fewer patient activities correlates with a lower expression of competences such as social networks; design; research; innovation of care; legal, financial and organizational frameworks; professional ethics and professional innovation.
18	Kinnear et al., 2014	Qualitative: Qualitative description	Healthcare professionals (n = 48) and social care professionals (n = 33) in England.	8 focus group interviews.	Dignity is considered to be a central aspect of care, and it encompasses a focus on “the little things,” as well as creating a safe atmosphere and treating one another as equals and individuals.
19	Rehnsfeldt et al., 2014	Qualitative: Qualitative description	Relatives of elders receiving care in Norway, Denmark, and Sweden. N = 28.	Interviews.	Dignity encompasses “feeling at home” and “the little extras.” However, non-caring cultures focus on routine, efficiency, and instrumentalism.
20	Rodríguez-Martín et al., 2016	Quantitative: Descriptive study	Nursing staff working in 62 units for older people in Southwest Finland. N = 874.	Individualized Care Scale-Nurse-B (ICS-Nurse-B). Questionnaire for nurses' socio-demographic and organizational data.	Participants generally had positive perceptions about the amount of individualized care for older people, which included taking into account patients' clinical situations and patients' decisional control. Individualized care provision correlated positively with age and type of organization.
21	Thompson et al., 2016	Qualitative: Qualitative description	Nursing staff in Great Britain. N = 13.	5 interviews.	Economic policies and the nature of nursing work were though to negatively impact the occupational status of nurses. This in turn influenced nurses' perception of their roles and their ability to enact their roles.
22	Van der Kooij et al., 2013	Quantitative: Randomized controlled trial Intervention: Integrated emotion-oriented care	Professional caregivers in 16 psychogeriatric nursing home wards in 14 nursing homes in The Netherlands. Experimental group: n = 46. Control group: n = 53.	Emotion-oriented Skills in the Interaction with Elderly People with Dementia (ESID). 39 criteria for quality standards for usual nursing home care.	Integrated emotion-oriented care increased caregivers' emotion-oriented skills and knowledge of residents, and did not consume more time than traditional care.
23	Wilson and Davies, 2009	Qualtitative: Descriptive study	Residents (n = 16), staff (n = 25), and families of residents (n = 18) from three care homes in England.	8 focus group interviews.	Staff adopted individualized task-centered, resident-centered and relationship-centered approaches to care delivery, which in turn influenced what relations where developed between residents, families, and staff.
24	Yeatts and Cready, 2007	Mixed method: Sequential exploratory Quantitative: Cohort study Qualitative: Qualitative description	Certified nurse aides (CNA, n = 314–354), nurses (n = 149–164), and residents of family members (n = 530–578) from 10 nursing homes in the USA.	Custom survey to measure global empowerment and its dimensions of autonomy, impact or meaningfulness, and competence, rating of CNA performance, self-esteem, burnout, job satisfaction, satisfaction with scheduling, commitment, intent to quit, and absenteeism. Observations of over 270 certified nurse aides meetings. Examination of weekly team-meeting summaries. Examination of written weekly responses and requests from nurse management.	Having work teams improved CNA empowerment; CAN performance; resident care and choices; procedures, coordination, and cooperation between CNAs and nurses; and tentatively decreased turnover. Work attitudes showed mixed results.