Influence of individuals’ attitudes and capabilities on implementation in aged care: a literature analysis

Introduction:
The aged care sector is undergoing significant reform and innovation. The successful implementation of innovations requires effective strategies, tailored to address the particular barriers and enablers experienced by individuals in their own context.

Aim:
This study aimed to identify key factors relating to individuals’ attitudes and capabilities that influence implementation in aged care.

Methods:
This study provides an in-depth, inductive qualitative content analysis of the literature included in a recent comprehensive scoping review on the implementation of innovations in aged care.

Results:
Attitude and capability factors were frequently identified as influencing implementation in aged care, as either barriers or enablers. Attitudes held by staff were predominant, and were primarily related to the innovation as well as the change process. Attitudes included resistance, concern, and defensiveness as well as enthusiasm, motivation, and a growth mindset. The beliefs that underpinned attitudes primarily related to the benefits associated with the innovation as well as perceived fears and threats, need/relevance, difficulty, enjoyment, and conflict. Capability factors largely related to staff knowledge of the innovation, background knowledge, and relevant skills as well as clarity of role-related responsibilities. The generally low skill level of the aged care workforce was also a factor, as were the capabilities of older people/clients.

Conclusions:
Attitudes and capabilities are key factors that can influence implementation, particularly those held by staff as well as other stakeholders. Identifying and monitoring stakeholders’ attitudes, underlying beliefs, and capabilities enables the selection of appropriate implementation strategies to optimize the successful introduction and sustainment of innovations to improve care for older people.