Burnout intervention studies for inpatient elderly care nursing staff: Systematic literature review

Burnout and Stress in Forensic Science Jobs: A Systematic Review

BACKGROUND/OBJECTIVES

Burnout and occupational stress are significant issues among forensic professionals, impacting their well-being and job performance. This systematic review aims to provide an up-to-date overview of the occupational stress and burnout experienced by forensic personnel, exploring the profound and multifaceted impact on their physical, mental, professional, and interpersonal well-being.

METHODS

A systematic review was conducted following PRISMA guidelines using Scopus and WOS databases to search for articles published from 1 January 2000 to 31 August 2024. The search used keywords related to burnout and forensic professions. Inclusion criteria were original articles in English and French, while reviews, book chapters, editorials, and notes were excluded. A total of 10 studies were included after eliminating duplicates and excluding irrelevant articles.

RESULTS

The review identified seven key findings. (1) High levels of occupational stress and burnout among forensic personnel necessitate effective stress management strategies and resilience training; (2) autopsy technicians in Romania experience burnout and alexithymia, particularly related to traumatic events involving children, highlighting the need for specialized support systems; (3) disparities in burnout and post-traumatic stress disorder (PTSD) symptoms were observed in autopsy technicians and resident doctors, suggesting tailored mental health resources; (4) organizational factors, such as peer support and compensation satisfaction, significantly impact burnout and secondary traumatic stress (STS) among sexual assault nurse examiners; (5) burnout among forensic physicians, both in Romania and Egypt, is linked to personality traits, job satisfaction, and socio-demographic factors; (6) pathologists face a range of health issues, including musculoskeletal problems and psychological disorders, underscoring the need for industry-specific health measures; and (7) the lack of wellness resources for forensic professionals calls for improved mental health support and training.

CONCLUSIONS

The findings highlight the pervasive issue of burnout and stress among forensic professionals globally. Addressing these challenges requires comprehensive stress management programs, tailored mental health resources, and organizational support. Future research should focus on developing and implementing effective interventions to enhance resilience and job satisfaction within this high-stress field.

Resident Aggression and Staff Burnout in Nursing Homes in Hong Kong

This study examined the effects of exposure to resident aggression, self-efficacy, neuroticism, and attitudes toward dementia on burnout among direct care workers (DCWs) in nursing homes. A convenience sample of 800 DCWs from 70 randomly selected nursing homes in Hong Kong were recruited and individually interviewed. DCWs reported past-month experiences of resident aggression, levels of burnout, self-efficacy, neuroticism, attitudes toward dementia, and other personal and facility characteristics. Hierarchical multiple regression analysis revealed that, while physical environment of the facilities, and demographic background and self-efficacy of DCWs were not significant contributing factors, DCWs' exposure to resident aggression, insufficient experience and training in dementia care, negative attitudes toward dementia, and neurotic personality were associated with higher levels of staff burnout. Findings point to the importance of mitigating resident aggression and adequately screen and train staff to optimize their empathy and competence in minimizing the risk of burnout.

Emotional Exhaustion in Healthcare Workers: Moving Beyond Coping Skills to Improve Organizational Conditions

OBJECTIVE

Emotional exhaustion (EE)-the first stage of burnout-is related to preventable work environment exposures. We examined the understudied impact of organizational support for safety (OSS) and safety hazards (SH) on EE in a mixed licensed and unlicensed population of healthcare workers (HCWs).

METHODS

A work environment exposures survey was conducted in five US public healthcare facilities in 2018-2019. A total of 1059 questionnaires were collected from a predominantly female population of mixed HCWs.

RESULTS

Mean EE scores were higher among women, direct care workers, and younger subjects. In linear regression models, EE was positively associated with SH, emotional labor, psychological demands, physical demands, job strain, assault, and negative acts, while OSS was negatively associated. Safety hazard s both mediated and moderated the relationship between OSS and EE.

CONCLUSIONS

When perception of SH is high, OSS has less impact on reducing EE, suggesting a need to effectively put safety policies to practice for improving EE in HCWS.

Individual and organizational interventions to promote staff health and well-being in residential long-term care: a systematic review of randomized controlled trials over the past 20 years

BACKGROUND

Staff in residential long-term care (RLTC) experience significant physical and mental work demands. However, research on specific interventions to promote staff health and well-being in RLTC facilities is limited. This systematic review aimed to synthesize the current evidence on health promotion interventions among RLTC staff.

METHODS

A comprehensive systematic literature review was conducted on studies published between January 2000 and April 2023. Four electronic databases were searched, including PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and PsychArticles via EBSCO. The review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The methodological quality of the included studies was assessed using the Risk of Bias Assessment tool (RoB 2).

RESULTS

A total of 26 publications, referring to 23 different interventions with a randomized controlled design were included. Among these interventions, ten used training/educational approaches, six used behavioral approaches, and seven employed a multimodal approach. Significant improvements in health and well-being outcomes were found in four interventions using a training/educational approach, three interventions using a behavioral approach, and four interventions using a multimodal approach. Within the interventions studied, twelve specifically targeted the reduction of job demands, while only one intervention exclusively addressed job resources among RLTC staff. Furthermore, ten interventions addressed primary outcomes that encompassed both job demands and job resources.

CONCLUSION

Current evidence for health promotion interventions among RLTC staff is still limited, but research suggests that there is potential to improve certain outcomes related to RLTC staff health and well-being. Future research is recommended to contemplate a tailored intervention design that encompasses both individual-level and organizational-level approaches, and gender-specific physiological and sociological characteristics of RLTC staff. Moreover, detailed reporting of the development process, and research on the interaction between job demands and resources of RLTC staff are also recommended.

Job demand and job resource factors explaining stress and job satisfaction among home care nurses - a mixed-methods sequential explanatory study

BACKGROUND

Increasing home care has been seen as a way to respond to the growing care needs of the aging population. To secure a sufficient number of nurses to provide home care, it is essential to identify and take into account the factors related to their well-being and job satisfaction. This study examined associations of both objective and subjective job demands and resources with stress and job satisfaction among nurses working in home care.

METHODS

This study used a mixed-methods sequential explanatory design. First, quantitative data was collected with a survey, followed by a qualitative survey with open-ended questions. Linear regression analyses and qualitative content analysis with an inductive approach were used to analyze the quantitative and qualitative data, respectively. Joint display in a form of a table was used to integrate the results.

RESULTS

Of the objectively measured job demands and resources, higher proportion of direct care time and higher number of interruptions were associated with higher stress in the fully adjusted models. Of the subjective measures, higher time pressure, role conflicts and disruptions were associated with higher stress. Higher time pressure, role conflicts, and disruptions in the workday were associated with lower job satisfaction, whereas higher care continuity and having more autonomy were associated with higher job satisfaction. The results of the qualitative study, in which the nurses described their experiences of their working week, partly explained and confirmed the results of the quantitative study but were also contradictory in some respects.

CONCLUSIONS

Many demands, both subjectively experienced and objectively measured in terms of work organization, may undermine home care nurses' well-being and enjoyment at work. A severe nursing shortage combined with a growing number of clients is the reality of home care, significantly increasing the risk of burnout and turnover among employees. Strategies must be developed urgently to ensure sufficient personnel in home care. For example, investments should be made in opportunities for autonomous planning of work, and promotion of good cooperation and functionality of work teams.

Bullying and burnout in critical care nurses: A cross-sectional descriptive study

BACKGROUND

Employee bullying and burnout are two crucial, prevalent and challenging concepts that adversely affect organizational staff behaviours. Also, adverse patient care is associated with nurse bullying and burnout.

AIM

This study aimed to assess the incidence and association between workplace bullying and occupational burnout among nurses in critical care units in Iran.

STUDY DESIGN

A cross-sectional descriptive study.

METHODS

The subjects were 184 nurses from critical care units in 6 teaching hospitals in Iran. Three questionnaires were distributed among the study population; (a) demographic characteristics questionnaire, (b) Maslach Burnout Inventory (MBI) and (c) bullying at Workplace Questionnaire. Descriptive statistics were used to present the workplace bullying and occupational burnout status among nurses. Linear and logistic regression analyses were conducted to estimate the relationship between workplace bullying with MBI and nurses' demographic characteristics, respectively.

RESULTS

62% of the nurses had moderate emotional exhaustion, 59.8% had moderate depersonalization and 46.2% had a moderate individual achievement. 75.5% faced workplace bullying. There was a positive and significant association between bullying scores and burnout in total (Pearson's r = 0.598, p < 0.001). Linear regression test showed a positive and significant relationship between bullying with MBI dimensions (R = 0.613, p < 0.001) for emotional exhaustion, (R = 0.679, p < 0.001) for depersonalization and (R = -0.417, p < 0.001) for individual achievement.

CONCLUSIONS

Among Iranian nurses, bullying is a prominent and substantial issue that significantly correlates with their negative performance by enhancing job burnout.

RELEVANCE TO CLINICAL PRACTICE

It is suggested that some measures are adopted to avoid workplace bullying and to reduce occupational burnout for nurses. Managers should create an environment that encourages nurses to voice their concerns - informing nurses about their rights and creating a positive atmosphere in the hospital.

Implementing complex interventions to mitigate burnout among qualified healthcare professionals: a realist review protocol

INTRODUCTION

Reported burnout rates among qualified healthcare professionals (QHP) are alarming. Systematic reviews evaluating the effectiveness of burnout interventions for QHP exist; however, findings are contradictory. In addition, to date, there is no indication of how these interventions work and what specific intervention elements mitigate burnout. This review aims to explain how burnout interventions work and the contextual factors that mediate the intended outcomes. Our ultimate goal is to formulate actionable recommendations to guide the implementation of complex burnout interventions for QHP working in the hospital setting.

METHODS AND ANALYSIS

In light of the heterogeneity and complexity of the interventions designed to address burnout, we will conduct a realist review using Pawson's five iterative stages to explore and explain how burnout interventions work, for whom, and in what circumstances. We will search PubMed, CINAHL, Scopus, PsycINFO and Web of Science from inception to December 2022. Grey literature sources will also be considered. The results will be reported according to the Realist and Meta-Narrative Evidence Syntheses-Evolving Standards quality and publication standards ETHICS AND DISSEMINATION: Findings will be disseminated in a peer-reviewed journal, conference presentations and through the development of infographics and relevant educational material to be shared with stakeholders and key institutions. This study is a secondary data analysis; thus, a formal ethics review is not applicable.

PROSPERO REGISTRATION NUMBER

CRD42021293154.

Nurses' emotional exhaustion: Prevalence, psychosocial risk factors and association to sick leave depending on care setting-A quantitative secondary analysis

AIMS

To explore differences in the prevalence, psychosocial risk factors and the connection to annual sick leave of nurses' emotional exhaustion depending on the care setting.

DESIGN

Quantitative study.

METHODS

We conducted a secondary data analysis of a cross-sectional, representative survey with German nurses (BIBB/BAuA-Employment Survey 2018). We analysed data from three groups of nurses (hospital care HC: n = 333, nursing homes NH: n = 143, home health care HHC: n = 109). We calculated prevalence estimates for all psychosocial risk factors and emotional exhaustion and utilized Χ² -tests to explore differences relating to the care setting. We calculated risk estimates using logistic regression analyses.

RESULTS

Forty-four per cent of all nurses reported symptoms of emotional exhaustion. Care settings did not affect prevalence estimates (HC: 45.3%, NH: 37.8%, HHC: 50.5%). Weekend work was a risk factor for exhaustion. Being at the limit of efficiency was the only work-related psychosocial risk factor being independent of the care setting. Emotional demands were a significant risk factor for nurses working in HC and NH, and low team cooperation was a risk factor for nurses working in NH. Nurses' emotional exhaustion is associated with more sick leave days.

CONCLUSIONS

The high prevalence of nurses' emotional exhaustion is independent of the care setting. This threatens nurses' health and negatively affects the organization and society due to the relation to sick leave. Weekend work and quantitative demands relate to exhaustion independently of the care context. Emotional demands and low team cooperation show context-specific correlations.

IMPACT

Organizational interventions that limit quantitative demands are needed to prevent exhaustion among nurses. In HC and NH, measures are needed to improve coping with emotional demands and to strengthen team cooperation. Policymakers and nursing managers should take action to address nurses' emotional exhaustion.

NO PATIENT OR PUBLIC CONTRIBUTION

Due to the study design.

Development of a nurse-manager dualistic intervention program to alleviate burnout among nurses based on the appreciative inquiry

Aims

To develop a feasible and effective nurse-manager dualistic intervention program to support nurses coping with burnout symptoms.

Background

Person-organization combined interventions were recommended as the most effective approach for reducing burnout symptoms. However, few interventions have been developed in the nursing field.

Methods

The Medical Research Council, United Kingdom (MRC UK), Framework for Development and Evaluation of Complex Interventions, was employed for nurse-manager dualistic intervention program development. The following three steps were followed for developing the dualistic intervention program: (1) identifying the evidence base by conducting extensive reviews of the relevant literature and a mixed study; (2) identifying/developing a theory by selecting the job demands-resources model and proposing the theoretical framework for intervention development; and (3) modifying the process and outcomes of the nurse-manager dualistic intervention program.

Results

The intervention program consists of six group sessions over 9 weeks. Researchers/managers are supposed to deliver the program. The main contents of the intervention are (1) inception (session 1); (2) discovery (session 2); (3) dream (session 3); (4) design (session 4); (5) destiny (session 5); and (6) keep (session 6). The emphasis of the intervention is on helping nurses dealing with burnout symptoms.

Conclusion

Following the guidance of the MRC framework, a feasible and potentially effective nurse-manager dualistic intervention program was developed for nurses coping with burnout. Future studies are needed to model the intervention and assess the effects and replicability of the intervention.

A systematic review of the relationships between nurse leaders' leadership styles and nurses' work-related well-being

AIM

This systematic review aimed to summarize current research knowledge about the relationships between nurse leaders' leadership styles and nurses' work-related well-being.

BACKGROUND

Due to the global shortage of nurses, it is essential for nurse leaders to maximize staff retention and work-related well-being.

METHODS

Following Cochrane Collaboration procedures, the PRISMA statement and PRISMA checklist, relevant quantitative studies published between 1 January 2012 and 31 December 2020 were retrieved from the CINAHL, Scopus, PubMed and Medic databases and then systematically reviewed. Seventeen cross-sectional and follow-up studies with surveys were retained for inclusion and evaluated with the Critical Appraisal of a Survey instrument. The data were summarized narratively.

RESULTS

Three core themes of leadership styles: destructive, supportive and relationally focused, were identified, with statistically significant direct and indirect connections between nurses' work-related well-being. Well-being was mainly assessed in terms of burnout. Effects of leadership styles on work-related well-being were reportedly mediated by trust in leader, trust in organization, empowerment, work-life conflict, relational social capital, emotional exhaustion, affectivity, job satisfaction and motivation.

CONCLUSION

Nurse leaders' leadership styles affect nurses' work-related well-being. In developing intervention studies and providing training on work-related well-being, the impact of the indirect effects and the mediating factors of the leadership styles should be acknowledged.

Effect of stress management based on cognitive-behavioural therapy on nurses as a universal prevention in the workplace: a systematic review and meta-analysis protocol

INTRODUCTION

The mental health status of nurses affects not only their well-being but also the organisational outcomes and the quality of patient care. Hence, stress management strategies are critical as a universal prevention measure that address an entire population and are not directed at a specific risk group to maintain nurses' mental health in the workplace. No systematic review or meta-analysis has been conducted to evaluate the effect of cognitive-behavioural therapy (CBT) that specifically focuses on universal prevention. Therefore, the aim of this study is to examine the effectiveness that is reported in published randomised controlled trial (RCT) studies.

METHODS AND ANALYSIS

This systematic review and meta-analysis will analyse published studies selected from electronic databases (ie, Cochrane Central Register of Controlled Trials, PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, Web of Science and the Japan Medical Abstracts Society). The inclusion criteria for studies are that they (1) were conducted to assess the effect of CBT on the mental health of nurses as a universal prevention, (2) used an RCT design and (3) provided sufficient results (sample sizes, means and SD) to estimate the pooled effect sizes with 95% CIs. Studies will be excluded if they only targeted nurses who had been screened as being at high risk in terms of their mental health and indicated that they required the prevention. The methodological quality of the included studies will be assessed using the Cochrane Collaboration's risk of bias tool.

ETHICS AND DISSEMINATION

Ethical approval is not required because this study is based on information obtained from previous studies. The results and findings of this study will be submitted for publication in a peer-reviewed international scientific journal. Results from this study will be helpful when implementing CBT strategies for nurses as a universal preventative measure in the workplace and for managing stress-related outcomes.

PROSPERO REGISTRATION NUMBER

CRD42020152837.

Burnout Among University Students During Distance Learning Period due to the COVID-19 Pandemic: A Cross Sectional Study at the University of Jordan

OBJECTIVE

The COVID-19 pandemic led to a deviation from classical face-to-face learning to distance learning. Few studies examined burnout among university students during the distance learning period due to the COVID-19 pandemic. This study that aims to investigate the prevalence of burnout among university students during distance learning and the factors associated with it.

METHOD

A cross-sectional study was conducted among undergraduate students at the University of Jordan. The modified version of the Maslach Burnout Inventory for students (MBI-SS) was used to assess burnout.

RESULTS

The total number of participants was 587 and the mean total of MBI-SS score was 63.34 ± 8.85. Based on the MBI-SS definition, 6.6% of the study participants were found to have symptoms of burnout. Practicing hobbies, level of satisfaction with distance learning, and thoughts about quitting courses were significant predictors of burnout.

CONCLUSION

This study showed a relatively low prevalence of burnout among students during the distance learning period with several factors associated with it. As a result, identifying these factors will help both students and educational institutions to implement strategies that are needed for the primary and secondary prevention of burnout.

Work-Related Stress among a Cohort of Italian Long-Term Care Workers during the COVID-19 Pandemic: An Observational Study

Despite long-term care (LTC) workers having been identified as particularly subject to chronic stress, only a few studies evaluated the impact of the COVID-19 pandemic on stress in this population. As far as the authors know, no studies have investigated the relationship between work-related stress and chronic stress in the LTC setting. This retrospective observational study aimed to assess the level of chronic stress in LTC workers, to identify some possible predictors and vulnerability factors, and to measure the impact of the COVID-19 pandemic on work-related stress. The study was based on the information gathered from two different questionnaires administered before and one year after the beginning of the pandemic, to a cohort of Italian LTC workers. We found that chronic stress was associated with lower resilience to stress scores (57.42 vs. 60.66) and with higher work-related stress scores (30.48 vs. 20.83). Interestingly, the overall level of work-related stress did not differ between the two questionnaires (27.84 vs. 29.08). However, the main components of the questionnaires changed; fatigue and burnout symptoms became more relevant after the pandemic. Results of this study suggests deepening knowledge of the components of stress to develop and implement effective stress mitigation interventions.

Addressing Nursing Personnel Burnout in Long-Term Care: Implementation of a Gratitude Journal

Burnout affects health care providers and leads to adverse consequences. A 21-day gratitude journaling activity implemented in a Midwest long-term care setting was a personal, low-cost, and low-tech intervention requiring minimal time commitment to address burnout. The Maslach Burnout Inventory was utilized to assess burnout pre- and post-intervention of a gratitude journal.

Leadership challenges and strategies to dementia care in Chinese faith-based nursing homes: A qualitative study

AIM

To address the need and fill a knowledge gap in understanding challenges and coping strategies from the perspectives of nursing home leadership.

BACKGROUND

The rapid increase of older adults with dementia in China highlights the need for research on dementia care in long-term care facilities.

METHODS

Semi-structured interviews were conducted among 20 facility directors employed by faith-based nursing homes across 12 provinces in China via phone or in-person in their native language. Two researchers fluent in Mandarin Chinese and English coded interview transcripts; thematic analysis was conducted to identify patterns.

RESULTS

Four primary challenges were identified, including recruiting and retaining nursing staff, funding, lacking governmental support, and discord with family members. The coping strategies included using external resources, incorporating religious beliefs, teamwork, rewarding performance, and improving staff skills and empathy.

CONCLUSIONS

This study contributes to nursing home practice knowledge by disseminating insights of administrators regarding culturally relevant dementia management strategies in China.

IMPLICATIONS FOR NURSING MANAGEMENT

Teamwork and staff encouragement Advocate for a sustainable governmental financial support Staff training and staff-resident ratio regulations and policy Seeking external resources Integrate faith-based means for problem management and service quality improvement.

Emotional availability in dyads of nursing aide - resident with dementia: Old tool, new perspective

Objectives

This study examined the emotional availability of nursing aide-resident with dementia dyads in a long-term care-facility. Emotional availability refers to the nursing aide’s sensitivity toward the resident, structuring their interactions in a non-intrusive and non-hostile manner and the resident’s responsiveness to and involvement of the nursing aide. The study evaluated the reciprocity in the emotional availability of nursing aides and the residents and examined whether emotional availability varies with the level of difficulty of taking care of the residents and with the context of the interaction.

Method

The study was conducted in three wards in one long-term care-facility. Twenty nursing aides and 40 residents took part in the study. Each nursing aide was videotaped during feeding, structured and unstructured interactions, with two residents, one that was nominated by the head nurse as difficult to take care of and one that was nominated as easy to take care of. The interactions were coded using the emotional availability scales.

Results

Linear mixed-effect model analyses indicated that higher emotional availability of nursing aides was related to higher emotional availability of the residents. Nursing aides’ emotional availability did not vary between “difficult” and “easy” residents or across the three interaction contexts. “Difficult” residents involved their nursing aides less than “easy” residents.

Discussion

The study documented the reciprocal nature of the interaction between nursing aides and residents with dementia. It suggests that nursing aides have an important role in promoting residents’ responsiveness and involvement.

Older assistant workers in intermediate care facilities, and their influence on the physical and mental burden of elderly care staff

Background

As there is a shortage of care staff in elderly care homes, seniors are expected to work as assistants to help the care staff. This study examined the influence of older assistant workers in intermediate elderly care facilities on care staff, specifically focusing on emotional exhaustion which is a sign of burnout. These facilities provide long-term nursing and supportive care to older residents.

Methods

Data from a mail survey of intermediate elderly care facilities with older assistant workers were analyzed. Care staff were asked about the advantages and disadvantages of introducing older assistant workers in elderly care work, and their degree of emotional exhaustion. We also assessed work self-evaluations of older assistant workers, including the benefits of the work, and physical and mental burdens.

Results

A significantly large number of care staff reported improvements in workload with the employment of older assistant workers. Intermediate elderly care facilities enrolling more older assistant workers showed lower mean emotional exhaustion among care staff, independent of possible covariates. While older assistant workers felt that their work contributed to helping both care users and staff, they also reported a mental burden.

Conclusions

Our results suggest that older assistant workers can play a significant role in reducing the physical and mental burden of intermediate elderly care facility staff. Thus, employing older assistant workers can be an effective approach to addressing shortages of care staff in elderly care homes.

Organizational Responsiveness to the COVID-19 Pandemic: a Mixed Methods Social Validity Assessment of Human Services Care Providers

OBJECTIVES

The COVID-19 pandemic posed many challenges to human services organizations serving persons with pre-existing conditions and health concerns. Study objectives were to assess organizational responsiveness to the pandemic through training, safety, and risk mitigation initiatives at community-based group homes for adults with intellectual disability (ID) and acquired brain injury (ABI).

METHOD

This was a two-phase mixed methods study with human services care providers. In phase 1, 54 focus group participants responded to standardized interviews about leadership actions in the early months of the COVID-19 pandemic and discussed implementation effectiveness. These qualitative findings informed the design and distribution of a multi-item questionnaire in phase 2 that quantified acceptance and approval of leadership actions among 498 participants.

RESULTS

Both focus group and questionnaire participants identified several consistent leadership actions that had a positive impact on risk mitigation, health promotion, and participant satisfaction. Participants also converged on priority needs and recommendations for performance improvement.

CONCLUSIONS

The study supports previous research on the effects of pandemic health crises among frontline healthcare workers and more definitively the impact on direct care providers of adults with ID and ABI during COVID-19. Care providers were able to judge organizational effectiveness and provide feedback to aide strategic planning. Mixed methods research provides an approach to large-scale program evaluation through integrated qualitative and quantitative analyses.

Assessments of stress of conscience, burnout and social support amongst care providers in home care and residential care for older people

BACKGROUND

Studies points to that levels of stress of conscience and burnout among staff in healthcare contexts may seriously affect their health.

AIM

To compare assessments and associations of stress of conscience, perceptions of conscience, social support and burnout amongst care providers working in home care respectively residential care for older people.

METHODS

This cross-sectional descriptive comparative study was performed among all care providers working in home care (n = 227) and residential care of older people (n = 354) in a municipality in northern Sweden. Data was collected using four different questionnaires. Analysis were performed using partial least square regression, descriptive statistics, statistical tests and effect size measures.

RESULTS

Care providers in residential care of older people assessed higher levels of stress of conscience compared to those working in home care. Exhaustion was an important predictor for belonging to the group of care providers working in residential care of older people. The most important predictor for belonging to the group of care providers working in home care were social support from one's immediate superior and co-workers. Women assessed significantly higher levels of stress of conscience and exhaustion compared to men.

CONCLUSION

Further research seems needed to investigate what the high levels of stress of conscience is caused by. A combined intervention consisting of work-directed measures against burnout and measures aiming at reducing stress of conscience is suggested.

Clinical research and burnout syndrome in Italy - only a physicians' affair?

Background

The burnout phenomenon has been extensively investigated among health care professionals, particularly focusing on physicians and nurses. However, literature concerning burnout in clinical research is poor and often neglects the other professional categories involved.

Methods

In March 2019, all members of Italian Group of Clinical Research Coordinator were invited to participate to a web survey, consisting of three sections: general information and workload; Maslach Burnout Inventory (MBI) test; subjective perception of oneself’s work stress and possible causes.

Results

The majority of respondents felt a form of distress. The main source was contract type (31.2%), followed by workload (20.5%) and lack of skills recognition (17.8%).

Results from MBI test confirmed the interviewees’ subjective perception: an intermediate level of emotional exhaustion (19.1 points) and a very high sense of reduced professional achievement (26.8 points) were observed. Both depersonalization and sense of reduced professional achievement showed weak to moderate correlations with emotional exhaustion. Emotional exhaustion was associated with contract type with high significance.

Conclusion

It is necessary to act on those qualitative factors that are greatly increasing the level of perceived stress, jeopardizing the quality of clinical research coordinators work and significantly amplifying the phenomenon of migration towards the private sector.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05158-z.

Exploring the Relationship Between Perceived Visual Access to Nature and Nurse Burnout

OBJECTIVE

This study aims to investigate the relationship between perceived visual access to nature views in nurse work and break environments and scores for subscales of Maslach Burnout Inventory among nurses.

BACKGROUND

Burnout is a severe problem among nurses. Literature shows a relationship between stress and burnout and between nature exposure and stress. However, the possible consequent relationship between connection to nature and nurse burnout needs further study.

METHODS

This cross-sectional study explored the relationship between the subscales (Emotional Exhaustion, Depersonalization, and Personal Accomplishment [EE, DP, and PA]) of the Maslach Burnout Inventory as "outcome variables" and perception of view duration, frequency of exposure to views, view content and artwork content as "explanatory variables" in a subset regression model. The study model also included organizational stressors, environmental design factors, unit type, workload, and personal factors as control variables. Fifty-one nurses working in six units in a large tertiary care hospital participated in the study.

RESULTS

Percentage of perceived nature views and organizational stressors were the top two best predictors correlating with EE (37% of the EE variance; p < .05). Percentage of perceived nature views, organizational stressors, and environmental design were the top three predictors correlating with DP (43% of variance for DP; p < .05). No significant relationship was found between study variables and PA.

CONCLUSIONS

The results of this study recommend perceiving nature views as an independent or integrated intervention to meditation and relaxation techniques. From a design standpoint, this study suggests that a unit and breakroom design with access to nature views could work as a consistent preventive intervention for burnout.

Socioeconomic Factors Related to Job Satisfaction among Formal Care Workers in Nursing Homes for Older Dependent Adults

Population ageing is increasing the demand for dependent care. Aged care nursing homes are facilities that provide formal care for dependent older persons. Determining the level of job satisfaction among workers in nursing homes and the associated factors is key to enhancing their well-being and the quality of care. A cross-sectional survey was administered online to nursing home workers (n = 256) in an inland region of Spain over the period from February to May 2017. The questionnaire collected data on sociodemographic variables and others related to training and job satisfaction. The results show that most of the care is delivered by women with a medium level of education. A total of 68% of workers had received formal training, although a significant percentage (65%) thought this was not useful. The highest level of satisfaction was found to be related to users and co-workers. Our factor analysis revealed that the satisfaction components are decision-making, working conditions—e.g., schedule—and the work environment—e.g., relationship with coworkers—. Length of service and working with highly dependent persons are negatively associated with these components. Working in social health care is negatively related to decision-making and working conditions. Training, in contrast, is positively associated with these components. Care is a job that requires appropriate training and preparation to provide quality assistance and to guarantee workers’ well-being.

A Cross-sectional Multicentre Qualitative Study Exploring Attitudes and Burnout Knowledge in Intensive Care Nurses with Burnout

AIM

Although nurses in intensive care units (ICUs) are exposed to prolonged stress, no burnout prevention policy has yet been established. This study aims to determine the attitudes and "sense" of knowledge of burnout in nurses with burnout.

METHODS

The study, which has a qualitative exploratory phenomenological design, was carried out in several Croatian ICUs in 2017. ICU nurses suffering from burnout according to their score on the Maslach Burnout Inventory were chosen randomly from five hospitals. Their participation was voluntary. Of the 28 participants, 86% were women (n=24) and 14% men (n=4). They were aged mainly between 36 and 45 (n=11 (40%)) and between 26 and 35 (n=10 (36%)). Semi-structured interviews were conducted up to the saturation point. The conversations were audio-recorded and transcribed verbatim. The text was analysed using inductive thematic analysis, with codes derived and grouped into clusters by similarities in meaning, and interpretation as the final stage.

RESULTS

Emergent themes, compromised private life, stressful work demands, stress reduction options, protective workplace measures and sense of knowledge reflected a variety of experiences, attitudes and knowledge of burnout.

DISCUSSION

Nurses with burnout provided an insight into their experience and attitudes, and the problems created by burnout. Given the poor sense of knowledge about this syndrome, there is a need to implement education on burnout in nursing school curricula, and clear strategies in the ICU environment, i.e. information, awareness-raising, and specific guidelines on coping, burnout detection and prevention. Approaching burnout prevention through attitudes/social learning may be a novel and feasible model of addressing this issue.

Predictors of Migrant Live-in Care Workers' Burden/Burnout and Job Satisfaction When Caring for Frail Older Persons in Israel

OBJECTIVES

To clarify how work characteristics affect migrant live-in care workers' burden/burnout as well as their job satisfaction.

METHODS

Data from 116 migrant live-in care workers were collected in 2013-2014 in Tel Aviv and Jerusalem through structured interviews about their job satisfaction and their degree of burden/burnout. Due to the conceptual and empirical similarity (zero-order correlation and joint internal reliability), of burden and burnout, the 2 were combined into one variable. These outcome measures were examined in connection with the older person's level of disability, care workers' relationship with the older person, and their employment conditions.

RESULTS

According to the regression models, work characteristics (care recipients' functional status and care workers' relationship with the care recipient) had a direct impact on burden/burnout. Employment-related variables (employment conditions and satisfaction with those conditions) had an indirect effect. A combination of work characteristics (relationship with the older person) together with the care worker's response to employment conditions (satisfaction with employment conditions) had a direct influence on the care workers' job satisfaction. Problematic employment conditions had an indirect effect.

DISCUSSION

The results suggest that fostering better relationships and improving employment conditions could help reduce care workers' burden/burnout as well as improve their degree of satisfaction.

Physical activity and health promotion for nursing staff in elderly care: a study protocol for a randomised controlled trial

INTRODUCTION

Nursing staff is burdened by high workload and stress. Furthermore, heavy lifting, as well as transferring nursing home residents, cause lumbar tissue damage and back pain. Exercise intervention studies to reduce work-related problems are rare and the evidence for efficacy of studies among nurses is limited. Studies including targeted analysis of requirements are necessary to generate effective recommendations and tailored interventions for health promotion programmes. The purpose of this multicentred intervention study is to identify work-related problems, to implement health promotion programmes and to evaluate their effectiveness.

METHODS AND ANALYSIS

A randomised controlled trial will be conducted, including a total of 48 nursing home facilities in eight regions of Germany with an estimated sample size of 700 nurses. Standardised ergonomics and posture training (10 weeks, once a week for 20-30 min) and subsequently, back-fitness training (12 weeks, once a week for 45-60 min) will be administered. Following the implementation of standardised health promotion programmes, further demand-oriented interventions can be implemented. The perceived exposure to work-related demands, work-related pain in different parts of the body, health-related quality of life, perceived stress, work-related patterns of behaviour and experience, presentism behaviour, work environment as well as general needs and barriers to health promotion, will be assessed at baseline (pre-test), at 10 weeks (post-test, after ergonomics training), at 22 weeks (post-test, after back-fitness training) and at 34 weeks of the programme (follow-up).

ETHICS AND DISSEMINATION

The study was reviewed and approved by the local ethics committee of the University of Hamburg (AZ: 2018_168). The results of the study will be published in open-access and international journals. Furthermore, the results will be presented in the participating nursing homes and at national and international conferences.

TRIAL REGISTRATION NUMBER

DRKS.de (DRKS00015241).

Is It Me or You? A Team Approach to Mitigate Burnout in Critical Care

Burnout-a combination of emotional exhaustion, depersonalization, and a diminished sense of individual accomplishment-is a serious issue for critical care nurses. Burnout has been examined as an individual's emotional state, but burnout is also a social phenomenon that may spread among colleagues through emotional contagion. Current interventions to reduce burnout are either person directed or organization directed; few interventions focus on the critical care nursing team and their social support and interactions. This article reviews burnout in critical care nursing through the lens of emotional contagion. We offer suggestions for team-based interventions to address burnout in critical care nurses.

Effects of a practical training programme on burnout among professional caregivers in a care home for older adults with dementia: a pilot study

AIM

As the number of persons with dementia has increased so has the need for both specialized care and long-term care centres. Professional caregivers working in these centres encounter specific problems, including stress, burnout, and feelings of dissatisfaction, each which can affect the quality of care. Due to the nature of their work, they are more likely to experience stress, which may lead to burnout syndrome. Therefore, the aim of this work was to assess the results of a practical training programme with regard to burnout among direct care professionals in a nursing home for people with dementia.

METHODS

A practical training programme was conducted for caregivers at the Sagrado Corazón de Jesús Nursing Home in Cuenca, Spain. The programme used a dynamic, interactive methodology to provide training related to concepts and strategies for dementia care. Weekly 2-h sessions were held over 9 months, from April 2016 to January 2017, with the post-test administered in February. Pretest and post-test measures were taken for a sample of 36 caregivers. An anova was used to analyze the differences in means before and after training. An ancova was also performed to determine the effects of the intervention.

RESULTS

The results revealed a significant difference between pre- and post-intervention emotional exhaustion and depersonalization scores. Personal accomplishment scores improved, but the changes were not significant.

CONCLUSION

A practical training programme for direct care professionals working with dementia patients can decrease burnout levels.

Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses

OBJECTIVE

Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses.

METHODS

Researches have been conducted within Cochrane Library, PubMed, Ovid, Scopus, EBSCO, and CINAHL published from inception to 2019. In addition, a manual search for relevant articles was also conducted using Google Scholar and ancestral searches through the reference lists from articles included in the final review. Two reviewers independently selected and assessed, and any disagreements were resolved through a larger team discussion. A data extraction spreadsheet was developed and initially piloted in 3 randomly selected studies. Data from each study were extracted independently using a pre-standardized data abstraction form. The the Risk of Bias in Systematic reviews and assessment of multiple systematic reviews (AMSTAR) 2 tool were used to evaluate risk of bias and quality of included articles.

RESULTS

A total of 22 studies published from 2014 to 2019 were eligible for analysis. Previous studies have examined burnout among physicians (n = 9), nurses (n = 6) and healthcare providers (n = 7). The MBI was used by majority of studies to assess burnout. The included studies evaluated a wide range of interventions, individual-focused (emotion regulation, self-care workshop, yoga, massage, mindfulness, meditation, stress management skills and communication skills training), structural or organizational (workload or schedule-rotation, stress management training program, group face-to-face delivery, teamwork/transitions, Balint training, debriefing sessions and a focus group) and combine interventions (snoezelen, stress management and resiliency training, stress management workshop and improving interaction with colleagues through personal training). Based on the Risk of Bias in Systematic reviews and AMSTAR 2 criteria, the risk of bias and methodological quality included studies was from moderate to high.

CONCLUSIONS

Burnout is a complicated problem and should be dealt with by using bundled strategy. The existing overview clarified evidence to reduce burnout of physicians and nurses, which provided a basis for health policy makers or clinical managers to design simple and feasible strategies to reduce the burnout of physicians and nurses, and to ensure clinical safety.

Effectiveness of stress management interventional programme on occupational stress for nurses: A systematic review

AIM

The purpose of this systematic review is to evaluate the effectiveness of stress management interventional programme in reducing occupational stress among nurses.

BACKGROUND

Nursing professionals are placed continuously at the forefront in the area of health care which makes them highly exposed to professional stress.

EVALUATION

Randomized controlled trial studies (RCTs) were systematically searched in eight different databases for works published in English from 2011 to 2019; inclusion criteria were applied by two reviewers critically and assessed the risk of bias using Consolidated Standards of Reporting Trials (CONSORT).

KEY ISSUES

The systematic search contributed to the extraction of approximately 10 most relevant RCTs. Most of the RCTs considered in this systematic review revealed that the stress reduction interventions and strategies were effective in reducing the levels of occupational stress experienced by nurses.

CONCLUSIONS

Current review shows that stress management interventional programme tends to be effective, but additional well-designed RCTs are needed to confirm their effectiveness.

IMPLICATIONS FOR NURSING MANAGEMENT

Implementing stress management interventions within health care organisations are likely to assist nurses in reducing occupational stress and in improving coping strategies used by nurses for dealing with stress.

Evaluating the Outcomes of a Web-Based Stress Management Program for Nurses and Nursing Assistants

OBJECTIVE

The purpose of this quality improvement project was to determine the utilization, satisfaction, and effect of a web-based stress management program for nurses and nursing assistants (NAs).

METHODS

This quality improvement project provided BREATHE, a web-based stress management program that consisted of six modules that describe, identify, and help nurses manage stress for 31 nurses and NAs working on a subacute rehabilitation unit at a mid-Atlantic community hospital.

MEASUREMENTS

The number of login attempts and time spent on the program were included, as were the nurse stress scale (NSS), a 34-item validated instrument that captures seven dimensions of stress, and a seven-item satisfaction survey given at the end of the modules.

RESULTS

Nurses utilized and were satisfied with the evidence-based program BREATHE and reported significant improvement in NSS scores.

LINKING EVIDENCE TO ACTION

Findings suggest that BREATHE was effective at reducing the NSS score among nurses and NAs. The web-based nature of the program allowed nurses to engage in it at times most convenient for them, which added to the program's acceptability and overall satisfaction.

Burnout syndrome in Brazilian and Spanish nursing workers

Objective:

to analyze the burnout dimensions scores in Brazilian and Spanish nursing workers.

Method:

quantitative, cross-sectional and comparative study conducted with 589 Nursing workers who answered the Sociodemographic and Professional Characterization Questionnaire and the Maslach Burnout Inventory. Descriptive and analytical analysis of the data was performed.

Results:

Spanish Nursing workers presented higher averages in the Depersonalization dimension (p = 0.004) and Brazilians, higher scores in the Professional Achievement dimension (p = 0.031). In both Spain and Brazil, nursing assistants / technicians were found to have higher Emotional Exhaustion than nurses; In Brazil, Depersonalization is higher in nurses and in Spain it is higher in Nursing assistants / technicians. Statistically significant results were found in the association of burnout dimensions with sociodemographic and work characteristics: age; professional category; workplace; work regime; work shift; time of professional experience; working time in the same workplace and consider stressful work.

Conclusion:

Although Brazilian and Spanish nursing workers score low levels of Depersonalization and high Professional Achievement, there are average levels of Emotional Exhaustion, indicating an important preventive factor to be worked on, since Emotional Exhaustion is considered the first stage of burnout.

Exploring Proactive Behaviors of Employees in the Prevention of Burnout

Extensive evidence indicates that burnout can have detrimental consequences for individuals as well as organizations; therefore, there is a great need for burnout prevention. While burnout prevention interventions initiated by the employer have previously been studied, the proactive behaviors employees deploy themselves to prevent burnout have received less research attention. The purpose of this exploratory qualitative interview study was to enhance our understanding of the self-initiated actions employees undertake to prevent burnout, using the model of proactive motivation and conservation of resources theory as theoretical frameworks. Findings indicated that most participants reported to engage in specific kinds of proactive burnout prevention behaviors. The reported self-initiated proactive actions were aimed at maintaining and/or increasing resources and/or reducing demands in the work, home, and personal domain. The study contributes to the literature by linking the proactive motivation process to the prevention of burnout and by focusing on both work and non-work factors. Results of this study can be used in further research into the (effectiveness of) employees’ proactive burnout prevention behaviors and serve as a starting point for developing interventions aimed at enhancing proactive burnout prevention.

Burnout in Nurses Working With Youth With Chronic Pain: A Pilot Intervention

Objective

Nurse burnout is a significant issue, with repercussions for the nurse, patients, and health-care system. Our prior mixed-methods analyses helped inform a model of burnout in nurses working with youth with chronic pain. Our aims were to (a) detail the development of an intervention to decrease burnout; (b) evaluate the intervention's feasibility and acceptability; and (c) provide preliminary outcomes on the intervention.

Method

In total, 33 nurses working on a pediatric inpatient care unit that admits patients with chronic pain conditions participated in the single-session 90-min groups (eight to nine nurses per group). The intervention consisted of four modules including (1) helping patients view pain as multifaceted and shift attention to functioning; (2) teaching problem-solving and reflective listening skills; (3) highlighting positives about patients when venting with coworkers; and (4) improving nurses own self-care practices. Measures provided assessment of feasibility, acceptability, and effectiveness at baseline and 3 months postintervention in a single group, repeated measures design.

Results

Data support the feasibility and acceptability of the intervention. Pilot outcome results demonstrated improvements in the target behaviors of education on psychosocial influences, self-care, and venting to coworkers as well as self-compassion, general health, and burnout. There were no changes in pain beliefs or the target behaviors of focus on functioning, empathizing with patient, or highlighting positives.

Conclusions

Our single-session tailored group treatment was feasible and acceptable, and pilot data suggest that it is beneficial, but a more comprehensive approach is encouraged to reduce burnout that might be related to multiple individual, unit, and system factors.

Evidence of Workplace Interventions-A Systematic Review of Systematic Reviews

Work environment factors are highly correlated with employees' health and well-being. Our aim was to sum up current evidence of health promotion interventions in the workplace, focusing on interventions for the prevention of musculoskeletal disorders, psychological and behavioral disorders as well as interventions for older employees and economic evaluations. We conducted a comprehensive literature search including systematic reviews published from April 2012 to October 2017 in electronic databases and search engines, websites of relevant organizations and institutions. It consisted of simple and specific terms and word combinations related to workplace health promotion based on the search strategy of a previous review. After full-text screening, 74 references met the eligibility criteria. Using the same search strategy, there was a higher proportion of relevant high-quality studies as compared with the earlier review. The heterogeneity of health promotion interventions regarding intervention components, settings and study populations still limits the comparability of studies. Future studies should also address the societal and insurer perspective, including costs to the worker such as lost income and lost time at work of family members due to caregiving activities. To this end, more high-quality evidence is needed.

Online positive psychology intervention for nursing home staff: A cluster-randomized controlled feasibility trial of effectiveness and acceptability

BACKGROUND

Nursing staff in nursing homes is at risk for stress-related problems. Positive psychology interventions have been shown to effectively improve well-being and decrease depressive symptoms, and may be beneficial for nursing staff. However, controlled studies with nursing staff are missing.

OBJECTIVES AND DESIGN

This is the first study to test the effectiveness and acceptability of an online multi-component positive psychology intervention in nursing home staff. This study used a cluster-randomized controlled design, with an intervention group and a control group, and measurements at baseline (T0) and following the training period (T1). We hypothesized that the intervention would improve general well-being, job satisfaction and work engagement, especially for people with low initial well-being, satisfaction or engagement. Furthermore, we explored the acceptability of such an intervention for nursing home staff.

SETTINGS AND PARTICIPANTS

All nursing staff of the units for physically frail older adults of four Dutch nursing homes belonging to one care organization were invited to participate in this study. A sample of 128 nursing staff completed T0, and 107 nursing staff completed T1, mostly licensed practical nurses with a mean age of 42 years.

METHODS

The 8-week online intervention concerned information and evidence-based exercises of six topics of Positive Psychology, which were completed individually at home. General well-being, job satisfaction and work engagement were measured, and participants evaluated the intervention.

RESULTS

No time by group interaction effect was found on general well-being nor on work engagement, but there was a small effect on job satisfaction. No moderation effects of baseline outcome measures were found. The evaluation of the intervention varied: a majority positively valued the intervention, in particular the topics "positive emotions" and "strengths", but most agreed that there was too much text and too many exercises.

CONCLUSIONS

The online multi-component positive psychology intervention had only very limited effectiveness, as the decrease in job satisfaction in the control group may reflect a regression to the mean. The high baseline levels of well-being and engagement, intervention content, obligatory character of the intervention, and individuality are discussed as possible reasons for these results. Opportunities lie in creating a concise, work focused positive psychology intervention for nursing staff, including some form of autonomy support.

Job demands, job resources, and behavior in times of sickness: An analysis across German nursing homes

BACKGROUND

The concept of presenteeism, that is, employees coming to work despite being sick, has recently received more attention in the literature. Presenteeism not only threatens employees' health but also substantially drains productivity and drives considerable costs. When they are sick, employees have the choice of whether to go to work or to stay at home. Therefore, determinants of (sickness) absenteeism and presenteeism should be examined simultaneously. Nursing homes are faced with a particularly high prevalence of both absenteeism and presenteeism and are therefore a relevant object of investigation.

PURPOSE

The aim of our study is to analyze the effect of job demands and job resources on absenteeism, presenteeism, and the tendency to choose one behavior (being absent or being present in times of sickness) rather than the other over the last 12 months. To do so, we identify the determinants of absenteeism and/or presenteeism behavior based on theory and existing research about absenteeism, presenteeism, and job demands and job resources. After our empirical analysis, we provide explanations for our findings and offer practical suggestions for how to decrease the frequencies of absenteeism and presenteeism.

METHODOLOGY

In this study, a sample of 212 nurses from German nursing homes was used for an ordinal logistic regression analysis.

RESULTS

Our results show that role overload significantly increases the frequencies of both absenteeism and presenteeism. A good team climate decreases absenteeism and increases the tendency to choose presenteeism rather than absenteeism, whereas strategic training and development opportunities decrease presenteeism and increase the tendency to choose absenteeism rather than presenteeism.

Effectiveness of interventions to reduce occupational stress among emergency department staff: a systematic review protocol

REVIEW QUESTION

The aim of the review is to synthesize the best available evidence on interventions targeting occupational stress and burnout among emergency department (ED) staff. The specific review questions are.

Does geriatric nursing staff burnout predict well-being of LTC residents?

Nursing staff in residential settings are exposed to a large number of stressors. This study examined the relationship between geriatric nursing staff (GNS) burnout and the well-being of residents in long-term care (LTC) facilities. Data were obtained concerning 590 older residents who were served by 315 GNS in 172 LTC facilities in Taiwan, using multilevel modeling. The depersonalization (DP) dimension of burnout in GNS was consistently related to various resident well-being outcomes. Higher DP among GNS was associated with lower residential satisfaction and perceived quality-of-life, as well as more depressive symptoms among older LTC residents. The findings support the claim that DP among GNS has a greater role in determining LTC resident well-being than other dimensions of burnout. Efforts should be made to mitigate the emergence of DP among GNS. Support and education are also needed to enable GNS to foster positive interactions and relationships with LTC residents.

Mind the gap: is the Canadian long-term care workforce ready for a palliative care mandate?

The average expected lifespan in Canadian long-term care (LTC) homes is now less than two years post-admission, making LTC a palliative care setting. As little is known about the readiness of LTC staff in Canada to embrace a palliative care mandate, the main objective of this study was to assess qualities relevant to palliative care, including personal emotional wellbeing, palliative care self-efficacy and person-centred practices (e.g. knowing the person, comfort care). A convenience sample of 228 professional and non-professional staff (e.g. nurses and nursing assistants) across four Canadian LTC homes participated in a survey. Burnout, secondary traumatic stress and poor job satisfaction were well below accepted thresholds, e.g. burnout: mean = 20.49 (standard deviation (SD) = 5.39) for professionals; mean = 22.09 (SD = 4.98) for non-professionals; cut score = 42. Furthermore, only 0–1 per cent of each group showed a score above cut-off for any of these variables. Reported self-efficacy was moderate, e.g. efficacy in delivery: mean = 18.63 (SD = 6.29) for professionals; mean = 15.33 (SD = 7.52) for non-professionals; maximum = 32. The same was true of self-reported person-centred care, e.g. knowing the person; mean = 22.05 (SD = 6.55) for professionals; mean = 22.91 (SD = 6.16) for non-professionals; maximum = 35. t-Tests showed that non-professional staff reported relatively higher levels of burnout, while professional staff reported greater job satisfaction and self-efficacy (p < 0.05). There was no difference in secondary traumatic stress or person-centred care (p > 0.05). Overall, these results suggest that the emotional wellbeing of the Canadian LTC workforce is unlikely to impede effective palliative care. However, palliative care self-efficacy and person-centred care can be further cultivated in this context.

Hospitalization Due to Assault Injury Across Different Age Groups, 2010 to 2014: A Population-Based Study in New South Wales, Australia

OBJECTIVE

Assault is a global public health issue that affects individuals of all ages. This study describes the epidemiological profile of assault-related hospitalization and health outcomes across different age groups in New South Wales, Australia.

METHODS

Population-based linked hospitalization and mortality data from January 1, 2010, to June 30, 2014, were used to identify assault-related hospitalizations. Age-standardized rates were calculated and health outcomes were examined by age group.

RESULTS

There were 22 579 hospitalizations due to assault, with an age-standardized rate of 55.9 per 100 000 population (95% confidence interval = 55.2 to 56.70). Assault by bodily force (63.1%) and by sharp or blunt objects (21.6%) were the most common injury mechanisms. Individuals above 60 years had the highest mean hospital length of stay at 7.3 days, 30- and 90-day mortality, and average hospitalization costs at $9757.

CONCLUSION

The findings have important implications in informing the development and strategies to reduce assault-related incidents in the community.

A Bright Side to the Work-Family Interface: Husbands' Support as a Resource in Double-and-Triple-Duty Caregiving Wives' Work Lives

Purpose of the Study

This study examined how women who combine long-term care employment with unpaid, informal caregiving roles for children (double-duty-child caregivers), older adults (double-duty-elder caregivers), and both children and older adults (triple-duty caregivers) differed from their workplace-only caregiving counterparts on workplace factors related to job retention (i.e., job satisfaction and turnover intentions) and performance (i.e., perceived obligation to work while sick and emotional exhaustion). The moderating effects of perceived spouse support were also examined.

Design and Methods

Regression analyses were conducted on survey data from 546 married, heterosexual women employed in U.S.-based nursing homes.

Results

Compared to workplace-only caregivers, double-duty-elder and triple-duty caregivers reported more emotional exhaustion. Double-duty-child caregivers reported lower turnover intentions and both double-and-triple-duty caregivers felt less obligated to work while sick when perceiving greater support from husbands.

Implications

Results indicate that double-and-triple-duty caregiving women's job retention and obligation to work while sick may depend on perceived spouse support, highlighting the important role husbands play in their wives' professional lives. Findings also lend support to the emerging literature on marriage-to-work positive spillover, and suggest that long-term care organizations should target marital relationships in family-friendly initiatives to retain and engage double-and-triple-duty caregiving employees.

Effects of singing groups on staff well-being: a feasibility study

AIMS

To determine the feasibility of recruiting and retaining staff 'singing for well-being' groups over three months and the acceptability of the proposed intervention and data collection methods, and to explore the potential effects of singing groups on staff well-being.

METHOD

This was a feasibility study that used a two-group wait-list crossover design. Standardised measures of well-being, engagement, burnout and organisational commitment were used, alongside participant feedback. Questionnaires were given to participants at baseline, three months and six months, with the mean group scores for the measures used calculated at each point.

FINDINGS

Participant recruitment did not meet the target set, and only half of the participants returned pre-intervention and post-intervention questionnaires. Acceptability of the programme was high and, despite limited data, positive effects emerged in relation to emotional and work-related well-being. Participant comments about the singing programme and facilitator were universally favourable.

CONCLUSION

This feasibility study suggests there may be several benefits of staff singing groups, in terms of improving the well-being of participants. However, proceeding to a full research trial would require additional time and resources to maximise recruitment.

Participatory redesign of work organisation in hospital nursing: A study of the implementation process

AIMS

The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units.

BACKGROUND

Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing.

METHODS

The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them.

RESULTS

Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals.

CONCLUSION

Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation.

IMPLICATIONS FOR NURSING MANAGEMENT

Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process.

Subtypes in clinical burnout patients enrolled in an employee rehabilitation program: differences in burnout profiles, depression, and recovery/resources-stress balance

BACKGROUND

Burnout is generally perceived a unified disorder with homogeneous symptomatology across people (exhaustion, cynicism, and reduced professional efficacy). However, increasing evidence points to intra-individual patterns of burnout symptoms in non-clinical samples such as students, athletes, healthy, and burned-out employees. Different burnout subtypes might therefore exist. Yet, burnout subtypes based on burnout profiles have hardly been explored in clinical patients, and the samples investigated in previous studies were rather heterogeneous including patients with various physical, psychological, and social limitations, symptoms, and disabilities. Therefore, the aim of this study is to explore burnout subtypes based on burnout profiles in clinically diagnosed burnout patients enrolled in an employee rehabilitation program, and to investigate whether the subtypes differ in depression, recovery/resources-stress balance, and sociodemographic characteristics.

METHODS

One hundred three patients (66 women, 37 men) with a clinical burnout diagnosis, who were enrolled in a 5 week employee rehabilitation program in two specialized psychosomatic clinics in Austria, completed a series of questionnaires including the Maslach Burnout Inventory - General Survey (MBI-GS), the Beck Depression Inventory, and the Recovery-Stress-Questionnaire for Work. Cluster analyses with the three MBI-GS subscales as clustering variables were used to identify the burnout subtypes. Subsequent multivariate/univariate analysis of variance and Pearson chi-square tests were performed to investigate differences in depression, recovery/resources-stress balance, and sociodemographic characteristics.

RESULTS

Three different burnout subtypes were discovered: the exhausted subtype, the exhausted/cynical subtype, and the burned-out subtype. The burned-out subtype and the exhausted/cynical subtype showed both more severe depression symptoms and a worse recovery/resources-stress balance than the exhausted subtype. Furthermore, the burned-out subtype was more depressed than the exhausted/cynical subtype, but no difference was observed between these two subtypes with regard to perceived stress, recovery, and resources. Sociodemographic characteristics were not associated with the subtypes.

CONCLUSIONS

The present study indicates that there are different subtypes in clinical burnout patients (exhausted, exhausted/cynical, and burned-out), which might represent patients at different developmental stages in the burnout cycle. Future studies need to replicate the current findings, investigate the stability of the symptom patterns, and examine the efficacy of rehabilitation interventions in different subtypes.

Interventions to improve working conditions of nursing staff in acute care hospitals: Scoping review

AIM

To conduct a scoping review to examine and map the interventions proposed for the improvement of the working conditions of nursing staff in acute care hospitals.

BACKGROUND

The Registered Nurse Forecasting (RN4CAST) project and other studies have determined the impact that the nursing staff has on the quality of care. The nursing staff's higher levels of burnout, job dissatisfaction and negative perception of the quality of care provided caused worse health outcomes.

METHODS

A scoping review was carried out. By searching in SCOPUS, PubMed, CINAHL, Cochrane, Dialnet and in the grey literature, 705 potentially relevant papers were identified. The final analysis included 21 papers and three grey documents.

RESULTS

The studies analysed proposed interventions at the macro-management, meso-management and micro-management levels, although the interventions at the macro- and meso-levels produce better staff outcomes.

CONCLUSIONS

The findings of this review can be applied to management at different levels: measures to improve the patient-nurse ratio at the macro-management level, the horizontal hierarchies at the meso-management level, the mind-body techniques at the micro-management level.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers and leaders should implement interventions at different organisational levels to improve the working conditions of the nursing staff and other health outcomes.

An Examination of the Moderating Effect of Proactive Coping in NICU Nurses

Neonatal intensive care unit (NICU) nurses experience increased risk for depression, secondary traumatic stress, and burnout. This study examined whether the use of problem-solving or support-seeking strategies moderated the relationship between secondary traumatic stress levels, depressive symptomology, and burnout in NICU nurses. Multiple linear regression and a hierarchical stepwise technique were used to conduct moderation analyses. Results indicated that support-seeking coping skills significantly moderated the relationship between secondary traumatic stress symptoms and burnout symptoms. Coping did not moderate the relationship between depression and burnout. These findings can be used to inform the development of programs that could promote the well-being and coping of nurses experiencing mental health difficulties or burnout and foster a healthy work environment for all NICU nurses so that they can provide the best possible intervention to vulnerable infants. Future research should aim to identify interventions that promote coping in NICU nurses.