Healthy aging at work – Development of a preventive group intervention to promote quality of life of nursing staff aged 45 years and older

Health Promotion for Outpatient Careworkers in Germany

Due to ongoing demographic changes, the need for care is increasing in Germany. The number of outpatient care services is also rising, and with it, the number of employees in outpatient care, who are also continuously becoming older. Workplace health promotion (WHP) becomes relevant in this context, as it can reduce negative strain reactions and promote employees’ health. The aim of this study was (1) to reveal implemented WHP interventions in German outpatient care services; (2) to examine the potential challenges regarding a successful implementation of WHP measures; and (3) to illuminate further requests and needs experienced by outpatient careworkers. In qualitative field research, 30 semi-structured individual interviews were conducted with German caregivers, using the problem-centered interview method. The collected data were deductively and inductively evaluated and interpreted, using qualitative content analysis according to Mayring. Outpatient caregivers reported various WHP measures known from their workplaces, such as the provision of fruit baskets, programmes to increase physical activity, or a subsidy for a personal gym. They further reported WHP, such as back training, known from other care services. However, the respondents spoke of the challenges regarding the implementation or the use of WHP interventions in general. The most frequently named barriers were a lack of time after work and interventions that were only offered in their leisure time. In the same course, the participants still needed offers to increase physical activity, joint activities, or relaxation techniques. However, respondents highlighted that they preferred the interventions to take place during working hours. This way, they would also be more likely to take advantage of the interventions. The results of this study provide an insight into various WHP measures that already exist, or that are desirable for implementation with regard to caregivers’ needs. Subjectively perceived challenges for a successful implementation of WHP measures represent the importance of adjustments in the work organization of caregivers. It becomes clear that WHP is not yet established in the ambulant care sector, although it appears to be imperative for keeping caregivers healthy. Considering the different needs of employees, the results can provide a basis for the development of needs-based health promotion measures for caregivers.

Workplace health promotion interventions for nurses in Germany: a systematic review based on the RE-AIM framework

Background

The German health care system is faced with a serious shortage of nurses. This is associated, amongst other things, with difficult working conditions and work-related health burdens. Workplace health promotion (WHP) is considered a promising approach to promote the health of nurses. The present review aims to give an overview on existing interventions in different nursing settings (acute care hospitals, long-term care (LTC) facilities and home-based long-term care) in Germany.

Methods

A systematic literature search was conducted in PubMed and PubPsych. Studies were included if published after 2010 and provided data of intervention studies on workplace health promotion among nurses in Germany (RCTs, non-RCTs, non-controlled intervention studies and pilot studies). The setting in which the study was conducted (acute medical care hospital, inpatient LTC facilities, home-based LTC, cross-setting) as well as the health issue assessed (physical health, mental health and/or violence experience) were extracted. The intervention was reported against the background of the quality criteria for prevention measures of the statutory health insurers in Germany. The results of the studies were presented according to the RE-AIM framework.

Results

Eleven studies on WHP for nurses were included, whereof seven studies were conducted in acute medical care hospitals and four in LTC facilities. No study reported results on WHP for nurses working in the setting of home-based LTC. Most studies aimed at improving mental health. The intervention contents and forms of implementation were heterogeneous. According to the RE-AIM criteria, the reporting of most studies showed several limitations, especially a lack of reporting on Implementation and Adoption. Most studies showed no statistically significant effect on the respective outcomes (Effectiveness). Four studies reported results on Maintenance indicating a sustained effectiveness.

Conclusion

Despite the high relevance for health promotion for nurses, our review showed a striking lack of intervention studies in this field. From this we derive a high need of tailored interventions, taking into account the setting-specific development, implementation of WHP interventions for nurses. With regard to the evaluation, the RE-AIM criteria should be taken more into account in order to meet the requirements of evaluating complex interventions and thus contribute to evidence development of WHP in nursing. In terms of content, the topic of violence prevention and dealing with experiences of violence should also be taken into account. Regarding the settings, the working conditions and health burdens in LTC facilities, home-based LTC and acute medical hospitals must be considered.

Trial registration

PROSPERO registration number: CRD42021231891

Betriebliche Gesundheitsförderung in der Pflege

Hintergrund

In der Pflegebranche nehmen Arbeitsunfähigkeitstage durch verschiedene Fehlbelastungen zu, welches die Relevanz der Betrieblichen Gesundheitsförderung (BGF) hervorhebt.

Ziel der Arbeit

Der Artikel soll die Thematik der BGF in der Pflege beleuchten und zudem eine Übersicht von bestehenden betrieblichen Gesundheitsförderungsmaßnahmen im Setting Pflege bieten.

Material und Methoden

In einer explorativen Literaturrecherche werden bisher verfügbare Erkenntnisse aus der BGF in der Pflege recherchiert und zusammengefasst. Aus diesen Forschungserkenntnissen werden Maßnahmenvorschläge für die Pflege-BGF abgeleitet. Die Vorschläge sollten aktualisiert werden, wenn derzeit laufende arbeitspsychologische Studien neue Erkenntnisse hervorgebracht haben.

Ergebnisse

Bestehende Interventionen in der Pflegebranche, welche beispielsweise Achtsamkeitstrainings, Maßnahmen zur Stress‑/Tabakkonsumreduzierung sowie die Förderung gesunder Ernährungsweise und körperlichen Aktivität beinhalten, werden dargestellt.

Diskussion

Studienergebnisse zeigen, dass Interventionen zur Stressreduzierung aus der stationären Pflege effektiv das Stresserleben der Pflegekräfte senken konnten. Web-basierte Interventionen scheinen darüber hinaus für das ambulante Pflegesetting als erstrebenswert. Mögliche Herausforderungen, wie fehlende Fachkenntnisse und -kräfte, für die BGF-Umsetzung werden diskutiert.

Healthy ageing at work- Efficacy of group interventions on the mental health of nurses aged 45 and older: Results of a randomised, controlled trial

Objective

This multicentre, randomised controlled trial (RCT) aimed to evaluate the efficacy of a small-group intervention promoting successful ageing at work in older nurses (aged ≥45).

Method

A sample of 115 nurses aged ≥45 from 4 trial sites in Germany were randomly assigned to either the intervention group (IG), that received a small-group intervention of seven weekly sessions of 120 min with a booster session after six weeks or to a wait-list control condition (WLC). Outcomes were measured via validated self-report questionnaires at baseline (T1) and at post-treatment (T2).

Primary outcomes were mental health-related well-being and mental health-related quality of life (QOL). The secondary outcomes included mental health-related and work-related measures.

Results

The intention to treat (ITT) analysis showed significant positive effects of the intervention on mental health. A significant small effect (d = 0.3) in favour of the IG was found for psychological health-related quality of life. Positive small effects (d = 0.24 to d = 0.31) were also found for work related mental strain.

Conclusions

Our small-group intervention based on a theory of successful ageing for nurses aged ≥45 was found to be effective with regard to improvements of psychological health related quality of life and other mental health-related outcomes. Thus, our study shows that the ageing workforce can be reached through specifically designed preventive interventions. The components of our intervention could be easily adapted to the belongings of other professions. Our results suggest that these components should be evaluated in various settings outside the healthcare sector.