They Care for Others, But What About Themselves? Understanding Self-Care Among DSPs' and Its Relationship to Professional Quality of Life

Psychosocial consequences of the COVID-19 pandemic and its effects on professional resilience and self-care on nurses: an example of Ankara

The COVID-19 pandemic has significantly impacted nurses, who are frontline care providers, with high infection risk, disease transmission to relatives, and adverse psychosocial effects. This descriptive and correlational study examines the psychosocial impact of COVID-19 on 224 nurses, focusing on their professional resilience and self-care during active care of COVID-19 patients from December 2022 to August 2023. Data was collected through demographic information forms, questionnaires, and scales. Structural equation modeling was used for the relational dimension of the study. The mean score of the nurses' COVID-19 Pandemic Psychosocial Impact Scale was 85.43 (SD = 22.08), while the Skovholt Practitioner Professional Resiliency and Self-Care Inventory had a mean score of 135.64 (SD = 19.73). A statistically significant low-level negative relationship between the scale scores (r = -0.220). The COVID-19 pandemic's psychosocial impact scores significantly impact personal vitality and stress, indicating a direct negative effect on these factors, according to structural equation modeling results.

Direct Support Professionals: Diversity, Disparities, and Deepening Crisis

In the United States, direct support professionals (DSPs) support people with intellectual and developmental disabilities (IDD) so they can live in the community. Thirty years of deinstitutionalization and the development of community living options would not have been possible without DSPs. Although life for people with IDD improved greatly, working conditions, wages/benefits, demands, stress/burnout, and trauma experienced by DSPs have worsened. Turnover and vacancy rates threaten the availability of community supports for too many people with IDD. DSPs from diverse racial, ethnic, linguistic, and cultural backgrounds face significant workplace disparities. These issues were discussed during the Research and Training Center on Community Living's 2022 State of the Science Conference. We propose important research questions needing solutions to continue constructively addressing these critical issues.

Content analysis of qualitative interviews for user-centered design of a prototype mobile health app for direct support professionals' resilience

BACKGROUND

Direct support professionals support people with intellectual and developmental disabilities with essential health and community living needs. Despite an unrelenting workforce shortage crisis, limited evidence-based resources exist for their support. Resilience, or the ability to thrive in the face of challenges, is a target for health care professional wellbeing initiatives. As an "invisible" workforce interspersed throughout various community-based settings, direct support professionals may benefit from resources provided via mobile health apps.

OBJECTIVES

To assess direct support professionals' acceptability of and preferences for the design of a mobile health app prototype to support their resilience, DSP Thrive.

METHOD

This concept generation and prototype design study employed a two-phase qualitative-descriptive design. Phase 1 assessed direct support professionals' acceptability of and preferences for a mobile health app for direct support professional resilience. Phase 2 elicited feedback on mock-up images of an initial prototype. Data were collected via qualitative interviews (n = 13), and transcripts were analyzed using content analysis.

RESULTS

Phase 1: Direct support professionals identified three primary opportunities for an app to support their resilience: learning via educational resources, practicing resilience strategies, and cultivating a peer support network. Based on these findings, the DSP Thrive app prototype was designed with Learn, Practice, and Connect functions. Phase 2: User feedback on walk-throughs of mock-up images indicated initial acceptability of the prototype design with considerations for further development identified.

CONCLUSIONS

Engaging direct support professionals in user-centered design of mobile health apps may help to bridge the gap to resilience resources for this essential workforce population.

A model of hope as a protective measure to lower burnout and secondary traumatic stress among employees working in developmental and intellectual disabilities services

BACKGROUND

Burnout and secondary traumatic stress (STS) are problems for the workforce supporting people with developmental disabilities. This study investigated hope as a potential protective resource for burnout and STS among the developmental disability services workforce.

METHOD

One hundred and fifty-two non-supervisor caseworkers from a state agency, developmental disabilities division were recruited to participate in an anonymous web-based survey.

RESULTS

The analyses showed that hope was negatively associated with the three dimensions of STS (intrusion, avoidance, and arousal) and burnout. Controlling for tenure in the workforce and STS, the results of the hierarchical regression analyses showed that hope accounted for a significant incremental variance to burnout.

CONCLUSION

These findings provide support for emerging literature showing hope as a protective resource to workforce burnout.

Burnout and secondary traumatic stress in staff working with people with intellectual disabilities: The role of adverse childhood experiences, resilience and trauma-informed organisational climate

BACKGROUND

There has been extensive research into adverse childhood experiences (ACEs), however, less consideration has been given to the prevalence and impact of ACEs for staff working with people with intellectual disabilities.

METHOD

Participants were staff employed by agencies that care for people with intellectual disabilities. An online survey collected demographic information and measures of ACEs, resilience, trauma-informed organisational climate, burnout and secondary traumatic stress. Correlation, regression, mediation and moderation analyses were used.

RESULTS

81.7% of 109 participants had experienced at least one ACE. Burnout, secondary traumatic stress and resilience were greater in the present study than in comparable samples. Trauma-informed organisational climate significantly predicted burnout and secondary traumatic stress. Resilience significantly predicted burnout.

CONCLUSIONS

Staff working with people with intellectual disabilities are likely to have experienced ACEs. Working in a trauma-informed organisational climate and resilience may be effective avenues for reducing burnout and secondary traumatic stress.

Understanding and measuring the work-related quality of life among those working in adult social care: A scoping review

The main aim of this scoping review was to understand how work-related quality of life (WRQoL) in adult social care has been defined and measured in the literature and to map key components of WRQoL among those working in adult social care and similar contexts. The scoping review included studies that: 1- focused on WRQoL/work-related wellbeing (and their synonyms); and 2- included adult social care or community health care. We searched existing evidence from November 2019 until July 2020 through an electronic literature search of eight major databases complemented by the grey literature, searching the reference lists and by contacting our existing network of experts in the field. In addition, we repeated the searches to identify any relevant literature published in 2021. Reporting followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist. In total, we included 68 publications. These publications indicate that there is an absence of agreement on a definition and measurement of WRQoL in adult social care. Based on a thematic analysis we identified six key components of WRQoL: organisational characteristics; job characteristics; mental wellbeing and health; physical wellbeing and health; spill-over from work to home; and professional identity. In summary, at the moment, there is no agreement on what WRQoL is and how to measure it in adult social care. As a result, there is very limited evidence on how to improve WRQoL among people working in adult social care. However, this scoping review suggests that there are six key components of WRQoL that researchers may consider to include in their future studies.

A Bibliometric Analysis of the Association Between Compassion Fatigue and Psychological Resilience From 2008 to 2021

Aims

A negative association between the lower level of psychological resilience (PR) and increased risk of compassion fatigue (CF) and higher Coronavirus disease 2019 (COVID-19) stress has been revealed. However, bibliometric studies have not been performed to comprehensively investigate this topic. This study aimed to identify the status and trends in the CF and PR field from 2008 to 2021 and during the COVID-19 pandemic.

Methods

We identified relevant literature from the Web of Science Core Collection® database using "resilience" and "compassion fatigue" on September 30, 2021. All search results were exported in plain text format for collaboration network analysis, reference-based co-citation analysis, analysis of journals, and keywords-based co-occurrence analysis, which were performed using Citespace® 5.8.R1.

Results

A total of 388 publications were identified finally, and there has been an increasing trend in the annual number of publications with light fluctuations. The analysis of journals and keywords indicated that nurses and social workers are the main research targets, and their mental problems are the main research topics. The turnover intention of health care providers has been a research focus, particularly during the COVID-19.

Conclusion

The results of the present study help us understand the status of the CF and PR field and its recent developments.

The Effect of a Web-Based Deep Breathing App on Stress of Direct Care Workers: Uncontrolled Intervention Study

Objectives: Studies have demonstrated success in reducing stress levels in complex interventions including deep breathing components. Breathing exercise interventions, however, tend not to be studied in isolation. The aim of the study was to examine the impact of a breathing exercise using a web-based app on the stress levels of direct care workers (DCWs) who serve people with intellectual and developmental disabilities. Design: Uncontrolled one-group intervention. Settings/Location: DCWs were recruited from intellectual and developmental disability service providers in a US Midwestern state. Subjects: Sixty-four DCWs who used the breathing exercise app at least 2 times. Interventions: Breathing exercise using a web-based app for a month. Outcome measures: Five measures were obtained from the data recorded in the app: initial stress level before exercise, exercise duration in minutes, change in stress level between before and after each breathing exercise, and frequency and number of days the app was used during a month. Participants' self-report of the number of days of app use was collected in a 1-month follow-up survey. Results: The participants appear to have a moderate stress level indicated by the initial stress level 5 out of 10. After the breathing exercise, the stress level decreased by 1.2 points from 5.0 (standard deviation [SD] = 1.8) to 3.7 (SD = 1.6) on average (paired t-test, p < 0.00005). Cohen's d 0.72 indicates a large effect size. Among within-individual factors, a higher initial stress level and longer app use per occasion were significantly associated with stress reduction. Among between-individual factors, only race was associated with stress reduction. Although there was no effect of being an African American alone on stress level change (coefficient = 0.44, 95% confidence interval = -0.29 to 1.18, p > 0.05), there was an additional reduction among African Americans in relation to the initial stress level, controlling for exercise duration. The number of breathing exercise days recorded in the app was not correlated with that of self-report (Pearson's correlation r = 0.12, p > 0.05). Although the app was used for 4.4 (SD = 4.2) days, participants reported using it for 10.7 (SD = 8.2) days on average in the follow-up survey. Conclusions: The findings suggest the benefit of breathing exercises using an app for reducing DCWs' stress levels. Regular use of such apps may assist with stress management and bolster overall health and well-being among DCWs.

Factor structure of the professional quality of life scale among direct support professionals: factorial validity and scale reliability

BACKGROUND

Direct support professionals (DSPs) support people with intellectual and developmental disabilities in activities of daily living. DSPs may experience both contentment and struggles with their work. As agencies grapple with their recruitment and retention, understanding DSPs' holistic work experience is important. The Professional Quality of Life (ProQOL) scale assesses multiple domains of work experiences (i.e. compassion satisfaction, burnout and secondary traumatic stress). Despite extensive use across helping professions, the ProQOL is largely absent from DSP research.

METHOD

This study examined the factor structure of the ProQOL with DSPs. Using secondary data from 495 DSPs, confirmatory factor analysis was conducted to determine if the original three-factor structure holds for this population.

RESULTS

We confirmed the factorial validity of the ProQOL with the three-factor solution. In the validation process, some modifications were suggested to the model, which also improved the scale reliability.

CONCLUSIONS

The current study provides initial evidence of the factorial validity of the ProQOL when used with DSPs, as well as recommendations for subsequent improvements and future research.