Cultivating Resilience Among Perinatal Care Providers During the Covid-19 Pandemic

The Covid-19 pandemic has further illuminated the already existing need for methods of building resilience in perinatal caregivers. Using a scoping review approach, literature was examined to identify evidence-based models of resilience building in a cohort of perinatal clinicians. Research published between January 2015 and 2020 was evaluated using PubMed, CINAHL, EMBASE, and PsycINFO databases. Of the initial 3399 records reviewed, 2 qualitative studies met the inclusion criteria. Given the deleterious effects of Covid-19 on perinatal care providers, and in light of the paucity of available studies, personnel, time, and funding should be allocated for research to address these issues.

Restoring confidence in return to work: A qualitative study of the experiences of persons with exhaustion disorder after a dialogue-based workplace intervention

Background

Stress-induced exhaustion disorder (SED) is a primary cause for sickness absence among persons with mental health disorders in Sweden. Interventions involving the workplace, and supporting communication between the employee and the supervisor, are proposed to facilitate return to work (RTW). The aim of this study was to explore experiences of persons with SED who participated in a dialogue-based workplace intervention with a convergence dialogue meeting performed by a rehabilitation coordinator.

Methods

A qualitative design based on group interviews with 15 persons with SED who participated in a 24-week multimodal rehabilitation program was used. The interviews were analyzed with the methodology of grounded theory.

Results

The analysis resulted in a theoretical model where the core category, restoring confidence on common ground, represented a health promoting process that included three phases: emotional entrance, supportive guidance, and empowering change. The health promoting process was represented in participant experiences of personal progress and safety in RTW.

Conclusions

The intervention built on a health-promoting pedagogy, supported by continuous guidance from a rehabilitation coordinator and structured convergence dialogue meetings that enhanced common communication and collaboration with the supervisor and others involved in the RTW process. The intervention balanced relationships, transferred knowledge, and changed attitudes about SED among supervisors and colleagues in the workplace. The inclusion of a rehabilitation coordinator in the intervention was beneficial by enhancing RTW and bridging the gaps between healthcare, the workplace, and other organizational structures. In addition, the intervention contributed to a positive re-orientation towards successful RTW instead of an endpoint of employment. In a prolonged process, a dialogue-based workplace intervention with convergence dialogue meetings and a rehabilitation coordinator may support sustainable RTW for persons with SED.

Need for recovery in relation to effort from work and health in four occupations

Objective

To examine three levels of need for recovery (NFR) after work in relation to effort from work demands, demand compensatory strategies, effort-moderating or -reversing resources, and health including health behaviors. A further purpose was to examine occupational characteristics determining NFR.

Methods

5000 engineers, carpenters, nurses, and home care nurses were invited to participate. NFR k-means clusters were calculated from 1289 participants. The effect from three levels of NFR regarding demands, compensatory strategies, resources at work, health, and health behaviors was examined using analysis of variance (ANOVA) and post hoc analysis. Prevalence ratios (PRs) of suboptimal health for three levels of NFR were calculated using Poisson regression. Linear stepwise multiple regression predictors explaining NFR were examined also occupation wise.

Results

NFR centroids at 5.8/33, 13.1/33, and 21.0/33 points were identified. ANOVA showed corresponding effects from NFR levels on work demands and compensatory strategies. The inversed proportion concerned levels of resources at work. Only the low NFR cluster negated regular health effects. The other two cluster groups also repeatedly worked while ill and presented PRs concerning health effects from 1.9 to 3.9 when compared to the low NFR group. Making good quality work, recovery opportunities, and thinking of work when off work were the most important predictors of NFR among 1289 participants with also occupation-wise interpretable profiles.

Conclusions

Three levels of NFR meant corresponding levels of work demands, work-demand compensatory strategies, and unfavorable health behaviors. An inversed proportion of resources related to the same levels of NFR. Low NFR meant no regular health effects which could guide limit values regarding salutary NFR. Important predictors of NFR were resources making a good quality work, recovery opportunities, and reversely effort from rumination when off work. Occupation-wise predictors could guide interventions.