OBJECTIVE: To evaluate the process of workers' health surveillance (WHS) targeting work functioning and mental health of health care professionals, alongside a randomized controlled trial comparing two strategies.
METHODS: Nurses and allied health care professionals working in one hospital were invited. Process indicators were assessed using methods such as questionnaires and track-and-trace data.
RESULTS: All participants (32%; N = 369) received screening and personalized feedback. In group 1, 41% went to a preventive consultation with their occupational physician. Protocol adherence of participating occupational physicians (n = 5) was high. They regarded the WHS mental module to be meaningful. In group 2, 16% logged into an e-mental health intervention. Most participants would appreciate a future offer of the WHS.
CONCLUSIONS: The WHS mental module was well received and fitted in the occupational health service activities. Nevertheless, response and compliance should be improved.
OBJECTIVES: Improvement of psychosocial work environment has proved to be valuable for workers' mental health. However, limited evidence is available for the effectiveness of participatory interventions. The purpose of this study was to investigate the effect on mental health among nurses of a participatory intervention to improve the psychosocial work environment.
METHODS: A cluster randomized controlled trial was conducted in hospital settings. A total of 434 nurses in 24 units were randomly allocated to 11 intervention units (n=183) and 13 control units (n=218). A participatory program was provided to the intervention units for 6 months. Depressive symptoms as mental health status and psychosocial work environment, assessed by the Job Content Questionnaire, the Effort-Reward Imbalance Questionnaire, and the Quality Work Competence questionnaire, were measured before and immediately after the 6-month intervention by a self-administered questionnaire.
RESULTS: No significant intervention effect was observed for mental health status. However, significant intervention effects were observed in psychosocial work environment aspects, such as Coworker Support (p<0.01) and Goals (p<0.01), and borderline significance was observed for Job Control (p<0.10).
CONCLUSIONS: It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment, but not mental health, among Japanese nurses.
BACKGROUND: Caring for a person with dementia can be physically and emotionally demanding, with many long-term care facility staff experiencing increased levels of stress and burnout. Massage has been shown to be one way in which nurses' stress can be reduced. However, no research has been conducted to explore its effectiveness for care staff working with older people with dementia in long-term care facilities.
METHODS: This was a pilot, parallel group, randomized controlled trial aimed at exploring feasibility for a larger randomized controlled trial. Nineteen staff, providing direct care to residents with dementia and regularly working ≥ two day-shifts a week, from one long-term care facility in Queensland (Australia), were randomized into either a foot massage intervention (n=9) or a silent resting control (n=10). Each respective session lasted for 10-min, and participants could receive up to three sessions a week, during their allocated shift, over four-weeks. At pre- and post-intervention, participants were assessed on self-report outcome measures that rated mood state and experiences of working with people with dementia. Immediately before and after each intervention/control session, participants had their blood pressure and anxiety measured. An Intention To Treat framework was applied to the analyses. Individual qualitative interviews were also undertaken to explore participants' perceptions of the intervention.
RESULTS: The results indicate the feasibility of undertaking such a study in terms of: recruitment; the intervention; timing of intervention; and completion rates. A change in the intervention indicated the importance of a quiet, restful environment when undertaking a relaxation intervention. For the psychological measures, although there were trends indicating improvement in mood there was no significant difference between groups when comparing their pre- and post- scores. There were significant differences between groups for diastolic blood pressure (p= 0.04, partial η2=0.22) and anxiety (p= 0.02, partial η2=0.31), with the foot massage group experiencing greatest decreases immediately after the session. The qualitative interviews suggest the foot massage was well tolerated and although taking staff away from their work resulted in some participants feeling guilty about taking time out, a 10-min foot massage was feasible during a working shift.
CONCLUSIONS: This pilot trial provides data to support the feasibility of the study in terms of recruitment and consent, the intervention and completion rates. Although the outcome data should be treated with caution, the pilot demonstrated the foot massage intervention showed trends in improved mood, reduced anxiety and lower blood pressure in long-term care staff working with older people with dementia. A larger study is needed to build on these promising, but preliminary, findings.
TRIAL REGISTRATION: ACTRN: ACTRN12612000659808.
OBJECTIVES: To study the effectiveness of a mental module for workers' health surveillance for health care workers.
METHODS: Nurses and allied health care professionals from one organization were cluster-randomized at ward level to an intervention or control group. The intervention included screening for work functioning impairments and mental health complaints. Positively screened workers were invited to visit their occupational physician. Outcome measures, including help-seeking behavior, work functioning, and mental health, were assessed at baseline, 3-month follow-up, and 6-month follow-up.
RESULTS: An effect of study-group × time interaction on help-seeking behavior was found (P = 0.02). Workers in the intervention group showed less work functioning impairments over time than the control group (P = 0.04).
CONCLUSION: The module can be used to stimulate help seeking from the occupational physician and to improve functioning in workers with mild to moderate work functioning, mental health complaints, or both.
TRIAL NUMBER: NTR2786.
Background. Burnout, a syndrome of emotional exhaustion, depersonalization, and diminished feelings of accomplishment, is common among pediatric oncology staff. This study explores a mindfulness-based course (MBC) to decrease burnout in a multidisciplinary group of pediatric oncology staff members in the United States and Israel. Materials and methods. Forty-eight participants, mostly nurses, were randomized to either the MBC intervention or a control group. MBC participants received eight weekly sessions of mindfulness education. The primary outcome studied was burnout. Secondary outcomes studied included depression and perceived stress. Results. Nearly 100% of the subjects exhibited signs of burnout at baseline and MBC did not result in any significant improvement in scores on burnout, perceived stress or depression scales. Qualitative analysis of diaries kept by subjects revealed reduced stress, improved inner peace, compassion and joy, better focus and self-awareness and less somatic symptoms in the intervention arm. Conclusions. Burnout is a major problem in pediatric oncology staff. Mindfulness practices can be taught in the workplace and may be a useful component of a multidimensional strategy to reduce burnout in this population.
OBJECTIVE: To evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) targeting work functioning (WF) and mental health (MH) of healthcare professionals in a randomised controlled trial.
METHODS: Nurses and allied health professionals (N = 1140) were cluster-randomised at ward level to the intervention (IG) or control group (CG). The intervention consisted of two parts: (a) online screening and personalised feedback on impaired WF and MH, followed by (b) a tailored offer of self-help EMH interventions. CG received none of these parts. Primary outcome was impaired WF (Nurses Work Functioning Questionnaire), assessed at baseline and after three and six months. Analyses were performed in the positively screened subgroup (i) and in all participants (ii).
RESULTS: Participation rate at baseline was 32% (NIG = 178; NCG = 188). Eighty-two percent screened positive for at least mild impairments in WF and/or MH (NIG = 139; NCG = 161). All IG-participants (N = 178) received part (a) of the intervention, nine participants (all positively screened, 6%) followed an EMH intervention to at least some extent. Regarding the subgroup of positively screened participants (i), both IG and CG improved over time regarding WF (non-significant between-group difference). After six months, 36% of positively screened IG-participants (18/50) had a relevant WF improvement compared to baseline, versus 28% (32/115) of positively screened CG-participants (non-significant difference). In the complete sample (ii), IG and CG improved over time but IG further improved between three and six months while CG did not (significant interaction effect).
CONCLUSIONS: In our study with a full compliance rate of 6% and substantial drop-out leading to a small and underpowered sample, we could not demonstrate that an EMH-approach to WHS is more effective to improve WF and MH than a control group. The effect found in the complete sample of participants is not easily interpreted. Reported results may be useful for future meta-analytic work.
TRIAL REGISTRATION: Dutch Trial Register NTR2786.
INTRODUCTION: Attrition in general surgery is a significant problem facing residency programs. On average one out of five residents leaves general surgery for another field. We utilized a randomized, controlled trial to determine whether a brief targeted intervention designed to improve residents' sense of belonging might decrease attrition. METHODS: Participants were junior residents from seven surgical specialties (n=35; 15 women). After a survey of attitudes and beliefs, we randomized men and women into either a belonging treatment or control condition. Junior residents read anecdotes from senior residents describing the challenges the seniors had faced early in residency (treatment condition) or describing challenging ethical dilemmas they had encountered early in residency (control condition). Several months later, juniors were asked about their attitudes and beliefs as a proxy for future intentions to leave residency. RESULTS: Residents who felt more like they belonged were more likely to think they would complete residency (r=0.51, p<0.01) and less likely to see themselves as a different type of physician (r=0.36, p<0.01). After the intervention, residents in the treatment condition had significantly lower rates of burnout than those in the control condition (p<0.05). CONCLUSIONS: The belonging intervention decreased the rate of burnout for those in the treatment condition. Because burnout positively correlates with absenteeism and high turnover rates, the residents in the treatment may be less likely to quit residency than those in the control. We intend to follow these residents for several years in order to assess the impact of our intervention on attrition.
PURPOSE: To determine the efficacy of a pragmatic low dose mindfulness-based worksite intervention on biological and behavioral indices of stress in healthcare professionals caring for seriously ill patients. METHODS: Participants (n=32) were recruited among the Surgical Intensive Care Unit (SICU) personnel of a large university hospital, and were randomized to intervention or wait-list control groups, stratified by gender. The low dose 8-week mindfulness-based intervention was delivered on site, one hour before shift change. RESULTS: Participants were representative of the SICU staff with 69% nurses, 88% females, age average of 44, and 11.8 (±10.1, SD) average years working in the SICU. Participant biological indices of stress, measured by the level of salivary α-amylase, was significantly reduced in the intervention group (t=2.562, p=0.026) only. Behaviorally, they rated their experience of stress using the Depression, Anxiety and Stress Scale (DASS-21), and rated sleep over the past month using the Pittsburg Sleep Quality Index (PSQI). There was a significant decrease of the scores on the DASS-21 stress subscale (t=2.245, p=0.040) and a significant improvement in the overall quality of sleep (t=2.482, p=0.027) between pre and post assessments in the intervention group with no changes for the wait list group. Work satisfaction also increased significantly (t=-3.2020, p=0.006) for the intervention group only. CONCLUSION: These data indicate the effectiveness of a mindfulness-based intervention delivered at the worksite towards stress reduction for staff in a high stress, hospital environment. The SICU personnel care for trauma 1 and 2 level patients and patients with severe pathology recovering from major surgery, and are confronted with catastrophic events on a regular basis. Given the nature of the job, work-related stressful events in the SICU will not change, but the resiliency tools offered via the intervention may help maintain wellness and prevent the deleterious effects of stress.
OBJECTIVE: The study was carried out in order to evaluate the prevalence of burnout in physiotherapists, and to assess whether "White Ball" Qigong exercises may be effective in burnout. This was aimed to provide preliminary data for the preparation and development of a larger study.
METHODS: Physiotherapists completed a demographic questionnaire and the Maslach Burnout Inventory (MBI) questionnaire. For the intervention and the control groups, the authors selected those physiotherapists with the highest levels of burnout on the most important subscale. The intervention group (eight physiotherapists) performed a specific qigong intervention as developed by the Heidelberg School of Chinese Medicine; the control group consisted of eight physiotherapists on a waiting list. At the end of a three-week period of treatment or waiting list, both groups repeated the MBI for the comparison of results.
RESULTS: Of 106 physiotherapists (36 males and 70 females) assessed by the MBI, Emotional Exhaustion subscale was seen in 52 (49.1%), Depersonalization subscale in 36 (33.9%), and Burnout in the Personal Accomplishment subscale in 33 (31.2%), of whom 4 (3.8%) suffered to a severe degree and 29 (27.4%) moderately. Within the study group qigong lowered the mean values of Emotional Exhaustion subscale from 38.0 to 31.4, whereas in the control group the values rose from 33.9 to 37.9. The differences between the two groups were statistically significant (P=0.023). Qigong lowered the mean value of Depersonalization subscale from 10.8 to 6.8. In controls the value rose from 7.3 to 10.6. The difference between the two groups was statistically significant (P=0.013). The mean values of Personal Accomplishment subscale decreased in both groups: from 35.4 to 33.9 in the intervention group, and from 37.5 to 37.1 in the control group. The difference between the two groups was not statistically significant.
CONCLUSION: The effects of "White Ball" Qigong on burnout symptoms are measurable by the MBI. The results are compatible with the thesis that this type of qigong is an effective tool for the self-management of burnout. It is easy to integrate into a daily routine as it takes only 2×5 min per day. On the basis of this evaluation, a study design can now be developed on a larger scale with appropriate blinding, follow-up testing and adequate controls.
PURPOSE: The purpose of this pilot study was to assess the feasibility of a Tai Chi workplace wellness program as a cost effective way of improving physical and mental health, reducing work related stress, and improving work productivity among older nurses in a hospital setting Design A randomized control trial of two groups (control and Tai Chi group). DESIGN: A randomized control trial of two groups (control and Tai Chi group). Settings: Northeastern academic medical center. Subjects: A convenience sample of eleven female nurses (mean age 54.4 years). Intervention: The Tai Chi group (n = 6) was asked to attend Tai Chi classes once a week offered at their worksite and to practice on their own for 10 minutes each day at least 4 days per week for 15 weeks. Controls (n = 5) received no intervention. Measures: SF-36 Health Survey, Nursing Stress Scale (NSS), Perceived Stress Scale (PSS), Sit-and-Reach test, Functional Reach test, the Work Limitations Questionnaire, workplace injury and unscheduled time off. Analysis: The two study groups were compared descriptively and changes across time in the intervention versus control were compared. RESULTS: The Tai Chi group took no unscheduled time-off hours, whereas, the control group was absent 49 hours during the study period. There was also a 3% increase in work productivity and significant improvement in functional reach (p=0.03) compared to the control group. Other outcomes were not statistically significant. CONCLUSION: This pilot study demonstrates the feasibility of Tai Chi with older female workers as a cost effective wellness option in the workplace; thus encouraging replication with a larger sample. Methodological implications were also addressed.
To evaluate the process of workers' health surveillance (WHS) targeting work functioning and mental health of health care professionals, alongside a randomized controlled trial comparing two strategies.
METHODS:
Nurses and allied health care professionals working in one hospital were invited. Process indicators were assessed using methods such as questionnaires and track-and-trace data.
RESULTS:
All participants (32%; N = 369) received screening and personalized feedback. In group 1, 41% went to a preventive consultation with their occupational physician. Protocol adherence of participating occupational physicians (n = 5) was high. They regarded the WHS mental module to be meaningful. In group 2, 16% logged into an e-mental health intervention. Most participants would appreciate a future offer of the WHS.
CONCLUSIONS:
The WHS mental module was well received and fitted in the occupational health service activities. Nevertheless, response and compliance should be improved.
