Burnout-Risiko in der stationären Langzeitversorgung: Ressourcen und Belastungen von Pflege- und Betreuungskräften

Scoping review meets expert interviews: Key issues of multimodal programs for workplace health promotion in long-term care facilities - "We can't just run a standard program"

Background

Long-term care facility employees' workload escalation intensifies negative risk for (nursing) staff health, residents, and the economy. Workplace health promotion (WHP) has emerged as a vital approach with positive impacts on employee well-being. This Scoping Review focuses on multimodal WHP programs in long-term care facilities, emphasizing barriers, facilitators, and the integration of complementary and integrative medicine (CIM).

Methods

Following the PRISMA-ScR guidelines, a systematic search strategy from February to April 2023 in Medline (PubMed), EMBASE (Ovid), and CINAHL (EBSCOhost) yielded 506 hits. Findings were enriched through semi-structured expert interviews. All data were analyzed with a deductive-inductive qualitative content analysis.

Results

Eleven publications met inclusion criteria and eight experts were interviewed based on key topics of the included publications. The integration of the results showed that primary obstacles highlight structural challenges (time, finances, hierarchies) and team dynamics (lack of support, communication issues, low motivation), while effective communication, support from the management, and participatory engagement enhance program success. CIM approaches are not explicitly referenced as such, despite widespread use.

Conclusion

An exclusive CIM-focus, with multimodal WHP programs for long-term care facilities is missing and should highlight the necessity of a multimethod approach intervention. While the need for further research about the specific topic of multimodal, CIM-based WHO programs in long-term care facilities - including cross-cultural and international comparisons - is apparent, an appropriate evaluation of complex interventions is challenging given the nature of multimodal WHP programs. A multi-method approach is therefore recommended as standard for further research in this area.

[Palliative care in nursing homes : Results of a survey about knowledge and self-efficacy of nursing staff]

BACKGROUND

Nursing homes are confronted more and more with palliative care patients, which present a challenge for nursing and medical personnel. Deficits in the palliative care of geriatric patients have been repeatedly demonstrated and many nursing home residents, especially those suffering from dementia, are undersupplied regarding pain management.

OBJECTIVES

The present study was carried out to measure the knowledge and self-efficacy of nursing staff in the province of Carinthia (Austria) regarding palliative care of nursing home residents.

MATERIAL AND METHODS

A total of 330 nursing personnel were surveyed using the Bonn test for knowledge in palliative care (BPW), which measures knowledge and self-efficacy in nursing home personnel. In addition to descriptive analyses, the effects of the professional group (registered nurses vs. nursing assistants) and working experience were tested.

RESULTS

On average a little more than half of the knowledge items were answered correctly. Nurses' self-efficacy was high. Registered nurses exhibited more knowledge and higher self-efficacy compared to nursing assistants. Effects of working experience could only be demonstrated regarding self-efficacy.

CONCLUSION

The results are to a large extent in line with results from Germany and indicate the necessity of interventions for improving nurses' knowledge as a major basis for adequate palliative care in nursing home residents.