Factors associated with health professionals' stress reactions, job satisfaction, intention to leave and health-related outcomes in acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organisations

Creative strengthening groups as a potential intervention to enhance job satisfaction and reduce levels of burnout in healthcare professionals: results from the randomized controlled trial UPGRADE

BACKGROUND

Healthcare professionals often face substantial work-related burdens. A large body of evidence has shown that poor working conditions can lead to low levels of job satisfaction, increased emotional stress and burnout. While symptom targeted interventions take effect after symptoms become manifest, preventive interventions are required to reduce the risk of work-related diseases. Therefore, the UPGRADE-trial aimed to evaluate the effectiveness of Creative Strengthening Groups as a potential intervention to enhance job satisfaction and work-related health. The German Innovation Fund (Innovationsfonds) funded the project.

METHODS

We conducted a randomized controlled trial and randomly assigned healthcare professionals to either the intervention or the control group. The intervention - Creative Strengthening Groups - consisted of two one-day classes. We evaluated the primary outcome job satisfaction and further work-related outcomes using standardized questionnaires. We collected data at baseline as well as after three and six months. The study was conducted between October 2019 to March 2023, including the pandemic period.

RESULTS

We enrolled 196 participants (intervention n = 88, control n = 108) with a mean age of 46.2 ± 12.1 years (84.5% female). 43.7% were nursing professionals. Job satisfaction in the intervention group increased from 55.47 ± 10.23 to 57.07 ± 11.65 after three months and decreased in the control group from 56.29 ± 19.69 to 53.47 ± 20.09. The difference between groups did not reach statistical significance. Additionally, change in patient-related stress significantly differed between groups (intervention: -3.9 ± 12.16 vs. control: 5.17 ± 17.43; p =.027) as well as personal burnout (intervention: -5.25 ± 13.1 vs. control: 4.35 ± 16.24; p =.011). Within the intervention group, we observed a greater improvement concerning work-related burnout in nursing staff in geriatric care than in hospitals (-15.27 ± 13.5 vs. +3.28 ± 13.7; p =.003).

CONCLUSION

Though the Covid-19 pandemic worsened working conditions for healthcare professionals, our results indicate that intervention has the potential to enhance job satisfaction and work related health. Notably, due to the overall workload and the pandemic restrictions, a high number of participants did not continually participate in both classes of the intervention and some did not return all questionnaires. As long as healthcare professionals in Germany are facing exceedingly bad working conditions, it is very difficult to support their resources such as self-efficacy, self-esteem, and optimism by health promotion interventions.

TRIAL REGISTRATION

The trial has been registered at the German Clinical Trials Register (DRKS; ID: DRKS00020908). Date of Registration: 2020-03-16.

Comparison of neuro-psychiatric disorders between older adults living in foster families or nursing homes

Professional foster families for dependent older adults are a housing model perceived as an alternative to nursing homes in the French West Indies. The clinical profile of older adults in foster families remains to be determined, particularly concerning neuropsychiatric symptoms (NPS) in the presence of major cognitive disorders. In this cross-sectional analysis from twin studies conducted in foster families (n = 107, mean age: 81.8 years, male/female ratio: 38/62) and nursing homes (n = 332; (mean age: 81.3 years, male/female ratio: 51/49), we compare the prevalence and severity of NPS, along with psychotropic drugs prescription, between older adults (≥ 60 years) living in both arrangements. The prevalence of major cognitive disorders and the total number of NPS (3.4 ± 2.7 in foster families vs. 3.4 ± 2.5; p = 0.946) were similar between the two groups. The prevalence of each NPS was similar except for apathy (20.0% in nursing homes vs. 8.5% in foster families, p = 0.006), aberrant motor behavior (22.1% in nursing homes vs. 36.2% in foster families, p = 0.004) and eating disorders and appetite (23.0% vs. 9.3%, respectively, p = 0.002). The use of antipsychotics was more frequent in nursing homes (36.7% vs. 26.2%, p = 0.046). This study suggests that the foster families' environment may be well suited for managing older adults with psycho-behavioral disorders.

A machine learning model to predict the risk factors causing feelings of burnout and emotional exhaustion amongst nursing staff in South Africa

BACKGROUND

The demand for quality healthcare is rising worldwide, and nurses in South Africa are under pressure to provide care with limited resources. This demanding work environment leads to burnout and exhaustion among nurses. Understanding the specific factors leading to these issues is critical for adequately supporting nurses and informing policymakers. Currently, little is known about the unique factors associated with burnout and emotional exhaustion among nurses in South Africa. Furthermore, whether these factors can be predicted using demographic data alone is unclear. Machine learning has recently been proven to solve complex problems and accurately predict outcomes in medical settings. In this study, supervised machine learning models were developed to identify the factors that most strongly predict nurses reporting feelings of burnout and experiencing emotional exhaustion.

METHODS

The PyCaret 3.3 package was used to develop classification machine learning models on 1165 collected survey responses from nurses across South Africa in medical-surgical units. The models were evaluated on their accuracy score, Area Under the Curve (AUC) score and confusion matrix performance. Additionally, the accuracy score of models using demographic data alone was compared to the full survey data models. The features with the highest predictive power were extracted from both the full survey data and demographic data models for comparison. Descriptive statistical analysis was used to analyse survey data according to the highest predictive factors.

RESULTS

The gradient booster classifier (GBC) model had the highest accuracy score for predicting both self-reported feelings of burnout (75.8%) and emotional exhaustion (76.8%) from full survey data. For demographic data alone, the accuracy score was 60.4% and 68.5%, respectively, for predicting self-reported feelings of burnout and emotional exhaustion. Fatigue was the factor with the highest predictive power for self-reported feelings of burnout and emotional exhaustion. Nursing staff's confidence in management was the second highest predictor for feelings of burnout whereas management who listens to employees was the second highest predictor for emotional exhaustion.

CONCLUSIONS

Supervised machine learning models can accurately predict self-reported feelings of burnout or emotional exhaustion among nurses in South Africa from full survey data but not from demographic data alone. The models identified fatigue rating, confidence in management and management who listens to employees as the most important factors to address to prevent these issues among nurses in South Africa.

Burnout and occupational stress of home care rehabilitation professionals transitioning out of the COVID-19 pandemic in Ontario, Canada

Introduction

The COVID-19 pandemic has significantly impacted the home healthcare industry, with increased rates of burnout and stress among homecare rehabilitation professionals (hcRPs). This study aimed to (1) examine the nature of burnout and occupational stress among homecare rehabilitation professionals at a large home care organization in Ontario, Canada, transitioning out of the pandemic, and (2) assess its impact on work participation and engagement.

Methods

We conducted a cross-sectional survey using the National Institute for Occupational Safety and Health Generic Job Stress Questionnaire and Copenhagen Burnout Inventory to examine burnout and job stress.

Results

One hundred thirty-nine participants identified that work stress and burnout are more likely to occur when one struggles to cope, experiences unexpected circumstances, and feels a lack of control, which can lead to anger and emotional exhaustion. The adjusted odds ratio for emotional exhaustion was 5.46, indicating that the probability of experiencing work stress among homecare rehabilitation professionals increases as emotional exhaustion increases. Significant associations were found between coping with daily tasks and levels of burnout.

Conclusion

Work stress and burnout influence coping, unexpected circumstances in homecare rehabilitation professionals work-life. Furthermore, highlighting the need to provide organizational support and policies that specifically address these issues in the home care sector.

The impact of job stress on job satisfaction and turnover intentions among bank employees during the COVID-19 pandemic

Objective

The main objective of this study is to explore the relationships among job stress, job satisfaction, and turnover intentions among bank employees during the COVID-19 pandemic, with a focus on variations across different demographic characteristics.

Methods

A cross-sectional design was employed, and data were collected from 501 bank employees using the Job Stress Questionnaire (JSQ), the Simplified Minnesota Satisfaction Questionnaire (MSQ), and the Intention to Leave Scale (ILS). Descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple regression analyses were used to test the research hypotheses.

Results

The findings show that job stress is significantly negatively correlated with job satisfaction and positively correlated with turnover intention. Interpersonal relationship stress emerged as the strongest predictor of turnover intention, while job autonomy stress significantly influenced job satisfaction. Demographic factors, including age, income, and education level, moderated these relationships, with younger, higher-income, and more educated employees reporting lower stress and higher satisfaction. Employees with dependents reported higher stress levels, lower job satisfaction, and greater turnover intentions compared to those without dependents.

Conclusion

This study underscores the importance of managing workplace stress and enhancing job satisfaction to reduce turnover intention, particularly during the COVID-19 pandemic. Interventions focused on improving interpersonal relationships and providing targeted support for older and lower-income employees are recommended to mitigate stress and improve retention rates.

Coaching Home Care Clients to Prepare Their Homes for Safe Care Visits: A Mixed-Methods Study to Evaluate a Nurse-Led Educational Intervention Process

Assuring home care (HC) workers' safety is challenging because the work environment is a private home. This paper presents the process evaluation for a proof-of-concept safety intervention study to assess whether nurse-led safety coaching, using motivational interviewing and a safety handbook, could enable HC clients to improve safety in their homes. The process evaluation objectives were to (i) document the intervention's implementation progress and (ii) assess the intervention's dose delivery, dose reception, and fidelity. Five agencies employing liaisons (n = 5) and nurse managers (NMs, n = 8) implemented this study's intervention and control arms. NMs assigned to the intervention arm (n = 6) coached 34 clients. Process evaluation metrics were assessed with mixed-methods data from (i) surveys completed by NMs during the intervention, (ii) postintervention audio-recorded and transcribed interviews (n = 6) with NMs and liaisons, and (iii) study progress tracking tools. The delivered dose efficiency was 85%, measured by the distribution of safety handbook copies to clients. About 94% of clients (n = 32) were considered "engaged" or "maybe engaged" during the safety coaching. Most coached clients (n = 30) were reachable for follow-up by NMs to assess intervention progress. Despite challenges, the intervention was implemented with good fidelity. Safety coaching can be applied in many HC contexts in larger populations.