Work-Related Burdens and Requirements for Health Promotion Programs for Nursing Staff in Different Care Settings: A Cross-Sectional Study

Perceived HRM and turnover intentions of elderly care workers: perspective from person-job fit and institutional ownership

BACKGROUND

Although the phenomenon of high turnover rate in the elderly care industry has existed for a long time, there are few studies that have constructed frameworks to comprehensively analyze the strength of the effects of various factors on the turnover intention of elderly care workers.. This study analyzed the impact of different types of perceived human resource management practices on elderly care workers' turnover intentions and whether this relationship is moderated by person-job fit and ownership of elderly care institutions.

METHODS

This is a cross-sectional and regional survey study. The study included questionnaire survey data from a total of 305 elderly care workers from 42 elderly care institutions in 21 provinces in China during June to September 2021. Descriptive statistics, Pearson correlation coefficient, multiple regression, and heterogeneity analyses were performed.

RESULTS

Perceived work environment ( β =-0.5164, p< 0.01), perceived occupational protection ( β =-0.3390, p< 0.01), perceived welfare benefits ( β = -0.2620, p< 0.01) and perceived competency training ( β = -0.1421, p< 0.1) were all significantly and negatively related to turnover intentions, the quality of perceived work environment has the greatest impact on elderly care workers' turnover intentions. Under the moderating effects of person-job fit and ownership of elderly care institutions, there existed heterogeneity between perceived human resource management and turnover intentions among elderly care workers. High level of person-job fit and elderly care institutions' public feature can effectively weaken the negative impact of each type of perceived human resource management on turnover intention among elderly care workers.

CONCLUSIONS

The managers of elderly care institutions should optimize the management mechanism, typically pay attention to elderly care workers' working environment, formulate and improve the professional standards and job requirements for elderly care workers, promote the public welfare value of nursing care services, and strengthen the sense of honor and responsibility of elderly care workers to reduce the turnover rate.

Individual and organizational interventions to promote staff health and well-being in residential long-term care: a systematic review of randomized controlled trials over the past 20 years

BACKGROUND

Staff in residential long-term care (RLTC) experience significant physical and mental work demands. However, research on specific interventions to promote staff health and well-being in RLTC facilities is limited. This systematic review aimed to synthesize the current evidence on health promotion interventions among RLTC staff.

METHODS

A comprehensive systematic literature review was conducted on studies published between January 2000 and April 2023. Four electronic databases were searched, including PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and PsychArticles via EBSCO. The review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The methodological quality of the included studies was assessed using the Risk of Bias Assessment tool (RoB 2).

RESULTS

A total of 26 publications, referring to 23 different interventions with a randomized controlled design were included. Among these interventions, ten used training/educational approaches, six used behavioral approaches, and seven employed a multimodal approach. Significant improvements in health and well-being outcomes were found in four interventions using a training/educational approach, three interventions using a behavioral approach, and four interventions using a multimodal approach. Within the interventions studied, twelve specifically targeted the reduction of job demands, while only one intervention exclusively addressed job resources among RLTC staff. Furthermore, ten interventions addressed primary outcomes that encompassed both job demands and job resources.

CONCLUSION

Current evidence for health promotion interventions among RLTC staff is still limited, but research suggests that there is potential to improve certain outcomes related to RLTC staff health and well-being. Future research is recommended to contemplate a tailored intervention design that encompasses both individual-level and organizational-level approaches, and gender-specific physiological and sociological characteristics of RLTC staff. Moreover, detailed reporting of the development process, and research on the interaction between job demands and resources of RLTC staff are also recommended.

Health status, resources, and job demands in geriatric nursing staff: A cross-sectional study on determinants and relationships

BACKGROUND

According to current estimates, the number of people needing care will double in the next 40 years. It is expected that between 130,000 and 190,000 additional nurses will be needed by 2030 in Germany. Physical and psychological burdens associated with nursing in long-term care facilities can develop into serious health risk factors and significantly impact occupational factors such as absenteeism, especially when linked to difficult working conditions. However, demands and resources specific to the nursing profession have not been analyzed extensively to preserve and promote nurses' workability and health adequately.

OBJECTIVE

Our study aimed to examine the extent to which perceived health among geriatric nursing staff in Germany is predicted by personal resources, job demands, and job resources. In addition, we analyzed the impact of different behavior and experience patterns on these relationships.

DESIGN, SETTING, AND PARTICIPANTS

An observational study was conducted between August 2018 and February 2020 in 48 nursing home facilities with 854 staff members in Germany as part of the project 'PROCARE - Prevention and occupational health in long-term care'.

METHODS

The survey contained instruments that measure workplace exposure, musculoskeletal complaints, physical and mental well-being, chronic stress, and work-related behavior and experience patterns. In addition, health-related information on physical activity and nutrition was collected. Data were analyzed using structural equation modeling.

RESULTS

The combined physical and mental workload for geriatric nurses is very high, with 75 % showing chronic stress. In the overall model, job and personal resources have a stronger association with mental health than physical health, while job demands have an equal impact on mental and physical health. Coping behavior also plays an important key role that should be assessed and considered. A behavior and experience risk pattern (health-endangering) is more strongly associated with a lower health status than a health-promoting behavior pattern. Results of the multigroup test showed that work-related behavior and experience patterns significantly moderate the relationship between physical health and mental health (χ2 = 392/p ≤ .001/df = 256/RMSEA = 0.028/CFI = 0.958/TLI = 0.931). Only 43 % show a health-friendly coping pattern.

CONCLUSIONS

Our findings underline the importance of holistic health promotion, which not only aims at changes at the behavioral level and the development of coping strategies but also takes on the task of reducing the workload and including measures to improve the working climate.

TRIAL REGISTRATION NUMBER

DRKS.de (DRKS00015241); August 9, 2018.

TWEETABLE ABSTRACT

Healthier coping patterns can benefit geriatric nurses' health. However, this is not a substitute for improving working conditions.

How to Address the Health of Home Care Workers: A Systematic Review of the Last Two Decades

Making home care a healthy workplace is a societal concern but research on specific interventions is still scarce. The aim of this systematic review was to provide an initial overview of interventions addressing home care workers' health. All (quasi-) experimental studies, presenting any intervention among home care employees, and reporting any outcome related to occupational health, safety, or well-being were included. PsycArticles, Medline, PubMed, and Web of Science were searched from January 2000 to February 2022. From 16,345 publications, 18 studies with 2432 participants were included and assessed with the Joanna Briggs Institute Critical Appraisal Tools. Organizational and training/educational approaches were found in five studies each, a behavioral approach in one, and seven studies presented a combined approach. Due to methodological limitations and the heterogeneity of interventions, the existing studies are insufficient to inform new programs, but emphasize the need for tailored approaches, integrated concepts, and participatory intervention development.

The Hidden Script of Work-Related Burdens in Home Care - A Cross Over Mixed Analysis of Audio Diaries

The lived experiences of work-related burdens in the daily working routines of home care workers are insufficiently investigated. Therefore, the aim of this study is to examine the types, frequencies, and distributions of work-related burdens and to explore their co-occurrence. Qualitative data was collected via audio diaries and analyzed applying a crossover mixed analysis using content as well as network analysis. In all, 23 home care workers (mean age = 46.70 ± 10.40; 91.30% female) produced 242 diary entries. Participants reported work-related burdens 580 times with 77 different types, predominately in relation to work organization (50.5%). Network analysis reveals a complex picture, which shows the strong relation between time pressure and travel between homes, and identifies additional tasks as the central node in the network of burdens. A holistic understanding of setting-specific burdens provides an important starting point for measures of workplace health promotion.

A systematic review study on the factors affecting shortage of nursing workforce in the hospitals

AIM

This study aimed to determine factors that influence the nursing workforce shortage and their impact on nurses.

DESIGN

This study applied a systematic review design.

METHODS

Using Cochrane library guidelines, five electronic databases were systematically searched (Research 4life-PubMed/Medline, Scopus, Embase, CINAHL) from 2010-2021. The remaining articles with pertinent information were presented in a data extraction sheet for further thematic analysis. A Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram was adopted and used. The studies published from 2010-2021 and in English language were examined and included in the systematic review.

RESULTS

Four themes were identified as factors influencing the nursing workforce shortage, including Policy and planning barriers, Barriers to training and enrolment, Factors causing nursing staff turnover and Nurses' stress and burnout. Nursing workforce shortage is a global challenge that roots in multiple causes such as individual, educational, organizational and managerial and policy-making factors.

Influencing factors on the health of nurses-a regression analysis considering individual and organizational determinants in Germany

BACKGROUND

The care sector is characterized by high absenteeism of nursing care employees due to illness. Organizational determinants that can affect the mental health of nurses are known. Although nurses are confronted with different framework conditions in different care settings, there is a lack of comparative data in Germany.

METHODS

The purpose of this study was to examined the relationship between work demands and employee health in different care settings. This cross-sectional survey was conducted between June and October 2021 in four acute care hospitals, seven inpatient care facilities, and five outpatient care services in Germany. 528 nursing care employees (acute care hospitals n = 234; inpatient care facilities n = 152; outpatient care services n = 142) participated in the survey (participation rate: 22.6%-27.9%). For each care setting, data was collected via questionnaire on individual determinants (gender, age, profession, working time), organizational work demands (quantitative workload, qualitative workload, organization of work, social work climate, after work situation, verbal violence, threats, physical violence) and employee health (subjective health status and work ability). Descriptive statistics and binary logistic regressions were performed.

RESULTS

Increasing age (OR = 0.650, 95% CI = 0.424-0.996) as an individual determinant and organization of work (OR = 0.595, CI = 0.362-0.978) as an organizational determinant were negatively associated with subjective health. Furthermore, age (OR = 0.555, 95% CI = 0.353-0.875), a demanding organization of work (OR = 0.520, CI = 0.315-0.858), increasing quantitative workloads (OR = 0.565, CI = 0.343-0.930) and a poorer perceived social work climate (OR = 0.610, CI = 0.376-0.991) were associated with lower work ability.

CONCLUSIONS

Based on the study results, health programs should target both individual and organizational factors. The findings seem to support the importance to include nursing care employees in the planning process, as it can have an impact on their health.

TRIAL REGISTRATION

The project was registered in the German Clinical Trial Register (DRKS00024961, 09/04/2021).

Effects of a Mindfulness Intervention Comprising an App, Web-Based Workshops, and a Workbook on Perceived Stress Among Nurses and Nursing Trainees: Protocol for a Randomized Controlled Trial

Background

Previous research has found digitally supported mindfulness interventions to be effective when used for stress management among workers in high-stress occupations. Findings on digitally supported mindfulness interventions among nurses working in acute inpatient care settings are heterogeneous, lack long-term follow-up, and do not assess adherence and acceptability.

Objective

This study aimed to investigate the effectiveness and efficacy of a digitally supported mindfulness intervention designed to improve health- and work-related outcomes among nurses and nursing trainees working in acute inpatient care settings.

Methods

We will conduct a multicenter randomized controlled trial using a wait-list control group design. Randomization will be stratified by hospital and job status (nurse or nursing trainee). Recruitment will take place on the web and offline during the working hours of nurses and nursing trainees. The intervention group will receive a digitally supported mindfulness intervention, which will comprise an app, 2 web-based workshops, and a workbook, whereas the wait-list control group will be scheduled to receive the same intervention 14 weeks later. The 2 web-based workshops will be led by a certified mindfulness-based stress reduction trainer. Nurses will use the app and the workbook independently. Self-report web-based surveys will be conducted on the web at baseline, at 10 weeks after allocation, at 24 weeks after allocation, and at 38 weeks after allocation. Outcomes of interest will include perceived stress (primary outcome), health- and work-related variables, and variables related to adherence and acceptability of the digitally supported mindfulness intervention. We will perform intention-to-treat and per-protocol analyses.

Results

Data collection will be completed by the beginning of August 2022. Data analyses will be completed by December 2022.

Conclusions

Our study design, including long-term follow-up and the investigation of variables related to adherence and acceptability, will ensure rigorous evaluation of effectiveness and efficacy. Relative to costly in-person intervention efforts, this program may present a cost-effective and potentially highly scalable alternative. Findings regarding effectiveness, efficacy, adherence, and acceptability will inform stakeholders’ decisions regarding the implementation of similar interventions to promote the well-being of nurses and nursing trainees, which may, in turn, alleviate detrimental stress-related outcomes (eg, burnout) because of work-related demands.

Trial Registration

German Clinical Trials Register DRKS00025997; https://tinyurl.com/433cas7u

International Registered Report Identifier (IRRID)

DERR1-10.2196/37195

Effectiveness and response differences of a multidisciplinary workplace health promotion program for healthcare workers

Background

Workplace health promotion (WHP) in the healthcare industry is an important yet challenging issue to address, given the high workload, heterogeneity of work activities, and long work hours of healthcare workers (HCWs). This study aimed to investigate the effectiveness and response differences of a multidisciplinary WHP program conducted in HCWs.

Methods

This retrospective cohort study included HCWs participating in a multidisciplinary WHP program in five healthcare facilities. The 20-week intervention included multiple easy-to-access 90-min exercise classes, one 15-min nutrition consultation, and behavioral education. Pre- and post-interventional anthropometrics, body composition, and physical fitness (PF) were compared with paired sample t-tests. Response differences across sex, age, weight status, and shiftwork status were analyzed with a generalized estimating equation.

Results

A total of 302 HCWs were analyzed. The intervention effectively improved all anthropometric (body mass index, waist circumference, waist-hip ratio, and waist-to-height ratio), body composition (body fat percentage, muscle weight, visceral fat area), and PF (grip strength, high jump, sit-up, sit-and-reach, step test) parameters in all participants (all p < 0.05). Subgroup analyses revealed shift workers had a more significant mean reduction in body mass index than non-shift workers (adjusted p = 0.045). However, there was no significant response difference across sex, age, and weight subgroups.

Conclusion

This study suggested that a multidisciplinary WHP program can improve anthropometric and PF profiles regardless of sex, age, and weight status for HCWs, and shifter workers might benefit more from the intervention.

Multicomponent exercises to prevent and reduce back pain in elderly care nurses: a randomized controlled trial

Background

Sports science is making an important contribution to health services research and supports the development of tailored interventions, e.g., in nursing settings. Working in elderly care is associated with a high prevalence of low back pain (LBP). Due to the diverse requirements and high strains, multicomponent programs are essential to address all relevant factors. This randomized controlled trial investigated the effects of a tailored ten-week ergonomics and twelve-week strength training on lifting behavior, strength endurance, LBP, functional impairment and adherence.

Methods

n = 42 nurses were randomly assigned to the intervention (IG; n = 20) or control group (CG; n = 22). They were eligible for participation if they were active in residential care and if they provided written informed consent. Other employees were excluded. The data were collected at baseline, at ten weeks (after ergonomics training), at 22 weeks (after strength training), and at 34 weeks (follow-up). The analysis combined physical tests with questionnaires (Progressive Isoinertial Lifting Evaluation, PILE-Test; Biering-Sørensen-Test; Visual Analog Scale Pain, VAS; Oswestry Disability Index, ODI; self-developed questionnaire for adherence). Group differences were analyzed by Chi²-Tests, ANOVA, and Linear Mixed Models.

Results

The IG showed an improved lifting performance (PILE-Test; 95% CI 1.378–7.810, p = .006) and a reduced LBP compared to the CG (VAS; 95% CI − 1.987 to 0.034, p = .043) after ergonomics training (PILE-Test, F_(1,34) = 21.070, p < .001; VAS, F_(1,34) = 5.021, p = .032). The results showed no differences concerning the Biering-Sørensen-Test and the ODI. Positive adherence rates were observed.

Conclusions

This approach and the positive results are essential to derive specific recommendations for effective prevention. The study results can be completed in future research with additional strategies to reduce nurses’ burden further.

Trial registration

The trial was registered at DRKS.de (DRKS00015249, registration date: 05/09/2018).

Health Promotion for Outpatient Careworkers in Germany

Due to ongoing demographic changes, the need for care is increasing in Germany. The number of outpatient care services is also rising, and with it, the number of employees in outpatient care, who are also continuously becoming older. Workplace health promotion (WHP) becomes relevant in this context, as it can reduce negative strain reactions and promote employees’ health. The aim of this study was (1) to reveal implemented WHP interventions in German outpatient care services; (2) to examine the potential challenges regarding a successful implementation of WHP measures; and (3) to illuminate further requests and needs experienced by outpatient careworkers. In qualitative field research, 30 semi-structured individual interviews were conducted with German caregivers, using the problem-centered interview method. The collected data were deductively and inductively evaluated and interpreted, using qualitative content analysis according to Mayring. Outpatient caregivers reported various WHP measures known from their workplaces, such as the provision of fruit baskets, programmes to increase physical activity, or a subsidy for a personal gym. They further reported WHP, such as back training, known from other care services. However, the respondents spoke of the challenges regarding the implementation or the use of WHP interventions in general. The most frequently named barriers were a lack of time after work and interventions that were only offered in their leisure time. In the same course, the participants still needed offers to increase physical activity, joint activities, or relaxation techniques. However, respondents highlighted that they preferred the interventions to take place during working hours. This way, they would also be more likely to take advantage of the interventions. The results of this study provide an insight into various WHP measures that already exist, or that are desirable for implementation with regard to caregivers’ needs. Subjectively perceived challenges for a successful implementation of WHP measures represent the importance of adjustments in the work organization of caregivers. It becomes clear that WHP is not yet established in the ambulant care sector, although it appears to be imperative for keeping caregivers healthy. Considering the different needs of employees, the results can provide a basis for the development of needs-based health promotion measures for caregivers.

Investigation of the Experience of Immigrant Nurses in a Diverse Cultural Setting

BACKGROUND

Work-related stress (WRS) is one of the most common stressors in healthcare workplace settings.

PURPOSE

This research study was designed to examine and discuss perceived WRS, job performance, social support, and the desire of immigrant nurses to work in a multicultural workplace.

METHODS

A case research mixed-methodology approach, a quantitative survey, and semistructured qualitative interviews were used in this research study. Three hundred twenty-one respondents were invited, of which 246 (76.6%) returned valid questionnaires. A purposeful sampling technique was used in the qualitative portion of the study. A semistructured interviewing system was used on 20 nurses.

RESULTS

"Workload" was the most common traumatic occurrence, whereas "treatment" and "death and dying" were the least common traumatic occurrences. Similarly, the mean of the social support scale, as defined using the McCain and Marklin Social Integration Scale, was moderate to high, suggesting that most of the participants received strong social support from their colleagues. The qualitative research found that the participants faced high pressures related to work and have struggled to acquire cultural skills, while having difficulties meeting their patients' cultural and spiritual needs and sustaining high-quality nursing care.

CONCLUSIONS

The findings of this study support that immigrant nurses working in the Kingdom of Saudi Arabia are stressed. A significant difference between the qualitative and quantitative results was found. The findings further contribute to our understanding of WRS, social support, job performance, and intention to stay among immigrant nurses in the Kingdom of Saudi Arabia.

The Second Side of the Coin-Resilience, Meaningfulness and Joyful Moments in Home Health Care Workers during the COVID-19 Pandemic

Nursing literature predominantly focuses on job demands but is scarce for resources related to nurses' work. In the face of the COVID-19 pandemic, resources that can buffer the health-impairing effects of increased demands gain importance. The aim of this study is to explore resilience, meaning of work and joyful moments in home health care workers in South Germany during the pandemic. Resilience and meaning of work were measured quantitatively; moments of joy were investigated qualitatively by audio diaries and analyzed with qualitative content analysis. In all, 115 home health care workers (mean age = 47.83 ± 11.72; 81.75% female) filled in the questionnaires and 237 diary entries were made by 23 persons (mean age = 46.70 ± 10.40; 91.30% female). The mean scores of resilience (5.52 ± 1.04; 1-7) and meaning of work (4.10 ± 0.92; 1-5) showed high levels, with significantly higher values in females. Home care workers experienced joyful moments 334 times in 60 different types in the categories of social relationships, work content, work organization, work environment and self-care. A deeper understanding of resilience, meaning of work and joyful moments provides a basis for the development of worksite health promotion programs that address both demands and resources in home health care workers.

Workplace health promotion interventions for nurses in Germany: a systematic review based on the RE-AIM framework

Background

The German health care system is faced with a serious shortage of nurses. This is associated, amongst other things, with difficult working conditions and work-related health burdens. Workplace health promotion (WHP) is considered a promising approach to promote the health of nurses. The present review aims to give an overview on existing interventions in different nursing settings (acute care hospitals, long-term care (LTC) facilities and home-based long-term care) in Germany.

Methods

A systematic literature search was conducted in PubMed and PubPsych. Studies were included if published after 2010 and provided data of intervention studies on workplace health promotion among nurses in Germany (RCTs, non-RCTs, non-controlled intervention studies and pilot studies). The setting in which the study was conducted (acute medical care hospital, inpatient LTC facilities, home-based LTC, cross-setting) as well as the health issue assessed (physical health, mental health and/or violence experience) were extracted. The intervention was reported against the background of the quality criteria for prevention measures of the statutory health insurers in Germany. The results of the studies were presented according to the RE-AIM framework.

Results

Eleven studies on WHP for nurses were included, whereof seven studies were conducted in acute medical care hospitals and four in LTC facilities. No study reported results on WHP for nurses working in the setting of home-based LTC. Most studies aimed at improving mental health. The intervention contents and forms of implementation were heterogeneous. According to the RE-AIM criteria, the reporting of most studies showed several limitations, especially a lack of reporting on Implementation and Adoption. Most studies showed no statistically significant effect on the respective outcomes (Effectiveness). Four studies reported results on Maintenance indicating a sustained effectiveness.

Conclusion

Despite the high relevance for health promotion for nurses, our review showed a striking lack of intervention studies in this field. From this we derive a high need of tailored interventions, taking into account the setting-specific development, implementation of WHP interventions for nurses. With regard to the evaluation, the RE-AIM criteria should be taken more into account in order to meet the requirements of evaluating complex interventions and thus contribute to evidence development of WHP in nursing. In terms of content, the topic of violence prevention and dealing with experiences of violence should also be taken into account. Regarding the settings, the working conditions and health burdens in LTC facilities, home-based LTC and acute medical hospitals must be considered.

Trial registration

PROSPERO registration number: CRD42021231891

Work-Related Health Burdens of Nurses in Germany: A Qualitative Interview Study in Different Care Settings

Background: The growing need for nursing care is offset by a shortage of nurses, who are exposed to high physical and psychological demands in their daily work and have above-average absences that vary between different care settings. Based on the data on sick days, the question arises: What are the subjective work-related health burdens of nurses in acute care hospitals, inpatient care facilities, and outpatient care services? Methods: Sixteen semi-structured interviews were conducted in different care settings between May and September 2021. Questions about the professional career, everyday working life and personal health, violence in the workplace, and organizational framework conditions were asked. Results: The experiences of the nurses highlighted that health-related burdens have varying manifestations in different care settings. This was reflected in three main categories: health, everyday working life, and experiences of violence. In particular, the different structural framework conditions that trigger stress and the occurrence of violence are important from the perspective of the nurses. Conclusions: The results of this exploratory study can serve as a baseline for obtaining further setting-specific quantitative data that can contribute to the development, implementation, and evaluation of target group-specific health promotion programs.

Health problems and violence experiences of nurses working in acute care hospitals, long-term care facilities, and home-based long-term care in Germany: A systematic review

Background

Working in the nursing sector is accompanied by great physical and mental health burdens. Consequently, it is necessary to develop target-oriented, sustainable profession-specific support and health promotion measures for nurses.

Objectives

The present review aims to give an overview of existing major health problems and violence experiences of nurses in different settings (acute care hospitals, long-term care facilities, and home-based long-term care) in Germany.

Methods

A systematic literature search was conducted in PubMed and PubPsych and completed by a manual search upon included studies’ references and health insurance reports. Articles were included if they had been published after 2010 and provided data on health problems or violence experiences of nurses in at least one care setting.

Results

A total of 29 studies providing data on nurses health problems and/or violence experience were included. Of these, five studies allowed for direct comparison of nurses in the settings. In addition, 14 studies provided data on nursing working in acute care hospitals, ten on nurses working in long-term care facilities, and four studies on home-based long-term care. The studies either conducted a setting-specific approach or provided subgroup data from setting-unspecific studies. The remaining studies did not allow setting-related differentiation of the results. The available results indicate that mental health problems are the highest for nurses in acute care hospitals. Regarding violence experience, nurses working in long-term care facilities appear to be most frequently affected.

Conclusion

The state of research on setting-specific differences of nurses’ health problems and violence experiences is insufficient. Setting-specific data are necessesary to develop target-group specific and feasible interventions to support the nurses’ health and prevention of violence, as well as dealing with violence experiences of nurses.

Research hotspots and trends in nursing education from 2014 to 2020: A co-word analysis based on keywords

AIMS

To investigate research hotspots and trends in nursing education from 2014 to 2020, and provide references for researchers to understand the research status and developing trends in this field.

DESIGN

A co-word analysis based on keywords.

METHODS

Data were obtained from nursing education-related academic research articles that were retrieved through a literature search using PubMed during the period of 2014-2020. Keywords included in the analysis of literature were considered as the research objects. Bibliographic Item Co-occurrence Matrix Builder (BICOMB) was employed to extract high-frequency keywords and generate co-occurrence matrix, graphical clustering toolkit (gCLUTO) was used to perform cluster analysis, and SPSS 25.0 was used to perform strategic diagram analysis.

RESULTS

Overall, 7857 articles were retrieved, from which 2679 keywords were obtained and 64 high-frequency keywords extracted. The results revealed seven hotspots in nursing education during the period of 2014-2020, which included research on: (i) continuing education in nursing, (ii) application and influence of the internet in nursing education, (iii) postgraduate nursing education, (iv) undergraduate nursing education and clinical quality training, (v) current development status and tendency of nursing education, (vi) nursing teaching methods and (vii) organization and management in nursing education.

CONCLUSION

The seven research hotspots could reflect the publication trends in nursing education. By providing a co-word analysis-including cluster and strategic diagram analysis-an overall command of the latest hotspots can be depicted, and researchers conducting research in nursing education can have some hints.

IMPACT

This study allows the development of future research on nursing education. Future researchers should explore the application of new network technologies in the process of nursing teaching, quality of postgraduate nursing education, innovative teaching methods as well as teaching strategies of improving students' clinical ability, current situation of economics and leadership in nursing education and ability of organization and management in undergraduate nursing education.

Work community factors, occupational well-being and work ability in home care: A structural equation modelling

Aim

To examine how work community factors are related to occupational well‐being and work ability, and how occupational well‐being is related to work ability.

Design

A cross‐sectional study was conducted among home care workers in one municipality in Finland.

Methods

A self‐administered survey on work and well‐being was filled out by 167 employees working two shifts in 2019. Structural equation modelling was used to analyse the association between work community factors, occupational well‐being and work ability.

Results

The only work community factor directly affecting Occupational well‐being was Information and work organization; the effect of the other two factors, Social support and Influence on work shifts, was indirect. All work community factors indirectly affected Work ability. Home care should emphasize information provision and work organization with optimal time use. This requires social support, a well‐functioning work atmosphere and providing employees with opportunities for influence and participation.

Interventions to promote physical and mental health of nurses in elderly care: A systematic review

This systematic review focuses on the current evidence on interventions to promote physical and mental health in elderly care nurses. The literature was identified through the electronic databases Medline, PsycINFO and CINAHL using a combination of synonyms of the terms "elderly care nurses", "physical activity", "stress management", "occupational stress", "musculoskeletal diseases" and "incapacity to work". The search was performed in January 2020 and repeated in November 2020. N = 6 randomized controlled studies were included investigating the effect of physical activity interventions, cognitive-behavioral interventions, organizational interventions and multicomponent interventions on physical and mental health in elderly care nurses. Both, the content of the interventions and the used outcome measures were heterogeneous. Four of the included studies had a high quality. They scored same or higher than seven (out of a maximum quality score of 14) with low risks of performance and attrition bias. Results suggest that cognitive-behavioral and multicomponent interventions seem to have an influence on physical and mental health factors such as job satisfaction, burnout, mental health symptoms and neck complaints. This systematic review demonstrated the potential of health promotion programs in elderly care nurses. Nevertheless, high quality randomized controlled trials are needed. Further research should consider the bottom-up approach for planning programs as well as recommended and standardized outcome measures and interventions.

Physical activity and health promotion for nursing staff in elderly care: a study protocol for a randomised controlled trial

INTRODUCTION

Nursing staff is burdened by high workload and stress. Furthermore, heavy lifting, as well as transferring nursing home residents, cause lumbar tissue damage and back pain. Exercise intervention studies to reduce work-related problems are rare and the evidence for efficacy of studies among nurses is limited. Studies including targeted analysis of requirements are necessary to generate effective recommendations and tailored interventions for health promotion programmes. The purpose of this multicentred intervention study is to identify work-related problems, to implement health promotion programmes and to evaluate their effectiveness.

METHODS AND ANALYSIS

A randomised controlled trial will be conducted, including a total of 48 nursing home facilities in eight regions of Germany with an estimated sample size of 700 nurses. Standardised ergonomics and posture training (10 weeks, once a week for 20-30 min) and subsequently, back-fitness training (12 weeks, once a week for 45-60 min) will be administered. Following the implementation of standardised health promotion programmes, further demand-oriented interventions can be implemented. The perceived exposure to work-related demands, work-related pain in different parts of the body, health-related quality of life, perceived stress, work-related patterns of behaviour and experience, presentism behaviour, work environment as well as general needs and barriers to health promotion, will be assessed at baseline (pre-test), at 10 weeks (post-test, after ergonomics training), at 22 weeks (post-test, after back-fitness training) and at 34 weeks of the programme (follow-up).

ETHICS AND DISSEMINATION

The study was reviewed and approved by the local ethics committee of the University of Hamburg (AZ: 2018_168). The results of the study will be published in open-access and international journals. Furthermore, the results will be presented in the participating nursing homes and at national and international conferences.

TRIAL REGISTRATION NUMBER

DRKS.de (DRKS00015241).

Analysis of Selected Body Composition Parameters and Ergonomic Safety among Professionally Active Nurses in Poland: A Preliminary Prospective Monocentric and Observational Study

Nurses consist of an occupational group that is particularly exposed to harmful work-related factors such as prolonged working hours, severe stress, fatigue, and excessive strain on the musculoskeletal system. According to nurses, the limitation of the application of ergonomic principles of work may contribute to the occurrence of numerous dangerous behaviors, improper eating habits, or deficiency of systematic physical activity. The most common consequences are nutritional disorders and musculoskeletal system dysfunctions. This prospective observational study was aimed at evaluating selected parameters of the body composition of professionally active nurses and at determining work-related risks during nursing activities. The study group consisted of 37 active nurses (38.38 ± 11.33 years). The research tool was a device for bioelectrical impedance analysis (BIA). A questionnaire designed by the authors was also implemented, which covered ergonomic principles, musculoskeletal injuries, and nutritional habits. In the present study, it was shown that all average values of the tested nurses' body composition parameters were within the normal range. The majority of respondents (97.3%) reached a high level of body water. A statistically significant correlation was found between the knowledge of the workplace ergonomic principles and body mass index. In conclusion, musculoskeletal pain and lack of implementation of ergonomic behaviors are a significant problem among nurses, which may be the cause of overweight or obesity in this occupational group.

Occupational Precariousness of Nursing Staff in Catalonia's Public and Private Nursing Homes

Nursing staff who provide care in the nursing homes of Catalonia have more precarious work conditions, including more demanding schedules and work overload, than those in other areas of care. This situation entails two major problems: Detrimental health results for nurses who face psychosocial and physical risks and a negative impact on the care provided to patients, with a decrease in the quality of care. This study aimed to describe the precarious employment situation of nursing staff in nursing homes. We carried out a descriptive study based on the employment precariousness scale (EPRES), which was administered to a sample of 239 nurses and nursing assistants working in public and private nursing homes in Catalonia. The highest level of job insecurity occurred among nursing assistants and in privately managed nursing homes. The precariousness of the working conditions of nursing staff poses a risk both to the workers themselves and to the people they tend to. For this reason, there is a need for greater knowledge on the scale of the problem and the implementation of appropriate legislative measures to alleviate it.