Literature Evaluation Table

PICO(T) Question Template

P

Population

Med surg registered nurses

I

Intervention

Resilience training programs

C

Comparison Comment by Author: Current practice or no practice

No participation in resilience training programs

O

Outcome Comment by Author: Must be a measurable patient outcome

Job stress and burnout

T

Timeline Comment by Author: Optional

(optional)

Intervention

In med surg registered nurses (P), how does participation in resilience training programs (I) compared to no participation in resilience training program (C) REDUCE job stress and burnout among nurses (O)?

Problem Statement

It is not known if the implementation of resilience training program (I) would impact job stress and burnout (O) among registered nurses (RN) (P).

Criteria

Article 1

Article 2

Article 3

Article 4

APA Reference

Include the GCU permalink or working link used to access the article

Safavi, N., Kamrani, M., & Asgharipour, N. (2023). Effect of resilience training on job burnout of hospital nursing staff. Iranian Journal of Psychiatry and Behavioral Sciences. https://doi.org/10.5812/ijpbs-129429

Hasani, H., Zarei, B., Danaei, Z., & Mahmoudirad, G. (2022). Comparing the effect of resilience skills training and metacognitive therapy on job stress in nurses: an experimental study. DOAJ (DOAJ: Directory of Open Access Journals), 27(5), 377–384.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9745846/

Rosen, B., Preisman, M., Read, H., Chaukos, D., Greenberg, R., Jeffs, L., Maunder, R. G., & Wiesenfeld, L. (2022). Resilience coaching for healthcare workers: Experiences of receiving collegial support during the COVID-19 pandemic. General Hospital Psychiatry. https://doi.org/10.1016/j.genhosppsych.2022.02.003

Foster, K., Cuzzillo, C., & Furness, T. (2018). Strengthening mental health nurses’ resilience through a workplace resilience program: A qualitative inquiry. Journal of Psychiatric and Mental Health Nursing, 25(5–6), 338–348. https://doi.org/10.1111/jpm.12467

Purpose/Aim of Study

The purpose of the study was to investigate the effect of RT on job burnout in nurses.

The purpose of the study was to compare the effectiveness of RT and metacognitive therapy (MCT) in reducing job stress among nurses.

The study aimed to explore the experiences of healthcare workers (HCWs) who received collegial support through the RT program, Resilience Coaching (RC) program, implemented by the department of psychiatry at an acute care hospital during the COVID-19 pandemic.

The study aims to explore the perspectives of mental health nurses who participated in an RT program called Promoting Adult Resilience (PAR), initiated by a mental health service.

Research question(s)

Does RT reduce job burnout among hospital staff?

This question was addressed by comparing the burnout scores of hospital staff who participated in RT to the burnout scores of hospital staff who did not participate in resilience training (Safavi et al., 2023).

What is the comparative effectiveness of RT and MCT in reducing job stress among nurses?

What are the experiences of HCWs in an acute care hospital who participated in the RC program during the COVID-19 pandemic, and how does this program impact their well-being and coping mechanisms?

What are the perspectives and experiences of mental health nurses participating in PAR program, in addressing workplace adversities and promoting their mental health and well-being?

Design

Is the article qualitative, quantitative, or mixed methods? Explain how you determined the type of research design.

Quantitative. The study uses numerical data to measure the effects of RT, such as the scores on the Connor-Davidson Resilience Scale (CD-RISC) and the Maslach Burnout Questionnaire (MBQ). Both are based on a Likert scale.

Quantitative. The study is an experimental design. This means that the researchers randomly assigned participants to one of three groups: RT, MCT, or control. Hasani et al. (2022) also used Likert scales like the Expanded Nursing Stress Scale (ENSS) to measure the outcomes in their study.

Qualitative. Rosen et al. (2022) conducted qualitative interviews with HCWs to determine their experiences with RC. The collected data was then transcribed verbatim.

Qualitative. The study used multiple qualitative data collection methods, including open-ended written responses, semi-structured interviews, and focus groups. The data were analyzed using thematic analysis, which is an inductive approach that allows for the identification of themes from the data.

Setting

Where did the study take place? What type of setting: inpatient, outpatient, etc.?

The study took place inpatient hospital setting at Ibn Sina Hospital of Mashhad, Iran, in 2019.

The study took place in the Emergency Department (ED) and intensive care units (Newborn Intensive Care Unit - NICU, Pediatric Intensive Care Unit - PICU, and Intensive Care Unit - ICU) of Valiasr Hospital in Birjand City, Iran. The study took place from November 2018 to January 2019.

The study took place at Sinai Health, a multi-site facility in Toronto, Canada. Sinai Health comprised of Mount Sinai Hospital, Hennick Bridgepoint Hospital, the Lunenfeld-Tanenbaum Research Institute, and community clinics. The setting encompasses both inpatient and outpatient facilities

The study took place in a large metropolitan public mental health organization in Australia between November 2016 and April 2017. Foster et al. (2018) did not specify the type of setting within the mental health organization.

Sample

Number and characteristics of participants

A total of 46 nurses working in Sina Hospital. Both the intervention group and the control group had a total of 23 nurses in 2019 with a total of 12 males and 34 females. The mean age of the intervention group was 38.47 years while that of the control group was 36 years.

A total of 54 nurses with an average of 5 years of working experience. Each group had 18 participants. That is, the resilience, MCT, and control groups. The mean age for all the study’s participants was 36.3 years.

The study included a total of 24 participants, with the following distribution across professional categories:

· Four physicians (17%)

· 10 nurses (42%)

· Eight allied health professionals (33%)

· Two other staffs (8%)

The male participants were four while the female participants were 20 and it was conducted for a year from April 2020.

The study included a total of 29 nurses. The distribution of nurses was even across various age groups. 72% of the participants were female while 28 % were male. Also, 76% were full-time employees in the mental health organization. 12 (41%) had been in their current role for at least 10 years (Foster et al., 2018).

Methods

Interventions/Instruments

Safavi et al. (2023) used control group received no intervention. Safavi et al. (2023) used the CD-RISC to measure resilience and the MBQ to measure burnout. Both outcomes were measured before and after the intervention. The same measurement questionnaires were also administered to the control group at the same time points.

Hasani et al. (2022) is a randomized controlled trial design, with participants randomly assigned to one of the three intervention groups or a control group. The resilience group received resilience skills training presented by the researcher in eight 45-minute sessions.

Rosen et al. (2022) conducted qualitative interviews to capture the experiences of HCWs with RC. The interviews were professionally transcribed, edited for clarity, and analyzed for themes by the research team.

The collection of data was done through open-ended written responses from 24 participants, individual semi-structured interviews with four participants, a focus group with three participants, and a focus group with five facilitators. Interviews were conducted via telephone, and focus groups were held in quiet rooms at the health service. Questions sought perspectives on the program and its usefulness, with prompts for examples.

The collected data was transcribed verbatim data and then subjected to thematic analysis to determine the themes. Specifically, QSR International’s NVivo 11 software was used for data analysis (Foster et al., 2018).

Analysis

How were the collected data analyzed?

The collected data were analyzed using descriptive statistics and Mann-Whitney and Kruskal-Wallis tests using SPSS version 19 software.

The Mann-Whitney U test was used to compare the change in resilience and burnout scores between the two groups because the data was not normally distributed. Additionally, Safavi et al. (2023) used the Kruskal-Wallis test to assess the difference in the mean scores of each subscale of the MBQ

The collected data were analyzed using the statistical package for social science (SPSS) software version 19. The analysis involved both descriptive and inferential statistical methods.

The statistical analysis included one-way ANOVA, Tukey's post-hoc test, analysis of variance with repeated measures, Bonferroni post-hoc test, chi-square, and Fisher's exact test (Hasani et al., 2022).

Data collection and thematic analysis were conducted concurrently to analyze the data. This allowed for an iterative and dynamic approach to understanding emerging themes.

A single interviewer conducted all the interviews. After each interview, the interviewer identified themes and discussed questions with the larger group of researchers.

Weekly reporting to the research team allowed for adjustments to topics based on emerging themes in coaching discussions and the evolving pandemic.

Foster et al. (2018) used QSR International's NVivo 11 software to manage and analyze the data. The researchers read and re-read the data to become familiar with it and later identified recurring patterns and themes in the data. The researchers then reviewed the themes to ensure that they were internally consistent and that they reflected the data. Finally, Foster et al. (2018) wrote a report that presented the findings of the analysis.

Outcomes/key findings of the study and implications for nursing practice

Summary of study results

The mean burnout score decreased from 53.48 to 47.48 in the intervention group after the intervention while that of the control group increased from 52.17 to 55.35 during the same period.

The number of participants with emotional exhaustion decreased from 16 to 12 in the intervention group after the intervention while the number of participants with emotional exhaustion increased from 14 to 18 in the control group after the intervention.

The mean resilience score increased from 58.43 to 61.22 in the intervention group after the intervention while the mean resilience score decreased from 59.35 to 57.17 in the control group after the intervention.

The findings of this study suggest that resilience training can be an effective intervention for improving resilience and reducing job burnout among nurses. Nursing educators and managers should therefore consider implementing resilience training programs for their employees.

The mean job stress score before the intervention was 53.48 in the RT group, 54.22 in the MCT group, and 52.17 in the control group.

However, the mean job stress score one month after the intervention was 46.22 in the RT group, 42.89 in the MCT group, and 56.95 in the control group.

Hasani et al. (2022) states that the job stress mean score for RT and MCT groups decreased significantly over time (p < 0.001). In the control group, the job stress mean score increased significantly over time (p < 0.001).

The implications of this study’s findings to nursing are that RT and MCT should be considered as interventions for reducing job stress among nurses. Also, nurse educators and managers should provide training in RT and MCT to nurses and that nurses should be encouraged to participate in RT and MCT programs (Hasani et al., 2022).

Participants stated that the program provided hospital staff with various benefits, including opportunities for connection, encouragement to prioritize personal wellness, and practical skills to help cope with challenges. RC also helped HCWs in accessing clinical mental health support when they requested it. This helped in managing their stress and improving their overall well-being.

It is also important to note that some participants felt that the program positively influenced participants' mood and contributed to a sense of work-life balance (Rosen et al., 2022). In general, RC contributed to a supportive work environment for the HCWs.

The implications of this study to nursing are that implementing an RC program can have significant benefits for healthcare workers. By providing opportunities for stress reduction and promoting work-life balance, nurses and other healthcare professionals may experience improved mental well-being and job satisfaction.

Participants reported that the PAR program helped them to understand resilience more clearly and to develop a more nuanced understanding of what resilience is.

Participants also reported that the PAR program helped them to strengthen their resilience by providing them with coping strategies for dealing with stress, self-care strategies for promoting resilience, and strategies for managing their emotional responses.

Finally, participants reported that they were able to apply the skills they learned in the PAR program to their work. They reported that the skills helped them to manage challenges at work, improve their practice, and feel more confident and resilient in their work.

According to Foster et al. (2018), the implications of the study to nursing are that RT programs are valuable for addressing workplace stressors and promoting resilience and overall well-being in mental health nurses.

Recommendations of the researcher

Safavi et al. (2023) state that resilience training programs for nurses should be introduced in hospitals to reduce their resilience and reduce burnout among nurses.

Hasani et al. (2022) recommends the incorporation of RT and MCT programs for nurses to reduce their job stress.

Rosen et al. (2022) states that healthcare organizations should consider the incorporation of RC programs as a standard support mechanism for HCWs, especially during challenging situations like the COVID-19 pandemic.

Foster et al. (2018) recommends using PAR in the metropolitan public mental health organization for nurses to improve their resilience, coping skills and overall well-being.

Foster et al. (2018) also recommends that quantitative research be conducted to further explore the effectiveness of PAR programs for nurses in the metropolitan public mental health organization.

Explain how this article supports your proposed PICO(T) question.

The intervention and comparison groups in the study are similar to that of the PICO. Safavi et al. (2023) PROVIDES evidence that resilience training can effectively reduce job burnout among nursing staff. The study found that nurses who participated in a resilience training program had significantly lower levels of burnout than nurses who did not participate in the program (Safavi et al., 2023).

The intervention and comparison of the study is similar to that of the PICO with an addition of a different comparison group, MCT. Therefore, Hasani et al. (2022) study’s findings provide valuable insights into the effectiveness of resilience training programs in reducing work-related stress among nurses.

Rosen et al. (2022) study supports the PICO by determining the experiences of RC program in improving the overall well-being of HCWs. RC is a type of RT that focuses on building psychological and emotional resilience in individuals (Rosen et al., 2022). As such, the interventions of the PICO and Rosen et al. (2022) study are similar with the only difference being the lack of comparison group in the study.

The intervention in Foster et al. (2018) study aligns with that of the PICO but lacks a comparison group. Foster et al. (2018) provides insights into the experiences and perspectives of mental health nurse with PAR, an RT program, in improving.