The effectiveness of primary nursing on burnout among psychiatric nurses in long-stay settings. Teaching health-care providers coping: results of a two-year study. Effects of relaxation training, combining imagery, and meditation on the stress level of Chinese nurses working in modern hospitals in Taiwan. The effects of a 24-h psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study. The effects of mindfulness-based stress reduction on nurse stress and burnout, Part II: A quantitative and qualitative study. Psychophysiological concomitants of organizational change in health care personnel: effects of a controlled intervention study. Does training in psychosocial interventions reduce burnout rates in forensic nurses? Effects of a 105 hours psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study. A pilot feasibility study of the effects of touch therapy on nurses. Recreational music-making: a cost-effective group interdisciplinary strategy for reducing burnout and improving mood states in long-term care workers. Effect of assertiveness training on levels of stress and assertiveness experienced by nurses in Taiwan, Republic of China. Relaxation training methods for nurse managers in Hong Kong: a controlled study. Effects of emotion-oriented care on work-related outcomes of professional caregivers in homes for elderly persons. Effectiveness of stress management training for nurses working in a burn treatment unit.
This study was set up to test the effectiveness of primary nursing on the burnout level of psychiatric nurses. It was expected that, under certain conditions, such as a primary nursing care delivery with an adequate feedback system, the burnout level would decrease. In a quasi-experimental research design, a cohort of 161 psychiatric nurses was followed for 2.5 years. Results showed that although the burnout level did not change as a result of primary nursing, psychiatric nurses and the practical nurses seemed able to work according to the principles of primary nursing. Strong indications were found that the job turnover decreased as a result of the introduction of primary nursing. Because two main problems were encountered in this study, a high drop-out due to job turnover among nurses and the imitation of the intervention by the control group, several additional analyses were performed. This study examined coping strategies and occupational burnout in a sample of 118 health-care providers. Subjects who participated in a 6-week program designed to improve coping reported significant short-term decreases in emotional exhaustion and lack of personal accomplishment, two dimensions of burnout. Subjects who received 1-hr coping "refresher" sessions at 5, 11, and 17 months showed consistent decreases in burnout throughout the 2-year period. However, those who did not receive the refresher sessions following the 6-week course showed only temporary improvement. Results indicate that health-care providers can be taught to employ adaptive coping strategies that improve levels of burnout, but long-term changes are achieved only through long-term coping training. The purpose of this study was to test the effectiveness of relaxation training, which was based on the cognitive-behavioral model and specifically focused on helping Chinese registered nurses employed in large teaching hospitals to reduce their work stress in Taiwan, Republic of China. The study design was a pretest-posttest control design with two posttest points. The 137 subjects were selected randomly from three first-ranked teaching hospitals. Twenty-three subjects in the experimental group and 23 in the control group from each hospital participated in the study. The treatment of the experimental group consisted of two sessions of relaxation training based on Smith's (1988) cognitive behavioral model of relaxation at weeks 1 and 2, with a follow-up session in the fifth week. The control group had the same sequence of sessions with a presentation by the researcher on theory analysis in nursing. The mean scores on the Nurse Stress Checklist (NSC) and the Chinese General Health Questionnaire (CGHQ) differed significantly between the experimental and control group in posttest 2 at week 5. These results supported the hypotheses that the relaxation training decreased the Chinese nurses' self-reported work stress as measured by NSC and increased the Chinese nurses' self-reported psychophysiologic health as measured by CGHQ. The significant difference on means of the CGHQ in posttest 1 at week 2 showed that the self-reported psychophysiologic health level responded to the relaxation training earlier than to the self-reported work stress level. In the relaxation treatment, duration of practice was an important factor of the effectiveness of the treatment on the dependent variable of NSC. It is suggested that even brief teaching of relaxation techniques may reduce work stress levels and promote a sense of psychophysiologic health in Chinese nurses who are employed in large teaching hospitals in Taiwan. The usefulness of psychological training programs (P.T.P.) in health care settings devoted to cancer care is beginning to be recognised but their content, form and effectiveness need further investigation. Seventy-two oncology nurses were randomly assigned to a 24-h P.T.P. or to a waiting list period. Attitudes were assessed by a semantic differential questionnaire, occupational stress was assessed by the Nursing Stress Scale and communication skills were assessed by standardised videotaped role-playing exercises. These were used to compare trained (T.S.) and control subjects (C.S.). The results show a significant training effect on attitudes (P = 0.05), especially on those related to self concept (P = 0.004), and on the level of occupational stress related to inadequate preparation (P = 0.02). Limited changes were found regarding post-training communication skills. T.S. were significantly more in control of the interview than C.S. (P = 0.02). The results indicate that 24-h P.T.P. assessed here are effective. The data also demonstrate the need to consolidate the skills acquired by regular post-training sessions. This article is the second in a series reporting on research exploring the effects of Mindfulness-based Stress Reduction on nurses and describes the quantitative data. The third article describes qualitative data. Treatment group participants reduced scores on 2 of 3 subscales of the Maslach Burnout Inventory significantly more than wait-list controls; within-group comparisons for both groups pretreatment and posttreatment revealed similar findings. Changes were maintained as long as 3-month posttreatment. Implications of these findings are discussed. To assess possible psychophysiological changes in personnel being exposed to organizational change and to assess the effects of a structured empowerment programme.
                A randomized, prospective, controlled, and non-blinded intervention was carried out in two wards within a geriatric hospital. The I-ward (intervention) was offered a structured intervention programme with a trained, registered psychologist during 20 weekly 1-hour sessions before and after the organizational change. The C-ward (control) was passively attended by the same psychologist during equal time conditions. Blood pressure as well as pulse rate were taken and blood samples were drawn from all participants before (0 weeks), immediately after the intervention (20 weeks) and after another 10 weeks' follow-up (30 weeks).
                There was a significant time x group interaction with increasing prolactin levels on the C-ward as compared to decreasing levels on the I-ward during the intervention.
                Our study results suggest a picture of differentiated changes in stress hormone levels. The I-ward exhibited less psychoendocrine stress compared to the C-ward, probably due to the intervention and the possibility for personnel to influence the programme. We suggest that psychosocial empowerment programmes are beneficial when organizational changes are enacted in health care settings. Mental Health Nurses working in secure environments with patients suffering from serious mental illness have been shown to be at risk of clinical burnout syndrome, this can have adverse effects both on the nurses' health and the standards of care that they deliver.
                To evaluate the effect of Psychosocial Intervention Training (PSI) on the knowledge, attitudes and levels of clinical burnout in a group of forensic mental health nurses.
                Baseline assessments of knowledge, attitude and burnout were completed by asking a group of 33 nurses working in a medium secure psychiatric unit to complete questionnaires. Twenty of the nurses volunteered to be included in a PSI training course and were randomly allocated either to receive the training or to a waiting list control group. The duration of the training was 6 months and on completion subjects in the experimental and control group completed the questionnaires again.
                Staff in the experimental group showed significant improvements in their knowledge and attitudes about serious mental illness and a significant decrease in burnout rates, whilst staff in the control group showed a small but nonsignificant improvement in knowledge and attitudes, and increase in burnout.
                The findings suggest that providing forensic mental health nurses with a better understanding of serious mental illness and training them in a broader range of interventions, helps them to be more positive in their attitudes towards the clients that they work with and experience less negative effects of stress resulting from their caring role. The implications of this study for clinical practice and future research will be discussed. There is today a wide consensus regarding the need to improve communication skills (CS) of health-care professionals (HCPs) dealing with cancer patients. Psychological training programs (PTPs) may be useful to acquire the needed CS. Testing the efficacy of PTP will allow to define their optimal content. The present study was designed to assess the impact of a PTP on HCP stress, attitudes and CS, and on HCP and patients' satisfaction with HCP communication skills in a randomised study. A total of 115 oncology nurses were randomly assigned to a 105-h PTP or to a waiting list. Stress was assessed with the Nursing Stress Scale, attitudes with a Semantic Differential Questionnaire, CS used during one simulated and one actual patient interview with the Cancer Research Campaign Workshop Evaluation Manual, and satisfaction with the nurses' CS with a questionnaire completed by the patients and the nurses. Trained (TG) and control (CG) groups were compared at baseline, after 3 months (just following training for TG) and after 6 months (3 months after the end of training for TG). Compared to controls, trained nurses reported positive changes on their stress levels (P</=0.05) and on their attitudes (P</=0.05). Positive training effects were found on CS used during the simulated interview: a significant increase in facilitative behaviours (open questions: P</=0.001; evaluative functions: P</=0.05) and a significant decrease in inhibitory behaviours (inappropriate information: P</=0.01; false reassurance: P</=0.05). Less positive training effects were found regarding interviews with a cancer patient: a significant increase in educated guesses (P</=0.001) was noticed. No training effect was observed on nurses' satisfaction levels, but a positive training effect was found on patients' satisfaction levels (P</=0.01). Although results outline PTP efficacy, they indicate the need to design PTP, amplifying the transfer of learned CS to clinical practice. The White House Commission on Complementary Alternative Medicine (CAM) has recommended that safe and effective CAM practices be evaluated to determine their role in maintaining wellness and promoting health. There is little research on individual bodywork/energy therapies and their effects on wellness. The purpose of this pilot study was to assess the effect of AMMA treatments on relaxation and anxiety in staff nurses, and to examine themes describing the nurses' experiences. It was hypothesized that nurses receiving AMMA treatments would demonstrate reduced anxiety, as measured by a Visual Analog Scale (VAS) and increased relaxation, measured by physiologic parameters. The study was designed as a prospective, randomized, blinded clinical trial, with convenience sampling of 24 nurses working 12-hour shifts. While both groups demonstrated decreased anxiety after intervention, the experimental group consistently showed greater differences between pre- and post-treatment anxiety scores. The mean change in physiologic parameters between groups was not significant. Themes derived from a final interview included: importance of touch in nursing care, stress reduction, increased self-awareness, the need for self-care and a new understanding of the mind-body connection. Outcomes suggest the need for further research with a larger population to assess this intervention's impact on anxiety, stress, self-care and caring relationships. This controlled, prospective, randomized study examined the clinical and potential economic impact of a 6-session Recreational Music-making (RMM) protocol on burnout and mood dimensions, as well as on Total Mood Disturbance (TMD) in an interdisciplinary group of long-term care workers.
                A total of 112 employees participated in a 6-session RMM protocol focusing on building support, communication, and interdisciplinary respect utilizing group drumming and keyboard accompaniment. Changes in burnout and mood dimensions were assessed with the Maslach Burnout Inventory and the Profile of Mood States respectively. Cost savings were projected by an independent consulting firm, which developed an economic impact model.
                Statistically-significant reductions of multiple burnout and mood dimensions, as well as TMD scores, were noted. Economic-impact analysis projected cost savings of $89,100 for a single typical 100-bed facility, with total annual potential savings to the long-term care industry of $1.46 billion.
                A cost-effective, 6-session RMM protocol reduces burnout and mood dimensions, as well as TMD, in long-term care workers. The purpose of the study was to examine the effectiveness of assertiveness training in improving self-perceived levels of stress and assertiveness among nurses in Taiwan, Republic of China. The two-group experimental design was conducted in a 2,000-bed veteran general hospital. A sample of 60 volunteer Chinese-speaking nurses participated in the study. Subjects were randomly assigned to one of two treatments: assertiveness training (AT) or alternate treatment control (ATC), which served as a control and contained updated knowledge of new computer technology for in patient settings. Subjects in each group participated in six 2-hour workshops in the same two-week period. All subjects were pre-, post-, and follow-up posttested for stress and assertiveness with the Perceived Stress Scale (PSS) and Rathus Assertiveness Schedule (RAS), respectively. Results revealed the following: (1) subjects in both groups of pretest were clearly subassertive and under considerable stress; (2) by the end of training, the AT group scored significantly higher on the rating of assertiveness than those in the ATC group, and had successfully maintained their improvement by the 4-week follow-up; and (3) by the end of training, the AT group reported significantly lower levels of stress than the ATC group as indicated on the PSS, and successfully maintained their improvements at the 4-week follow-up. Overall, the results indicate clear support for the effectiveness of assertiveness training for treating subassertive behaviors and stress in a population of professional nurses in Taiwan. Nurse managers are under increased stress because of excessive workloads and hospitals' restructuring which is affecting their work tasks. High levels of stress could affect their mental health. Yet, few stress management training programmes are provided for this population. The purpose of this study was to apply stretch-release relaxation and cognitive relaxation training to enhance the mental health for nurse managers. A total of 65 nurse managers in Hong Kong were randomly assigned to stretch-release relaxation (n = 17), cognitive relaxation (n = 18), and a test control group (n = 35). Mental health status was assessed using the Chinese version of State-Trait Anxiety Inventory and the Chinese version of the General Health Questionnaire. Participants were assessed at the pretreatment session, the fourth posttreatment session, and at the 1-month follow-up session. The results revealed both the stretch-release and cognitive relaxation training enhanced mental health in nurse managers in Hong Kong. The application of relaxation training in enhancing mental health status for nurses and health professionals is discussed. A randomized controlled trial was conducted on the effects of emotion-oriented care on professional caregivers in homes for elderly persons. Emotion-oriented care is used in the care for cognitively impaired elderly persons and is mainly based on the validation approach.
                Sixteen homes for the aged were randomly allocated to an intervention or control group. Three hundred professional caregivers were included in the study. The eight intervention homes received a training program in emotion-oriented care. In the eight control homes, usual care was continued. Measurements about job satisfaction, burnout, and sick leave were performed at baseline and after 3, 6, and 12 months of follow-up.
                Modest positive effects were found in favor of the intervention group. These related to various aspects of job satisfaction and burnout. The effects were not very consistent over time. No differences in sick leave were found.
                From this study, as well as other studies in this field, no strong effects were found of emotion-oriented care on work-related outcomes in professional caregivers. Additional research is therefore needed. In these new studies, special attention should be given to the optimization of the implementation process of emotion-oriented care programs. All fourteen nurses working in a burn unit were given three hours of individual training in cognitive behavioral stress management skills. Anxiety measures were obtained before, during, and after training by weekly administration of the State-Trait Anxiety Inventory, and by daily administration of a nurses' stress scale constructed for this study. Nurses were randomly assigned to two groups which were treated using a successive-groups time-series design. Results suggested that stress management training was effective in reducing work-related anxiety among inexperienced nurses but not among experienced nurses. The gains made by the inexperienced nurses may have been more associated with increases in their understanding of stress and their feelings of control over stress than with changes in their actual stress management behavior.