TY - JOUR
T1 - Effects on staff outcomes from an intervention for management of neuropsychiatric symptoms in residents of young-onset dementia care units
T2 - A cluster randomised controlled trial
AU - van Duinen-van den IJssel, Jeannette C. L.
AU - Bakker, Christian
AU - Smalbrugge, Martin
AU - Zwijsen, Sandra A.
AU - Appelhof, Britt
AU - Teerenstra, Steven
AU - Zuidema, Sytse U.
AU - de Vugt, Marjolein E.
AU - Verhey, Frans R. J.
AU - Koopmans, Raymond T. C. M.
N1 - Funding Information:
This study was funded by the Netherlands Organization for Health Research and Development (ZonMw nr: 733050402 ), Archipel Care Group in the Netherlands , Florence Care Group in the Netherlands , the Dutch Alzheimer Society and the Dutch Young-onset dementia Knowledge Centre . We are grateful for the cooperation of the staff of the participating nursing homes. We thank Mandy Wijnen and Yvette Daniels for collecting the data.
Funding Information:
This study was funded by the Netherlands Organization for Health Research and Development (ZonMw nr:733050402), Archipel Care Group in the Netherlands, Florence Care Group in the Netherlands, the Dutch Alzheimer Society and the Dutch Young-onset dementia Knowledge Centre. We are grateful for the cooperation of the staff of the participating nursing homes. We thank Mandy Wijnen and Yvette Daniels for collecting the data.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/8
Y1 - 2019/8
N2 - Background: Neuropsychiatric symptoms are common in nursing home residents with young-onset dementia and burdensome for nursing staff. It is known that neuropsychiatric symptoms are associated with burn-out complaints and low job satisfaction. An intervention aimed at decreasing neuropsychiatric symptoms in nursing home residents with young-onset dementia might also result in less burnout complaints and job demands and improve job satisfaction in nursing staff.Objectives: The aim was to evaluate the effect of the intervention on nursing staff burnout, job satisfaction and job demands.Design: Cluster randomised controlled trial using a stepped wedge design with a total duration of 18 months, with four assessments.Setting: Thirteen young-onset dementia special care units across the Netherlands were, by means of random allocation software, assigned to three groups crossing over at different time points.Participants: All nursing staff, in total 391, were invited to participate. 305 nursing staff participated during the course of the study of whom 71 participated in all assessments.Intervention: An educational program followed by a structured multidisciplinary care program aimed at the management of neuropsychiatric symptoms. The care program consists of evaluation of psychotropic drug prescription followed by detection, analysis, treatment and evaluation of treatment of neuropsychiatric symptoms.Methods: Emotional exhaustion, depersonalisation and personal accomplishment were assessed with the Utrecht Burnout Scale. Job satisfaction and job demands were assessed with subscales of the Leiden Quality of Work Questionnaire.Results: The baseline burnout risk on emotional exhaustion and personal accomplishment was average, and low on depersonalisation. The mean scores for job satisfaction were above average and for job demands average. Linear mixed models showed that the intervention had no effect on emotional exhaustion (estimated effect -0.04, 95% confidence interval -1.25 to 1.16), depersonalisation (estimated effect 0.24, 95% confidence interval -0.26 to 0.74), personal accomplishment (estimated effect -0.82, 95% confidence interval -1.86 to 0.22) job satisfaction (estimated effect -0.40, 95% confidence interval -0.98 to 0.17) and job demands (estimated effect -0.04, 95% confidence interval -0.57 to 0.49). A significant difference was found between registered nurses and other nursing staff on emotional exhaustion and job satisfaction. Compared to other staff members, registered nurses' emotional exhaustion scores slightly increased while job satisfaction slightly decreased when using the intervention.Conclusion: The intervention was not effective on three dimensions of burnout, job satisfaction and job demands. Staff scored positive on the outcomes of interest before implementation of the intervention, leaving little opportunity for improvement. (C) 2019 Elsevier Ltd. All rights reserved.
AB - Background: Neuropsychiatric symptoms are common in nursing home residents with young-onset dementia and burdensome for nursing staff. It is known that neuropsychiatric symptoms are associated with burn-out complaints and low job satisfaction. An intervention aimed at decreasing neuropsychiatric symptoms in nursing home residents with young-onset dementia might also result in less burnout complaints and job demands and improve job satisfaction in nursing staff.Objectives: The aim was to evaluate the effect of the intervention on nursing staff burnout, job satisfaction and job demands.Design: Cluster randomised controlled trial using a stepped wedge design with a total duration of 18 months, with four assessments.Setting: Thirteen young-onset dementia special care units across the Netherlands were, by means of random allocation software, assigned to three groups crossing over at different time points.Participants: All nursing staff, in total 391, were invited to participate. 305 nursing staff participated during the course of the study of whom 71 participated in all assessments.Intervention: An educational program followed by a structured multidisciplinary care program aimed at the management of neuropsychiatric symptoms. The care program consists of evaluation of psychotropic drug prescription followed by detection, analysis, treatment and evaluation of treatment of neuropsychiatric symptoms.Methods: Emotional exhaustion, depersonalisation and personal accomplishment were assessed with the Utrecht Burnout Scale. Job satisfaction and job demands were assessed with subscales of the Leiden Quality of Work Questionnaire.Results: The baseline burnout risk on emotional exhaustion and personal accomplishment was average, and low on depersonalisation. The mean scores for job satisfaction were above average and for job demands average. Linear mixed models showed that the intervention had no effect on emotional exhaustion (estimated effect -0.04, 95% confidence interval -1.25 to 1.16), depersonalisation (estimated effect 0.24, 95% confidence interval -0.26 to 0.74), personal accomplishment (estimated effect -0.82, 95% confidence interval -1.86 to 0.22) job satisfaction (estimated effect -0.40, 95% confidence interval -0.98 to 0.17) and job demands (estimated effect -0.04, 95% confidence interval -0.57 to 0.49). A significant difference was found between registered nurses and other nursing staff on emotional exhaustion and job satisfaction. Compared to other staff members, registered nurses' emotional exhaustion scores slightly increased while job satisfaction slightly decreased when using the intervention.Conclusion: The intervention was not effective on three dimensions of burnout, job satisfaction and job demands. Staff scored positive on the outcomes of interest before implementation of the intervention, leaving little opportunity for improvement. (C) 2019 Elsevier Ltd. All rights reserved.
KW - Burnout
KW - Job satisfaction
KW - Job demands
KW - Nursing home
KW - Nursing staff
KW - Psychosocial intervention
KW - Young-onset dementia
KW - CHALLENGING BEHAVIOR
KW - JOB-SATISFACTION
KW - NURSING STAFF
KW - PEOPLE
KW - NURSES
KW - DEMANDS
KW - BURNOUT
KW - STRESS
KW - STRAIN
KW - ATTITUDES
U2 - 10.1016/j.ijnurstu.2019.03.006
DO - 10.1016/j.ijnurstu.2019.03.006
M3 - Article
C2 - 30979401
SN - 0020-7489
VL - 96
SP - 35
EP - 43
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
ER -