Mindful Self-Compassion Training to Improve Retention, Job Satisfaction, and Attitudes Toward Dementia Among Long-Term Care Nursing Assistants
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 39
- 试验地点
- 2
- 主要终点
- Study Participant's Self-Rating of Likelihood to Leave Job in the Coming Year Over Time
研究概览
简要总结
Certified nursing assistants (CNAs), who provide the majority of care to persons with chronic disease and/or cognitive impairment from Alzheimer's disease and related dementias, face tremendous job and home stress, and as a result absenteeism and job turnover are high. This is a preliminary study that will tailor Mindful Self-Compassion (MSC) - a promising new program designed to cultivate greater self-care, and strengthen resilience and coping skills - for the CNA population and study its effectiveness. If results are favorable, MSC could be incorporated into CNA training programs, thereby helping contribute to a more effective and stable long-term care workforce.
详细描述
U.S. nursing homes (NHs) serve 1.6 million older persons, all of whom have significant physical and/or cognitive impairment, and the majority of whom have Alzheimer's disease or a related cognitive disorder. In these settings the vast majority of hands-on care is provided by an estimated 634,000 certified nursing assistants (CNAs) - paraprofessional caregivers who are racially diverse, largely female, and an annual income equivalent to the poverty threshold for a family of four. Despite the crucial role of CNAs in providing care for the long-term care population and efforts to recruit and retain a stable workforce, absenteeism rates are high and annual turnover averages 65%, with adverse impact on the quality of care provided to NH residents, making CNA retention a policy priority.
CNAs have significant life stressors that affect their ability to work, such as single parenthood, poor physical health, difficulty finding childcare, and transportation problems. They also face emotionally and physically demanding job tasks, particularly when working with persons with Alzheimer's disease and related dementias, and many lack helpful strategies for dealing with stress, negative feelings, and burden.
A newly developed, standardized Mindful Self-Compassion (MSC) intervention may have particularly high impact and relevance for the high-stress lives of NH CNAs. MSC training has been shown to increase wellbeing, compassion for others, and stress-coping skills. However, little is known about the impact, feasibility and acceptability of MSC training in low-educated, stress-burdened paraprofessional populations such as CNAs, or whether it can impact outcomes such as burnout, absenteeism, and turnover.
This preliminary study will modify, refine, and test a MSC training intervention for CNAs, to be known as the CNA Wellbeing Program, who care for nursing home residents. The researcher teams' goal is to increase CNA coping skills and well-being, thereby reducing intent to leave the job, reducing burnout, and improving job satisfaction and attitudes toward people with dementia. The proposed research will be conducted in 3 similarly rated and structured community NHs. In Aim 1 the investigators will assess intervention feasibility and acceptability in one NH, using the knowledge they gain to tailor an evidence-based MSC program specifically for CNAs. In Aim 2 the investigators will pilot test the MSC training program with 30 CNAs who work in 2 similarly rated and structured NHs, evaluating the fidelity of the revised training and exploring trends in immediate, 3-month, and 6-month outcome measures in order to inform power calculations for future trials.
The specific aims are:
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Certified Nursing Assistant employed by one of 3 study Nursing Homes
- •Aged 18 and over
- •Speak English
- •Work at least 20 hours as a CNA at one of our proposed Nursing Homes
- •Expect to attend at least 75% of the intervention classes
- •Expect to stay at least the course of the intervention on the job
- •Score in the top 50% on the PSS-10 (Perceived Stress Scale) (if more than 20 participants interested)
排除标准
- •Younger than 18
- •Working fewer than 20 hours a week
- •Unable to attend at least 75% of the intervention classes
- •Expect to leave their position during the intervention
结局指标
主要结局
Study Participant's Self-Rating of Likelihood to Leave Job in the Coming Year Over Time
时间窗: Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months
The researchers will assess intent to leave job by asking "How likely is it that you will leave this job in the next year? "Would you say... 1 is Not at All Likely, 2 is Somewhat Likely, 3 is Very Likely." Minimum = 1 (best value), maximum = 3 (worst value). For the primary outcome analysis, intent will be evaluated by totaling the count of participants who responded "Somewhat Likely", "Very likely", or "Not at all likely." This was collected over the course of four time frames: Baseline, End-of Intervention interview, 3-Month Follow Up Interview, and 6-Month Follow Up Interview.
次要结局
- Change in Mean Score Over Time on PROMIS Depression Scale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Job Satisfaction Scale (JSS)(Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Approach to Dementia Questionnaire (ADQ) - Recognition of Personhood Subscale(Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Maslach Burnout Inventory (MBI) - Personal Accomplishment Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Perceived Stress Scale (PSS)(Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Self-compassion Scale-Short Form (SCS-SF)(Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Self-compassion Scale-Short Form (SCS-SF) - Isolation Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Percent of Classes Attended by Participating CNAs(Participants will be followed for the duration of the intervention, an expected average of 6-8 weeks)
- Change in Mean Score Over Time on Maslach Burnout Inventory (MBI) - Depersonalization Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Self-compassion Scale-Short Form (SCS-SF) - Self-kindness Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Self-compassion Scale-Short Form (SCS-SF) - Over-identification Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Percent of Participants Attending All Intervention Sessions(Participants will be followed for the duration of the intervention, an expected average of 6-8 weeks)
- Mean Number of Days Per Week Spent in Out-of-Class Informal Exercise(Participants will be followed for the duration of the intervention, an expected average of 6/8 weeks)
- Change in Mean Score Over Time on Maslach Burnout Inventory (MBI) - Emotional Exhaustion Subscale(Participants will be followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Self-compassion Scale-Short Form (SCS-SF) - Self-judgment Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Self-compassion Scale-Short Form (SCS-SF) - Common Humanity Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Change in Mean Score Over Time on Self-compassion Scale-Short Form (SCS-SF) - Mindfulness Subscale(Participants were followed for the duration of the intervention and 6 additional months after the intervention ends, an expected average of 8 months)
- Percent Intervention Minutes Attended by Participants(Participants will be followed for the duration of the intervention, an expected average of 6-8 weeks)
- Mean Number of Days Per Week Spent in Out-of-Class Formal Exercise(Participants will be followed for the duration of the intervention, an expected average of 6/8 weeks)
- Study Participant's Self-Rating of Satisfaction With the MSC Course(At the conclusion of the week 6/8 class, during the End-of-Intervention Interview, participants were asked their satisfaction with the course)