Jeannette C L van Duinen-van den IJssel1, Christian Bakker2, Martin Smalbrugge3, Sandra A Zwijsen3, Britt Appelhof4, Steven Teerenstra5, Sytse U Zuidema6, Marjolein E de Vugt7, Frans R J Verhey7, Raymond T C M Koopmans8. 1. Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands; Radboud Alzheimer Centre, Nijmegen, the Netherlands. Electronic address: jeannette.vanduinen-vandenIJssel@radboudumc.nl. 2. Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands; Radboud Alzheimer Centre, Nijmegen, the Netherlands; Florence, Mariahoeve, Centre for Specialized Care in Young-Onset Dementia, Den Haag, the Netherlands. Electronic address: Christian.Bakker@radboudumc.nl. 3. Amsterdam UMC, Department of General Practice & Elderly Care Medicine/Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. 4. Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands; Radboud Alzheimer Centre, Nijmegen, the Netherlands; Archipel Care Group, Landrijt, Centre for Specialized Care, Eindhoven, the Netherlands. 5. Section Biostatistics, Department of Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands. 6. Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands. 7. School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, the Netherlands. 8. Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands; Radboud Alzheimer Centre, Nijmegen, the Netherlands; De Waalboog, "Joachim en Anna", Centre for Specialized Geriatric Care, Nijmegen, the Netherlands.
Abstract
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.
RCT Entities:
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.
Authors: Jeannette C L van Duinen-van den IJssel; Christian Bakker; Martin Smalbrugge; Sandra A Zwijsen; Eddy Adang; Britt Appelhof; Sytse U Zuidema; Marjolein E de Vugt; Frans R J Verhey; Raymond T C M Koopmans Journal: Int J Geriatr Psychiatry Date: 2019-11-07 Impact factor: 3.485