JMIR Publications

ABSTRACT

Background:

Global workforce challenges facing healthcare providers are linked to low levels of job satisfaction, recruitment, retention and staff wellbeing, with detrimental impacts on patient care outcomes. During COVID-19, the central role of nurses was evident, with the pressures they faced placing many under acute stress, testing their resilience. This led to increases in mental health issues and burnout among nurses reported, with an increase in the number of nurses leaving the profession. Resilience building programmes can provide targeted support for staff who endure unprecedented levels of stress and can improve psychological health and wellbeing in nurses. Resilience interventions have been found to enhance resilience in nurses, and support recruitment and retention, with web-based formats key to increasing their accessibility.

Objective:

To report on a pilot randomised controlled trial to evaluate a web-based resilience enhancement programme for nurses working during the COVID-19 pandemic (REsOluTioN).

Methods:

The study was a 1:1 two-armed pilot randomized trial, conducted in a mental health and community Trust in South England between August 2021 and May 2022. Local research ethics committee approvals were obtained. CONSORT 2010 extension guidelines for reporting pilot and feasibility trials were used. Nurses working in all mental health and community settings across the Trust were invited to participate. The REsOluTioN intervention lasted four weeks, consisting of pre-reading, web-based facilitated sessions and mentorship support. Outcome measures included trial engagement, acceptability and changes in resilience and psychological wellbeing. Qualitative participant feedback on the importance of the tool was also collected. Statistical tests were undertaken to analyse the dataset.

Results:

One hundred and eight nurses were recruited across a range of age groups, levels of seniority and years working in the profession. All participants recognised the importance of resilience in the workplace, and most felt REsOluTioN had been useful in improving their resilience levels, self-confidence, relationships with colleagues, care outcomes and communication skills. No statistically significant differences were observed between intervention and waitlist control groups and time on wellbeing or resilience scores.

Conclusions:

REsOluTioN web-based training is acceptable and feasible for use among nurses working in frontline clinical settings. The non- significant difference between groups at six weeks in terms of resilience and psychological well-being must be interpreted with caution due to small sample size and reduced statistical power. Overall, the training was very well received and identified a desire from nurses for web-based resilience training tools to be implemented as a way of optimising resilience, psychological health, communication practices and the workplace environment. Clinical Trial: The trial protocol is registered on ClinicalTrials.gov (NCT05074563).