减轻养老院痴呆症专业护理人员职业压力的干预措施:系统回顾与荟萃分析。

Dementia (London, England) Pub Date : 2024-02-01 Epub Date: 2023-12-08 DOI:10.1177/14713012231220963
Hayley Antipas, Jeanette Tamplin, Tanara Vieira Sousa, Felicity A Baker
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引用次数: 0

摘要

目的:养老院中痴呆症专业护理人员的职业压力会对护理质量、护理人员的健康和劳动力的可持续性产生不利影响。本研究的目的是研究有关减轻该人群职业压力的干预措施的证据:方法:我们对 CINAHL、PsycINFO、PubMed 和 MEDLINE 数据库进行了系统性检索,以确定 1995 年至 2022 年 3 月间用英语发表的有关压力干预措施的原始 RCT 研究报告。两位独立审稿人对搜索结果进行了筛选。两位审稿人使用唐斯和布莱克核对表和偏倚风险评估质量和偏倚风险。元分析和亚组分析检验了与对照组相比,干预对压力的综合影响:有 10 项研究符合纳入标准,这些研究报告了 92 家机构的 15 项干预措施和 28 项结果,涉及 1,397 名护理人员。我们发现,干预措施对护理人员压力的影响较小且不明显(g = -.27, p = .16)。亚组分析可部分解释异质性。干预措施可减轻非客户行为造成的压力和负担(n = 3)(g = -.85,p < .001),并提高照顾者的自我效能(n = 4)(g = -.35,p = .07)。我们无法确定最有效的干预类型,但以组织为重点的干预显示出最大的潜力(g = -.58, p = .08):结论:改善护理人员个人和组织资源的干预措施可以减轻与客户无关的压力和负担,并提高自我效能感。建议老年护理提供者优先考虑教育与组织支持干预。需要对纵向效应和高风险护理人员进行研究。讨论了局限性:CRD42022313715(2022年4月注册)。
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Interventions for mitigating occupational stress for professional dementia caregivers in residential aged care: A systematic review with meta-analysis.

Objective: Occupational stress in professional dementia caregivers in residential aged care facilities has adverse effects on care quality, caregivers' health, and workforce sustainability. The purpose of this study was to examine the evidence regarding interventions to mitigate occupational stress for this population.

Methods: A systematic review of CINAHL, PsycINFO, PubMed and MEDLINE databases was conducted to identify original RCT research reporting on stress interventions, published in English between 1995 and March 2022. Search results were screened by two independent reviewers. Quality and risk of bias were appraised using the Downs and Black Checklist and Risk of Bias by two reviewers. Meta-analysis and subgroup analysis examined the pooled intervention effects on stress compared to control.

Results: 10 studies met the inclusion criteria, and these reported on 15 interventions and 28 outcomes from 92 facilities, involving 1,397 caregivers. We found a small and insignificant effect of interventions on caregiver stress (g = -.27, p = .16). Heterogeneity was partially explained by subgroup analysis. Interventions can mitigate stress and burden not attributed to client behaviour (n = 3) (g = -.85, p < .001), and improve caregivers' self-efficacy (n = 4) (g = -.35, p = .07). We were unable to determine the most effective type of intervention, although organisation focused interventions showed the greatest potential (g = -.58, p = .08).

Conclusion: Interventions that improve caregivers' personal and organisational resources can reduce non-client associated stress and burden and increase self-efficacy. Aged care providers are recommended to prioritise education with organisational support interventions. Research on longitudinal effects and high-risk caregivers is required. Limitations are discussed.

Prospero registration number: CRD42022313715 (registered April 2022).

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