Effectiveness of an integrated platform-based intervention for promoting psychosocial safety climate and mental health in nursing staff: A pragmatic cluster randomised controlled trial

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-03-31 DOI:10.1016/j.ijnurstu.2025.105076

Leif Boß , Jennifer Ross , Dorota Reis , Sarah Pischel , Tim Mallwitz , Hanna Brückner , Grit Tanner , Helge Nissen , Lina Kalon , Marlies Schümann , Thomas Lennefer , Monique Janneck , Jörg Felfe , Antje Ducki , Dirk Lehr

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Abstract

Background

Organisational and individual factors cause strain in the daily lives of nurses and other healthcare professionals, who have a high prevalence of stress-related disorders. Accordingly, there is a strong need for integrated occupational health promotion interventions that include both work-directed and person-directed interventions. The psychosocial safety climate is seen as an overarching occupational health objective and can potentially be improved by implementing integrated mental health interventions.

Objective

Following an integrated approach, we developed an occupational e-mental health platform, Care4Care, which integrates both work- and person-directed interventions for promoting mental health in nurses. We evaluated the effects of the platform compared with those of an extended care-as-usual control condition.

Design

Clustered randomised controlled trial.

Setting

Healthcare service facilities in Germany nationwide.

Participants

347 nursing staff members (intervention: 211, control: 136) from 33 healthcare service facilities.

Methods

The participants received either immediate access to the platform or access to two short subcomponents of the platform plus routine occupational health promotion offerings as well as delayed access to the whole platform after 6 months. The primary outcome was improvement in the psychosocial safety climate after 6 months. The secondary outcomes included perceived stress, depressive symptoms, and other strain-related indicators.

Results

Bayesian multilevel analyses revealed an improvement of approximately 2 points (Cohen's d = 0.25) in the psychosocial safety climate in the intervention group compared with the control group. Applying a 95 % credible interval, this effect contained zero (− 0.32, 4.44), which indicated uncertainty about the effectiveness of the intervention on the psychosocial safety climate. The analyses of the secondary outcomes revealed effects in the expected direction with high credibility for a decreasing effect on perceived stress and considerable uncertainty with regard to all other secondary and tertiary outcomes. A total of 85 (40 %) participants in the intervention group used Care4Care, whereas 37 (27 %) participants in the control group used the two subcomponents of the platform.

Conclusions

This study highlights the potential of an occupational e-mental health platform that combines work- and person-directed interventions with face-to-face components for nursing staff. The findings emphasise the necessity of conducting more in-depth implementation studies to identify the factors that facilitate the successful implementation and uptake of occupational e-mental health platforms.

Registration

German Clinical Trials Register – DRKS (DRKS00027869). Registration date: February 23, 2022. Start of recruitment: June 21, 2022.

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综合平台干预对促进护理人员心理社会安全气候和心理健康的有效性：一项实用的集群随机对照试验

组织和个人因素导致护士和其他医疗保健专业人员的日常生活紧张，他们有很高的患病率的压力相关障碍。因此，非常需要综合的职业健康促进干预措施，包括以工作为导向和以个人为导向的干预措施。社会心理安全环境被视为职业健康的首要目标，可以通过实施综合心理健康干预措施加以改善。目的：采用综合方法，我们开发了一个职业电子心理健康平台Care4Care，该平台整合了以工作和个人为导向的干预措施，以促进护士的心理健康。我们评估了该平台的效果，并将其与长期照护的对照条件进行了比较。聚类随机对照试验。在德国全国范围内设置医疗保健服务设施。参与者：来自33个医疗保健服务机构的347名护理人员（干预：211名，对照组：136名）。方法参与者可以立即使用平台，也可以使用平台的两个短子组件以及常规的职业健康促进产品，并在6个月后延迟使用整个平台。主要结果是6个月后心理社会安全气候的改善。次要结局包括感知压力、抑郁症状和其他菌株相关指标。结果贝叶斯多水平分析显示，干预组与对照组相比，心理社会安全气氛改善约2点（Cohen’s d = 0.25）。应用95%可信区间，该效应包含零（- 0.32,4.44），这表明干预对心理社会安全气候的有效性存在不确定性。对次要结果的分析显示，在预期的方向上，对感知压力的影响降低具有很高的可信度，而对所有其他次要和第三次要结果的影响相当大。干预组共有85名（40%）参与者使用Care4Care，而对照组中有37名（27%）参与者使用该平台的两个子组件。本研究强调了职业电子心理健康平台的潜力，该平台将以工作和个人为导向的干预措施与护理人员面对面的组成部分相结合。调查结果强调有必要进行更深入的实施研究，以确定促进成功实施和采用职业电子心理健康平台的因素。德国临床试验注册- DRKS （DRKS00027869）。报名日期：2022年2月23日。招聘开始：2022年6月21日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).