| Study characteristics |
| Methods |
Study design: randomised controlled trial
Study grouping: parallel group |
| Participants |
Baseline characteristics
Engagement in proactive behaviours
Age (mean (min‐max): 27. 8 (22‐54) Sex (N % female): 106 (82%) Sample size: 130 Years of experience (mean ± SD): NR
Control (care as usual)
Age (mean (min‐max): 27. 2 (21–52) Sex (N % female): 97 (89%) Sample size: 109 Years of experience (mean ± SD): NR
Overall
Included criteria: eligible participants were newly graduated nurses who worked at any clinical department of Uppsala University Hospital and participated in the transition‐to‐practice program
Excluded criteria: NR
Pretreatment: no group differences reported
Type of healthcare worker: exclusively nurses
Response rate: 86%
Compliance rate: 95% |
| Interventions |
Intervention characteristics
Engagement in proactive behaviours
-
Description of the intervention:
Session 1: The model of the intervention Presentation/discussion about the newcomer experience, stress, and stress‐related ill health Presentation/discussion of the socialisation processes role clarity, task mastery, and social acceptance and their association with experiences of stress when transitioning into a new profession. Discussion about obstacles to engaging in proactive behaviours, with a focus on emotional experiences and fatigue Increase engagement in leisure activities. Discussion about strategies to recover energy with a focus on sleep, physical exercise, social interactions, and personal interests. Homework assignment. Individual exercise with the goal of increasing engagement in one specific recovery‐promoting leisure activity per week based on the principles of approach behaviours and action planning. Session 2: Follow‐up on session 1. Repetition of session 1. Discussion of experiences of trying to increase engagement in leisure activities (homework assignment from session 1). Reduce engagement in avoidance behaviours. Discussion of common fears experienced as a newcomer and the effect of fears on behaviours, with a focus on avoidance of proactive behaviours and effects on the socialisation processes and management of challenges. Homework assignment Individual exercise with the goal of increasing engagement in one specific recovery‐promoting leisure activity per week based on the principles of approach behaviours and action planning Individual exercise with the goal of reducing avoidance behaviours/increasing engagement in proactive behaviours based on principles of systematic exposure and action planning. Session 3: Follow‐up on sessions 1 and 2. Repetition of Session 1 and 2. Discussion of experiences of trying to increase engagement in leisure activities as well as decrease avoidance behaviours/increase engagement in proactive behaviours (homework assignment from Session 2). Summary of intervention Key take‐home messages.
The number of sessions: 3 Duration of each session on average: three hours Duration of the entire intervention: nine hours Duration of the entire intervention short vs long: short Intervention deliverer: first author, psychologist Intervention form: group Type of the intervention: Intervention type 1 ‐ to focus one’s attention on the experience of stress
Control (care as usual)
Description of the intervention: The control intervention consisted of the ordinary content of the transition‐to‐practice program. The total time of activities was the same for the control intervention as for the experimental intervention. The purpose of the control intervention was to facilitate the professional adjustment of the new RNs. The sessions focused on subjects such as patient care (e.g. nutrition, wound treatment), communication skills, team management, and the role, rights, and responsibilities of nurses. The control intervention was managed by the clinical training centre at the hospital where the study took place The number of sessions: three Duration of each session on average: three hours Duration of the entire intervention: nine hours Duration of the entire intervention short vs long: short Intervention deliverer: NR Intervention form: Group Type of the intervention: Intervention type 1 ‐ to focus one’s attention on the experience of stress
|
| Outcomes |
Items from the Stress and Energy Questionnaire
|
| Identification |
Sponsorship source: Funding: This study was supported by AFA insurance [Grant no 140007]
Country: Sweden
Setting: University hospital
Comments: NR
Authors name: Elin Frögéli
Institution: Department of Clinical Neuroscience, Karolinska Institute
Email: elin.frogeli@ki.se
Address: NR
Time period: 2016‐2017 |
| Notes |
Included in analysis 1.1 |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
Quote: "The participants were randomized to one of two groups of equal size at a 1:1 ratio, stratified by clinical ward. Specifically, person 1 that was registered for the program was allocated to group 1, person 2 was allocated to group 2, person 3 to group 3, and so on. However, if person 1 and person 3 came from the same clinical ward, person 3 was placed in group 2. Person 4 was then placed in group 1 and person 5 in group 2, and so on. The purpose of this design was to avoid having too many nurses from the same clinical ward being placed in the same study group, as this would cause problems of staffing on the clinical wards."
Sequence generation process not mentioned. |
| Allocation concealment (selection bias) |
High risk |
Participants and/or investigators enroling participants could possibly foresee assignments and thus introduce selection bias. |
| Blinding of participants and personnel (performance bias)
All outcomes |
High risk |
Quote: "Finally, no measures were taken to assure that there was no diffusion of information between the groups, which may have affected the results."
Participants were not blinded. |
| Blinding of outcome assessment (detection bias)
All outcomes |
High risk |
Participants were not blinded whereas outcomes are self‐reported. |
| Incomplete outcome data (attrition bias)
All outcomes |
Unclear risk |
Quote: "Attrition Analysis: We investigated differences in the study variables at baseline between participants who responded at follow‐up and those who did not. These analyses revealed no differences."
Randomized 239 ‐> lost to follow‐up ‐> 55 = 23% but no differences between responders and not responders. However, these analyses have not been reported. |
| Selective reporting (reporting bias) |
Unclear risk |
No mention of a protocol, nor did we find one |
| Other bias |
Unclear risk |
Quote: "The reliability of some of the measures in the present trial was questionable, which may have limited the ability to properly assess the outcomes."
‘Loosely’ validated outcome measure |
