Table 1 Characteristics of included randomized controlled trials
Author, year, country | Study Design (control) | Participants | n; mean age (SD)a | Gender (female %)a | Intervention description | Duration | Measure (s) | Primary outcome (s) | Results (Post [ES] / (Follow-up [ES])b |
|---|---|---|---|---|---|---|---|---|---|
Intervention type: Behavioral approach (n = 6) | |||||||||
Balk-Møller et al. (2017), Denmark | RCT (usual practice) | RLTC staff | IG (152); 47.0 (10.0) CG (117); 47.0 (9.9) | IG: 92.1 CG: 92.3 | SoSu-life: A Web- and app-based tool: -Suggestions for activities and programs, practical tips and tricks -Social features: weekly assignments, colleague challenges -Participants chose pledge at the beginning: lose weight, eat healthier, improve physical fitness, improve physical strength, quit smoking, decrease no of cigarettes smoked, maintain healthy lifestyle -Subsequent communication—feedback, frequency, and content of emails and text messages provided by the program, and topics for user-to-user communication, Messages contained information about specific health issues related to the pledge, general tips, and tricks on health and well-being -Initial 16-weeks included team competition, subsequent 22 weeks without team competition | 16 to 38 weeks | Digital electronic scale | Body weight | +[NA]/+[NA] |
Brox & Foystein (2005), Norway | RCT (usual practice) | Nurses and nurse aides | IG (63); 42.5 (NA) CG (64); 42.5 (NA) | IG: 97.0 CG: 96.0 | Physical exercise program: -Light aerobic exercise classes -Classes regarding nutrition and stress management | 24 weeks | UKK walking test COOP/WONCA Community insurance register | Cardiorespiratory fitness Overall Health Sickness absences | - - - |
Kamioka et al. (2010), Japan | CRT (usual practice) | Nurses | IG (44); NA CG (44); NA | IG: 100 CG: 100 | Education and exercise program: -Lecture contained information on risk factors, biomechanics of care-movement, treatment, and recommended exercise, eight elements of stretching, leaflet for monitoring -DVD of the series of exercises was distributed to each nursing home | 12 weeks | 10-cm Visual Analogue Scale | Pain | - |
Kloos et al. (2019), Netherlands | CRT (usual practice) | Nursing staff | IG (79); 39.6 (13.0) CG (49); 44.7 (10.0) | IG: NA CG: NA | Online multicomponent Positive Psychology intervention: -8 modules, key topics: positive emotions, discovering and using strength, optimism, self-compassion, resilience, positive relations -> each module consists of psychoeducation and five exercises -One lesson per week advised | 8 weeks | Mental Health Continuum-Short Form Maastricht Job Satisfaction for Healthcare Utrecht Work Engagement Scale | Well-being Job satisfaction Work engagement | - +[0.10]e - |
Perez et al. (2022), Spain | CRT (wait-list) | Nurses | IG (35); NA CG (39); NA Total sample: 37.0 (9.13) | IG: NA CG: NA Total sample: 89.6 | Online Mindfulness-based intervention: -Elements of mindfulness-based stress reduction and mindfulness-based cognitive therapy -Main characteristics: six recorded sessions of 60Â min, videos, interactive exercises, relaxation and breathing techniques, individual reflective writing exercise -Assignments to practice in daily life -Weekly sessions, tasks, and audio-guided meditation were provided -Users were informed via notifications | 6 weeks | Professional Quality of Life Scale Spanish Adaptation | Compassion satisfaction Burnout Compassion fatigue | - / - +[NA] / +[NA] +[NA] / +[NA] |
Riello et al. (2021), Italy | RCT (alternative activity) | Medical/healthcare, administrative, technical personnel | IG (119); NA CG (119); NA | IG: 87.4 CG: 89.1 | Self-help plus (SH+) program: -Teaching a series of psychological techniques to cope with stress or promoting reflection on relevant topics such as work roles and related emotions -Distribution of an individual self-help audio-visual tool -SH + includes a pre-recorded audio course, originally meant to be delivered by facilitators in a group setting and an illustrated self-help book | 1 week | Impact of Event Scale-Revised Generalized Anxiety Disorder Scale | Subjective distress Anxiety symptoms | - / - - / - |
Intervention type: Training/educational approach (n = 10) | |||||||||
Barbosa et al. (2015), Portugal | CRT (education only) | Nursing assistants | IG (27); 43.4 (10.0) CG (31); 45.9 (8.0) | IG: 100 CG: 100 | Person-Centered Care-Based (PCC) Psychoeducational intervention: -Education component aimed to provide nursing assistants with: (1) principles to integrate person-centered care within the care routines (2) basic knowledge about dementia (3) PCC-based interaction strategies; in the three days after session, support of experts during morning care | 8 weeks | Perceived Stress Scale 12 Maslach Burnout Inventory Minnesota Satisfaction Questionnaire | Perceived stress Burnout Job satisfaction | - - - |
Barbosa et al. (2016) Portugal | Perceived Stress Scale 12 Maslach Burnout Inventory Minnesota Satisfaction Questionnaire | Perceived stress Burnout Job satisfaction | 6-month follow-up - - - | ||||||
Bieldermann et al. (2021), Netherlands | CRT (usual practice) | Nursing staff | IG (168); 41.1 (12.2) CG (124); 40.3 (10.4) | IG: 96.4 CG: 96.9 | The educating Nursing Staff Effectively (TENSE) program: -3-day workshop (2 sessions of 2.5Â h), followed by 2 follow-up sessions (2 sessions of 2.5Â h) Content of the educational program: -Providing knowledge about dementia -Educating about the origins of challenging behavior and how to manage it -Educating how to recognize distress caused by challenging behavior in yourself and in colleagues -Practicing general behavior management skills that can be used in approaching the resident -Practicing how to signal signs of impending challenging behavior | 24 weeks | Utrecht Burnout Scale - C | Burnout: Emotional exhaustion Depersonalization Personal accomplishment | - / - - / - - / - |
Bramble et al. (2011), Australia | CRT (education only) | Nursing staff | IG (31); 39.8 (8.5) CG (27); 41.2 (8.4) | IG: 87.1 CG: 92.6 | Family involvement in care (FIC) - Education program: -First session: information about dementia -Second session: problems faced by family members of residents with dementia in RLTC -Third session: how to negotiate with family caregivers to increase involvement in care; introduction of partnership contract agreement role negotiation, therapeutic communication, conflict resolution skills | 4 weeks | Caregiver Stress Inventory Staff Perceptions of Caregiving Role Knowledge of Dementia Test Attitudes Towards Family Checklist | Experienced stress Experienced stress Knowledge of dementia Attitude towards family | NA / NA NA / NA NA / NA NA / NA |
Chenoweth et al. (2014), Australia | CRT (usual practice) | Nursing staff | IG (17); NA CG (18); NA | IG: NA CG: NA | Humor intervention: -Staff attended trainings sessions with experienced humor performer the intervention compromised humor sessions among professional performers, nursing staff, and residents | 12 weeks | Self-developed questionnaire | Well-being | - / - |
Davison et al. (2007), Australia | CRT (usual practice) | Registered Nurses, unlicensed Nursing assistants | IG I (29); NA IG II (35); NA CG (26); NA Total sample: 45.0 (11.0) | IG I: NA IG II: NA CG: NA Total sample: 90.0 | IG I: Dementia training program + peer support -Combination of didactic and experiential learning, -skills to use in caring for residents with dementia-related behaviors, peer support program was to facilitate informal group support, whereby staff members could discuss challenging behaviors, their subsequent emotional reactions and how to cope with work-related stress IG II: Dementia training program only | 24 weeks | Maslach Burnout Inventory Self-Efficacy of Dementia Care | Burnout Self-efficacy | IG I: - / - IG II: - / - IG I: +[NA] / +[NA] IG II: - / - |
Irvine et al. (2007), USA | RCT (usual practice) | Nurse Aides | IG (34); NA CG (28); NA | IG: 88.2 CG: 82.1 | Internet-based interactive multimedia training: -Skills to approach an agitated resident showing potentially dangerous behaviors, skills to de-escalate situations -Intervention strategy: A.I.D. - approach: Assess, Investigate, Do Something -> emphasis on person-centered approach -> content was delivered online via video vignettes, video clips, voice over clips, and video testimonials | NA | Self-developed questionnaire Self-developed questionnaire Self-developed questionnaire Self-developed questionnaire Self-developed questionnaire | VST- knowledge VST self-efficacy Attitudes Self-efficacy Behavioral intentions | + [0.24]f + [0.33]f + [0.40]f + [0.36]f + [0.17]f |
Leontjevas et al. (2020), Netherlands | stepped-wedge CRT (usual practice) | RLTC staff and other disciplines | IG (NA); NA CG (NA); NA Total sample: N = 796; 39.4 (11.9) | IG: NA CG: NA Total sample: 96.0 | The Act in case of Depression program: -3-hour training workshop -Evidence-based pathways for screening, identifying, diagnosing, treating, and monitoring depression -Consists of three components: structured assessment with a two-step screening and diagnostic procedure, three multidisciplinary treatment modules, and monitoring of treatment results | NA | 8-item Scale by de Jonge (1995) Maastricht Work Satisfaction Scale for Healthcare Questionnaire on Experience and Assessment of Work | Job demands Job satisfaction Workplace autonomy | - - - |
O’Brien et al. (2019), USA | RCT (wait-list) | Nurses and nurse aides | IG (37); NA CG (34); NA Total sample: 37.9 (13.2) | IG: NA CG: NA Total sample: 86.0 | Group-based Acceptance and Commitment intervention: (1) acquisition and practice of acceptance, mindfulness, and cognitive delusion techniques (2) values identification and how they can be embedded in daily work tasks; (3) making explicit commitments to changing work behaviors that interfere with values | 2 weeks | Risk for Nursing Assault and Injury Inventory General Health Questionnaire | Work environment Workdays loss Injury frequency Musculoskeletal complaints Mental health symptoms | +[0.01]f - - +[0.08]f |
Pillemer et al. (2003), USA | CRT (usual practice) | Nursing staff | IG (256); NA CG (399); NA | IG: 92.2 CG: 94.7 | Cooperative communication intervention: -1 day workshop (7 h) (1) active/empathic listening skills. Focusing on identifying ‘‘communication helpers’’ that encourage others to express their opinions and feelings. (2) Feedback. Focusing on providing verbal cues to a conversation partner that allow a person to know how a message is received, permitting the speaker to adjust the message as needed. (3) I-messages. Focusing on using the first-person singular to express a problem or complaint. | 8 weeks | Family Behaviors Scale Family Empathy Scale Maslach Burnout Inventory Self-developed question | Perception family behavior Perception family empathy Burnout Intention to quit | +[NA] / - NA - / - +[NA] / - |
Torres-Castro et al. (2022), Mexico | CRT (usual practice) | RLTC staff, Health professional, Managers | IG (57); 36.4 (12.2) CG (39); 39.5 (12.6) | IG: 70.0 CG: 85.7 | Programmed for Optimizing Care in Dementia (PROCUIDA-Demencia) intervention: -2-day training workshop: (1) Understanding challenging behavior, managing stress and distress, ways to improve communication and interaction (2) Team group work and organizational psychology elements to improve inter-personal skills (3) A set of psychosocial measures including doll therapy, psychomotor dance therapy, and reminiscence therapy | 12 weeks | Maslach Burnout Inventory Approaches to Dementia Questionnaire Sense of Competence in Dementia Care Staff | Burnout Attitudes towards people with dementia and their care Level of staff sense of competence | - - - |
Intervention type: Multimodal approach (n = 7) |  |  |  |  |  |  | |||
Doran et al. (2018) I, USA | CRT (education only) | Nurse aides, nurses, housekeeper dietary, service workers, concierge staff, activities staff, kitchen staff, maintenance | IG (48); NA CG (50); NA | IG: 84.8 CG: 93.9 | Worksite Heart Health Improvement Project (WHHIP)c: -Component 1: Environment and policy assessment -> recommendations for workplace (environmental) changes -Component 2: Education -> 30Â min group education session on cardiovascular disease and health -Component 3: Motivation and active engagement -> Individual goal-setting, health competitions, social support dyads, testing of healthy foods, education on healthy eating, group sessions discussing exercise, diet, stress management modifications, group sessions -Component 4: Technology enhanced motivation -> 96 motivational text messages over 8 months -Component 5: Booster and long-term adherence -> Weekly booster sessions on motivation and engagement to improve cardiovascular health; mentoring and fostering of dyad partners | 36 weeks | Depression-Anxiety-Stress Scale Modified Block Dietary Fat Screener Modified Block Dietary Fat Screener Pittsburgh Sleep Quality Index | Mood Sodium intake Fat intake Sleep quality | - / +[NA] / +[NA] - / +[NA] / - - / - / - - / - / +[NA] |
Doran et al. (2018) II, USA | Digital blood pressure manometer Digital blood pressure manometer Finger-prick blood samples BMI Formula Pedometer | SBP DBP Cholesterol BMI Physical activity (steps) | - / - - / + [NA] - / - - / + [NA] +[NA] / +[NA] | ||||||
Flannery et al. (2012) I, USA | CRT (education only) | Nursing assistants | IG (24); 43.3 (13.1) CG (15); 39.4 (13.1) | IG: 100 CG: 100 | Worksite Heart Health Improvement Project (WHHIP)c: -Component 1: Environmental and policy assessment Assessing organizational, community, and policy factors affecting nursing assistants’ health -Component 2: Education of nursing assistants Providing foundation for cardiovascular disease prevention, encourage nursing assistants to make exercise and diet changes at work -Component 3: Ongoing Motivation of nursing assistants Motivating nursing assistants to exercise and reduce dietary fat and salt intake, actively engaged nursing assistants in physical activity and healthy eating | 12 weeks | Nursing Home Administration Job Satisfaction Questionnaire Effort-Reward-Imbalance questionnaire Work ability index | Job satisfaction Effort Reward Over commitment Work ability | - / - - / - - / - - / - +[NA] / +[NA] |
Flannery et al. (2012) II, USA | Exercise Self-efficacy Self-efficacy for health-related Diet Pedometer Digital blood pressure manometer Digital blood pressure manometer Finger-prick blood samples BMI Formula The Center for Epidemiologic Studies Depression Scale | Exercise self-efficacy Self-efficacy for health- related diet Physical activity SBP DBP Cholesterol BMI Depressive symptoms | - / - - / - - / - +[NA] / +[NA] - / - +[NA] / +[NA] - / - +[NA] / +[NA] | ||||||
Jeon et al. (2015), Australia | CRT (usual practice) | RLTC staff | IG (202); 46.5 (NA) CG (301); 47.1 (NA) | IG: NA CG: NA | Clinical Leadership in Aged Care (CLiAC) programd: -Structured education and support program, designed to promote safe, high-quality person-centered and evidence-based care by assisting middle managers to develop effective team relationships and person/client-centered leadership strategies that enable them to deal with the day-to-day realities of care service -Participants received a set of learning resources for team building activities -Developing team-based action plans, providing education sessions | 48 weeks | Work Environment Scale - R Multi-factor Leadership Questionnaire Organization register | Work environment Involvement Peer cohesions Supervisor support Autonomy Task orientation Work pressure Clarity Control Innovation Physical comfort Management Leadership support Transformational Transactional Passive avoidant Leadership Turnover rate | - / - - / - - / +[NA] - / - - / - - / - - / - - / - - / - - / - - / +[NA] - / +[NA] - / +[NA] - / +[NA] - / - |
Kossek et al. (2019), USA | CRT (usual practice) | Nursing staff, Managers | IG (420); NA CG (511); NA | IG: NA CG: NA Total sample: 92.3 | STAR (Support, Transform, Achieve, Results) interventiond: -Leader family & work support training -Work site facilitator-led participatory ROWE (Results-oriented Work Environment) training -Supervisory training on strategies to demonstrate support for employees’ personal and family lives while also supporting employees’ job performance -Participatory training sessions to identify new work practices -Activities included employee group sessions, after-session work-improvement redesign, leader computer-based training, behavioral self-monitoring by leaders and coworkers | 16 weeks | K-6 Mental Health Screening Questionnaire Perceived Stress Scale 4 | Psychological distress Perceived stress | - / - - / - |
Marino et al. (2016), USA | CRT (usual practice) | Nursing staff, Managers | Nursing home staff: IG (652); 37.8 (12.7) CG (568); 38.9 (12.3) Manager: IG (33); 43.2 (9.2) CG (32); 45.9 (11.9) | Nursing home staff: IG: 93.7 CG: 91.7 Manager: IG: 93.9 CG: 90.6 | STAR (Support, Transform, Achieve, Results) interventiond: -4 sessions for all employees and managers together -> Increase of support for coworkers, more results-oriented work culture, eliminating negative judgement ->Collective self-monitoring of their experiences and how often they applied the learned techniques -3 sessions for managers and supervisors only -> Provision of an handheld device with an application -> possibility to focus on specific supportive behavior e.g. Creative Work-Life Management for two weeks plus feedback on goal progress | 16 weeks | Wrist-worn sleep monitor | Nursing home staff: Mean total sleep time Nighttime sleep duration Wake after sleep onset Number of Naps Nap duration Manager: Mean total sleep time Nighttime sleep duration Wake after sleep onset Number of Naps Nap duration | - / - - / - - / - - / - - / - - / - - / - - / - - / - - / - |
Pillemer et al. (2008), USA | CRT (usual practice) | Nursing assistants | IG (379); NA CG (383); NA | IG: 93.4 CG: 92.4 | Retention specialist programd: -Staff member was selected to be facility retention specialist -> advocate & implement programs to improve staff retention and commitment throughout the facility -Component 1: specialized retention training -Component 2: ongoing technical assistance -Component 3: leveraging community resources | 48 weeks | Self-developed questionnaire Self-developed questionnaire Generic Job Satisfaction Scale Self-developed question Organization registers Self-developed question | Attitudes toward the facility Perceived Facility Retention Effort Job satisfaction Job stress Turnover rate Intention to Quit | +[NA] / - - / +[NA] - / - - / - - / +[NA] - / +[NA] |
Tveito et al. (2009), Norway | RCT (wait-list) | RLTC staff and other disciplines | IG (19); NA CG (21); NA | IG: 100 CG: 100 | Integrated Health programc: -Physical exercise, health information/stress management training & practical examination of workplace -One hour three times a week, consisted of: boy awareness, warm-up/aerobics/ergonomics, cool-down exercises, strength/stabilizing, stretching, relaxation -15Â h of information on stress, coping, health and lifestyle & practical examination of workplace -Health and lifestyle information focused on exercise, nutrition, sleep, smoking, activity and musculoskeletal problems. The stress management training focused on both the positive and negative consequences of stress and how to cope with stress. | 36 weeks | Subjective Health Complaints Inventory Organization register | Subjective somatic and psychological complaints Sick absence | - / NA - / - |