Randomised control trial of a proactive intervention supporting recovery in relation to stress and irregular work hours: effects on sleep, burn-out, fatigue and somatic symptoms

Abstract

Objectives: To examine if a proactive recovery intervention for newly graduated registered nurses (RNs) could prevent the development of sleep problems, burn-out, fatigue or somatic symptoms.

Methods: The study was a randomised control trial with parallel design. Newly graduated RNs with less than 12 months' work experience were eligible to participate. 461 RNs from 8 hospitals in Sweden were invited, of which 207 signed up. These were randomised to either intervention or control groups. After adjustments, 99 RNs were included in the intervention group (mean age 27.5 years, 84.7% women) and 108 in the control group (mean age 27.0 years, 90.7% women). 82 RNs in the intervention group attended a group-administered recovery programme, involving three group sessions with 2 weeks between each session, focusing on proactive strategies for sleep and recovery in relation to work stress and shift work. Effects on sleep, burn-out, fatigue and somatic symptoms were measured by questionnaires at baseline, postintervention and at 6 months follow-up.

Results: Preventive effect was seen on somatic symptoms for the intervention group. Also, the intervention group showed less burn-out and fatigue symptoms at postintervention. However, these latter effects did not persist at follow-up. Participants used many of the strategies from the programme.

Conclusions: A proactive, group-administered recovery programme could be helpful in strengthening recovery and preventing negative health consequences for newly graduated RNs.

Trial registration number: NCT04246736.

Keywords: burnout; fatigue; occupational health; preventive medicine; psychological; sleep.

Figure 1

Participant flow chart.

Figure 2

Mean values and SEs in intervention and control group at baseline, post and follow-up measures. DBAS, Dysfunctional Beliefs and Attitudes about Sleep, 0 do not agree–10 do fully agree; ISI, Insomnia Severity Index, 0–28 severe problems; KSQ, Karolinska Sleep Questionnaire, 1 always–6 never; PSS, Perceived Stress Scale, 0 never–40 very often; SSS8, Somatic Symptom Scale-8, 0–32 very high somatic symptom burden; SMBQ, Shirom-Melamed Burn-out Questionnaire, 1 almost never–7 almost always; WIPL, Work Interference with Personal Life, 1 not at all–5 almost all the time.