Online positive psychology intervention for nursing home staff: A cluster-randomized controlled feasibility trial of effectiveness and acceptability

Background Nursing staff in nursing homes is at risk for stress-related problems. Positive psychology interventions have been shown to effectively improve well-being and decrease depressive symptoms, and may be beneficial for nursing staff. However, controlled studies with nursing staff are missing. Objectives and design This is the first study to test the effectiveness and acceptability of an online multi-component positive psychology intervention in nursing home staff. This study used a cluster-randomized controlled design, with an intervention group and a control group, and measurements at baseline (T0) and following the training period (T1). We hypothesized that the intervention would improve general well-being, job satisfaction and work engagement, especially for people with low initial well-being, satisfaction or engagement. Furthermore, we explored the acceptability of such an intervention for nursing home staff. Settings and Participants All nursing staff of the units for physically frail older adults of four Dutch nursing homes belonging to one care organization were invited to participate in this study. A sample of 128 nursing staff completed T0, and 107 nursing staff completed T1, mostly licensed practical nurses with a mean age of 42 years. Methods The 8-week online intervention concerned information and evidence-based exercises of six topics of Positive Psychology, which were completed individually at home. General well-being, job satisfaction and work engagement were measured, and participants evaluated the intervention. Results No time by group interaction effect was found on general well-being nor on work engagement, but there was a small effect on job satisfaction. No moderation effects of baseline outcome measures were found. The evaluation of the intervention varied: a majority positively valued the intervention, in particular the topics “positive emotions” and “strengths”, but most agreed that there was too much text and too many exercises. Conclusions The online multi-component positive psychology intervention had only very limited effectiveness, as the decrease in job satisfaction in the control group may reflect a regression to the mean. The high baseline levels of well-being and engagement, intervention content, obligatory character of the intervention, and individuality are discussed as possible reasons for these results. Opportunities lie in creating a concise, work focused positive psychology intervention for nursing staff, including some form of autonomy support.