Hospital workers, both those who work directly with patients and those behind the scenes, have faced enormous challenges during the pandemic, leading to significant mental health burdens, including increased stress, anxiety, and burnout. While these problems have been well documented, there has been little research on the efficacy of methods to address them. But a recent study published in JAMA Network Open looked at a program that shows promise for struggling healthcare workers.
The study looked at the feasibility of Promoting Resilience in Stress Management (PRISM), a skills-based training program designed to mitigate stress and build resilience in situations of elevated stress. This study used a program called PRISM at Work, a version of PRISM adapted for healthcare workers. Participants completed a baseline survey, attended classes, then completed a follow-up survey.
Of 153 participants, 140 were female, 12 were male, and one was nonbinary. The mean age was 40.6 years, and 84% of participants were white. Just over half (53%) were in patient-facing roles (nurses, doctors, and allied health professionals), while the remaining 47% were in non-patient-facing roles (such as managers, research staff, and business office workers). The baseline scores found low levels of perceived resilience, moderate levels of stress and anxiety, and high levels of burnout/exhaustion.
Participants were divided into 15 classes with eight to 12 people in each. Feasibility was defined as 70% completion among the enrolled participants. Of the 153 who completed the baseline survey, 145 (95%) attended the first session. Of those, 78% completed five or six of the six total sessions. Follow-up surveys were completed by 91% of the participants, and 64% answered open-ended questions. None of the participants expressed concerns that prompted support greater than the program’s coaches could offer.
Eighty-eight percent of the participants who filled out follow-up surveys said they were satisfied overall with the program. Attendees were also largely satisfied or very satisfied with the frequency of the sessions (91%) and the length of the sessions (83%).
Of the participants who answered the open-ended questions, 99% said they could nominate someone at their workplace who would benefit from the program. Forty-eight percent said they thought everyone at work would benefit. Those who responded to the open-ended questions most often mentioned community, connection, and support as the things they liked best about the program. Suggestions for improvement included extending the program by making the sessions longer or by having more sessions. These results suggest that the PRISM at Work program is both feasible and acceptable to participants.
Baseline scores of resilience increased by a mean of 1.74 points, stress decreased by a mean of 2.4 points, anxiety was down by 2.04, and burnout/exhaustion dropped by 0.37, a slight improvement post-PRISM.
The authors point out that it is unclear if the baseline low-resilience scores were due to the COVID-19 pandemic or whether they were common before the pandemic. “Regardless,” they write, “opportunities to learn, reflect on, and develop one’s resilience resources are necessary.”
This study showed that programs such as PRISM at Work are feasible, acceptable, and could potentially be effective in addressing such issues. However, the authors also warn that efforts must come from both healthcare workers themselves and the healthcare organizations they are a part of.
Abby Rosenberg, MD, associate professor of pediatrics, Division of Hematology/Oncology, at the University of Washington School of Medicine in Seattle, Washington, and lead author of the study, noted that people seem to be hungry for a means of coping with the stress and burnout that has plagued healthcare in recent years. But she added that programs like this, though well-received and helpful, are “not a panacea, not a singular fix.” We need to fix the system that has created the problem in the first place.
This study was funded by an internal grant sponsored by the Seattle Children’s Research Institute COVID funds. Rosenberg disclosed grants for unrelated work from the National Institutes of Health, the American Cancer Society, Arthur Vining Davis Foundations, Cambia Health Solutions, Conquer Cancer Foundation of ASCO, CureSearch for Children’s Cancer, the National Palliative Care Research Center, and the Seattle Children’s Research Institute.
JAMA Netw Open. 2022;5(7):e2220677. Full text
Avery Hurt is a Birmingham, Alabama-based freelance science writer who writes often about the science and practice of medicine.
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