Resilience Intervention for Critical Care Nurses

Study Overview
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Brief Summary
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The Corporate Athlete® Resilience (CAR) Training Program is a 1-day training program that uses a holistic approach that focuses on moving between stress and strategic recovery to help build resilience and enable higher performance. The purpose of this RCT is to determine whether the CAR Training Program has significant impact on nurses' resilience and stress mindset in their personal lives and their working environment. Knowledge from this study can be applied to interventions in the future to improve resilience behavior.

Detailed Description
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The ongoing nursing shortage in the U.S health care system is a multifaceted issue. One factor leading to the nursing shortage is high turnover, particularly among critical care nurses due to their experiences with stressful work environments, ethical dilemmas, and high rates of patient morbidity and mortality. There is also a high prevalence of psychological disorders, such as anxiety, depression, and Post Traumatic Stress Disorder (PTSD) among critical care nurses. Consequences of turnover and low nurse staffing include lower quality of care, lower patient satisfaction, increased medical errors, increased rates of health care associated infections, and higher 30-day mortality rates. Resilience is defined as the ability to adapt to life's ever-changing landscape and recover quickly from the stressors and potential stressors. It is a learned psychological characteristic that can be used to bounce back after disruption and successfully adapt to stressful work experiences in a positive manner.

Official Title
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A Randomized Controlled Trial of a Resilience Intervention for Critical Care Nurses

Conditions
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Stress

Intervention / Treatment
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* Behavioral: Corporate Athlete Resilience (CAR) Training Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult ≥ 18 years old Employed as a critical care nurse at Florida Hospital in an adult ICU, PICU, PCVICU, or Level 3 NICU at the Altamonte, Orlando, or Winter Park campus Able to speak, read, and understand English fluently Able to provide informed consent Meet ≥ 2 stress experience level parameters on the Stress Mindset Measure - General (SMM-G) Meet ≤ 4.3 on the Brief Resilience Scale (BRS) Willing to attend a full-day training program at HPI on the designated training date Willing and able to comply with all study procedures and requirements for the duration of the study. Exclusion Criteria: Meet < 2 stress experience level parameters on the SMM-G Meet > 4.3 on the BRS Receive a high score of ≥ 27 on the Emotional Exhaustion domain and/or a high score of ≥ 13 on the Depersonalization domain of the Maslach Burnout Inventory (MBI)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>The intervention group will attend in the 1-day Corporate Athlete Resilience (CAR) Training Program in Lake Nona. | Behavioral: Corporate Athlete Resilience (CAR) Training Program<br>* A 1-day training program developed by the J&J Human Performance Institute (HPI), which uses a holistic approach that focuses on moving between stress and strategic recovery to help build resilience and enable higher performance.<br>|
| No Intervention: Control<br>The control group will attend the 1-day CAR Training Program in Lake Nona after a 3-month wait list period, which will be three months after the intervention group attends the intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stress Mindset Measure - General (SMM-G) | Participants will respond to an 8-item questionnaire measuring stress. Responses will be provided on the following 5-point scale: 0=Strongly Disagree, 1=Disagree, 2=Neither Agree nor Disagree, 3=Agree, 4=Strongly Agree. | Change from Baseline SMM-G score at 6-months post CAR Training | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived Stress Scale (PSS) | Participants will respond to a 10-item questionnaire measuring perceived stress. Responses will be provided on the following 5-point scale: 0=Never, 1=Almost Never, 2=Sometimes, 3=Fairly Often, 4=Very Often. | Change from Baseline PSS score at 6-months post CAR Training | 
| Brief Resilience Scale (BRS) | Participants will respond to a 6-item questionnaire measuring resilience. Responses will be provided on the following 5-point scale: 1=Strongly Disagree, 2=Disagree, 3=Neutral, 4=Agree, 5=Strongly Agree. | Change from Baseline BRS score at 6-months post CAR Training | 
| Maslach Burnout Inventory Human Serices Survey (MBI-HSS) for Medical Personnel (MP) | Participants will respond to a 22-item questionnaire measuring burnout. Responses will be provided on the following 7-point scale: 0=Never, 1=A few times a year or less, 2=Once a month or less, 3=A few times a month, 4=Once a week, 5=A few times a week, 6=Everyday. | Change from Baseline MBI-HSS (MP) score at 6-months post CAR Training | 
| Public Health Surveillance - Wellbeing Scale (PHS-WB) | Participants will respond to a 10-item questionnaire measuring perception of personal well-being and satisfaction. Responses will be provided on a 5-point scale (6 items) and a 10-point scale (4 items). | Change from Baseline PHS-WB score at 6-months post CAR Training | 
| RAND Medial Outcomes Study (MOS) Sleep Scale Survey | Participants will respond to a 12-item questionnaire with self-reported information related to sleep patterns. Responses will be provided on the following 6-point scale: 1=All of the time, 2=Most of the time, 3=A good bit of the time, 4=Some of the time, 5=A little of the time, 6=None of the time. | Change from Baseline RAND MOS Sleep Scale Survey score at 6-months post CAR Training | 
| RAND 36-Item Short Form Health Survey (SF-36) | Participants will respond to a 36-item questionnaire with self-reported health ratings and perceived impact of one's health on a variety of daily activities. Response options for questionnaire items vary from 3-point scale, 5-point scale, and Yes/No responses. | Change from Baseline RAND SF-36 score at 6-months post CAR Training | 
| Absenteeism & Presenteeism questions of the World Health Organization's Health and Work Performance Questionnaire (WHO-HPQ) | Participants will respond to 11 absenteeism and presenteeism questions abstracted from the full HPQ. Responses for 2 items require self-reported information regarding hours worked and hours the employer expects the participant to work in 7 days. 6 items require participants to provide work experience information from the past 4 weeks. Responses for 3 items are provided on a 10-point scale in which 0=Worst Performance, and 10=Top Performance. Responses are input into a provided formula for scoring; a higher absenteeism score indicates higher amount of absenteeism, while a higher presenteeism score indicates lower amount of lost performance. | Change from Baseline WHO-HPQ score at 6-months post CAR Training | 
| Work Productivity and Activity Impairment Questionnaire (WPAI) | Participants will respond to a 6-item questionnaire, answering questions about the perceived effect of personal health problems on one's ability to work or perform activities. Responses are provided in a Yes/No format or using a 10-point scale in which 0=Health problems had no effect on my work and 10=Health problems completely prevented me from working. | Change from Baseline WPAI score at 6-months post CAR Training | 
| Energy Management Behaviors Questionnaire (EMB) | Participants will respond to a 21-item questionnaire, providing a self-reported level of engagement in various activities. Responses are provided using the following 7-point scale: 1=Never, 2=Almost never, 3=Seldom, 4=Sometimes, 5=Usually, 6=Very Often, 7=Always. | Change from Baseline EMB score at 6-months post CAR Training | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Resilience, High Performance, Critical Care Nurse