Browsing by Author "Hazelhof, TJGM"

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Effects on staff outcomes and process evaluation of the educating nursing staff effectively (TENSE) program for managing challenging behavior in nursing home residents with dementia: A cluster-randomized controlled trial
Bielderman, A. ; Nieuwenhuis, A.F.M. ; Hazelhof, TJGM ; Gaal, B.G.I. van ; Schoonhoven, Lisette ; Akkermans, R. ; Spijker, A ; Koopmans, R.T.C.M. ; Gerritsen, D.L.
2021, Article / Letter to editor (International Journal of Nursing Studies, vol. 120, (2021))Background: Challenging behavior is prevalent in people with dementia residing in nursing homes and places a high burden on the nursing staff of dementia special care units. This study evaluates an educational program for nursing staff for managing challenging behavior: The Educating Nursing Staff Effectively (TENSE) program. This program can be tailored to care organizations' wishes and needs and combines various learning styles. Objective: The aim of this cluster-randomized controlled trial was to examine the short-term (3 months) and long-term (9 months) effects of the TENSE training program on experienced stress, work contentment, and stress reactions at work in nursing staff working in dementia special care units. Design: Cluster-randomized controlled trial. Methods: Nursing staff members of 18 dementia special care units within nine nursing homes from different Netherlands regions were randomized into an intervention (n = 168) or control (n = 129) group. The TENSE program consisted of a three-day training course and two follow-up sessions after three and six months, respectively. The primary outcome was stress experienced by nursing staff measured with the Utrecht Burnout Scale - C. Secondary outcomes were work contentment and stress reactions at work. Furthermore, process evaluation data on the reach of and compliance with the program and the program's feasibility and relevance were collected. Data were collected between November 2012 and November 2014. Results: In general, the participants appreciated the quality and relevance of the TENSE training and evaluated the content of the training as beneficial. The TENSE training had no effect on the components of experienced stress, i.e., emotional exhaustion (p = 0.751), depersonalization (p = 0.701), and personal accomplishment (p = 0.182). Furthermore, no statistically significant effects of the intervention on work contentment and stress reactions at work were found. Conclusions: The TENSE training program did not have an effect on experienced stress, work contentment, nor stress reactions at work of nursing staff working in dementia special care units. In future studies, more focus on practicing new skills seems needed. (C) 2021 The Authors. Published by Elsevier Ltd.
Nursing staff stress from challenging behaviour of residents with dementia: a concept analysis
Hazelhof, TJGM ; Schoonhoven, Lisette ; Gaal, B.G.I. van ; Koopmans, R.T.C.M. ; Gerritsen, D.L.
2016, Article / Letter to editor (International Nursing Review - Sci, vol. 63, iss. 3, (2016), pp. 507-516)Aim: Provide insight into the concept of stress in the context of challenging behaviour of nursing home residents with dementia and its causes and consequences. Background: Challenging behaviour is frequent in residents with dementia, but consequences for nursing staff are unclear. Introduction: Challenging behaviour of residents can be enervating for nurses and may lead to stress. Although stress in general is associated with negative outcomes, an overview of stress in this context would be a welcome addition to the field. Method: Concept analysis according to Walker and Avant. Results: Identified antecedents of stress: physical and verbal aggression, conflicts, excessive demands and being unresponsive (residents), age, experience, tenure, nursing level and training (nursing staff). Defining attributes: disturbed homoeostasis and the personal appraisal of the situation. Identified consequences regard health, psychological aspects and behaviour. Discussion: Intervening in the identified factors may contribute to prevention of stress in nursing staff. Limitations: Given a lack of strong empirical studies, our analysis is not based on a high level of evidence and needs to be tested. Papers from before 1990 might have been missed. Conclusion: The concept analysis revealed that nursing staff stress in the context of challenging behaviour may result from resident and nursing staff factors. Besides health and psychological consequences, behavioural consequences can enormously impact the well-being of residents. Implications: Application in daily care to support teams in influencing resident and nursing staff factors could prevent stress, for instance using behavioural management training or recruiting higher educated nursing staff. Given the increasing complexity of care, creating specialized units with specifically trained staff for different groups of people with dementia may be desirable.

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