Burdens, resources, health and wellbeing of nurses working in general and specialised palliative care in Germany - results of a nationwide cross-sectional survey study

Elisabeth Diehl; Sandra Rieger; Stephan Letzel; Anja Schablon; Albert Nienhaus; Luis Carlos Escobar Pinzon; Pavel Dietz

doi:10.1186/s12912-021-00687-z

Burdens, resources, health and wellbeing of nurses working in general and specialised palliative care in Germany - results of a nationwide cross-sectional survey study

BMC Nurs. 2021 Sep 6;20(1):162. doi: 10.1186/s12912-021-00687-z.

Authors

Elisabeth Diehl¹, Sandra Rieger², Stephan Letzel², Anja Schablon³, Albert Nienhaus^{3

4}, Luis Carlos Escobar Pinzon^#^{2

5}, Pavel Dietz^#²

Affiliations

¹ Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131, Mainz, Germany. elidiehl@uni-mainz.de.
² Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 67, 55131, Mainz, Germany.
³ Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf, Building W38, Martinistraße 52, 20246, Hamburg, Germany.
⁴ Department for Occupational Medicine, Hazardous Substances and Health Science, Institution for Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33/35/37, 22089, Hamburg, Germany.
⁵ Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany.

^# Contributed equally.

Abstract

Background: Palliative care in Germany is divided into general (GPC) and specialised palliative care (SPC). Although palliative care will become more important in the care sector in future, there is a large knowledge gab, especially with regard to GPC. The aim of this study was to identify and compare the burdens, resources, health and wellbeing of nurses working in GPC and SPC. Such information will be helpful for developing prevention programs in order to reduce burdens and to strengthen resources of nurses.

Methods: In 2017, a nationwide cross-sectional survey was conducted. In total, 437 nurses in GPC and 1316 nurses in SPC completed a questionnaire containing parts of standardised instruments, which included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ), the Patient Health Questionnaire (PHQ-2), the Resilience Scale (RS-13) Questionnaire, a single question about back pain from the health survey conducted by the Robert Koch Institute as well as self-developed questions. The differences in the variables between GPC and SPC nurses were compared.

Results: SPC nurses reported higher emotional demands as well as higher burdens due to nursing care and the care of relatives while GPC nurses stated higher quantitative demands, i.e. higher workload. SPC nurses more often reported organisational and social resources that were helpful in dealing with the demands of their work. Regarding health, GPC nurses stated a poorer health status and reported chronic back pain as well as a major depressive disorder more frequently than SPC nurses. Furthermore, GPC nurses reported a higher intention to leave the profession compared to SPC nurses.

Conclusions: The findings of the present study indicate that SPC could be reviewed as the best practice example for nursing care in Germany. The results may be used for developing target group specific prevention programs for improving health and wellbeing of nurses taking the differences between GPC and SPC into account. Finally, interventional and longitudinal studies should be conducted in future to determine causality in the relationship of burdens, resources, health and wellbeing.

Keywords: Burnout; Depression; Intention to leave the profession; Prevention; Strain; Stress.