Evaluating the impact of reflective practice groups for nurses in an acute hospital setting

Abstract

Objective: This study represents phase one of a three-year research project aiming to investigate the impact of reflective practice groups for nurses. Background: Evidence indicates that increased job demands, and inadequate support contribute to nursing burnout, reduced capacity and workplace attrition. There is some evidence that group interventions may help address such issues. Study Design/Methods: This study utilised a cross sectional, quantitative research methodology. Overall, 251 nurses completed questionnaires incorporating 11 validated subscales. Levels of compassion satisfaction, intolerance to uncertainty, inhibitory anxiety, group cohesiveness, psychological distress, and psychosocial safety were evaluated in relation to number of groups attended, for both individual nurses and work groups. The data was then examined alongside existing personal and job resources. Results: Individual nurses who attended 6–18 reflective practice groups demonstrated increased tolerance to uncertainty and less inhibitory anxiety, whilst those who attended more than 18 groups demonstrated increased compassion satisfaction and group cohesiveness. There was, however, no evidence to indicate more pervasive, work group benefits. Whilst the second part of the study confirmed that reflective practice group attendance was significantly correlated with increased compassion satisfaction, it was not able to explain changes in levels of burnout, secondary traumatic stress or compassion satisfaction over and above personal factors, job factors and levels of psychological distress. Conclusion: Professional quality of life involves a complex set of variables. Reflective practice group attendance is correlated with a number of benefits for nurses however cause and effect were not clearly determined. A subsequent study will focus on the more subtle mechanisms and indirect effects of the groups on nurses’ personal resources. Relevance: This research supports the role of person and job factors in explaining professional quality of life for nurses and provides evidence to support a number of positive outcomes for nurses attending reflective practice groups; establishing a foundation for future studies to explore impacts and mediators in greater detail. What is already known about the topic? Personal and job resources can buffer against job demands to improve Professional Quality of Life (ProQoL). Nurses who lack personal resources are more likely to report burnout. What this paper adds: Personal resources of autonomy, self-efficacy and optimism are particularly important for nursing ProQoL. Higher levels of RPG attendance are correlated with improved tolerance to uncertainty, reduced inhibitory anxiety, increased compassion satisfaction and improved group cohesion. An explanatory link between RPG and variations in ProQoL is still not clear as RPG attendance in itself was not found to account for changes in ProQoL over personal resources, job resources and job demands. The study identifies a direction for further research into the role RPG may play in the development of personal resources for nurses.