Empowering female immigrant nurses
to care for their own mental health
Sigma Theta Tau International's 26th International Nursing Research
San Juan, Puerto Rico
23-27 July 2015
Dr Joy Penman
Acknowledgement
Augusta Zadow Scholarship Grant
Aimed to promote mental health and
wellbeing, improve morale and develop
coping skills of vulnerable female
immigrant workers
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Introduction
Overcoming the workforce shortages in aged care in Australia
Use of immigrant workers in aged care
Employment experiences
Concerns about their vulnerable position (low pay, low status)
Serious implications
Background
Need to improve employment experiences of
immigrant group
Need to empower immigrant workers to care for
their own mental health by expanding their coping
abilities and assisting them to develop job resilience
The intervention
Develop an educational material and conduct workshops in order to:
increase female immigrant nurses’ knowledge and skills in maintaining and
promoting mental, psychosocial and emotional health and well-being; equip them to
care for their own mental, psychosocial and emotional health and well-being by
teaching self-management skills and effective coping strategies; develop their self-
confidence and belief in their capacity in order to reach personal and professional
goals; and assist them in becoming successful nurses in rural and regional aged
care services.
AimDescribe the learning environment aimed at assisting female
immigrant nurses in maintaining and promoting mental health
and well-being
Discuss the outcomes of the educational workshops
conducted in five rural and regional areas of South Australia
MethodsPre- and post-intervention mixed method research design
The questionnaires sought information on: the nature of
employment pressures; current coping strategies; managing
stressful situations; understanding of job resilience;
maintenance and promotion of happiness; and impact of the
workshop.
Procedure
Preparation of the educational
resource manual and
accompanying workshops
Formation/maintenance of a
reference group (purpose and
function, members, meetings,
outcomes)
Educational resource manual
and workshopsTopics covered:
• What it is like to work in aged care
• Definitions and importance of mental, psychosocial and
emotional health
• What is stress
• Mental health assessment
• Building from your own resources
Topics covered (continued)
• Resources and strategies for coping
• Intra-, inter- and transpersonal approaches in caring for your
mental health
• Organisational and community support available
• What is resilience
• Developing workplace resilience
• Case scenarios
• Summary of the program
• Additional resources, and
• Future directions
Participants
Various regional aged care
services in South Australia
Information sheets distributed by
Directors of Nursing
Arrangements of workshops
Issues about ethics, consent,
anonymity and participation
http://wwp.greenwichmeantime.com/images/time/australia/south-australia.jpg
Findings• Twenty-five (25) female immigrant nurses (6 nurses did not
complete the program)
• Eleven (11) services were involved
• Findings showed: clearer and better understanding of ways of
maintaining and promoting mental health and well-being;
opportunity to reflect on one’s own practice; ability to assess
one’s own mental health; enhanced ability to cope with the
pressures of work; opportunities for peer support; and increased
work readiness and morale.
•
• .
Learning that transpired
I have learned a lot of strategies to care for my own MH.
Different ways of stress management and thinking
positively about own mental status
With this educational session, I can understand the
importance of our mental health while working.
Learning that transpired
Very good workshop. Helps us to understand more on how to cope
up with stress.
The most important outcome was learning new stress reduction
techniques and coping skills.
Encouraged me to care for my own mental health …
How to decrease our anxiety levels with mental exercises like
meditation, massage therapy and other therapies.
… that mental health is essential for a happy life.
The most important outcome – I learned so many things about
coping up and how to care for my MH.
The best things
Having intimate group sessions, the books provided are very helpful, the two
session course instead of the one is good, no information overload.
The resource mats, PPT presentation, interactive session, and encourage
participation of audience.
The best about the workshops is the way how you cope and how to care your MH.
I am very pleased that there is interest demonstrated for immigrant nurses.
I enjoyed the sessions and learned a lot!
It helped me a lot, thank you!
Statistical analysisQ1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9
Estimate
of mean
difference 0.56 0.76 0.84 0.80 0.64 0.72 0.96 0.60 0.44
p – value 0.002 <0.000 <0.000 <0.000 <0.000 0.006 <0.000 0.005 0.009
Mean
response
pre 3.04 2.84 2.84 2.80 3.04 2.84 2.44 2.64 3.20
Mean
response
post 3.60 3.60 3.68 3.60 3.68 3.56 3.40 3.24 3.64
Twenty-five (25) nurses answered the nine (9) questions of a survey conducted before and following an intervention (workshops). The responses were on a 5 point Likert scale with an approximately equal interval between points. The parametric test, the paired T test, was used to identify differences in the mean response to individual questions. The test assesses the probability of observing such a change in the mean score by chance. A non-parametric test (Wilcoxon signed rank) supported the conclusions.
Interesting results
The test results were highly statistically significant for every question; there was a marked difference in responses before and after the intervention.The largest changes were seen on questions 7, 3, 4 and 2, with an increase in mean score of at least 0.76.With a score of 2 as ‘neutral’, 4 as ‘strongly agree’, all means were on the positive side before the activity, and most were around midway between ‘agree’ and ‘strongly agree’ after the intervention.Values for question 9 “Mental health is a priority for me” were fairly high to start with and show the smallest mean increase.
Question 4 (good understanding of how mental health may be maintained and promoted) was a good summary of response to the intervention, mostly positive increases in answers.
Question 7 (I have a healthy
lifestyle observing healthy
diet, regular exercise and rest
and relaxation) had the
highest change in response.
So perhaps after the
intervention these nurses
seem to better understand
what constitutes a healthy
lifestyle. There seemed to be
an improved understanding of
healthy lifestyle.
DiscussionValue of the reference group
Meeting objectives
Issues or constraints in delivering the project related to:
- number and selection of participants
- location of participants
- logistics
- availability of participants
Implications of results
Recommendation:
- expansion of the workshops for future collaborations in
education, research and clinical practice
Future plans
• Expand the initiative to
metropolitan aged care services
• Survey the same participants
six to twelve months after
workshop completion
• Facilitate mental health specific
forum/s with a focus on mental
health research and the aged
care workforce
Conclusion
CONCLUSION
All objectives were achieved. The project plan was carried out as
originally intended. This initiative is one way of improving the
employment experiences of immigrant group. Qualitative findings
shed light on the statistical results demonstrating that this
intervention can empower these immigrant workers to care for
their own mental health, expand their coping abilities and assist
them to develop job resilience. For generalisability however, more
research is needed.
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