The Effect of Resilience Training Program on the Job Burnout of Nurses: A Quasi-experimental Study

Job burnout is a very serious problem for the nursing staff and can decrease the quality of care they provide. Nurses are at risk of job burnout due to the difficult working conditions and high expectations due to their caring role. Better speaking, nurses work in stressful and challenging environments that threaten their mental health and are predisposed to burnout. For example, nurses experience physical aggression from patients in the workplace, which can play a role in the occurrence of burnout. High levels of burnout jeopardize work motivation in nursing staff and increase their negligence in the workplace. The higher burnout level of nurses is associated with their lower empathy with their colleagues, patients, and families. In contrast, nurses with low levels of burnout are less likely to leave their jobs and have higher levels of organizational trust. Nurses working in intensive care units experience various stresses and are more at risk of burnout than other nurses. For this reason, researchers suggest that interventions such as resilience training need to be performed for this group of nurses. Resilience improves the quality of work of nurses and promotes their job satisfaction. Conversely, nurses without resilience have fewer professional competencies. Accordingly, nursing researchers suggest implementing resilience training programs to improve nurses' mental health. The researcher, as a psychiatrist nurse in the intensive care unit, observed that nurses become psychologically incapacitated when they suffer from burnout. Therefore, this idea came to the researcher's mind that the problem may be due to nurses' unfamiliarity with the concept of resilience. Given the foregoing, the importance of the concept of burnout in the nursing profession. Given that one of the roles of psychiatric nurses is their educational role, the researcher decided to conduct a study to determine the effect of resilience training on burnout of nurses working in intensive care units.

This quasi-experimental study was conducted in 2019, and 96 nurses from intensive care units of teaching hospitals affiliated to Iran University of Medical Sciences were selected via convenience sampling and divided into experimental and control groups via nonrandom allocation. Each group consisted of 48 nurses. The resilience training program was conducted for the experimental group in a two-day workshop, 4 hours each day, but the control group received no treatment. The content of the program was presented through a lecture using slides followed by questions and answers, group discussions with the participants, and the expression of their experiences. Also, a working group was set up for nurses to cite skill-related examples, practice each skill, and role play. Four weeks after the intervention, the post-test was administered in 2 groups. Data were collected using demographic form and Maslach and Jackson Burnout Inventory. Also, data were analyzed using descriptive (mean and standard deviation) and inferential statistics (Chi-square, independent t-test, paired t-test, ANCOVA, and Fisher's exact test). In order to comply with ethical considerations, a code of ethics was obtained from the Research Ethics Committee of Iran University of Medical Sciences. In addition, nurses were told that their information would be kept confidential and that there would be no obligation to participate in the study.

The results of independent t-test showed no statistically significant difference between the two groups in terms of severity and frequency of burnout scales before the treatment (P>0.05). The results of ANCOVA revealed a statistically significant increase in the mean scores of individual failure in the experimental group compared to the control group after the treatment and the mean scores of the severity and frequency of emotional burnout and depersonalization were significantly lower in the experimental group compared to the control group (P<0.001). The results of paired t-test revealed that there was an improvement in the severity and frequency of individual failure scores in the posttest compared to the pretest and the mean scores of severity and frequency of emotional burnout and depersonalization decreased significantly (P<0.001). Analyzing the results of the control group showed no significant difference in the severity and frequency of all burnout scales in the post-test compared to the pretest (P>0.05), while there was a significant difference in the frequency of burnout scales between the pretest and posttest (P<0.01).

Based on the results of the present study, it can be acknowledged that nurses' burnout, as a variable that is rooted in organizational psychology, is strongly influenced and improved by the implementation of resilience-based psychological intervention. According to the results, resilience training is effective in improving emotional exhaustion, depersonalization, and personal accomplishment of nurses. Thus, such an intervention can increase nurses’ resilience and reduce their burnout and ultimately improve the quality of their function. According to the findings of this study, the resilience training program reduces the burnout of nurses and, given that nursing is one of the professions that makes people prone to burnout, it is suggested that nursing managers pay more attention to resilience training programs with high applicability, in order to reduce the burnout of nursing staff in general and nurses working in intensive care units in particular. Also, given that the nurses participating in the present study could not receive the necessary training on resilience during continuous sessions due to their busy schedule, it is recommended that a similar study be conducted using a virtual network-based approach for nurses.