Resource Navigators for Caregiver Burnout

Overseen By Sharon Sharon Straus, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Unity Health Toronto

Disqualifiers: Not PSW, Not Ontario, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 12

174 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how effectively resource navigators (health and wellness support services) assist staff in long-term care and retirement homes in accessing health and wellness resources. The goal is to determine if this support improves overall wellness, reduces burnout, and enhances adherence to COVID-19 guidelines. Participants will either work with a resource navigator or not, and their experiences will be compared. Individuals working in Ontario long-term care or retirement homes who are comfortable using email might be suitable for this study. As an unphased trial, this study provides a unique opportunity to contribute to the enhancement of workplace wellness and support systems.

Do I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. It seems unlikely that you would need to stop, as the trial focuses on resource navigation for caregiver burnout, not medication use.

What prior data suggests that resource navigators are safe for improving staff wellness?

Research shows that resource navigators, like those tested in this trial, have helped caregivers manage stress and improve well-being in other situations. These navigators direct caregivers to appropriate health and wellness resources. Studies have found that caregiving can cause stress, affecting both physical and mental health. However, connecting caregivers with health resources through navigators is generally safe. No major negative effects have been reported from this kind of support. The focus remains on providing guidance, not medical treatment, which keeps the risk of harm low. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the use of Resource Navigators to address caregiver burnout because this approach offers personalized support that current care options often lack. Unlike standard resources that might just provide information, Resource Navigators engage directly with caregivers by offering bi-monthly sessions tailored to individual needs, in addition to monthly resource updates. This personalized touch allows for more adaptive and responsive support, potentially reducing stress and enhancing the well-being of caregivers more effectively than traditional methods.

What evidence suggests that resource navigators are effective for caregiver burnout?

Research shows that resource navigators can improve care and reduce stress and burnout. In this trial, participants in the intervention group will have sessions with a resource navigator twice a month and receive monthly resources. Patient navigators, such as nurse navigators, have been proven to increase patient satisfaction and overall care quality. Studies also indicate that programs supporting caregivers can lower their stress and burnout. Specifically, a program that combined education and support found that caregivers felt less overwhelmed and more confident. Overall, these findings suggest that resource navigators could positively affect the well-being of staff in long-term care and retirement homes by offering guidance and support. ^{1 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for full-time or part-time employees aged 18 and older who work in Ontario long-term care or retirement homes, including PSWs and support staff. Participants must be comfortable with English and willing to use email for study communications.

Inclusion Criteria

Work in an Ontario Long-term care or retirement home

Comfortable speaking and reading English

Access to and willingness to use email for study communications

Exclusion Criteria

Do not have access to or unwillingness to use email for study communications

Do not identify as or are not employed as a PSW and other support service staff

Do not work in an Ontario long-term care or retirement home

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive 6 months of tailored 1:1 support from a resource navigator and educational resources

6 months

12 sessions (virtual, 1-hour each)

Control

Participants receive monthly educational resources only

6 months

Follow-up

Participants are monitored for changes in wellness, burnout, and other outcomes

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Resource Navigators

Trial Overview The trial tests if resource navigators can improve the wellness of long-term care and retirement home staff by providing one-on-one support. It compares a group with navigator access to a control group without it, focusing on wellness, burnout, vaccine status, and COVID-19 outcomes.

How Is the Trial Designed?

Group I: Intervention Group Experimental Treatment 1 Intervention

Receiving sessions with a resource navigator 2x a month, and monthly resources.

Group II: Control Active Control 1 Intervention

Receiving monthly resources only

Who Is Running the Clinical Trial?

Unity Health Toronto

Lead Sponsor

Trials

572

Recruited

470,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

University of Toronto

Collaborator

Trials

739

Recruited

1,125,000+

Published Research Related to This Trial

Burnout among palliative care providers is influenced by a complex interplay of personal, social, and organizational factors, highlighting the need for a deeper understanding of its causes.

While some interventions to reduce burnout show promise, there is a lack of long-term data on their effectiveness and impact on healthcare provider retention, indicating a critical need for further research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Burnout of healthcare professionals in supportive and palliative care: a summary of recent literature. Oldenburger, E., De Roo, ML.[2023]

The article compiles a variety of resources aimed at enhancing well-being and addressing burnout, specifically within the Veterans Health Administration and academic medical centers.

It discusses challenges related to burnout and proposes strategies to mitigate these issues, highlighting the importance of targeted interventions in healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Practice Resources to Address Radiologist Burnout. Weissman, IA., Van Geertruyden, P., Prabhakar, AM., et al.[2023]

Caregivers with higher self-efficacy in obtaining respite and controlling upsetting thoughts are associated with lower health risk behaviors, indicating that confidence in managing caregiving stress can lead to better health outcomes.

The study highlights the importance of personal resources, like self-efficacy beliefs, in promoting caregiver well-being and suggests that enhancing these beliefs may improve caregivers' physical health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The relationship between self-efficacy and cumulative health risk associated with health behavior patterns in female caregivers of elderly relatives with Alzheimer's dementia. Rabinowitz, YG., Mausbach, BT., Thompson, LW., et al.[2008]

Caregiver burnout in geriatrics is linked to a loss of meaning regarding aging and the role of elderly individuals in life, highlighting the emotional challenges faced by those in this field.

Finding meaning in their work is crucial for caregivers, as they serve an important role in supporting and conveying the value of elderly care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Caregivers in geriatrics: burnout and loss of meaning]. Bouisson, J.[2018]

Adverse events in hospital nursing units are linked to increased burnout among nurses, indicating that these incidents have broader negative impacts beyond just the patients involved.

The relationship between adverse events and nurse burnout is stronger when nurses have a high sense of workgroup identification, but this effect can be reduced if the safety climate in the workplace is perceived as positive.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse Events and Burnout: The Moderating Effects of Workgroup Identification and Safety Climate. Vogus, TJ., Ramanujam, R., Novikov, Z., et al.[2021]

Physicians involved in adverse events often experience emotional distress, which significantly increases their risk of burnout, with an adjusted odds ratio of 1.90 for those affected.

Peer support is a crucial factor in reducing burnout among physicians after adverse events, as those who received such support had a lower risk of burnout (adjusted odds ratio of 0.65), highlighting the importance of fostering supportive environments in healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multispecialty Physician Online Survey Reveals That Burnout Related to Adverse Event Involvement May Be Mitigated by Peer Support. Gupta, K., Rivadeneira, NA., Lisker, S., et al.[2023]

The review analyzed 18 primary nursing research studies and found that oncology nurse navigators positively impact measurable patient outcomes, including faster diagnosis and treatment, improved mood states, and higher patient satisfaction.

As the role of nurse navigators expands globally, it is crucial for nurses to embrace these opportunities to enhance patient care and evaluate the implications for their education and practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oncology nurse navigator. Case, MA.[2022]

A systematic review of seven studies highlights the effectiveness of oncology nurse practitioner navigators in improving timely care and enhancing patient and staff satisfaction.

The review emphasizes the importance of well-defined metrics for evaluating navigation programs, aligning with expert consensus recommendations, while also calling for more rigorous research tools in this field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic review of oncology nurse practitioner navigation metrics. Johnson, F.[2022]

Patients who had contact with an oncology nurse navigator (ONN) reported higher satisfaction scores on outpatient surveys compared to those without ONN contact, indicating a positive impact on patient experience.

Specifically, patients with ONN contact felt that nurses were more concerned about their questions and worries, and that staff were more sensitive to the challenges posed by their condition or treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcome Measurement: Patient Satisfaction Scores and Contact With Oncology Nurse Navigators. Yackzan, S., Stanifer, S., Barker, S., et al.[2020]

The Caregiver Support Clinic (CSC) effectively addressed the often-overlooked needs of caregivers for patients with advanced cancer, providing a supportive environment for discussing their challenges.

The integrated model of care, combining palliative medicine and social work, improved care coordination and reduced duplication of efforts, suggesting it is a beneficial and feasible approach for supporting caregivers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing a Novel Interprofessional Caregiver Support Clinic: A Palliative Medicine and Social Work Collaboration. Toor, H., Barrett, R., Myers, J., et al.[2022]

In a study of 249 residents and practicing physicians, it was found that supportive leadership and physician engagement significantly reduced the rate of adverse events related to patient safety, while high workload increased these events.

Burnout, particularly emotional exhaustion and interpersonal disengagement, was identified as a mediator that influences how work conditions affect the rate of adverse events, highlighting the importance of addressing burnout to improve patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events. Jarrar, M., Al-Bsheish, M., Albaker, W., et al.[2023]

The literature on home safety for caregivers is limited, highlighting a gap in understanding the specific safety risks associated with providing care in an uncontrolled home environment.

Nurses play a crucial role in assessing caregivers' knowledge and abilities, emphasizing the need for education and resources to ensure safe and quality care for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety of Care by Caregivers of Cancer Patients. Given, BA.[2020]

The survey of 819 patient navigators revealed significant differences in their roles and responsibilities based on their type, with nurse navigators more likely to have clinical duties and work in hospital settings, while lay navigators were less involved with underserved populations.

The study highlights the importance of using the Consolidated Framework for Implementation Research (CFIR) to understand how different types of patient navigators impact program implementation and patient outcomes, suggesting that future research should focus on care coordination outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The early dissemination of patient navigation interventions: results of a respondent-driven sample survey. Valverde, PA., Calhoun, E., Esparza, A., et al.[2019]

The breast cancer navigation (BCN) program significantly improved physician workflows, with many physicians stating it made their day easier and enhanced care coordination and patient experience.

Patients also reported high satisfaction with the support they received during diagnosis communication, indicating that the BCN program effectively met their needs during a challenging time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Breast Cancer Navigation: Using Physician and Patient Surveys to Explore Nurse Navigator Program Experiences. Dillon, EC., Kim, P., Li, M., et al.[2021]

After high-reliability training, caregivers did not significantly increase the overall number of event reports, but there was a notable decrease in clinical process error reports, indicating a potential improvement in identifying and addressing specific types of safety issues.

The study found differences in reporting patterns between day and night shifts, suggesting that factors beyond training may influence caregivers' willingness to report safety events, highlighting the need for further research into motivators for reporting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the Use of High-Reliability Principles to Increase Error Event Reporting: A Retrospective Review. Duffey, P., Oliver, JS., Newcomb, P.[2019]

Citations

1. withpower.com withpower.com/trial/phase-covid-19-2023-a101e

Resource Navigators for Caregiver Burnout The available research shows that patient navigators, including nurse navigators, improve patient satisfaction and care outcomes. For example, the 'Outcome ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7302999/

Effectiveness of Powerful Tools for Caregivers on ... The aim of this study was to evaluate the effectiveness of a psychoeducational intervention, Powerful Tools for Caregivers (PTC), for family caregivers of ...

3. caregiver.org caregiver.org/resource/caregiver-statistics-health-technology-and-caregiving-resources/

Health, Technology, and Caregiving Resources Further supporting this is the fact that 17% of caregivers feel their health in general has gotten worse as a result of their caregiving responsibilities. [AARP ...

4. cdn.clinicaltrials.gov cdn.clinicaltrials.gov/large-docs/59/NCT05214859/Prot_SAP_004.pdf

Study Protocol and Statistical Analysis Plan caregiver support program that could improve caregiver stress, burnout as well as cultivate positive affectivity. They can also develop alternative ways to.

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2791523/

Physical and Mental Health Effects of Family Caregiving Caregiving has all the features of a chronic stress experience: It creates physical and psychological strain over extended periods of time.

6. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK2665/

Supporting Family Caregivers in Providing Care - NCBI - NIH Research supporting this caregiver-as-client perspective focuses on ways to protect family caregivers' health and safety.

7. cdc.gov cdc.gov/mmwr/volumes/73/wr/mm7334a2.htm

Changes in Health Indicators Among Caregivers This report compares changes in the prevalence of 19 health indicators among caregivers and noncaregivers from 2015–2016 to 2021–2022.

8. hsrd.research.va.gov hsrd.research.va.gov/research_topics/caregiving.cfm

Caregivers and Family Support - VA Health Systems Research VA's caregiving research focuses on addressing both the practical needs of those who provide essential care to Veterans, and their own health and well-being.