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

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to test how well resource navigators help long-term care and retirement home staff access the various health and wellness resources available to them and the effects that this has on their health and wellness overall. The main questions it aims to answer are: - How does one-on-one support from a resource navigator affect the wellness of long-term care and retirement home staff, including burnout, vaccination status, and COVID-19 infection? Researchers will compare participants in the intervention group (where participants are paired with a resource navigator) and the control group (where participants are not paired with a resource navigator) to see the impact access to a resource navigator has on wellness (primary outcome), burnout, knowledge of, access to and use of wellness resources, knowledge/alignment with provincial public health guidelines related to SARS-CoV-2 vaccine outcomes, SARS-CoV-2 infection, hospitalization, and death (secondary outcomes). Hypothesis: Researchers anticipate that those in the intervention group (have access to a resource navigator) will report a higher positive change in wellness between baseline and 6 months.

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 data supports the idea that Resource Navigators for Caregiver Burnout is an effective treatment?

The available research shows that patient navigators, including nurse navigators, improve patient satisfaction and care outcomes. For example, the 'Outcome Measurement' study highlights that satisfaction with care is a positive outcome of using oncology nurse navigators. Additionally, the 'Breast Cancer Navigation' study suggests that patient navigators enhance patient experiences. While these studies focus on cancer care, they indicate that similar navigation roles can be effective in other areas, like caregiver burnout, by improving satisfaction and support. ^{1 2 3 4 5}

What safety data exists for Resource Navigators for Caregiver Burnout?

The provided research does not directly address safety data for Resource Navigators for Caregiver Burnout or similar services like Health and Wellness Support Services. The studies focus on burnout related to adverse events in healthcare settings, the impact of work conditions on burnout, and the role of peer support in mitigating burnout. However, they do not provide specific safety data for the treatment in question. ^{6 7 8 9 10}

Is the treatment Resource Navigators a promising treatment for caregiver burnout?

Yes, Resource Navigators is a promising treatment for caregiver burnout because it provides support and resources to help caregivers manage stress and improve their well-being. This can help caregivers continue their important roles with less stress and better health. ^{11 12 13 14 15}

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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 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]

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]

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]

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]

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Oncology nurse navigator. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

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

3. England pubmed.ncbi.nlm.nih.gov

The early dissemination of patient navigation interventions: results of a respondent-driven sample survey. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Outcome Measurement: Patient Satisfaction Scores and Contact With Oncology Nurse Navigators. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Breast Cancer Navigation: Using Physician and Patient Surveys to Explore Nurse Navigator Program Experiences. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Adverse Events and Burnout: The Moderating Effects of Workgroup Identification and Safety Climate. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Safety of Care by Caregivers of Cancer Patients. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Multispecialty Physician Online Survey Reveals That Burnout Related to Adverse Event Involvement May Be Mitigated by Peer Support. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Evaluating the Use of High-Reliability Principles to Increase Error Event Reporting: A Retrospective Review. [2019]

11. United States pubmed.ncbi.nlm.nih.gov

Burnout of healthcare professionals in supportive and palliative care: a summary of recent literature. [2023]

12. United States pubmed.ncbi.nlm.nih.gov

Practice Resources to Address Radiologist Burnout. [2023]

13. United States 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. [2008]

14. United States pubmed.ncbi.nlm.nih.gov

Implementing a Novel Interprofessional Caregiver Support Clinic: A Palliative Medicine and Social Work Collaboration. [2022]

15. France pubmed.ncbi.nlm.nih.gov

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