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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