Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition‐to‐practice programme for newly graduated nurses

Abstract

AimTo investigate how NGNs perceived and applied an intervention for preventing stress‐related ill health embedded in a transition‐to‐practice programme when entering their professional life.DesignA qualitative exploratory descriptive design was selected for this study to gain insights and perspectives on the adoption and utilization of the intervention.MethodsIn this qualitative methodology process evaluation, semi‐structured and audio‐recorded interviews were conducted with a sample of 49 nurses. Data were collected between December 2016 and July 2017, and were sorted in NVivo 12 Plus, followed by thematic analysis.ResultsThe analysis resulted in three change processes stimulated by the intervention: (a) Building acceptance of being new; (b) Gaining insight into professional development and health and (c) Practical steps for skills development, healthy habits and better‐organized work. In addition to the three themes, barriers that hindered the progression of the processes were also described. Each process influenced the development of the others by stimulating a deeper understanding, motivation to change and courage to act. Several barriers were identified, including the use of cognitively demanding intervention tools, fatigue, high work demands, inconvenient work hours and a hostile social climate on the ward.ConclusionThis process evaluation showed that newly graduated nurses used knowledge from the intervention and adopted new behaviours largely in accordance with how the intervention was intended to work.ImpactWhen entering a new profession, it is crucial to receive a well‐thought‐out, structured and targeted introduction to the new professional role, tasks and work group. Nurses stated that the intervention increased their understanding of the role as new nurses and their insight into how to develop skills that promoted better functioning and recovery. The intervention also stimulated the development of new health behaviour and some new learning strategies.

What is a process evaluation when used alongside a randomised controlled trial?

“…Process evaluation supports understanding of these key features of complex interventions and allows consideration of how an intervention delivered in one location may be adaptable to another location through that understanding of context and adaptability. There are increasing numbers of examples of process evaluations linked to nursing relevant RCTs 21,22 and these demonstrate the additional value that is offered over and above understanding whether or not an intervention is effective.…”