Workforce resilience supporting staff in managing stress: A coherent breathing intervention for the long‐term care workforce

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 72; no. 3; pp. 753 - 766
• Main Authors: DeGraves, Brittany S., Titley, Heather, Duan, Yinfei, Thorne, Trina E., Banerjee, Sube, Ginsburg, Liane, Salma, Jordana, Hegadoren, Kathleen, Angel, Cybele, Keefe, Janice, Lanius, Ruth, Estabrooks, Carole A.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.03.2024; Wiley Subscription Services, Inc
• Subjects: Anxiety; coherent breathing; COVID-19; Feedback; healthcare aide; Insomnia; long‐term care; Mental depression; mental health; Older people; Questionnaires; Sleep disorders; staff well‐being; Statistical analysis; Stress; staff well-being; coherent breathing; mental health; healthcare aide; long-term care
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.18727

Background Staff in long‐term care (LTC) homes have long‐standing stressors, such as short staffing and high workloads. These stressors increased during the COVID‐19 pandemic; better resources are needed to help staff manage stress and well‐being. The purpose of this study was to evaluate the effect of a simple stress management strategy (coherent breathing). Methods We conducted a pre–post intervention study to evaluate a self‐managed coherent breathing intervention from February to September 2022. The intervention included basic (breathing only) and comprehensive (breathing plus a biofeedback device) groups. Six hundred eighty‐six participants were initially recruited (359 and 327 in the comprehensive and basic groups respectively) from 31 LTC homes in Alberta, Canada. Two hundred fifty‐four participants completed pre‐and post‐intervention questionnaires (142 [55.9%] in comprehensive and 112 [44.1%] in basic). Participants were asked to use coherent breathing based on a schedule increasing from 2 to 10 min daily, 5–7 times a week over 8 weeks. Participants completed self‐administered online questionnaires pre‐ and post‐intervention to assess outcomes—stress, psychological distress, anxiety, depression, resilience, insomnia, compassion satisfaction, compassion fatigue, and burnout. We used a mixed‐effects regression model to test the main effect of time (pre‐ and post‐intervention) and group while testing the interaction between time and group and controlling for covariates. Results We found statistically significant changes from pre‐ to post‐intervention in stress (b = −2.5, p < 0.001, 95% CI = −3.1, −1.9), anxiety (b = −0.5, p < 0.001, 95% CI = −0.7, −0.3), depression (b = −0.4, p < 0.001, 95% CI = −0.6, −0.2), insomnia (b = −1.5, p < 0.001, 95% CI = −2.1, −0.9), and resilience (b = 0.2, p < 0.001, 95% CI = 0.1, 0.2). We observed no statistically significant differences between the two intervention groups on any outcome. Conclusions Our findings suggest that coherent breathing is a promising strategy for improving stress‐related outcomes and resilience. This intervention warrants further, more rigorous testing.