Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr. (0812), La Jolla, CA 92093-0812, USA.
Behav Res Ther. 2009 Nov;47(11):954-60. doi: 10.1016/j.brat.2009.07.006. Epub 2009 Aug 5.
Understanding the implementation of evidence-based practice (EBP) in community service settings is critical for the successful translation of research to practice. However, we have limited research evidence about the impact of EBP implementation on the mental health and social service workforce. In a previous study we demonstrated reduced staff turnover where an EBP was implemented with fidelity monitoring in the form of supportive ongoing supervision and consultation. Other research has shown that staff burnout and emotional exhaustion in particular is associated with poor quality of care and increased staff turnover intentions and turnover. Current research, however, has focused less on the effects that EBP implementation may have on staff emotional exhaustion. The present study investigates the association of EBP implementation and fidelity monitoring with staff emotional exhaustion in a statewide EBP implementation study. The 21 case-management teams in this study were randomized in a 2 (EBP vs. services as usual [SAU]) by 2 (monitoring vs. no monitoring) design. The EBP in this study was SafeCare, a home-based intervention that aims to reduce child neglect in at-risk families. SafeCare was developed from a behavior analysis approach and is based in cognitive behavioral principles. In keeping with our previous research, we hypothesized that providers implementing SafeCare with monitoring would have the lowest levels of emotional exhaustion and those receiving additional monitoring not in the context of EBP implementation would have higher emotional exhaustion relative to the other groups. Results supported our hypotheses in that we found lower emotional exhaustion for staff implementing the EBP but higher emotional exhaustion for staff receiving only fidelity monitoring and providing SAU. Together, these results suggest a potential staff and organizational benefit to EBP implementation and we discuss implications of the findings relative to EBPs and to fidelity monitoring.
了解循证实践(EBP)在社区服务环境中的实施对于成功将研究转化为实践至关重要。然而,我们对 EBP 实施对心理健康和社会服务劳动力的影响的研究证据有限。在之前的研究中,我们证明了在以支持性持续监督和咨询形式进行保真度监测的情况下实施 EBP 可以降低员工离职率。其他研究表明,员工倦怠和情绪疲惫特别与护理质量差、员工离职意愿和离职率增加有关。然而,目前的研究较少关注 EBP 实施可能对员工情绪疲惫产生的影响。本研究在一项全州范围内的 EBP 实施研究中调查了 EBP 实施和保真度监测与员工情绪疲惫之间的关联。本研究中的 21 个案例管理团队在 2(EBP 与常规服务[SAU])×2(监测与不监测)设计中进行了随机分组。本研究中的 EBP 是 SafeCare,这是一种旨在减少高危家庭中儿童忽视的家庭干预措施。SafeCare 是从行为分析方法发展而来的,基于认知行为原则。与我们之前的研究一致,我们假设在监测下实施 SafeCare 的提供者的情绪疲惫程度最低,而在没有实施 EBP 的情况下接受额外监测的提供者的情绪疲惫程度相对较高。结果支持了我们的假设,我们发现实施 EBP 的员工情绪疲惫程度较低,而仅接受保真度监测且提供 SAU 的员工情绪疲惫程度较高。总之,这些结果表明 EBP 实施对员工和组织有潜在的益处,我们讨论了这些发现相对于 EBPs 和保真度监测的意义。